Improving Patient Care Delivery In A Small Alaska Native Health Care Organization, Annette Cecile Siemens

Walden Dissertations and Doctoral Studies

Chronic diseases impose heavy burdens on the United States health care system, particularly among some ethnic/racial groups such as American Indian and Alaska Natives who experience higher incidence of these diseases than non-Native population. In an effort to improve the health status of its patients, the Ukudigaunal Wellness Center (UWC) partnered with the Improving Patient Care (IPC) Collaborative to implement changes designed to improve chronic disease care for Native Alaskans through intensive monitoring of screening for chronic disease and selected chronic disease outcomes. For this program evaluation, the units of analysis were the changes in health service delivery and the …

Drawing Comparisons Across Community Health Agents (Acs), Nurses And Physicians In Brazil’S Unified Health System (Uhs), Rahbel Rahman

Social Work Faculty Scholarship

Recent WHO guidelines emphasize on empowering communities to take ownership of their healthcare needs. Brazil’s UHS is a model for delivering community-based care through Family Health Strategy (FHS) interdisciplinary teams - ACS, nurses, and physicians. Our study compares nurses, physicians and ACS on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on comparisons across providers to develop interprofessional training and implement system-level interventions.

Is There An Association Between Non-Va Medical Care Coordination And Utilization Of Care?, Brenda Joyce Robisnon

Walden Dissertations and Doctoral Studies

The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of …

Evaluating Key Predictors Of Employee Response To Change In The Pharmaceutical Industry, Otis S. Johnson

Walden Dissertations and Doctoral Studies

This study addressed the factors that predict employee response to large-scale change in the United States pharmaceutical industry. When poorly executed, major organizational changes such as mergers and acquisitions are often disruptive and costly to organizations and demoralizing to employees. Although employee responses to change have been studied in several industries, employee responses during change execution in the pharmaceutical industry have not been subject to study. The purpose of this correlational study was to reduce the knowledge gap related to organizational change in the pharmaceutical industry by evaluating key predictors of employee response to large-scale change. The theoretical framework consisted …

The Association Between Demographic Factors And Use Of California's Health Insurance, Chiquita Theresa Tuttle

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordability Act of 2010 (PPACA) addressed the access to healthcare in the United States. One of the problems of this healthcare access was rooted in disproportionally lower access among minority populations. The purpose of this quantitative study, guided by the consumer behavior theory, was to examine the association between race/ethnicity and enrollment within the Covered California-?¢ (CoveredCA) Insurance Exchange. A cross-sectional study design was used to investigate the association between race/ethnicity and the use of Covered CA health benefit exchange. Logistic regression analysis was used to examine the relationship between enrollment and race/ethnicity, having adjusted for …

Falls And Related Injuries Based On Surveillance Data: U.S. Hospital Emergency Departments, George K. Quarranttey

Walden Dissertations and Doctoral Studies

Falls can lead to unintentional injuries and possibly death, making falls an important public health problem in terms of related health care cost, incurred disabilities, and years of life lost. Approximately 1 in every 3 Americans ages 65 years and older is at risk of falling at least once every year. Children, young adults, and middle-aged adults are also vulnerable to falls. The purpose of this study was to examine the epidemiology of falls and fall-related injuries using surveillance data from nationally representative samples of hospital emergency departments in United States. The study was guided by a social-ecological model on …

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

The Utility Of Health Care Performance Indicators In Evaluating Low Back Surgery, Pradeep K. Narotam

Walden Dissertations and Doctoral Studies

Low back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was …

Leading By Design: Physicians In Training And Leadership Awareness, Meridithe Anne Mendelsohn

Antioch University Dissertations & Theses

Patient-centered care requires robust physician leadership in all aspects of healthcare in order to lead organizations to this ideal.Programs in Graduate Medical Education provide inconsistent and limited exposure to formal leadership development experiences for physicians in their final year of residency training.Literature addressing leadership training for residents focuses on the scarcity of effective programs that deliver adequate training and provide measurable outcomes.The purpose of this study was to explore how chief medical and surgical residents develop leadership awareness and experience training in leadership and engage chief residents, faculty mentors, and program administrators in a collaborative process, developing a leadership training …

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …

How N.Y.’S Biggest For-Profit Nursing Home Group Flourishes Despite A Record Of Patient Harm, Jennifer Lehman

Capstones

How N.Y.'s Biggest For-Profit Nursing Home Group Flourishes Despite a Record of Patient Harm

The state’s “character-and-competence” reviews are supposed to weed out operators with histories of violations and fines— but regulators don’t always act on the full story.

What's Happening: December 28, 2015, Maine Medical Center

What's Happening

No abstract provided.

What's Happening: December 21, 2015, Maine Medical Center

What's Happening

No abstract provided.

Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby

Doctor of Nursing Practice (DNP) Projects

Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …

Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn

Doctor of Nursing Practice (DNP) Projects

Health care is a complex business currently undergoing extensive reform. These changes require new methods of care deliver and ways in which health care organizations are operating. At the forefront of this change effort is the 2010 Patient Protection and Affordable Care Act, which is transforming health care from a volume-based, fee-for-service process to the delivery of services that have value, improve quality outcomes, increase satisfaction, elicit greater efficiency, demonstrate improved safety outcomes, show cost-effectiveness, promote better access to services, and result in high reliability between providers and organizations. The goal of providing a more positive health care experience is …

A Population Health Approach For Community Health Improvement, Sandra Gregg

Doctor of Nursing Practice (DNP) Projects

Providence Health & Services (Providence), a not-for-profit Catholic health care system serving five western states, established an organizational vision of Creating healthier communities, together (Providence Health & Services, 2014). This vision served as the catalyst for the alignment of divisional initiatives to positively impact community health status. To effectively achieve its vision, the organization committed to the incorporation of population health principles in the development of an infrastructure to expand the reach and impact of community investments, along with the establishment of effective processes for inter-divisional collaboration and compliance with community benefit mandates. Thus, in 2015, Providence established a community …

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

What's Happening: December 14, 2015, Maine Medical Center

What's Happening

No abstract provided.

Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2014, Puerto Rico’s twenty federally funded community health centers, operating in 71 sites located throughout the Commonwealth, served 330,736 patients, approximately one in ten Commonwealth residents. Compared to other Puerto Rico residents, health center patients are less likely to be insured. Despite considerable growth in Medicaid as a result of the supplemental funding provided under the Affordable Care Act, in 2014, 12.2% of health center patients remained uninsured.

Compared to health centers outside Puerto Rico, Puerto Rico’s health centers show a greater proportion of Medicaid patients served (69% compared to 46% outside Puerto Rico), a greater dependence on physician …

Mediating Teachers As Learners: Conversations From Shared Experience, Paul Watkins

Administrative Issues Journal

Race to the Top mandates, much like other comprehensive reforms before, focuses on teacher quality and student outcomes. Measuring teacher quality, under Race to the Top reforms, remains a subject of uncertainty, particularly measuring for improvement. This article argues that a central purpose of classroom evaluation is to provide supportive, targeted feedback by differentiating teachers as learners. Drago-Severson and Mezirow offer a framework for adult learning that overlays this theoretical analysis. The three cases explored for this article demonstrate levels of adult learning among teachers, directing the novice to addressing the fully formed transformational learner. The cases promote professional learning …

What's Happening: December 7, 2015, Maine Medical Center

What's Happening

No abstract provided.

The Relationship Of Grade Span In 9th Grade To Math Achievement In High School, John West, Mary Lou Miller, Jim Myers, Timothy Norton

Administrative Issues Journal

Purpose, Scope, and Method of Study: The purpose of this study was to determine if a correlation exists between grade span for ninth grade and gains in math achievement test scores in 10th grade and 12th grade. A quantitative, longitudinal, correlational research design was employed to investigate the research questions. The population was high school students in the United States from public and private schools who were in the ninth grade for the first time during the 1989-1990 school year. The data collection instrument was the National Educational Longitudinal Study of 1988 (NELS:88). Further sampling and data analysis was conducted …

Women In Business: Influences On The Undergraduate Major Choices, Victoria Geyfman, Christina M. Force, Laura M. Davis

Administrative Issues Journal

This study employs a survey of undergraduate business school freshmen to examine factors that influence their decision to study business and whether these factors differ by gender. Specifically, the study examines internal factors, such as students’ perceived aptitudes and interests in the subject; external factors, such as compensation and job availability; and social/interpersonal influences, such as input of teachers, school counselors, parents, and friends. This paper follows up on the authors’ earlier work, which found that despite an increase in the number of male students enrolled in business programs across the nation during the period between 2003 and 2011, female …

Implementing A One-To-One Technology Initiative In Higher Education, Daryl Fridley, Diana Rogers-Adkinson

Administrative Issues Journal

This paper describes the process of conceptualizing and implementing a one-to-one technology initiative at a regional comprehensive university. Organized around the principle that sustainable change requires attention to clear, justifiable goals, attention to key decisions, the development of stakeholder investment, adequate training, building appropriate infrastructure, and a concern for sustainability, the authors provide specific examples detailing how the change initiative in which they participated addressed each of those areas.

Agenda Of 12/04/2015 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Notice Of 12/04/2015 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Minutes Of 12/04/2015 Hsc Board Of Directors Mtg, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Despite Best Intentions: A Critical Analysis Of Social Justice Leadership And Decision Making, David E. Dematthews, Angus Shiva Mungal, Paul A. Carrola

Administrative Issues Journal

The purpose of this article is to explore the relationship between social justice leadership and organizational decision making in order to make recommendations for how principals can make more socially just decisions in difficult school contexts. This article begins with a discussion of social justice leadership, facets and theories associated with social justice, and how facets can be contradictory and problematic in practice. Then, rational choice theory is presented to detail key assumptions and criticisms that are associated with decision-making in complex organizations. Next, rational choice theory is utilized as a straw man for analyzing principal decision-making in complex organizations …

Hypertension Patient Compliance, Taylor Myers

University Honors Program

Hypertension is a prevalent condition in the United States that often has many comorbidities. It is usually asymptomatic, so patients are less likely to comply with treatment if they feel healthy. This is a growing concern due to the complications that can arise from hypertension. Hypertension can be associated with a lower quality of life in patients that have symptoms. However, in patients that do not show symptoms they may feel that they have a higher quality of life by not changing their preexisting habits. The reasons for patient noncompliance will be studied as well as interventions to increase compliance, …

Redefining The Core Competencies Of Future Healthcare Executives Under Healthcare Reform, Dianne B. Love, M. Femi Ayadi

Administrative Issues Journal

As the healthcare industry has evolved over the years, so too has the administration of healthcare organizations. The signing into law of the Patient Protection and Affordable Care Act (ACA) has brought additional changes to the healthcare industry that will require changes to the healthcare administration curriculum. The movement toward a vertically integrated delivery system for healthcare has demanded that healthcare executives have a new set of skills and competencies. These competencies include management skills across hospitals, ancillary providers, physician practices, ambulatory settings, as well as skills in risk management and quality. Healthcare organizations can transform healthcare delivery through the …