Medicine and Health Sciences Commons^™

Transformational Leadership, Job Satisfaction, Organizational Commitment, And Non-Supervisory Nurses' Intention To Leave, Audrey E. Gregory

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The United States is currently experiencing a nursing shortage. To compound the problem, hospital nurses are leaving their organizations and executives are scrambling to figure out the reasons behind the increased turnover. Many factors are associated with nurses' intention to leave their current employment. Among these factors are job satisfaction, organizational commitment, work satisfaction, work setting, control over practice, salary, nurse-physician collaboration, job stress, and leadership style. Effective nursing leadership is an integral factor in the retention of hospital nurses and nurses who perceive their nursing leadership as participative and transformational may be more likely to be satisfied with their …

Conflict Management Education In Medicine: Considerations For Curriculum Designers, Jeffery Kaufman

Online Journal for Workforce Education and Development

It is important to address conflict in the medical field for a variety of reasons ranging from reducing turnover to increasing the quality of care received by patients. One way to assist with the management of medical conflict is by teaching resolution techniques to medical personnel. There is an opportunity for conflict management curriculum to address many of the issues facing physicians, administrators, staff and patients, however, it is also necessary for those developing that curriculum to understand the nature of the environment and appropriate conflict management tools to be used in that environment as part of the design process. …

What's Happening: May, 2011, Maine Medical Center

What's Happening

No abstract provided.

Industrial Engineering Analysis To Improve Phlebotomy Lab Operations, Natassia Taylor

Industrial Engineering Undergraduate Honors Theses

Phlebotomy lab inefficiencies commonly produce numerous grievances: 1) from patients and healthcare providers for lengthy wait times; and 2) from healthcare administrators for excessive unnecessary costs. These time and cost issues ordinarily occur due to one or more of the following causes: 1) the lab is understaffed; 2) staff duties are not effectively coordinated, 3) insufficient resources are available, or 4) inefficient flow processes for ordered (and re-ordered additional) tests and specimen collection. These factors can cause increased patient wait time to unacceptable levels. We examine current phlebotomy lab practices at a local facility and propose methodologies to improve quality, …

Violence Towards Remote Area Nurses: A Delphi Study To Develop A Risk Management Approach, Kylie M. Mccullough

Theses : Honours

Incidents of occupational violence against nurses are unacceptably high. Remote Area
Nurses in Australia frequently encounter violence in the work place and have limited
resources to deal with the problem. Adopting a risk management approach, and
utilising the Delphi method, a panel of expert Remote Area Nurses (n=10) from
geographically diverse communities, identified and prioritised hazards that increase the
risk of violence and made suggestions for controlling those hazards.
Priority hazards included; building maintenance and design, attending call-outs away
from the clinic, staff inexperience and lack of knowledge about the community, as well
as intoxicated clients, communication difficulties and a …

Evaluating Consumer Preferences For Medicare Part D Using Conjoint Analysis, La'marcus Wingate

Theses and Dissertations (ETD)

The establishment of an outpatient prescription drug benefit in Medicare, Medicare Part D, was one of the more significant events in United States healthcare reform history. Many seniors have chosen to enroll in the plan as the program has an enrollment of over 27 million. One central premise of Medicare Part D was that the plan would be administered entirely through private insurance plans. Because many plans would be competing against one another for potential beneficiaries, it was expected that companies would offer seniors plans with high quality benefits at lower costs that would presumably be attractive to seniors. However, …

The Influence Of Patient-Reported Provider Availability Factors On Nonurgent Emergency Department Use, Cheryl Anne Dewood

Theses and Dissertations (ETD)

Purpose. The purpose of this study was to examine the influence of patient‑perceived provider availability on nonurgent emergency department use (NUEDU). The study population consisted of a nationally‑representative population of non‑elderly adults who were continuously privately insured (CPI) for at least a year before an emergency department visit that was determined to be nonurgent, and who reported having a regular source of care (RSC).

Methods. Data were obtained from a nationally‑representative longitudinal survey, the Medical Expenditure Panel Survey (MEPS). The classification of ED visits as nonurgent was based on patient report using a method developed for this study. Patient­‑perceived provider …

Analysis Of Out-Of-Pocket Expenditures Of Oral Oncologics For Tennessee Recipients Of Medicare Part D, Eve Carolyn Elias

Theses and Dissertations (ETD)

Background: There are few studies that examine patients' costs of oral oncology drugs from Medicare Part D plan providers. These drugs can impose a financial burden to beneficiaries, and, due to their cost, place beneficiaries in the coverage gap in a short period of time. In addition to examining costs, there is little published concerning the potential impact of drug utilization management techniques on access to these drugs in Medicare Part D plans. This study examined the roles of prior authorization, step-therapy, and placement of drugs in higher formulary tiers on patients' out-of-pocket costs, and access to therapy.

Methods …

Emergency Physicians' Perspectives On The Usability Of Health Information Exchange, Shirley A. Thorn

Theses and Dissertations (ETD)

Emergency physicians are key users of health information exchanges (HIE). Understanding their perspectives on the usability of HIE is important if the full potential of the HIE is to be achieved. The literature identified that emergency physician experiences with HIEs are unexplored areas requiring further studies. The purpose of this study using grounded theory methods was to understand the perspectives of emergency physicians concerning the usability of HIEs. The fundamental question was how do emergency physicians use the HIE in making clinical decisions?

Rich and thick data were collected from 15 emergency physicians in four urban hospitals in the mid-south …

Leveraging Complex Event Processing For Smart Hospitals Using Rfid, Wen Yao, Chao-Hsien Chu, Zang Li

Research Collection School Of Computing and Information Systems

RFID technology has been examined in healthcare to support a variety of applications such as patient identification and monitoring, asset tracking, and patient–drug compliance. However, managing the large volume of RFID data and understanding them in the medical context present new challenges. One effective solution for dealing with these challenges is complex event processing (CEP), which can extract meaningful events for context-aware applications. In this paper, we propose a CEP framework to model surgical events and critical situations in an RFID-enabled hospital. We have implemented a prototype system with the proposed approach for surgical management and conducted performance evaluations to …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

The Hospitalist: Better Value In Inpatient Care?, Lisa Sprague

National Health Policy Forum

From perhaps a few hundred practitioners in 1996 to an estimated 30,000 today, the discipline called hospital medicine has shown remarkably rapid growth. It represents a fundamental separation of the inpatient and outpatient components of internal and family medicine. The split has implications for the quality and efficiency of care delivery, the outlook for the physician workforce, and the development of new models such as accountable care organizations (ACOs).

Medicare's Bundling Pilot: Including Post-Acute Care Services, Laura A. Dummit

National Health Policy Forum

Fee-for-service Medicare, in which a separate payment is made for each service, rewards health care providers for delivering more services, but not necessarily coordinating those services over time or across settings. To help address these concerns, the Patient Protection and Affordable Care Act of 2010 requires Medicare to experiment with making a bundled payment for a hospitalization plus post-acute care, that is, the recuperative or rehabilitative care following a hospital discharge. This bundled payment approach is intended to promote more efficient care across the acute/post-acute episode because the entity that receives the payment has financial incentives to keep episode costs …

A Primary Care Workload Production Model For Estimating Relative Value Unit Output, Rachel G. Murphy

Theses and Dissertations

Health care costs have grown to unsustainable levels nationally and within the Department of Defense. Military health care costs have historically been difficult to isolate, causing budget cuts to be the vehicle for cost control. Maximum efficiency, therefore, is the goal in order to show improvement. With the Air Force’s new preventive health plan, they aim to drive a long-term posture for cost reduction through prevention. This research effort aimed to develop a tool to assist in future efforts to understand and improve efficiency in workload output, and whether a relationship exists between patient workload demand and the per-encounter variables …

What's Happening: March-April, 2011, Maine Medical Center

What's Happening

No abstract provided.

Update - March 2011, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Quid Pro Quo, Quid Vadis - Conflict of Interest Policy of Loma Linda University School of Medicine
-- San Bernardino - A Case Study in Environmental Justice
-- Editorial

[ Claritás - Clarity in Ethics Essay Contest - Health Care: Business or Service? ]
-- First-place 2009 graduate essay winner, Mark Warren, School of Medicine, Loma Linda University
-- Second-place 2009 undergraduate essay winner, Sidney E. Irving, School of Nursing, Loma Linda University

-- 2009 Contributor's Convocation: A New View
-- 2010 Contributor's Convocation: Ethics in the Inland Empire
-- Ethics Alumni Updates

Detecting Hospital Quality With Pridit., Robert D. Lieberthal, Phd

College of Population Health Lectures, Presentations, Workshops

Presented for the Temple University, Fox School of Business Department of Risk, Insurance & Healthcare Management. Robert A. Hedges Research Seminar Series, Philadelphia, PA.

25 PowerPoint slides

Associated papers available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1475-6773.2007.00821.x/abstract

and the 2008 Proceedings of the Joint Statistical Meeting.

University Reading: How Do We Turn It On?, John-Nathan Trice, Barbara Johnson Wilmes

Administrative Issues Journal

Universities and colleges are experiencing increasing challenges of educating millennial students, individuals who lack motivation and tenacity to engage in the learning process. Ideally, university students have read materials and are prepared to engage in collegial interaction. The purpose of this study was to determine whether university students are preparing for class and whether instructional reading strategies are effective to engage them in meeting course requirements. Results indicated that participants overwhelmingly do not read prior to class, but with research-based interventions, millennial students engaged in reading assignments and obtained content information relevant to the course.

Administrative Strategies For Preparing Teaching Candidates To Be Building-Level Technology Change Agents, Richard Rose

Administrative Issues Journal

Teacher education graduates in their early years of service are ill-prepared to act as building-level change agents who can advocate for the enhanced use of technology in the classroom. In this study, a group of experienced teachers seeking the M.Ed. in Educational Technology suggest that the lack of confidence which new teachers show in relation to technology can be traced back to the absence of rigorous technical skill-building in both their Introduction to Educational Technology class and methods classes. These tech-savvy mid-career teachers then identify obstacles to enhancing pre-service teacher education programs with more effective preparation in teaching with technology …

A Connection Between Moral Imperative And Women’S Leadership?, Sarah W. Nelson, Patricia L. Guerra, B. Genise Henry

Administrative Issues Journal

This paper describes a qualitative study of two school districts’ efforts to support school leaders in developing the knowledge and skills to analyze, understand, and transform system inequities. The results suggest that, despite being armed with knowledge and skills, leaders may be reluctant to act even when doing so is within the scope of their authority. This work draws from Fullan’s (2003) concept of moral imperative and examines the connection between moral imperative and women’s ways of leading. The findings have implications for educational leadership programs that seek to prepare school leaders capable of challenging and changing inequitable systems.

University Technology Transfer Factors As Predictors Of Entrepreneurial Orientation, Dorothy M. Kirkman

Administrative Issues Journal

University technology transfer is a collaborative effort between academia and industry involving knowledge sharing and learning. Working closely with their university partners affords biotechnology firms the opportunity to successfully develop licensed inventions and gain access to novel scientific and technological discoveries. These factors may enhance a firm’s entrepreneurial orientation by supporting innovative, proactive, and risk-taking behaviors. This study investigates whether university technology transfer characteristics such as the transfer process, transfer modes (formal and informal), and transfer terms influence entrepreneurial orientation. Using survey data from biotechnology firms that develop human health therapies, the findings suggest that the transfer process and informal …

University In Transition: Faculty Sense-Making And Responses, Leslie D. Gonzales, Rodolfo Rincones

Administrative Issues Journal

Across the institutional spectrum, universities are attempting to reposition themselves as more research dominant institutions, a pattern referred to as “mission creep.” Such changes in university missions have several critical implications for faculty members and their work. In this qualitative study, we interviewed ten tenure-track faculty members to explore how they make sense of and respond to Sun University’s creeping university mission. Through qualitative data analysis, we found that faculty use organizational scripts to construct and make sense of their role, yet they do so towards different ends. Some faculty members own the transition and attempt to contribute to its …

Radical Change In Faculty And Student Evaluation: A Justifiable Heresy?, Jeffery Gentry

Administrative Issues Journal

This article addresses the connection between two continuing trends in higher education: semester evaluation of faculty by students (SE’s) and grade inflation. The two phenomena are explored historically; then a two-part plan is proposed to enhance the evaluation of both students and faculty. This solution does not replace current evaluation practices; it merely adds information on each student’s relative performance. Although subject to criticism as radical reform, the plan is offered as a feasible check on grade inflation and diminished student responsibility—one that is consistent with long held higher education values, as well as recent calls for increased educational accountability. …

Innovation In Competency-Based Program Development: Leveraging The Advisory Board Faculty Alliance, Esmeralda De Los Santos, Daniel G. Dominguez, Kevin Lafrance

Administrative Issues Journal

This paper describes the use of advisory boards in the development of two competency-based business programs: one graduate and the other undergraduate. Though the programs varied significantly in structure and content, both used focus group methodology to collect comprehensive and relevant input from advisory board members comprised of local subject matter experts. Analysis of each program’s developmental efforts demonstrates that, while the programs varied significantly in many aspects, both achieved the intended outcome. In both cases, advisory board input contributed to the development of a competency model and associated program curriculum that closely aligned with the program’s specific disciplines.

Pedagogical Design For A Cross-Functional Course In The Accelerated Mba Program, Bhanu Balasubramnian, Tanja Steigner, Kevin R. Coulson

Administrative Issues Journal

The sub-prime financial crisis exposed weaknesses in the financial risk management of several prominent firms. A deficient risk management is mainly attributed to the lack of integration of finance with other business disciplines. In this paper, we describe a tested implementation of a cross-functional project that improves students’ understanding of firm-value creation and risk management. While this approach can be implemented in any MBA program, we focus specifically on accelerated MBA programs with tight time constraints. Our methods are different from most other integrated courses in several ways. Our cross-functional project bridges the knowledge gaps of students in the area …

Final Report: The Practice And Impact Of Shared Decision-Making, Shared Decision-Making Study Group For The Dirigo Health Agency’S Maine Quality Forum

Population Health & Health Policy

Several recent developments are likely to address those factors seen as contributing to shared decision-making’s mixed results: the lack of a nationally recognized certification process; insufficient funds to adequately invest in the training and infrastructure to support shared decision-making; and adequate methods for monitoring its effectiveness.

Administrative Issues Journal: Table Of Contents

Administrative Issues Journal

No abstract provided.

Letter From The Editor-In-Chief, Tami Moser

Administrative Issues Journal

No abstract provided.

The Interim Superintendent: A Case Study, Gary Bigham, Susan J. Nix

Administrative Issues Journal

Considering the vitally important role that the superintendent plays in the overall functioning and wellbeing of any school district, the filling of that position should never be done in haste. Due to the importance of this process and the time it requires, school districts often employ an interim superintendent. In this single case study, one researcher engaged in qualitative research by actually assuming the role of an interim superintendent in a small West Texas school. The findings that emerged from this study consisted of identifying duties and roles of the interim superintendent in comparison with those of the regular superintendent. …

The District-Wide Sustainability Of A Professionallearning Community During Leadership Changesat The Superintendency Level, Chuey Abrego, Anita Pankake

Administrative Issues Journal

The purpose of this mixed methods follow-up single case study was two-fold: to determine if a school district was able to sustain a professional learning community (PLC) and to identify factors that enhanced, inhibited, or promoted the sustainability of a PLC from a district-wide perspective, with particular focus on how a change in leadership, i.e. a new superintendent, affected the sustainability of PLC attributes. In addition, the role of trust in influencing the sustainability of a professional learning community will be discussed in this paper.