Medicine and Health Sciences Commons^™

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Healthcare Employees’ Perceptions On The Effects Of Internal Audits, Jeremy Mason

MUSC Theses and Dissertations

With limited research on the perceptions of internal audits, this study was

able to add more literature to the subject. The study’s aim was to survey

employee perceptions of the effects of internal audits. This study will provide organizations with results pertaining to how employees perceive the usefulness of internal audits. The study team conducted a single-site study and invited the healthcare organization's employee population to participate in the study. The survey captured 40 responses from 361 invitees (11%). The survey explored the perceptions on six categories of internal audits: Efficiency, Ethical Behavior, Effectiveness, Auidotr-Auditee Relationship Exchange, Learning from Audit, …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

What Does It Look Like For Mental Healthcare Organizations To Be Healthy Places To Work? An Action Research Study, Stephanie L. Fox

Antioch University Full-Text Dissertations & Theses

Mental healthcare organizations have a reputation for being unhealthy places to work. The irony of this reputation is keenly felt by its workforce who report unsustainable workloads, high levels of stress, and lack of support or engagement from higher-level leadership. As a mental healthcare provider now in a position of leadership, who has worked across all levels of care within the sector, it was of interest to me to explore how a mental health organization can become a healthier and more sustainable place to work. I approached this study with the assumption that if an organization was healthy and intentional …

Organizational Compassion: Ameliorating Healthcare Workers' Suffering And Burnout, Rachel Thienprayoon, Shane Sinclair, Beth A. Lown, Teresa Pestian, Eli Awtrey, Naomi Winick, Jason Kanov

Journal of Wellness

No abstract provided.

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …

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 …

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. …

Servant Leadership Characteristics And Empathic Care: Developing A Culture Of Empathy In The Healthcare Setting, Mark Anthony Martin

Antioch University Full-Text Dissertations & Theses

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven …

Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus

Walden Dissertations and Doctoral Studies

Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …

Health Systems In Transition: Professional Identity Work In The Context Of Shifting Institutional Logics, Yiannis Kyratsis, Rifat Atun, Nelson Phillips, Paul Tracey, Gerard George

Research Collection Lee Kong Chian School Of Business

We investigate how established professionals manage their identities in the face of identity threats from a contested shift in the professional logic that characterizes their field. To do so, we draw on interviews with 113 physicians from five European transition countries who faced pressure for change in their professional identities due to a shift in the logic of healthcare from a logic of "narrow specialism" in primary care that characterized the Soviet health system to a new logic of "generalism" that characterizes primary care in the West. We found three important forms of professional identity threats experienced by physicians during …

Exploring Customer Service Through Hospital Management Strategies, Delores Leonard Leonard

Walden Dissertations and Doctoral Studies

Patient demand for a better quality of healthcare and services has increased as insurance companies have decreased payments to hospitals. The purpose of this qualitative single exploratory case study was to explore hospital managers' strategies to improve customer service. Data were gathered from semistructured interviews with 5 hospital managers who implemented customer service strategies in their hospital systems, hospital policy and procedure documents, and qualitative data from the Consumer Assessment of Healthcare Providers and Systems Hospital Compare website. Expectation-confirmation theory served as the conceptual framework that grounded the study. Data were analyzed using methodological triangulation, and 3 themes emerged: the …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

The Efficacy Of Psychosocial Services In Comprehensive Cancer Care: A Program Evaluation, Nicola B. Mucci

Antioch University Full-Text Dissertations & Theses

On average, regardless of other factors, persons affected by cancer will experience some level of distress associated with the disease and its sequelae. Left untreated, psychosocial problems can, and often do, adversely affect a person's health and healthcare treatment. As a result, national initiatives have been implemented to recognize and treat psychosocial stressors to optimize a person's functioning and facilitate successful movement through the medical system. A program evaluation was conducted to examine how Providence Regional Cancer Partnership has addressed the psychosocial needs of its patient population. Specifically, the psychosocial services department, Patient Support Services, was evaluated to understand how …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

The Ins And Outs Of Change Of Shift Handoffs Between Nurses: A Communication Challenge, John S. Carroll, Michele Williams, Theresa M. Gallivan

Michele Williams

Background: Communication breakdowns have been identified as a source of problems in complex work settings such as hospital-based healthcare. Methods: The authors conducted a multi-method study of change of shift handoffs between nurses, including interviews, survey, audio taping and direct observation of handoffs, posthandoff questionnaires, and archival coding of clinical records. Results: The authors found considerable variability across units, nurses and, surprisingly, roles. Incoming and outgoing nurses had different expectations for a good handoff: incoming nurses wanted a conversation with questions and eye contact, whereas outgoing nurses wanted to tell their story without interruptions. More experienced nurses abbreviated their reports …

The Role Of Agency In Community Health Outcomes: Local Health Departments And Childhood Immunization Coverage Rates, James Anthony Ransom

Antioch University Full-Text Dissertations & Theses

Organizational culture is defined as a system of shared meaning held by members of an organization that distinguishes it from other organizations. How organizational culture is experienced in the public sector, particularly local health departments (LHDs), is not well understood. The purpose of this study was to determine whether LHD organizational culture impacts childhood immunization coverage rates. I used a modified organizational culture survey tool, the Organizational Management Survey, to quantify organizational culture and determine whether an LHD's organizational culture helps explain variations in childhood immunization coverage rates. In addition, qualitative data from an earlier study of LHD immunization staff …

Partnerships Between Hospitals And Community: A Qualitative Study On Collaboration For Spiritual Care In Healthcare, Angela E. Schmidt

Theses and Dissertations (Comprehensive)

Partnerships between Hospitals and Community: A Qualitative Study on Collaboration for Spiritual Care in Healthcare

Abstract:

Hospital-Community Collaborative (HCC) arrangements for the provision of spiritual care have been brokered in certain Ontario hospitals with varying degrees of success. The current study investigated how a community based organization could effectively partner with a healthcare institution to ensure spiritual care support for hospital patients. It asked the question: What factors are essential to make a hospital-community collaboration function well as a model for the provision of spiritual care? Qualitative research was conducted with four hospital corporations with HCC partnerships to ascertain the …

Facilitating Emergence: Complex, Adaptive Systems Theory And The Shape Of Change, Peter Martin Dickens

Antioch University Full-Text Dissertations & Theses

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience …

Technological Iatrogenesis: The Manifestation Of Inadequate Organizational Planning And The Integration Of Health Information Technology., Patrick Albert Palmieri

Patrick Albert Palmieri

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational–technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern. Recognizing the technology–organizational misalignments that result from HIT adoption is …

Contextual Leadership: The Social Construction Of Leadership In A Comprehensive Healthcare System, Mark J. Moir

Antioch University Full-Text Dissertations & Theses

Healthcare is a complex and dynamic environment containing a plurality of social forces and perspectives that shape the organizational culture and the nature of the leadership. As leadership is a social phenomenon, it is important to understand the complex social processes that mediate our perceptions and that in turn influence processes of leader attribution. The central purpose of this study has been to illuminate the nature of culturally specific processes that emerge within a specific organizational setting and that fuel leader attribution and the social construction of leadership. Accordingly, this qualitative study has developed a Grounded Theory utilizing Situational Analysis …

Designing And Implementing A Balanced Scorecard: Lessons Learned In Nonprofit Implementation, Andra Gumbus, Tom Wilson

WCBT Faculty Publications

The balanced scorecard has been referred to as the management innovation of the century, and extensive articles have been written using case studies of organizations that use this performance measurement system. This article addresses the key issues of design and implementation with a step-by-step guide to how to design a balanced scorecard and lessons to avoid implementation problems in government and nonprofit settings.

Designing A Strategy To Effectively Communicate The Balanced Scorecard, Andra Gumbus, Bridget Lyons, Tom Wilson

WCBT Faculty Publications

As increasing numbers of organizations adopt the balanced scorecard (BSC) to align strategy with operations and measure progress toward meeting strategic goals, the importance of successful communication of the scorecard throughout the organization has become apparent. Successful implementation and effective use of the BSC occurs when organizational stakeholders recognize its role, use, and benefits. In the March/April 2003 issue of Cost Management, we detailed how Bridgeport Hospital, a member of Yale New Haven Health System (YNHHS), adopted the BSC and used the scorecard to align capital investment decisions with strategy.1 In this article, we will profile how the hospital designed …