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Articles 3961 - 3990 of 8961

Full-Text Articles in Medicine and Health Sciences

Managerial Competencies Driving Successful Change Initiatives: A Multiple Case Study Of Healthcare Administrators, William King Selsor Jan 2020

Managerial Competencies Driving Successful Change Initiatives: A Multiple Case Study Of Healthcare Administrators, William King Selsor

Walden Dissertations and Doctoral Studies

Healthcare administrators’ competencies for driving successful strategic change initiatives in healthcare organizations remain outdated and limited in the management literature. The purpose of this qualitative, multiple case study was to explore the perceptions of healthcare administrators on the specific nature of management competencies needed to drive successful strategic change initiatives within healthcare organizations. To address the research problem and purpose of the study, qualitative data were collected from multiple sources of evidence, including semi-structured interviews with seven healthcare administrators, archival data, and reflective journaling notes. This study was framed by Kash, Spaulding, Johnson, and Gamm’s conceptual framework, the comparison of …

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Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone Jan 2020

Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone

Walden Dissertations and Doctoral Studies

Hospitals, along with other health care providers, are a central part of every health care system and responsible for a great share of healthcare expenditure. In the United States, the cost of health care is much higher than it is anywhere else. High expenditures for hospital services could reduce the resources available for primary care and other services that could do more for population health. The purpose of this study was to explore the competition among general medical and surgical hospitals in the Deep Southern states of Mississippi, Alabama, Georgia, South Carolina, and Louisiana to determine if increasing the level …

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Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson Jan 2020

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

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Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry Jan 2020

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

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Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander Jan 2020

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

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Understanding Behavioral Health Stigma Within The Healthcare Workforce, Jason Robert Martin Jan 2020

Understanding Behavioral Health Stigma Within The Healthcare Workforce, Jason Robert Martin

Walden Dissertations and Doctoral Studies

Individuals who seek mental health treatment in the United States face significant barriers. One such barrier is the belief that those seeking mental health treatment are subpar people with some moral failure. One area where this phenomenon exists is the behavioral healthcare workforce. This study was conducted to understand the phenomenon of stigma that behavioral healthcare leaders exhibit toward behavioral healthcare patients using the Baldrige framework as its conceptual framework. Using a qualitative approach and case study design, interviews were conducted with 6 leaders within a large healthcare system in the suburbs of a major metropolitan area to evaluate their …

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Influence Of Supervisor Support And Resilience On Productivity And Turnover Intentions In Pediatric Health Care, Adrienne Y. Martin Jan 2020

Influence Of Supervisor Support And Resilience On Productivity And Turnover Intentions In Pediatric Health Care, Adrienne Y. Martin

Walden Dissertations and Doctoral Studies

Workplace violence has become a critical safety issue in the health care setting, often leading to increased stress levels and employees that feel unsupported and inadequately prepared; which leads to increased turnover, and subsequently, diminished overall organizational productivity and poorer patient outcomes. The purpose of this study was to examine whether supervisor support and resilience affect productivity and turnover intent related to professional role and work experience following workplace violence in the pediatric health care setting. Organizational support theory and the framework of the resilience model provided the theoretical structure for this study. Data were collected through anonymous surveys with …

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Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King Jan 2020

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

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Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews Jan 2020

Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews

Walden Dissertations and Doctoral Studies

Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this …

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Strategies For Implementing The International Organization For Standardization 15189 For Medical Laboratories, Wilson Mtotela Jan 2020

Strategies For Implementing The International Organization For Standardization 15189 For Medical Laboratories, Wilson Mtotela

Walden Dissertations and Doctoral Studies

Inadequate quality management systems (QMS) in medical laboratories result in errors, which cost the United States healthcare industry approximately $29 billion per year. Healthcare managers who fail to implement the International Organization for Standardization (ISO) 15189 QMS are at high risk of managing costs. Grounded in Lewin’s 3-step organizational change model and the force field analysis, the purpose of this qualitative multiple case study was to explore strategies healthcare managers use to design, develop, and implement an ISO 15189 QMS using a mentorship approach. The participants comprised 5 healthcare managers from the United Republic of Tanzania, East Africa, who implemented …

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Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays Jan 2020

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

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Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood Jan 2020

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

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Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch Jan 2020

Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch

Walden Dissertations and Doctoral Studies

AbstractElectronic health record system implementations have a high failure rate when properly developed strategies are not used. These implementation failures affect healthcare workers and practitioners core roles through a lack of documentation practices, which decreases the quality of the care of the patients. Grounded in the technology acceptance model, the purpose of this qualitative multiple case study was to explore the strategies information technology systems engineers use for the implementation of Health Information Management Systems. The participants were 10 information technology systems engineers from three healthcare organizations in the greater Tennessee area. The data were collected through recorded participant interviews …

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Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio Jan 2020

Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio

Walden Dissertations and Doctoral Studies

Heart failure is a chronic health condition that can have devastating effects on thephysical and social well-being of patients. One critical component to heart failure treatment is understanding of the disease process and daily self-management for patients. The gap in practice at an acute care facility in the northwest United States was the lack of comprehensive discharge patient teaching to patients diagnosed with heart failure. The project explored if a heart failure education session for nurses would increase knowledge and competency on heart failure education. Knowle’s theory of adult learning was used to frame the project components. Thirty-one nursing staff …

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The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik Jan 2020

The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik

Walden Dissertations and Doctoral Studies

Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …

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Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia Jan 2020

Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia

Walden Dissertations and Doctoral Studies

Patient satisfaction presents an emerging area of research for healthcare providers because major healthcare providers like Medicare/Medicaid control the finances of healthcare institutions as based on their patient and customer satisfaction. The purpose of this study was to examine the impact of servant leadership on customer service, and patient satisfaction, in the Inland Empire Region of Southern California. The theoretical framework applied to this study was the servant leadership theory. Participants consisted of 82 managerial staff within the University Health System, which is comprised of a teaching hospital, 5 behavioral health centers, 10 federally qualified health centers, and a public …

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Association Between Factors Related And Stress, Depression And Suicidal Risk Among Health Care Personnel During Covid-19 Second Outbreak In Thailand, Aphichaya Polrak Jan 2020

Association Between Factors Related And Stress, Depression And Suicidal Risk Among Health Care Personnel During Covid-19 Second Outbreak In Thailand, Aphichaya Polrak

Chulalongkorn University Theses and Dissertations (Chula ETD)

Health care personnel are one of most affected by COVID-19 situation. The aim of this study was to identify the prevalence of stress, depression and suicidal risk and associated factors among health care personnel during COVID-19 second outbreak in Thailand. This study was cross-sectional study, which used secondary data collected during December 17, 2020 to February 23, 2021. Total of 4,970 health care personnel participated in this research. The instruments of this research were ST-5, 9Q and 8Q. Multivariable logistic regression analysis was performed to identify factors associated with stress, depression and suicidal risk outcomes. The prevalence of stress, depression …

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The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early Jan 2020

The Role Of Patient Room-Type, Interruptions, And Intrapersonal Resources In Nurse Performance And Well-Being, Jennifer Early

Theses and Dissertations

Interruptions create a complex challenge in health care. Because some interruptions are necessary in health care, they cannot be completely eliminated. Thus, their effects must be appropriately mitigated. To better understand predictors and consequences of interruptions, as well as factors that may mitigate their negative effects, I employed Job Demands-Resources (JD-R) theory, supplemented by additional constructs from organizational behavior and psychology to develop a model of predictors and mitigators of interruptions. Twenty registered nurses providing care on a progressive acute care unit with single- and double-occupancy patient rooms volunteered to participate in this study. The study incorporated nurse-level questionnaires, event-level …

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The Relationships Among External Environments, Organizational Structures, And Performance In Pursuit Of The Clinical And Academic Missions At Academic Health Centers, Eric J. Strucko Jan 2020

The Relationships Among External Environments, Organizational Structures, And Performance In Pursuit Of The Clinical And Academic Missions At Academic Health Centers, Eric J. Strucko

Theses and Dissertations

Clinical and academic missions place Academic Health Centers (AHCs) at the center of the American health care system, and the future viability of these institutions requires successful performance in competitive environments. AHCs are organizations involving hospitals, physician group practices, and medical schools, and treat patients with complex conditions, conduct bio-medical and health science research, and educate future physicians and health professionals. AHCs account for 20% or $540 billion of national health care expenditures, conduct over 80% of all heart, liver, and lung transplants, utilize over $27 billion in annual sponsored research funding, and graduate approximately 17,300 medical doctors annually. Financial …

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Data Science Methods For Standardization, Safety, And Quality Assurance In Radiation Oncology, Khajamoinuddin Syed Jan 2020

Data Science Methods For Standardization, Safety, And Quality Assurance In Radiation Oncology, Khajamoinuddin Syed

Theses and Dissertations

Radiation oncology is the field of medicine that deals with treating cancer patients through ionizing radiation. The clinical modality or technique used to treat the cancer patients in the radiation oncology domain is referred to as radiation therapy. Radiation therapy aims to deliver precisely measured dose irradiation to a defined tumor volume (target) with as minimal damage as possible to surrounding healthy tissue (organs-at-risk), resulting in eradication of the tumor, high quality of life, and prolongation of survival. A typical radiotherapy process requires the use of different clinical systems at various stages of the workflow. The data generated in these …

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The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson Jan 2020

The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson

Antioch University Dissertations & Theses

Across the United States, each state has a public mental health system that is designed to support children and youth with emotional and behavioral challenges. This is critically important as recent estimates show that one in six children in the United States has a diagnosed mental health condition (Whitney & Peterson, 2019). The design and structure of these systems vary by state, but consistent across them is the presence of a state-designated leader who is faced with an array of constraining factors that influence their behavior and shape the resulting system. This study describes the experience of leaders in children’s …

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Understanding The Context And Social Processes That Shape Person- And Family-Centered Culture In Long-Term Care: The Pivotal Role Of Personal Support Workers, Ellen Helena Melis Jan 2020

Understanding The Context And Social Processes That Shape Person- And Family-Centered Culture In Long-Term Care: The Pivotal Role Of Personal Support Workers, Ellen Helena Melis

Antioch University Dissertations & Theses

This single, exemplar case study explored the context and social processes that shape person-and family-centered culture in a long-term care (LTC) home, using grounded theory and situational analysis for the data collection and analysis. Findings revealed one core dimension: needing to be heard, valued, and understood, and five key roles: personal support workers (PSWs), executive director (ED), senior leadership, nurse managers, and residents and families, which informed five dimensions, each focused on enhancing care for residents: (a) attending to residents’ daily care needs (PSWs), (b) advocating strategically (ED), (c) translating vision into programs and policies (senior leadership), (d) ensuring quality …

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Beyond Borders: Nigerian Diaspora, Men's Experiences Of Intimate Partner Violence, Christiana Ifeyinwa Chineme Jan 2020

Beyond Borders: Nigerian Diaspora, Men's Experiences Of Intimate Partner Violence, Christiana Ifeyinwa Chineme

Walden Dissertations and Doctoral Studies

Culture and social structures are factors in the way people view or think of intimate partner violence (IPV). A significant gap exists in the current literature regarding whether changes exist in IPV experience because of continuous and direct contact between individuals from different cultural origins. Despite the increasing emphasis on the social and structural determinants of IPV-related behaviors, research and interventions lag on how people view IPV while they live in their native country and when they migrate and are exposed to a different culture and social structure. The purpose of this qualitative phenomenological research was to explore the IPV …

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Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson Jan 2020

Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson

Walden Dissertations and Doctoral Studies

Seismic data loss attributed to cybersecurity attacks has been an epidemic-level threat currently plaguing the U.S. healthcare system. Addressing cyber attacks is important to information technology (IT) security managers to minimize organizational risks and effectively safeguard data from associated security breaches. Grounded in the protection motivation theory, the purpose of this qualitative multiple case study was to explore risk-based strategies used by IT security managers to safeguard data effectively. Data were derived from interviews of eight IT security managers of four U.S. government health institutions and a review of relevant organizational documentation. The research data were coded and organized to …

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A Health Care Management Organization's Internal Controls Strategy For Managed Care, Elizabeth E. David Jan 2020

A Health Care Management Organization's Internal Controls Strategy For Managed Care, Elizabeth E. David

Walden Dissertations and Doctoral Studies

A lack of effective operational internal controls among health management organization (HMO) leaders could lead to poor operational practices, mismanagement of the government's health care funds, increased health care spending, and a negative impact on patient health outcomes. Grounded in transformational leadership theory, the purpose of this qualitative, single case study was to explore successful internal control strategies used by leaders at a southeastern Pennsylvania HMO. Data were collected from semistructured interviews with 5 participants who held positions of director or above within the organization for at least 3 years, had institutional knowledge, and had responsibility for overseeing the organization's …

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The Prevalence Of Secondary School Sport Safety Policies Within State Athletic Associations And Legislation, Samantha E. Scarneo, William M. Adams, Susan W. Yeargin, Madeline A. Konz, James E. Potter, Douglas J. Casa Jan 2020

The Prevalence Of Secondary School Sport Safety Policies Within State Athletic Associations And Legislation, Samantha E. Scarneo, William M. Adams, Susan W. Yeargin, Madeline A. Konz, James E. Potter, Douglas J. Casa

Internet Journal of Allied Health Sciences and Practice

Purpose: The location of secondary school health and safety policies impacts how they are implemented by the sports medicine team and stakeholders. Yet, a comprehensive list of each state’s policy locations has not been established. The purpose of this study was to describe where secondary school health and safety policies were located at the state level within the United States. Method: Emergency related health and safety policies were designated as either being located in the state high school athletics association (SHSAA), state legislation (LEGIS), or in both SHSAA and LEGIS (BOTH). Designation was determined by two researchers who independently …

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Managing Clinic Variability With Same-Day Scheduling, Intervention For No-Shows, And Seasonal Capacity Adjustments, Kum Khiong Yang, Tugba Cayirli Jan 2020

Managing Clinic Variability With Same-Day Scheduling, Intervention For No-Shows, And Seasonal Capacity Adjustments, Kum Khiong Yang, Tugba Cayirli

Research Collection Lee Kong Chian School Of Business

This study investigates demand and capacity strategiesfor managing clinic variability. These include (i) same-day scheduling tocontrol random walk-ins, (ii) no-show intervention, where the clinic callsadvance-booked patients a day before to identify and release canceled slots tosame-day patients, and (iii) adjustments to daily number of appointments foradvance-booked patients to match seasonal variations in same-day demand. Thesestrategies are tested over the individual-block/fixed-interval (IBFI) and theDome appointment rules. The resulting appointment systems are tested underscenarios with different levels of same-day demand, demand seasonality,no-shows and cost ratios. The goal is to minimize the weighted sum of patients’wait time and physician’s idle-time and overtime. Our …

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Development Of A Hybrid, Interprofessional, Interactive Quality Improvement Curriculum As A Model For Continuing Professional Development, Isabelle S Kusters, Megan E Gregory, Jennifer L Bryan, Sylvia J Hysong, Lechauncy D Woodard, Aanand D Naik, Kyler M Godwin Jan 2020

Development Of A Hybrid, Interprofessional, Interactive Quality Improvement Curriculum As A Model For Continuing Professional Development, Isabelle S Kusters, Megan E Gregory, Jennifer L Bryan, Sylvia J Hysong, Lechauncy D Woodard, Aanand D Naik, Kyler M Godwin

Faculty, Staff and Students Publications

Over the past 20 years, there has been an increased focus on quality improvement (QI) in health care, which is critical in achieving care that is patient-centered, safer, timelier, and more effective, efficient, and equitable. At the center of this movement is QI education, which is known to lead to learning, behavior change, and improved outcomes. However, there is a need for the development and provision of long-duration, interactive, interprofessional training in QI, to allow for in-depth learning and application of learned skills. To this end, we designed a curriculum for an established interprofessional, interactive, web-based QI fellowship for doctorally …

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What's Happening: December 30, 2019, Maine Medical Center Dec 2019

What's Happening: December 30, 2019, Maine Medical Center

What's Happening

No abstract provided.

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Letter From The Editors, Administrative Issues Journal Editors Dec 2019

Letter From The Editors, Administrative Issues Journal Editors

Administrative Issues Journal

No abstract provided.

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