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Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd Jan 2023

Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd

Walden Dissertations and Doctoral Studies

Healthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …


Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins Jan 2023

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins

Walden Dissertations and Doctoral Studies

Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …


Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …


Strategies For Maximizing The Use Of Electronic Health Records Systems In Medical Clinics, Alexandra Nieves Rivera Jan 2023

Strategies For Maximizing The Use Of Electronic Health Records Systems In Medical Clinics, Alexandra Nieves Rivera

Walden Dissertations and Doctoral Studies

Ineffective leadership can negatively impact the use of electronic health records (EHR) systems in medical clinics. Healthcare managers who fail to maximize the use of EHR systems are missing out on the opportunity to optimize the quality of medical care that their clinic provides. Grounded in complexity leadership theory, the purpose of this qualitative multiple-case study was to explore strategies healthcare managers use to maximize the use of EHRs systems. Participants comprised six healthcare managers who successfully implemented strategies to maximize the use of EHRs systems. Data were collected from semistructured interviews and publicly available information. Thematic analysis was used …


Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …


Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …


Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii Jan 2023

Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii

Walden Dissertations and Doctoral Studies

Officials from the Centers for Medicare and Medicaid Services (CMS) created the hospital valued-based purchasing (VBP) program focused on controlling cost, inefficiencies, and quality-of-care. Hospital leaders are incentivized or penalized based on meeting quality outcomes and risk millions of dollars in reimbursement if they do not meet the quality-of-care standards specified in the CMS hospital VBP program. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies hospital leaders used to improve patient satisfaction to increase VBP performance-based reimbursements. Participants included eight hospital leaders from seven hospitals in California who successfully implemented …


Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …


Impact Of A Workplace Wellness Program On Health Literacy And Type 2 Diabetes Management Among Blue-Collar Workers In South Carolina, Caitlin E. Townsend Jan 2023

Impact Of A Workplace Wellness Program On Health Literacy And Type 2 Diabetes Management Among Blue-Collar Workers In South Carolina, Caitlin E. Townsend

Walden Dissertations and Doctoral Studies

The prevalence of chronic diseases and their management is significantly different between blue- and white-collar employees. Social determinants of health are determining factors of health for blue-collar manufacturing employees in South Carolina. Type 2 Diabetes is a complex chronic condition that has been associated with serious co-morbidities, but it can be managed and/or treated. Workplace wellness programs provide an ideal setting for health education and promotion efforts targeted toward population health management. While workplace wellness programs have been proven successful, there is limited research on the relationship and impact on health literacy. This quantitative, descriptive study used secondary data to …


The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco Jan 2023

The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco

Walden Dissertations and Doctoral Studies

The clinical laboratory plays a crucial role in aiding physicians to diagnose disease. With numerous studies on “Speak Up” culture well-documented among providers and nurses surrounding patient safety, gaps in literature exist concerning “Speak Up” culture that address team effectiveness and organizational performance within the clinical lab setting. The purpose of this quantitative correlation study was to investigate the relationship between “Speak Up” culture level, team effectiveness, and organizational performance among health care workers employed in the clinical lab. The high-performance work practices model was utilized as the conceptual framework to ground this study. Research questions assessed the link between …


Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte Jan 2023

Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte

Walden Dissertations and Doctoral Studies

Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …


Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn Jan 2023

Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn

Walden Dissertations and Doctoral Studies

In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …


Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu Jan 2023

Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu

Walden Dissertations and Doctoral Studies

Nurse turnover is a significant problem that hospital managers and administrators face in delivering high-quality patient care while ensuring organizational profitability. In the United States, the average cost of replacing a nurse ranges from $40,000 to $100,000. Hospital managers are significantly challenged to reduce nurse turnover and keep costs down. Grounded in the Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore the strategies hospital managers use to reduce nurse turnover. The participants included five hospital managers at five medical centers in Arizona with successful experience in reducing nurse turnover. Data were collected from semistructured interviews …


The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire Jan 2023

The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire

Walden Dissertations and Doctoral Studies

AbstractHospital readmissions have continuously been a concern to healthcare providers and policymakers because of their negative impacts on the economy and the well-being of patients. A gap in knowledge exists in the understanding of the factors that have led to increased readmissions due to chronic cardiovascular diseases (Heart Failure) and respiratory diseases (chronic obstructive pulmonary disease [COPD] and Asthma). The aim of this study was to examine the relationship between poverty rate and hospital readmission rates for patients with COPD, Heart Failure, and Asthma in the United States using secondary data from the Healthcare Cost and Utilization Project’s (HCUP’s) Nationwide …


Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner Jan 2023

Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner

Walden Dissertations and Doctoral Studies

Lack of employee engagement as a result of deficient behavioral leadership strategies has the potential for adverse business outcomes on productivity, business mission, and strategy. As a result of this qualitative single case study, hospital department managers who apply behavioral leadership strategies are more likely to promote an environment conducive to employee engagement. Grounded in the employee engagement theory, the purpose of this qualitative single case study was to explore behavioral leadership strategies hospital department managers use to promote an environment conducive to employee engagement. The participants were five hospital department managers who had been successful with employee engagement. Data …


Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris Jan 2023

Impact Of Pulmonary Embolism Response Teams On Patient Quality Ratings, Sabrina Renee' Simpkins-Morris

Walden Dissertations and Doctoral Studies

AbstractLeaders of health care organizations have limited evidence of the impact of pulmonary embolism response teams (PERTs) on quality outcomes for patients with an intermediate and high-risk pulmonary embolism (PE). The purpose of this quantitative study was to determine whether there was any significant difference in patient HCAHPS linear mean scores for instructions given about medication and overall care between acute care hospitals with and without PERT teams. Donabedian’s framework for assessing health care quality was used as the theoretical foundation for this research. Survey data collected by the Centers for Medicare and Medicaid, as part of its Hospital Consumer …


Individuals’ Lived Experiences With Pharmaceutical Patient Assistant Programs, Marcia Clarke-Burke Jan 2023

Individuals’ Lived Experiences With Pharmaceutical Patient Assistant Programs, Marcia Clarke-Burke

Walden Dissertations and Doctoral Studies

AbstractPharmaceutical patient assistance programs (PAPs) were introduced as an alternative to address patients’ inability to obtain necessary prescription drugs. However, individuals were not fully exploring the beneficial nature of PAPs due to a poor understanding of the programs. Additional research is needed to understand how PAPs impact patients’ outcomes and costs of care. Grounded in Andersen and Newman’s model of health care utilization, this qualitative research was guided by the hermeneutic phenomenological research design. Data were collected during interviews with 11 participants located in various states regarding their participation in PAPs and their lived experiences in using PAPs. Collected data …


Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon Jan 2023

Using Multi-Theory Model (Mtm) To Predict Intention To Promote Physical Activity By Primary Care Providers, Shirley Mcclendon

Walden Dissertations and Doctoral Studies

Physical inactivity persists as a public health concern worldwide and results in more than a million deaths per year. This modifiable behavior can result in improved health when primary care providers (PCPs) communicate recommendations to patients and behavior change is supported. In this study, a quantitative cross-sectional design was used to investigate the intentions of PCPs in providing physical activity counseling, using the constructs of the multi-theory model (MTM) of health behavior change as the theoretical framework. An anonymous 37-item electronic survey was administered to participants practicing primary care and family medicine from rural areas in the Southeastern region of …


The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik Jan 2023

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …


Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks Jan 2023

Experiences And Attitudes Regarding The Availability And Usage Of Telemedicine Services Among Providers During A Pandemic, Keya Gaston Brooks

Walden Dissertations and Doctoral Studies

Telehealth became a prominent fixture in the way healthcare was delivered during COVID-19. Providers were forced to offer telehealth as an optional mode of care. Although little research was available, studies about the experiences and attitudes of providers regarding their intention and willingness to use telemedicine before the pandemic was exiguous. The purpose of this study was to understand providers perception and use behavior patterns regarding the acceptance and adoption of telemedicine during the pandemic. Data collected from the COVID-19 Healthcare Coalition Telehealth Impact Survey was used to help characterize the experiences and attitudes of providers regarding telehealth utilization during …


Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin Jan 2023

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …


How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez Jan 2023

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …


Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo Jan 2023

Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo

Walden Dissertations and Doctoral Studies

AbstractOne of the most frequent medical errors in contemporary medicine is incorrect prescriptions, and the profits from retail pharmacy operations are adversely impacted by the costs associated with prescription errors. Independent pharmacy managers are interested in finding workable strategies to mitigate the cost of prescription errors and increase profit. Using the resource-based theory of competitive advantage (RBTCA), the purpose of this qualitative multiple-case study was to explore strategies some independent pharmacy managers in Texas use to mitigate the cost of pharmacy employee prescription errors and increase profitability. The participants were five independent pharmacy managers who implemented strategies to mitigate the …


Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi Jan 2023

Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi

Walden Dissertations and Doctoral Studies

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines …


Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr Jan 2023

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …


Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate Jan 2023

Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate

Walden Dissertations and Doctoral Studies

Many individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …


Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase Jan 2023

Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …


Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker Jan 2023

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …


Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …


African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser Jan 2023

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …