Medicine and Health Sciences Commons^™

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …

Assessment Of Tuberculosis Underreporting By Level Of Reporting System In Lagos, Nigeria, Mustapha Gidado

Walden Dissertations and Doctoral Studies

Abstract

Tuberculosis (TB) is the leading cause of death from a single infectious disease. Unfortunately, 4.1 million cases were missed in 2017 globally, and Nigeria contributes 9% of the missing TB cases. At least 73% of the estimated TB cases in Nigeria were not reported in 2017 to the National TB Program (NTP); therefore, the true burden of TB was not certain, and this affected planning for prevention and control of TB. This quantitative secondary data analysis (NTP Lagos TB Inventory study database) guided by the integrated behavioral model assessed TB underreporting based on the TB reporting process in Nigeria. …

Caregivers' Challenges In Accessing Services For Children With Autism, Anita Payne Jones

Walden Dissertations and Doctoral Studies

The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall …

Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez

Walden Dissertations and Doctoral Studies

African American men are more likely to have diagnosed or undiagnosed diabetes than non-Hispanic White Americans and are less likely to adhere to treatment. Culture in the African American community plays a key role in how this community copes with illness and the health care system. The purpose of this study was to examine the lived experiences of social and cultural determinants of Type 2 diabetes self-management among African American men. Bandura's social cognitive theory provided the theoretical framework for the study. The research question sought to identify cultural and social factors that contribute or protect how African American men …

Use Of The Kawa Model To Facilitate Interprofessional Collaboration: A Pilot Study, Jennifer E. Lape, Ashley Lukose, Diana R.M. Ritter, Brian D. Scaife

Internet Journal of Allied Health Sciences and Practice

Purpose: The Kawa (river in Japanese) model uses the metaphor of a river to view one’s life from a metaphysical perspective, with consideration given to the interaction between social and physical environments, life circumstances, assets, and liabilities. Preliminary research suggests that the Kawa model may be an effective tool for interprofessional collaboration, but studies employing the model with diverse groups of healthcare professionals have not been undertaken. The purpose of this pilot study was to determine if the Kawa model could serve as an effective collaboration tool for a diverse healthcare team within a skilled nursing facility.

Method: A pilot …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Impact Of Area-Under-The-Curve Monitoring For Vancomycin On Incidence Of Acute Kidney Injury In Orthopedic Patients, Kelli R. Keats

MPA/MPP/MPFM Capstone Projects

Vancomycin is an antibiotic used regularly in hospitals across the world. The most concerning adverse effect of vancomycin is its documented effect on kidney function. This study examines the impact of two dosing strategies of vancomycin on patients’ kidney function at the University of Kentucky Albert B. Chandler Medical Center. It specifically focuses on patients on the orthopedic service because these patients traditionally receive higher doses of vancomycin for longer periods of time due to the severity of their infections, which puts them at an increased risk of vancomycin-induced nephrotoxicity compared to other patients.

This study will serve as a …

Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover

Walden Dissertations and Doctoral Studies

The value-based purchase requirement of the Patient Protection and Affordable Care Act puts pressure on hospital leaders to control cost while improving quality of care. The resource dependency theory was the theoretical framework for this correlational study. Archival data from the Centers for Medicare and Medicaid Services collected from 166 acute care urban hospitals for the Fiscal Year 2016. Multiple linear regression analysis was used to determine the relationship between nursing salaries per patient day, cost of uncompensated care as a percentage of net patient revenue, percentage of net income from patient services, and overall patient satisfaction for quality of …

Effective Nurse Recruitment Methods For Long-Term Care Facilities, Keith Laprade

Walden Dissertations and Doctoral Studies

Nurse recruitment is a challenge for long-term care (LTC) leaders. Some owners of LTC businesses lack knowledge of how to attract, market, and hire qualified nurses to help ensure success. The purpose of this multiple case study was to explore the methods and strategies LTC leaders used to recruit nurses. The target population consisted of leaders of 3 LTC facilities who were responsible for recruiting nurses. This selection was based on findings that organization leaders experienced a downsizing of more than 20% of their personnel. The conceptual framework was the motivation-hygiene theory. Working conditions were influenced by Herzberg's 2-factor principles …

Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster

Walden Dissertations and Doctoral Studies

Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and …

Examining How Primary Care Team Structures Are Used And Their Effect On Cross-Disciplinary Relationships: A Qualitative Study, Matthew J. Depuccio

Theses and Dissertations

Team-based primary care is an innovative care delivery model that has the potential to improve access to comprehensive, coordinated, and high-quality patient care. It is understood that in order for primary care teams to work effectively, health care providers must work across disciplinary boundaries and develop strong relationships that enable them to coordinate their roles and expertise. This research investigated how health care providers make use of different team structures (i.e., tools) to manage their interdependent work, enabling them to deliver team-based primary care. This research also examined how team structures influence the intra-team relationships important for coordinating care. By …

Employee Commitment Among Direct Care Professionals In An Intermediate Health Care Facility, Sharron Theresa Nicholson-Mccall

Walden Dissertations and Doctoral Studies

Lack of employee commitment affects the overall practice in healthcare organizations and can cause a disruption in the lives of people with intellectual disabilities who are receiving care. Researchers have demonstrated that increasing employee commitment and decreasing employee turnover are related to employee commitment in healthcare organizations. The purpose of this single case study was to explore strategies that leaders of an intermediate care facility for individuals with intellectual disabilities in the northwestern United States used to enhance employee commitment. Meyer and Herchovitch's model of employee commitment was the conceptual framework for this study. Data were collecting from semistructured interviews …

Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb

Walden Dissertations and Doctoral Studies

Implementation of electronic health records (EHRs) is a driver for the improvement of health care and the reduction of health care costs. Developing countries face substantial challenges in adopting EHRs. The complex adaptive system conceptual framework was used to guide this single case study to explore strategies that health care leaders used to successfully implement the EHR system. Data were collected from 6 health care leaders from an island in the Caribbean using a semistructured interview technique. Data were analyzed using the Bengtsson's 4-stage data analysis process, which includes decontextualization, recontextualization, categorization, and compilation. The results of the study yielded …

Strategies For Reducing Nurses' Turnover In Specialty Care Clinics, Lawrence Benjamin

Walden Dissertations and Doctoral Studies

The nursing shortage and high turnover rates are a problem in Canada and the world over. The purpose of this single case study was to explore leadership strategies that nurse leaders in specialty care clinics in Canada use to reduce nurse turnover. The participants were 7 nurse leaders from a single organization with specialty care clinics across Canada who all had above average nurse retention rates when compared to the case organization's average nurse retention rate. The authentic leadership theory was the conceptual framework. Data sources for this study were company documents, participants' semistructured interview responses, member checking of the …

Strategies For Achieving Patient-Centered Healthcare And Cost Containment, Quincy Von Handy

Walden Dissertations and Doctoral Studies

Implementing successful value-centered care strategies that support patient-centeredness while reducing cost is a significant challenge for healthcare leaders. In 2001, the Committee on Quality of Healthcare in America and the Institute of Medicine identified patient-centeredness as 1 of 6 improvement goals to improve quality of care for the 21st century. The purpose of this multiple case study was to explore patient-centered strategies that healthcare managers used to reduce the cost of healthcare for elderly patients without reducing the quality of patient care. The conceptual framework that grounded this study was patient-centered care, and the opposing theory was the primary care …

Mobile Technology Deployment Strategies For Improving The Quality Of Healthcare, Won K. Song

Walden Dissertations and Doctoral Studies

Ineffective deployment of mobile technology jeopardizes healthcare quality, cost control, and access, resulting in healthcare organizations losing customers and revenue. A multiple case study was conducted to explore the strategies that chief information officers (CIOs) used for the effective deployment of mobile technology in healthcare organizations. The study population consisted of 3 healthcare CIOs and 2 healthcare information technology consultants who have experience in deploying mobile technology in a healthcare organization in the United States. The conceptual framework that grounded the study was Wallace and Iyer's health information technology value hierarchy. Data were collected using semistructured interviews and document reviews, …

A Delphi Study Analysis Of Best Practices For Data Quality And Management In Healthcare Information Systems, Olivia L. Pollard

Walden Dissertations and Doctoral Studies

Healthcare in the US continues to suffer from the poor data quality practices processes that would ensure accuracy of patient health care records and information. A lack of current scholarly research on best practices in data quality and records management has failed to identify potential flaws within the relatively new electronic health records environment that affect not only patient safety but also cost, reimbursements, services, and most importantly, patient safety. The focus of this study was to current best practices using a panel of 25 health care industry data quality experts. The conceptual lens was developed from the International Monetary …

A Game-Theoretic Approach To Share The Costs Of Cooperating Healthcare Networks, Jay M. Lightfoot

Journal of International Technology and Information Management

The growing demand for healthcare services combined with the disarray in the health insurance market in the United States has created a situation where rival health networks are aggressively competing by building duplicate health facilities and providing redundant services in localized geographic regions. Unfortunately, this strategy can reduce the quality of patient care and decrease profits (Kaissi & Charland, 2013). A solution to this problem is for health networks to cooperate and share healthcare equipment, facilities, and personnel. Toward that end, this paper presents a game-theoretic method that can share these costs in a fair, efficient, and repeatable manner.

Mobile Iot Adoption As Antecedent To Care-Service Efficiency And Improvement: Empirical Study In Healthcare-Context, Samyadip Chakraborty, Vaidik Bhatt

Journal of International Technology and Information Management

Internet of things (IoT) is the buzzword and pioneering breakthrough approach highlighted in today’s industry 4.0, where the devices are seamlessly integrated with each other, sharing vital information in real-time sync. With the wearable IoT devices, the diagnostic readings and physical measurements of the patients can be shared with the physician on the go and suitable diagnosis can as well be shared with patient in the real-time on their own mobile devices through IoT applications. This study empirically examines the importance of m-IoT adoption on the information pervasiveness across the network and patient stakeholders and in turn investigating how efficiency …

The Health Care Systems Of The United States And Spain: A Comparison, Tasia Harman

Senior Honors Theses

When it comes to understanding and improving the United States health care system, comparison and analysis with the health care system of another country provides valuable insights. In this thesis, the United States’ health care system was compared to that of Spain, as the health care system of Spain is generally ranked well above the United States in terms of quality, function, and cost. In the comparison, information such as the health of the population, the quality of health care received, accessibility, and health care costs indicate the state of the health care systems and their ability to function well …

Certified Nursing Assistant Turnover & Impacts On Rural Skilled Nursing Facilities A Qualitative Study & Recommendations For Practitioners, Marisa E. Hansen

All Graduate Theses, Dissertations, and Other Capstone Projects

The cumulative growth in the aging population in the U.S. calls for a high demand for long-term care (LTC) facilities. Furthermore, the LTC (e.g., nursing homes and assisted living facilities, etc.) consumers have become widely diverse (i.e., not just limited to older groups but now included children and adults with disabilities); demand for wide range of needs and support services. In coping with this changing environment, the LTCs, especially operating in rural settings, are faced with multifaceted challenges related to direct care staffing and turnover. In response to this outlook, the present study explores a research question to understand, how …

Towards Earlier Identification: Physicians Assistants' Perceptions Of Their Ability To Identify, Diagnose, And Refer Patients With Autism Spectrum Disorder., Denise Rizzolo, Noël E Smith, Timothy C. Mccall

Clinical Research and Leadership Faculty Publications

No abstract provided.

An Analysis Of Employee Motivation After Metamorphose, Conglomerated Public Health Care Systems, Aleta Marie Lymon

Walden Dissertations and Doctoral Studies

A global epidemic of metamorphosed, conglomerated health care systems changed the face of public health care organizations. The problem is, public health care organizations merge into new systems, but the culture for each merged organization has not been formed under the new system. Public administrators, health care workers and the Department of Health and Human Services are affected when there are issues in health care behavioral practices and performance outcomes. Research found that employee motivation is hard to achieve when there are issues within the internal structure of a new system. Using Herzberg's motivation-hygiene and Tajfel and Turner's social identity …

Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight

Walden Dissertations and Doctoral Studies

Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and …

Improving Gonorrhea Result Notification And Response Among African American Women, Lashonda Ouk

Walden Dissertations and Doctoral Studies

Previous research has shown that 45% of malpractice claims are due to insufficient and late follow-up of test results and limited communication methods provided to patients. This study explored the preferred communication methods between a patient and a healthcare provider. The technology acceptance model served as the conceptual framework. A quantitative research design was used to examine patients’ perceived usefulness, attitude, perceived ease of use, and adaptability regarding mobile technology. The primary means of data collection was the use of a survey questionnaire. Participants included a random sample of 118 women seen in a local health department in the women’s …

Patient Safety Problems, Procedures, And Systems Associated With Safety Reporting And Turnover, Grace Hilario

Walden Dissertations and Doctoral Studies

Research has shown that 400,000 people die every year due to preventable medical errors. Medical error reporting and safety is a responsibility of all members of a health care organization. Creating an environment that addresses and prevents potential or actual safety problems can help reduce the incidence of medical errors made by nurses in the workplace. The purpose of this quantitative research study was to determine if nurses' perceptions of safety problems and error-preventing procedures and systems affected their comfort in reporting safety problems and intent to leave. High-reliability theory was the theoretical foundation for this study. Data were obtained …

African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris

Walden Dissertations and Doctoral Studies

Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …

Health Care Leaders' Strategies To Reduce Nursing Turnover, John Clayton Phelps

Walden Dissertations and Doctoral Studies

Health care leaders who lack effective nurse turnover strategies can negatively affect patient quality of care, productivity, and profitability. The purpose of this single case study was to explore strategies health care leaders used to reduce nursing turnover in a health care organization. The conceptual framework for this study was Herzberg's 2-factor theory. Data were collected from semistructured interviews with 4 health care leaders in the West Texas region who had a history of reducing nurse turnover for a minimum of 5 years from the date of hire, and from review of organizational documents related to the strategies to reduce …

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …

Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh

Walden Dissertations and Doctoral Studies

Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …