Medicine and Health Sciences Commons^™

Impact Of Improving Throughput In The Emergency Department, Katherine J. Edrington

Doctor of Nursing Practice (DNP) Projects

The purpose of this project was to evaluate the patient experience in the emergency department (ED) and in the inpatient setting while correlating increased throughput and patient outcomes at a suburban Acute Care facility in Ohio. The culture in the organization has lacked accountability and ownership of the patients. The ED admitted length of stay (ALOS) was 358 minutes in the beginning of 2013. For the first time in the organization’s history, the ED ALOS is now typically less than the recommended benchmark of 300 minutes. A report of findings among ED’s surveyed showed the ALOS best practice is 244 …

Community Health Worker Interventions For Latinos With Type 2 Diabetes: A Systematic Review Of Randomized Controlled Trials, Tariana V. Little, Monica L. Wang, Eida M. Castro, Julio Jiménez, Milagros C. Rosal

Tariana V. Little

This systematic review aimed to synthesize glucose (HbA1c) outcomes of community health worker (CHW)-delivered interventions for Latinos with type 2 diabetes that were tested in randomized controlled trials and to summarize characteristics of the targeted populations and interventions, including the background, training, and supervision of the CHWs. Searches of PubMed and Google Scholar databases and references from selected articles identified 12 studies that met the inclusion criteria. Of these, seven reported statistically significant improvements in HbA1c. Study participants were largely low-income, female, and Spanish-speaking and had uncontrolled diabetes. The CHWs led the interventions alone, in pairs, or as part of …

Book Review: Questioning Protocol, Barbara Lewis Mba

Patient Experience Journal

In her review of Questioning Protocol by Randi Redmond Oster, Barbara Lewis shares how this new and award winning book takes the reader on Randi Oster's harrowing journey of navigating the healthcare system while helping her teenage son’s battle with Crohn’s disease. Seventeen chapters build a chronological story of success, frustration and failure in dealing with modern medicine and a healthcare industry that may appear foreign to the outsider.

Book Review: The Language Of Caring Guide For Physicians: Communication Essentials For Patient-Centered Care (2nd Edition), Chet Wyman Md

Patient Experience Journal

In thie book review for Wendy Leebov and Carla Rotering’s The Language of Caring Guide for Physicians: Communication Essentials for Patient-Centered Care (2nd edition), the author/reviewer conveys his perspective on the essential value of this publication. He offers his recommendation of this book for anyone who wants to improve their own communication skills and also for physician leaders responsible for initiatives to engage physicians and improve service quality, patient outcomes, and CAHPS scores for a department or organization, noting it is an essential read in today’s healthcare environment.

Exploring The Impact Of An Interprofessional Care Protocol On The Patient Experience And Outcomes For Seniors With Diabetes, Linda J. Mast Phd, Facmpe, Ateequr Rahman Phd, Diane Bridges Phd, Neil L. Horsley Dpm

Patient Experience Journal

Contemporary healthcare has placed intensified focus on the patient experience. Ultimately the patient experience is influenced by relationships with healthcare providers. In order to make a positive impact on patient outcomes and quality of care, the patient experience must be positive. Interprofessional collaboration is recognized as a key aspect of a culture that fosters patient-centered care and a positive patient experience. This quasi-experimental study explores the impact of interprofessional collaboration to develop a preventive services care protocol for seniors with diabetes. Patients were studied over six months using pre-test and post-test measures. Both quantitative data from clinical outcomes and qualitative …

Using A Data-Driven Organizational Improvement Model To Engage An Interdisciplinary Team In Transforming A Public Women’S Health Clinic, Kenneth J. Feldman, Molly Lopez, Morris Gagliardi

Patient Experience Journal

Gouverneur Health is the largest diagnostic and treatment center in New York State, and part of the New York City Health and Hospitals Corporation (HHC), a public benefit corporation with $6.7 billion in annual revenues. HHC is the largest municipal healthcare system in the United States serving 1.4 million patients, including more than 475,000 uninsured city residents.[1] Within Gouverneur, the Women’s Health department is committed to providing high quality services that improve patients' health and wellbeing, yet patient experience, flow, clinic access and education are in need of process improvements. To enhance patient experience and identify strategies replicable for other …

The Relationships Between Hcahps Communication And Discharge Satisfaction Items And Hospital Readmissions, Fadi Hachem, Jeff Canar, Francis Fullam Ma, Andrew S. Gallan Phd, Samuel Hohmann, Catherine Johnson

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey has become a key metric used by organizations and patients to evaluate patient experience. Readmissions also continue to be a metric used to evaluate performance because of the added cost to both healthcare systems and patients. Both measures are also seen in programs such as Value Based Purchasing that have an effect on hospital reimbursements. Previous studies have demonstrated a relationship between patient perceptions and quality of care, and have found patients to be reliable evaluators of their care. While good communication and positive provider relationships have been related …

Creating And Sustaining A Culture Of Accountability For Patient Experience, Denise M. Kennedy Mba, Roshanak Didehban Mhs, Fache, John P. Fasolino Md

Patient Experience Journal

Improving the quality of the patient experience has become an imperative for healthcare organizations. Value-based payment models include patient perception data, and a negative experience can impact an organization’s finances. Sustainable improvement requires more than quick-fix cosmetic enhancements, ‘flavor-of-the-month’ service trainings, or bonuses for front-line staff. Organizations must actually improve the patient experience. Doing so requires a culture of accountability and a systematic framework for collecting and acting on patient perception data.

This article revisits Mayo Clinic Arizona's (MCA) "7-prong" model for improving service quality: (1) multiple data sources to drive improvement; (2) accountability; (3) service consultation and improvement tools; …

Enhancing Patient Experience By Training Local Trainers In Fundamental Communication Skills, Calvin L. Chou, Laura Cooley, Ellen Pearlman, Maysel Kemp White

Patient Experience Journal

Medical centers have a vested interest in improving patient experience through enhancing communication skills. The American Academy on Communication in Healthcare has helped institutions across the country establish internal expertise through delivering train-the-trainer programs. The phases of the program include preparing for implementation of the program, having program participants undergo a fundamental communication skills workshop and then understanding the theoretical and practical rationales underlying the workshop, setting up practice sessions for participants to achieve mastery, and ensuring long-term viability of a communication skills improvement initiative. Outcomes for participants include increased self-assessed personal communication skill, optimism about rolling out a communication …

Beyond Credentialing In Physician Selection: Application Of An Instrument That Measures Behavioral Aptitude, Edgar Staren Md, Phd, Mba, Susan Hirt Ph.D., Doug Rath M.A.

Patient Experience Journal

This article explores the idea that the assessment of candidates for the role of physician caregiver can be enhanced by evaluating their inter-personal and behavioral aptitude as well as their clinical skills. The objective of this work was to determine whether results of a structured interview correlate to performance ratings for physicians. Two data sets were collected: a structured aptitude assessment for physicians (the Physician Interview) and job performance data for physicians. Analysis of performance data allowed categorization of the physicians into three groups: top performers, contrast performers, and neither. The two data sets were then analyzed to assess the …

The Patient Experience Movement Moment, William Lehrman Phd, Geoffrey Silvera Mha, Jason A. Wolf Phd

Patient Experience Journal

For years, the patient experience movement has continued to gain momentum. From a novel concept, there is an emerging consensus that the patient experience is a fundamental aspect of provider quality; one that complements established clinical process and outcome measures but is neither subsumed nor secondary to them. An increasing volume of research as encouraged by publications such as Patient Experience Journal show this to be true. As the expectation of a high-quality patient experience becomes the norm, these developments have brought us to what we call the patient experience movement moment and there is little doubt that the patient …

To Serve Patients Is Our Greatest Privilege, David T. Feinberg Md, Mba

Patient Experience Journal

In his guest editorial, Dr. David Feinberg of UCLA Health System reminds us of the power of patient voice and the lessons we should be open to learning from those we serve every day. He offers, "It is a blessing for us to work in an environment where we have the opportunity every day to touch someone’s life so deeply. We must never lose sight of that. It is our responsibility to not just treat our patients, but also to embrace them."

A Gathering Place For Patient Experience Research: The Power Of Community, Jason A. Wolf Phd

Patient Experience Journal

In introducing Issue 2, we explore the power of community and its implications in shaping not only the purpose and intent of Patient Experience Journal, but of the patient experience movement itself. Community defined in this moment is simple, yet significant, the key being unity around common interest and its focus on ownership and participation. The idea of community bears great weight and has provided strong guidance and purpose for the work of experience excellence. It supports the goal of elevating the conversation, helps align the voices engaged and provides the space for listening, learning and impact.

Experience Framework …

Interpreting, Stephanie Jo Kent

Doctoral Dissertations

What do community interpreting for the Deaf in western societies, conference interpreting for the European Parliament, and language brokering in international management have in common? Academic research and professional training have historically emphasized the linguistic and cognitive challenges of interpreting, neglecting or ignoring the social aspects that structure communication. All forms of interpreting are inherently social; they involve relationships among at least three people and two languages. The contexts explored here, American Sign Language/English interpreting and spoken language interpreting within the European Parliament, show that simultaneous interpreting involves attitudes, norms and values about intercultural communication that overemphasize information and discount …

Measuring Health Literacy Among Somali Men Over The Age Of 45 - A Pilot Study, Vasty Klutse

Master of Science in Nursing Theses

Somali immigrants to the United States are at a particularly increased risk of lower health literacy due to barriers such as language, lower education levels, culture and decreased access to health care resources. Low health literacy puts individuals and communities at risk for poor health outcomes and health disparities. However, as far as is known, there is limited information addressing the health literacy levels and its effects on Somali men. There are no available studies on the health literacy levels in this population. The purpose of this study is to identify Somali men over the age of 45 and measure …

Women’S Perception And Attitude Towards Male Dominancy And Controlling Behaviors, Tazeen S. Ali Dr, Noureen Karamali Dr, Omer Malik Dr

Tazeen S Ali Dr

Introduction/Background: The study was conducted in urban Karachi, Pakistan to investigate women’s perceptions and attitudes towards male dominancy, female autonomy, and controlling behavior of husbands. Method: This was investigated in a population based study with a cross-sectional design, involving married women aged 25 to 60 years. A Structured questionnaire developed by World Health Organisation (WHO) on violence was used. Community midwives interviewed these married women living in pre-selected low, middle and upper socio-economic areas of urban Karachi, Pakistan. Findings: This study revealed women’s overall perception regarding male dominancy and controlling behavior and highlighted this attitude, as being acceptable to women. …

Impact Of International Collaborative Project On Cultural Competence Among Occupational Therapy Students, Divya Sood, Danila Cepa, Sebestina Anita Dsouza, Shovan Saha, Ruby Aikat, Alicia Tuuk

The Open Journal of Occupational Therapy

Occupational therapy (OT) educators recognize a need to ensure that OT students are culturally competent. The researchers developed the International Collaborative Project on Cultural Competence (ICPCC) to help students understand the impact of cultural context on client care. Entry-level MOT students from a university in the US (N = 18) collaborated with BOT students (N = 4) and advanced MOT students (N = 9) from two universities in India using an online course management system WebCT. The study explored the impact of the ICPCC on OT students’ cultural competence and discusses students’ perceptions of culture on the OT process. The …

Using Online Digital Tools And Video To Support International Problem-Based Learning, Susanne P. Lajoie, Cindy E. Hmelo-Silver, Jeffrey G. Wiseman, Lap Ki Chan, Jingyan Lu, Chesta Khurana, Ilian Cruz-Panesso, Eric Poitras, Maedeh Kazemitabar

Interdisciplinary Journal of Problem-Based Learning

The goal of this study is to examine how to facilitate cross-cultural groups in problem-based learning (PBL) using online digital tools and videos. The PBL consisted of two video-based cases used to trigger student-learning issues about giving bad news to HIV-positive patients. Mixed groups of medical students from Canada and Hong Kong worked with facilitators from each country along with an expert facilitator. The study used AdobeConnect to support the international model through synchronous video interaction and shared applications. This study examines strategies and challenges in facilitating PBL across distance and cultures. Discourse was analyzed using both an inductive and …

Acculturation, Self-Efficacy And Breastfeeding Behavior In A Sample Of Hispanic Women, Ivonne F. Hernandez

USF Tampa Graduate Theses and Dissertations

Breastfeeding confers immunological, physiological and psychological benefits for the infant and mother as well as social and economic benefits to the nation. The United States Department of Health and Human Servcies (HHS), Healthy People 2020 has established national objectives for the initiation and duration of breastfeeding at 82% initiation, 61% at six months and 34% at one year. In addition, they have set goals for exclusive breastfeeding at 3 months to be 46% and 25% at 6 months of infant's age. Currently breastfeeding initiation is at the highest recorded level of 76.9%, yet significant disparities exist (CDC, 2012). The purpose …

Defining Patient Experience, Jason A. Wolf Phd, Cpxp, Victoria Niederhauser Drph, Rn, Dianne Marshburn Phd, Rn, Ne-Bc, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

In recent years, perceptions of performance and quality of healthcare organizations have begun to move beyond examining the provision of excellent clinical care, alone, and to consider and embrace the patient experience as an important indicator. There is a need to determine the extent to which clear and formal definitions exist, have common overarching themes, and/or have unique, but important constructs that should be considered more widely. In this article, we provide a 14-year synthesis of existing literature and other sources (2000-2014) that have been used to define patient experience. A total of 18 sources (articles or organizational websites) were …

Women’S Perception And Attitude Towards Male Dominancy And Controlling Behaviors, Tazeen S. Ali, Noureen Karamali, Omer Malik

School of Nursing & Midwifery

Introduction/Background: The study was conducted in urban Karachi, Pakistan to investigate women’s perceptions and attitudes towards male dominancy, female autonomy, and controlling behavior of husbands.
Method: This was investigated in a population based study with a cross-sectional design, involving married women aged 25 to 60 years. A Structured questionnaire developed by World Health Organisation (WHO) on violence was used. Community midwives interviewed these married women living in pre-selected low, middle and upper socio-economic areas of urban Karachi, Pakistan.
Findings: This study revealed women’s overall perception regarding male dominancy and controlling behavior and highlighted this attitude, as being …

Dr. Who?: The Science And Culture Of Medical Wear Design, Patricia Duignan

Theses and Dissertations

The multi-million-dollar medical uniform industry has not utilized advancements in garment and textile technology that could positively impact the protection of healthcare professionals and patients. In most cases the uniforms meet basic requirements – they clothe the professional in a recognizable way. Little innovation in design, function and performance, has been applied to these garments. This is particularly evident in the case of the stereotypical white lab coat worn by many physicians, despite evidence indicating that these lab coats may carry contamination and play a role in the spread of deadly bacteria. Healthcare Associated Infections (HAIs) are among the most …

Hypertension Management Among Cambodian-Americans In Rhode Island, Rathana Long

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Hypertension is a major risk factor for heart disease and stroke and the focus of much study in the US. However, there is limited transfer of this knowledge in terms of hypertension management in certain recent immigrant groups such as the Cambodian-­‐Americans. Cambodian-­‐Americans are often included among the Asian/Pacific Islanders and are one of the fasting growing populations in the US. The purpose of this study was to explore how Cambodians in Rhode Island manage hypertension. This study used a survey design with a convenience sample of 30 participants who could read, write, and understand English. It was conducted at …

Characterisation Of The Vaginal Microflora Of Human Immunodeficiency Virus (Hiv) Positive And Negative Women In A Sub-Urban Population Of Kenya, Teresa N. Kiama, Rita Verhelst, Paul M. Mbugua, Mario Vaneechoutte, Hans Verstraelen, Benson Estambale, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Lactobacilli predominate normal vaginal microflora and are important in maintenance of vaginal health. The current study set out to identify and compare culture isolates of vaginal microflora of human immunodeficiency virus (HIV) positive (HIV+ ) and HIV negative (HIV- ) women at different phases during menstrual cycle from a sub-urban population of Kenya. Seventy four (74) women, 41 HIV+ and 33 HIV- , followed up two consecutive menstrual cycles, had high vaginal swabs taken to prepare Gram stains for six visits and anaerobic cultures for four. All 751 isolates identified by t-DNA polymerase chain reaction (PCR) belong to 51 species. …

Exploring Essential Characteristics Of Self-Determination For Diverse Students Using Data From Nlts2, Karrie A. Shogren, William Kennedy, Chantelle Dowsett, Mauricio Garnier-Villarreal, Todd D. Little

College of Nursing Faculty Research and Publications

This study explored the impact of race/ethnicity on three of the four essential characteristics of self-determination—autonomy, self-realization, and psychological empowerment—directly assessed in the National Longitudinal Transition Study-2. Specifically, the impact of race/ethnicity was examined with six disability groups established in previous research: high incidence disabilities (learning disabilities, emotional disturbances, speech language impairments, and other health impairments), sensory disabilities (visual and hearing impairments), cognitive disabilities (autism, multiple disabilities, and deaf-blindness); intellectual disability, traumatic brain injury, and orthopedic impairments. Measurement equivalence was established across groups, but significant differences in the latent means, variances, and covariances were found suggesting a complex pattern of …

The Art Of Collaboration In Academic And Clinical Partnerships, Kelsey Spencer Bennett

Online Theses and Dissertations

Occupational therapists in various settings share a professional identity valuing occupation. Their socialization into a practice setting is context-dependent, in terms of the skills needed and roles to be enacted. Collaboration between occupational therapists in clinical and academic settings benefits each participant, along with presenting challenges given the systems where they work. The purpose of this project was to delve into understanding the culture of the settings (academic and clinical) influencing a community-based research partnership. Through a mini-ethnographic approach, similarities and differences of culture emerged describing the depth of components for the collaboration between research group members. This description may …

Understanding And Building Resilience With Art: A Socio-Ecological Approach, Meagan Shand

Theses: Doctorates and Masters

Resilience is a widely researched phenomenon, it means different things to different people and is perceived and measured according to the theoretical lens being applied. The following thesis reviews the theoretical development of resilience that has led to contemporary understandings, to establish a platform for the research topic - understanding and building resilience with Art. Narrative research methods are combined with art processes to illuminate the stories of eight culturally diverse women participating in a community based mental health art program, in Western Australia. Fifteen resilience themes emerged from the collective experience, and are presented in a socio-ecological framework to …

Sexual Rights For Marginalized Populations, Louis Graham, Mark Padilla

Louis F Graham