Medicine and Health Sciences Commons^™

Caring But Still Hurting: Uninsured Patients' Illness And Healthcare Experiences At A U.S. Free Clinic, Danaya Amornnimit, Eda G. Christensen, Adelaida Salmeron, Kian Robison, Sofia Ampudia Arroyo, Jessica Benelli, Brenda Spearman, Akiko Kamimura

Patient Experience Journal

While free clinics provide essential healthcare to socioeconomically disadvantaged populations, patients' lived experiences in these settings remain underexplored. This qualitative study examined how uninsured patients at a U.S.-based free clinic perceive their illness experiences and interactions with healthcare providers. From October to December 2024, semi-structured interviews were conducted with 21 adult patients (ages 18–72; M = 49.14), most of whom were non–U.S.-born and primarily Spanish-speaking. Participants described illness as entangled with emotional distress, social isolation, stigma, and disruptions to identity and family roles—revealing a psychological burden that extends beyond physical symptoms. These findings highlight the need to integrate psychosocial and …

From Drifting To Anchored: How Online Health Communities Can Transform Care For Complex Chronic Illness, Mads Eggerding

Patient Experience Journal

This personal narrative recounts a 25-year diagnostic odyssey with Ehlers-Danlos syndrome, defined by medical fragmentation, dismissed symptoms, and profound isolation. It illustrates how Online Health Communities (OHCs) bridged the chasm between lived experience and a clinical system ill-equipped for complex chronic illness. For patients like me, these digital forums provide the peer validation, practical knowledge, and self-advocacy tools necessary to navigate a disjointed healthcare landscape. For providers, this story underscores a critical opportunity: proactive, non-judgmental engagement with OHCs is not a threat to expertise but a foundational strategy for patient-centered care. By acknowledging and constructively partnering with these patient-led spaces, …

Secondary Infertility: A Personal Story Of Loss And Grief, Ben Hughes

Patient Experience Journal

An increasing number of people worldwide are experiencing fertility and this trend is reflected in the data from the United Kingdom. However, most research focuses on the experiences of women and so the male perspective is largely missing from the literature. This narrative is an account of my personal journey of secondary infertility. Presenting a male perspective of infertility provides a point of view which is rarely explored and is about a topic which feels largely a societal taboo. I chart how infertility has changed me, what it has meant to me through my years of trying to come to …

When Hope Meets Harm: A Story Of Trust, Pain, And Consent In Intimate Care, Sharon I. Choe, Erin Foster

Patient Experience Journal

Transparent communication is key to building and maintaining strong patient-provider relationships. In this article, I interviewed a patient who shared her experience undergoing treatment for a chronic vulvar condition and the consequences that followed. She described a painful procedure for which she felt unprepared and later realized she had not been educated about the need for ongoing care. Years later, this gap in understanding contributed to irreversible disease progression. After re-establishing care with a dermatologist she felt comfortable confiding in, the patient expressed a desire for her story to be shared. This narrative presents her experience as she shared it …

Ai As A Physician Companion In Enhancing Trust In Healthcare, Saria Gouher

Patient Experience Journal

Trust remains a fundamental pillar of the physician–patient relationship, ensuring care that is safe, evidence-based, and grounded in shared decision-making; however, the increasing use of artificial intelligence tools such as ChatGPT has introduced a new dynamic in how patients interpret symptoms and seek medical advice. This narrative describes a clinical encounter involving an elderly patient with multiple myeloma whose caregiver used ChatGPT to evaluate new-onset slurred speech suggestive of stroke, resulting in an urgent recommendation driven by incomplete clinical information. Through comprehensive history-taking, physical examination, and careful review of the Artificial Intelligence (AI)-generated response, the physician reassured the caregiver, contextualized …

Building Trust In The Absence Of Certainty: Community As Trust In Action, Jennifer A. Owens

Patient Experience Journal

This personal narrative explores how trust is experienced and sustained in the context of serious illness, where uncertainty is persistent and control is limited. Drawing on the lived experience of caregiving for a child with an undiagnosed congenital diaphragmatic hernia (CDH), this personal narrative examines how trust emerges not as a matter of belief or individual choice, but as something recognized through the actions of others.

Rebuilding Trust After Bondi Beach: Healing Patients, Protecting Caregivers, And The Sacred Work Of Care, Anne Marie Hadley

Patient Experience Journal

The Bondi Beach tragedy of December 14, 2025 profoundly disrupted Australia's collective sense of safety, belonging, and trust. Beyond the immediate loss of life and injury, such events exert lasting impacts on healthcare systems and the people who work within them. This article explores how trust can be rebuilt not only for patients and communities, but also for caregivers themselves. Drawing on trauma-informed care, psychological safety, and human experience design, it examines the often-overlooked dimensions of staff safety, the essential role of pastoral care and chaplaincy, and the particular vulnerabilities experienced by faith-based caregivers during periods of social fracture and …

Supporting The Human Experience: Why Compassion Outperforms Empathy In Care Delivery, Katelyn Carey

Patient Experience Journal

Healthcare professionals are often taught that empathy, defined as imagining oneself in the emotional experience of another, is essential to providing excellent care. Yet in high-stress, high-stakes clinical environments, the very tool given to increase patient and employee connection can contribute to disengagement, burnout, and diminished resiliency. This research review article examines the longstanding conflation of empathy and compassion in healthcare and argues that the distinction between the two is not merely semantic but critical to provider well-being and patient outcomes. Drawing on research from neuroscience, psychology, and communication studies, the piece outlines how emotional, perspective-taking empathy activates the brain's …

Racial Concordance And The Assumption Of Trust: Why Engagement Is Often Mistaken For Partnership In The Care Of Black Men, Samantha Faith Calhoun, Lacretia Carroll, Y'Esha Williams-Click, Kola Brown

Patient Experience Journal

Race concordance between patients and clinicians is frequently promoted as a strategy to improve trust and engagement for Black men in healthcare. Evidence suggests that encounters with Black male clinicians often increase patient comfort and observable engagement; however, engagement alone does not necessarily reflect trust. Drawing on professional experience as a nurse and researcher working with Black men, and on prior research examining shared decision-making preferences among Black men with hypertension in the U.S. Mid-South, this Personal Narrative examines how race-concordant encounters may rely on presumed trust, leading clinicians to advance diagnosis and treatment planning without adequate co-construction of care. …

Building Or Breaking Trust In Healthcare Through Patient And Family Engagement In Research And Service Design: The Need For Authentic Engagement Practices, Lisa D. Hawke, Hajar Seiyad, Shoshana Hauer, Charlotte Munro, Natasha Y. Sheikhan

Patient Experience Journal

Trust in the healthcare system is an important driver of public health, but is sometimes lacking among individuals and communities. Patient and family engagement in research and service development is one proposed means of influencing trust. Patients and families can be engaged authentically and meaningfully as partners in the conduct of research and the development of healthcare services. When engagement is conducted following best practices, patients and families have the opportunity to build strong mutual relationships with project leads, hold a share of the power in the discipline, and exercise choice to influence the research and service development agenda. These …

Co-Designing Trust: Patient Experience, Relationships, And The Design Of Care, Toni Land

Patient Experience Journal

Trust can have a positive or negative impact on patients, families, and community healthcare experience. Although important, it is often treated as something soft and intangible rather than something intentionally measured and designed. Currently, healthcare organizations collect and report patient experience data related to communication, courtesy, respect, and responsiveness. But these measures do not capture the specific behaviors that influence whether trust builds or whether it stalls. This commentary explores trust as a foundational behavioral and environmental element in healthcare and challenges that improving trust requires more than good intentions; it requires bringing voices to the table through co-design. Starting …

A Modern Playbook For Trust Across The Health Ecosystem, Erin O'Malley

Patient Experience Journal

Public trust in health care delivery, public health, and biomedical innovation is at a historic low. While many place the blame on the COVID-19 pandemic and the proliferation of social media, the reality is that distrust is a deeply rooted structural challenge that has plagued the U.S. for centuries. It is tied to historical movements for medical freedom and centuries of systemic discrimination and earned mistrust among minoritized communities. Today, this crisis is compounded by a lack of shared values and facts and the rising dominance of tribal identity over objective science. The Coalition for Trust in Health & Science …

Healing The Social Covenant: Rebuilding Trust And Re-Humanizing Healthcare, Cynda Hylton Rushton

Patient Experience Journal

Violence against healthcare workers continues to escalate despite substantial investments in security measures, workplace violence prevention programs, and legislative protections. Although these interventions are necessary, they have not produced sustained improvements in workforce safety or retention, suggesting that workplace violence is more than a behavioral or security problem. This commentary argues that it also reflects a deeper erosion of trust within healthcare. Drawing on evidence linking workplace violence to burnout, moral injury, psychological distress, and turnover intention among nurses, we propose that repairing trust is essential to sustaining the workforce and healthcare.Building on our earlier work, Rebuilding a Foundation of …

Trust: Why A Commitment To Human Experience Matters, Jason A. Wolf

Patient Experience Journal

Trust is one of the most essential elements in our overall human existence. It is a critical part of our human experience, one that reaches well beyond the boundaries of healthcare. Trust is the element that holds society together. It emerges in the relationship of one human being connecting with another human being, and it reaches to the engagements people have with organizations, institutions, and systems as well. Trust, while hard to hold, is ever present. It is a powerful force that guides our way of being, our interactions, our choices, even if we ourselves are not directly conscious of …

Assessing And Addressing Financial Risk In Capitated Primary Care Contracts, Michael R. Wieck Dba, Laurence Smith, Steven R. Stout Dba

Engaged Management ReView

We employ multivariate statistical modeling and Monte Carlo simulation to study systematic and unsystematic financial risk faced by physician groups under capitated contracts with Medicare Advantage Organizations (MAOs). We use mixed methods and a standard reimbursement formula for risk-sharing contracts with primary care physicians (PCPs). We find that diversifying risk simply by increasing the size of a practice is insufficient to mitigate risks of large negative cash flows from capitation contracts and can result in financial failure. However, if use of costly medical services by patients is reduced from levels typically experienced under traditional Medicare to the levels of patients …

Same-Day Cancellation Reduction In An Ambulatory Surgery Unit, Anthone Dalit Vengersammy

Master's Projects and Capstones

Problem: Same-day surgical cancellations in the outpatient surgery setting remain a significant operational and patient care challenge. Preventable cancellations negatively affect patient experience, operating room efficiency, staff productivity, and healthcare costs. 

Context: A microsystem and organizational culture assessment identified several factors contributing to same-day cancellations, including unclear preoperative instructions, incomplete medical clearance, inconsistent patient education, lack of standardized workflows, unclear staff responsibilities, and communication gaps among interdisciplinary teams. SWOT and gap analyses were used to identify opportunities for improvement and guide intervention planning.

Interventions: Quality improvement interventions were implemented through iterative Plan-Do-Study-Act (PDSA) cycles. Strategies included revising preoperative patient instructions, …

Improving Fluoride Varnish Application Rates In A Pediatric Primary Care Microsystem, Roman G. Roxas

Master's Projects and Capstones

Problem

Childhood caries is a preventable public health issue disproportionately affecting the underserved. National guidelines recommend fluoride varnish (FV) application during well‑child visits. In California, fewer than 15% of children under age six received FV. In a pediatric primary care clinic, baseline performance was 11% in 2025.

Context

A six‑month quality improvement project was implemented. Key barriers included reduced team cohesion, workflow variability, unclear roles, and underutilized electronic health record (EHR) prompts.

Interventions

The change package standardized medical assistant–led workflows, activated EHR prompts, and provided targeted education. Leadership reinforcement through regular huddles supported adoption, consistency, and team engagement.

Measures

Outcome …

Improving Patient Satisfaction Through Post-Urgent Care Visit Follow-Up Calls: A Quality Improvement Project, Lindsay Boyer

Doctor of Nursing Practice Final Project Abstract

Purpose This quality improvement project aimed to determine whether implementing standardized post-visit follow-up calls within 24–48 hours of urgent care visits would improve patient satisfaction by increasing the clinic’s Net Promoter Score (NPS) from a baseline of 62. Background Declining NPS scores during peak clinic seasons suggested a gap in post-visit communication and follow-up, highlighting the need for a standardized nursing intervention to better support patients after discharge.

Methodology Guided by the AIDET communication framework and the Plan-Do-Study-Act cycle, scripted follow-up calls were implemented across five cycles from February to April 2026 to assess recovery, reinforce discharge instructions, answer questions, …

The Effect Of Telehealth Expansion On The Health Equity Of Underserved Populations, Mansi B. Satani

Electronic Theses, Projects, and Dissertations

The rapid expansion of telehealth, during and after the COVID-19 pandemic, has changed healthcare delivery in the United States. The use of telehealth can potentially decrease disparities related to isolation, shortage of providers and barriers to transportation, however, its impact on health equity in underserved populations is unknown. This paper explores how telehealth expansion impacts rural populations' access to healthcare, health outcomes, and equity. It also examines its impact on populations with low income, racial, ethnic minorities, and Medicaid recipients who frequently encounter obstacles to healthcare and digital access (Nouri et al., 2020; Shah et al., 2024). A mixed-method design …

Mda At Your Service: Updating Your Practice Roster With The Mda, Mda Membership Department Staff

The Journal of the Michigan Dental Association

This question-and-answer article provides practical guidance for MDA members on updating practice rosters, accessing continuing education opportunities, addressing staffing shortages through virtual assistants, and participating in the MDA LEAD Program. The article highlights available member resources and emphasizes professional development, workforce support, and leadership growth within organized dentistry.

Enhancing Heart Failure Transitional Care To Reduce 30-Day Readmission Rate, Thuy Nhu Uyen Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project is to reduce 30-day readmissions for adult patients with heart failure (HF) by implementing a standardized HF pathway beginning in the intensive care unit (ICU) and continuing through discharge.

Background: The project was implemented within a large healthcare organization in Northwest Houston, Texas.

Methodology: This project utilized a pre- and post-implementation design guided by the Plan-Do-Study-Act (PDSA) model. Eligible adult patients (≥18 years) with a primary or secondary HF diagnosis were identified during March 2026. The My Pathway to Wellness HF education pathway was initiated at the time of ICU downgrade …

Analysis Of The Cannabinoid Compositions, Byproducts And Heavy Metals In Unregulated Cannabinoid Products By Hplc-Ms/Icp-Ms, Simone K. Melle

All NMU Master's Theses

The rapid expansion of unregulated hemp-derived products has created a need for analytical methods that characterize both cannabinoid composition and contaminant occurrence. This thesis used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify cannabidiol (CBD), Δ8-tetrahydrocannabinol (Δ8-THC), and Δ9-tetrahydrocannabinol (Δ9-THC), and inductively coupled plasma mass spectrometry (ICP-MS) to measure Al, As, Cd, Cr, Cu, Fe, Mg, Ni, Pb, and Zn in commercial hemp-derived products, laboratory-prepared hemp oils, cultivated hemp tissues, extracted material, and post-harvest soil. Commercial products showed wide cannabinoid variability, with several samples containing more than one target cannabinoid, while laboratory-prepared plant oils showed a more consistent profile dominated by …

August 2026, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• National Wellness Month

• Stress Management Tips for Bulldogs

• Bulldog Resources

• Bulldog Wellness Bingo Challenge

The Comfort Cart Initiative: A Quality Improvement Intervention To Improve Patient Satisfaction In The Emergency Department, Heidy Cladimir Ayala

Doctor of Nursing Practice Final Project Abstract

The Comfort Cart Initiative: A Quality Improvement Intervention to Improve Patient Satisfaction in the Emergency Department

Purpose

The Comfort Cart QI project aimed to improve Emergency Department patient, parent, and guardian satisfaction by 10% over an 8-week implementation period.

Background

In healthcare, patient satisfaction is an important indicator of the quality of care provided, and many literature reviews suggest it is closely associated with patient-centered care.

 Methodology

The Comfort Cart intervention is an evidence-based quality improvement project employing a pre- and post-intervention design, conducted over an 8-week period, in the Emergency Department. The project was guided by Kolcaba's Comfort Theory …

Integrating Music Therapy Into Post-Surgical Care: A Quality Improvement Strategy For Reducing Post-Operative Anxiety, Yosdania Hernandez Benitez

Doctor of Nursing Practice Final Project Abstract

Integrating Music Therapy into Post-Surgical Care: A Quality Improvement Strategy for Reducing Post-Operative Anxiety

Purpose

This quality improvement (QI) project aimed to reduce postoperative anxiety among adult patients after general surgery in the post-anesthesia care unit (PACU) by 30% using nurse-led music therapy in an ambulatory surgical center.

Results

Mean VAS-A scores decreased from 6.9 (SD = 0.5) pre-intervention to 4.0 (SD = 0.5) post-intervention, representing a 2.9-point (41.9%) reduction in anxiety and exceeding the project's target of 30%. Nurse adherence to the intervention protocol was 100%, and the mean patient satisfaction score was 4.6/5.0. All 100 patients completed both …

Mda Insurance: Voluntary Benefits Help With Employee Recruitment, Satisfaction, Retention, Craig Start

The Journal of the Michigan Dental Association

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This article discusses how voluntary employee benefits can strengthen recruitment, retention, and employee satisfaction in dental practices. Topics include health insurance, disability coverage, life insurance, critical illness protection, accident insurance, vision plans, and cafeteria plans. The author explains how benefit offerings can improve workplace competitiveness while helping employees manage financial risks and healthcare costs.

Healthcare Access And The Persistent Racial Disparities In Low Birth Weight, Zaheda A. Hussain, Yadanar Moe

DePaul Discoveries

Low birth weight (LBW), defined as less than 2,500 grams, is an influential factor contributing to infant mortality in the United States, with significant racial disparities between Black and White mothers. This study analyzed data from 3,054 Black and White mothers collected from the 2018 National Health Interview Survey to explore the association between access to medical care and LBW within different racial groups. The prevalence of LBW was 8.0%. Overall, mothers without a usual place of medical care had, on average, an 18% higher risk of LBW than those with a usual place (OR = 1.18, 95% CI: 0.80–1.74). …

Leveraging Health Information Exchange (Hie) Data To Demonstrate The Impact On Health Outcomes Of Community Based Organization Interventions: Case Studies Of Housing Placement And Medically Tailored Meal Program, Kevin Kramer, Harm Scherpbier, William Marella

College of Population Health Faculty Papers

Objective

Methods

Psychotropic Medication Use In Older Adults In A Long-Term Care Facility: Implications For Screening Tool, Callie M. Johnson

Dissertations

Psychotropic medication use in older adults aged 65 years and older residing in the long-term care facility has a complex issue in the high use of psychotropic medications. Older adults residing  in long-term care (LTC) facilities are affected and prescribed at least one psychotropic or antidepressant medication.

July 2026 Mda Insurance — Voluntary Benefits Help With Employee Recruitment, Satisfaction, Retention, Craig Start

The Journal of the Michigan Dental Association

Craig Start, president of MDA Insurance, addresses the ongoing dental staffing shortage by advocating for comprehensive employee benefit packages. He explains how offering a mix of employer-paid and voluntary benefits, such as disability, life, and vision insurance, can make a practice a more desirable employer. The article specifically highlights the MDA Health Plan and employee-paid options like critical illness insurance, which help offset financial exposure from high-deductible plans. Start notes that these voluntary benefits are cost-effective for employers and can be administered through pre-tax cafeteria plans to improve employee economic security and retention.