Medicine and Health Sciences Commons^™

Bacterial Endotoxin Detection In Hyaluronic Acid-Based Medical Devices, Larissa F. Baeva, Srilekha Sarkar Das, Victoria M. Hitchins

United States Food and Drug Administration: Publications

A simple and rapid method has been developed for testing bacterial endotoxin in hyaluronic acid (HA)-based medical devices. High-molecular-weight HA (HMW HA) in solution or HA-based medical devices was digested by the enzyme hyaluronidase to reduce solution viscosity by truncating the long chains of HA and to test for bacterial endotoxin. The bacterial endotoxin level was detected and measured by kinetic chromogenic Limulus Amebocyte Lysate (LAL) assay. The method was applied to two different ophthalmic viscosurgical devices (OVDs) and one dermal filler, and may easily be adapted to use with up to 3% HA solutions and other HA-based medical devices.

Exploring The Importance Of Team Psychological Safety In The Development Of Two Interprofessional Teams, Denise O'Leary

Articles

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without …

Speaking Of Urgent Care Centers: Language Matters, Sayeedul Islam, Michael H. Chetta, Andrzej Kozikowski, Samantha Misner

Department of Behavioral Science Publications and Research

With the adoption of the Affordable Care Act, it is necessary for health care facilities to focus on patient perceptions and care experience. The urgent care industry has grown exponentially as demand for more accessible patient services has increased. There is little research on how patients perceive their care experiences and what influences their satisfaction in the urgent care setting. The present study proposes a series of research questions exploring the relationship between language and ratings of urgent care facilities. This study aimed to: (1) identify which words were tied to patient experience, (2) identify the language used by satisfied …

Is The Nationwide Health Information Network Feasible?, Tyler Godby, Christian Gomes, Jazmine Valle, Alberto Coustasse

Management Faculty Research

Nationwide Health Information Network (NHIN) use in healthcare facilities was examined for utilization and efficacy, although the advantages are abundant, healthcare facilities have been reluctant to adopt it due to associated costs. The purpose of this study was to analyze the feasibility of a U.S NHIN by exploring and determining the benefits of and assessing the barriers to its implementation. The results of this study suggest that implementation and utilization of NHIN by healthcare industry stakeholders leads to an increased quality of patient care, increased patient-provider communication, and cost savings opportunities. Increased quality of care is achieved by reducing adverse …

Mobile Health Interventions For Adult Obesity In The United States: Analysis Of Effectiveness And Efficacy, David P. Paul Iii, Keerthi Gochipathala, Alberto Coustasse, Bezawit Wodajo, Niharika Bhardwaj

Management Faculty Research

The Unites States continues to struggle with the negative health effects associated with increasing population obesity, a problem which has been historically difficult, if not impossible, to solve. Mobile health applications represent a potential partial solution to this problem. We examine the existing literature on the effects of mobile health applications on body weight, waist circumference, BMI, and lifestyle, examining both physical findings as well as adherence, satisfaction and cost effectiveness. The use of mobile for weight reduction looks promising, but evidence is mixed, which is not surprising given the rapidly evolving nature of the mobile application field.

Realizing Improved Patient Care Through Human-Centered Design In The Operating Room, Volume 2, Clemson Center For Health Facilities Design & Testing

Center for Health Facilities Design and Testing

This 4-year grant from the Agency for Healthcare Research and Quality supports the development of a learning lab focused on designing a safer, more ergonomic operating room. Sponsor: Agency for Healthcare Research Quality Project period: 9/1/15 to 8/31/19 Project Description: The overarching goal of the learning lab titled, “Realizing Improved Patient Care through Human-Centered Design in the Operating Room (RIPCHD.OR) is to develop an evidence-based framework and methodology for the design and operation of operating rooms such that it impacts improved perioperative outcomes including surgical site infections, surgical errors and staff injuries.

Dental Practice Success Vol. 2 No. 4, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

Telestroke: An Approach To The Shortage Of Neurologists In Rural Areas, Sarah Mcsweeney, Jean Pritt, Angie Swearingen, Alberto Coustasse

Management Faculty Research

Telestroke has provided swift, lifesaving treatment and has afforded patients the ability to be treated in an efficient manner in rural areas where neurologists may not always be available. It has been reported that Telestroke in rural areas has increased the ability to treat patients by being able to access a neurologist for assistance in evaluating the patient to determine if administering lifesaving in treatments were needed. The utilization of Telestroke has been shown to increase the use of IV Tissue Plasminogen Activator (tPA) which improves outcomes such as better quality of life, lower disability and improved rehabilitation. Employment of …

The Qualitative And Quantitative Effects Of Patient Centered Medical Home In The Veterans Health Administration, Samuel N. Lovejoy, Eric Stalnaker, William K. Willis, Alberto Coustasse

Management Faculty Research

Since the 1990’s, the Veteran’s Health Administration (VHA) has implemented a system of primary care that has been considered some of the best care that can be offered (Klein, 2011). The Patient Center Medical Home (PCMH) Model, also called “Patient Aligned Care Team” (PACT) in the VHA, has been coordinating and integrating services which ensure optimal health outcomes at an acceptable value (Bidassie, Davies, Stark, & Boushon, 2014).

PACT was created in 2010, building on 20 years of the VHA transforming from a loosely based system of inpatient services to a provider of outpatient primary care for veterans. From 2010 …

Big Data Management In United States Hospitals: Benefits And Barriers, Chad Schaeffer, Ariful Haque, Lawrence Booton, Jamey Halleck, Alberto Coustasse

Management Faculty Research

Big Data has been considered as an effective tool to reduce healthcare costs by eliminating adverse events and reducing readmissions in hospitals. The purpose of this study was to examine the emergence of Big Data in the United Sates healthcare industry, to evaluate hospital’s ability to effectively make use of complex information, and to predict the potential benefits hospitals might realize if they are successful. The findings of the research suggest that there were a number of benefits expected by hospitals when using Big Data analytics, including cost savings and business intelligence. In addition, hospitals have recognized that there have …

Quality Of Care And Profitability In Not-For-Profit Versus For-Profit Nursing Homes, David P. Paul Iii, Tyler Godby, Sarah Saldanha, Jazmine Valle, Alberto Coustasse

Management Faculty Research

Nursing home residents across the Unites States rely on quality care and effective services. Nursing homes provide skilled nurses and nursing aides who can provide services 24 hours a day for individuals that could not perform these tasks for themselves. Not-for-Profit (NFP) versus For-Profit (FP) nursing homes have been examined for utilization and efficacy, however, it has been shown that NFP nursing homes generally offer higher quality care and greater profit margins compared to FP nursing homes. The purpose of this research was to determine if NFP nursing homes provide enhanced quality care and a larger profit margin compared to …

Costs, Staffing, And Services Of Assisted Living In The United States: A Literature Review, Amy Kisling, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Assisted Living Facilities (ALFs), which provide a community for residents who require assistance throughout their day, is an important part of the long-term care system in the US. The costs of ALFs are paid either out of pocket, by Medicaid or by Long-Term Care Insurance (LTCI). Monthly costs of ALFs have increased over the past five years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the US to determine the impact healthcare on costs. The methodology for this study was a literature review and a total of 32 sources …

Bundle Vs. Non-Bundle: Looking At Differences In Care And Outcomes At A Skilled Nursing Facility, Georgia Tsmasiros

Capstone Projects 2015-Present

The Centers for Medicare and Medicaid Services (CMS) introduced the Bundled Payments for Care Improvement Initiative (BPCI) in 2013 in an effort for consumers to have higher quality and more coordinated care. This research compared the care and outcomes of four individuals with bundled payment insurance plans and four non-bundle insured individuals with the same diagnosis, accessing rehabilitation services at a skilled nursing facility. The results show no observable differences between the outcomes of individuals with a bundled insurance plan and individuals without a bundled insurance plan. The financial implications are negative for healthcare agencies participating in BPCI who must …

Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek

International Journal of Applied Management and Technology

For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 …

Children's Mercy Hospital Annual Report 2015, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Workforce Planning And Development In Times Of Delivery System Transformation, Patricia Pittman, Ellen Scully-Russ

Health Policy and Management Faculty Publications

Background

As implementation of the US Affordable Care Act (ACA) advances, many domestic health systems are considering major changes in how the healthcare workforce is organized. The purpose of this study is to explore the dynamic processes and interactions by which workforce planning and development (WFPD) is evolving in this new environment.

Methods

Informed by the theory of loosely coupled systems (LCS), we use a case study design to examine how workforce changes are being managed in Kaiser Permanente and Montefiore Health System. We conducted site visits with in-depth interviews with 8 to 10 stakeholders in each organization.

Results

Both …

Attitudes Of Mothers And Daughters Towards Menstrual Suppression, Jacqueline M. Devaney

Honors Undergraduate Theses

Recent biomedical advancements, cultural practices, and individual preferences have altered the ways in which biological process such as menstruation are perceived and managed. Increasingly, women are interested in suppressing menstruation to alleviate its negative symptoms, including bloating, menstrual cramps, fatigue, and irritability. This topic is especially relevant for adolescent girls, as mothers and daughters might have to negotiate attitudes towards daughters’ menstrual suppression. Therefore this study aims to examine how this topic is discussed and understood within the mother-daughter dyad. It is also important to consider how these attitudes are shaped by cultural background, ethnicity, socioeconomic class, and religion. Through …

Development And Content Validation Of An Emergency Department Ehr Safety Educational Program, Ursula Renee Jernigan

Walden Dissertations and Doctoral Studies

Emergency Department (ED) providers and staff experience challenges with using electronic health record (EHR) software to document and communicate about patient care. These difficulties are often caused by inadequate training in the use of the organization's EHR system. Challenges with EHR use have been linked to increased ED patient wait times, which impacts patient safety by delaying care and increasing the potential for medication errors. Providing education that addresses EHR software; EHR usability; and collaboration among staff, providers, and EHR system managers has been shown to reduce ED wait times and decrease the risk of medication errors. The purpose of …

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …

Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman

Walden Dissertations and Doctoral Studies

Business leaders lack strategies to implement the employer shared responsibility provision of the Patient Protection and Affordable Care Act (ACA). Small businesses pay approximately 18% more than larger companies for the same health coverage. Within a conceptual framework of management by objectives, the purpose of this qualitative multiple case study was to explore the strategies small business leaders use to implement the employer shared responsibility provision of the ACA. Data were gathered from the review of company documents, observations, and semistructured interviews with 5 senior business leaders from small business organizations in the Mid-Atlantic region of the United States. Data …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

Perspectives Of Young Adults Toward Tobacco Use, Caroline Oluwatosin Omoalako-Adesanya

Walden Dissertations and Doctoral Studies

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …

Moving Forward With Family Centered-Care: One Step At A Time, Adrianne Dunbar

UReCA: The NCHC Journal of Undergraduate Research and Creative Activity

Family-centered care is an evolving process between patients, families, and health care providers. The family centered care model emphasizes the strength families bring to the healing process. The research project was a quasi-experimental pre-and post-test study with a communication intervention phase. The study was conducted in a Surgical-Trauma Intensive Care Unit (STICU) in a university affiliated hospital in the Southeast with restricted visitation hours. The purpose of this IRB-approved study was to measure the nurses’ perceptions of communication involvement with family members before and after the intervention phase. Approximately 50% of eligible participants responded. The communication intervention phase consisted of …

The Health Resilience Program - A Program Assessment, Keri B Vartanian, Sarah Tran, Bill J. Wright, Grace Li, Megan Holtorf, Michael Levinson

Articles, Abstracts, and Reports

No abstract provided.

The Impact Of Information Technology On Patient Engagement And Health Behavior Change: A Systematic Review Of The Literature, Suhila Sawesi, Mohamed Rashrash, Kanitha Phalakornkule, Janet S. Carpenter, Josette F. Jones

Pharmacy Faculty Articles and Research

Background: Advancements in information technology (IT) and its increasingly ubiquitous nature expand the ability to engage patients in the health care process and motivate health behavior change.

Objective: Our aim was to systematically review the (1) impact of IT platforms used to promote patients’ engagement and to effect change in health behaviors and health outcomes, (2) behavior theories or models applied as bases for developing these interventions and their impact on health outcomes, (3) different ways of measuring health outcomes, (4) usability, feasibility, and acceptability of these technologies among patients, and (5) challenges and research directions for implementing …

Handoffs, Safety Culture, And Practices: Evidence From The Hospital Survey On Patient Safety Culture, Soo-Hoon Lee, Phillip H. Phan, Todd Dorman, Sallie J. Weaver, Peter J. Pronovost

Management Faculty Publications

Background: The context of the study is the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety.

Methods: The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. …

Abortion, Informed Consent, And Regulatory Spillover, Katherine A. Shaw, Alex Stein

Indiana Law Journal

The constitutional law of abortion stands on the untenable assumption that any state’s abortion regulations impact citizens of that state alone. On this understand-ing, the state’s boundaries demarcate the terrain on which women’s right to abortion clashes with state power to regulate that right.

This Article uncovers a previously unnoticed horizontal dimension of abortion regulation: the medical-malpractice penalties imposed upon doctors for failing to inform patients about abortion risks; the states’ power to define those risks, along with doctors’ informed-consent obligations and penalties; and, critically, the possi-bility that such standards might cross state lines. Planned Parenthood v. Casey and other …

Disability Rights And Labor: Is This Conflict Really Necessary?, Samuel R. Bagenstos

Indiana Law Journal

In this Essay, I hope to do two things: First, I try to put the current labor-disability controversy into that broader context. Second, and perhaps more important, I take a position on how disability rights advocates should approach both the current contro-versy and labor-disability tensions more broadly. As to the narrow dispute over wage-and-hour protections for personal-assistance workers, I argue both that those workers have a compelling normative claim to full FLSA protection—a claim that disability rights advocates should recognize—and that supporting the claim of those workers is pragmatically in the best interests of the disability rights movement. As to …