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Articles 31 - 60 of 80
Full-Text Articles in Medicine and Health Sciences
Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight
Utilization Of Preventative Care Services By African Americans Post-Affordable Care Act, Madalyn Mcknight
Walden Dissertations and Doctoral Studies
Preventative care services allow patients to be fully equipped with the knowledge, tools, and other resources to help them discover and treat many diseases and illnesses so that the burden of costs will not fall on patients and their families. Since the passage of the Affordable Care of Act (ACA) by President Barack Obama, the requirement for health insurance coverage has not translated to utilization of preventative care services. The purpose of this study is to determine the motivation for African Americans who have insurance coverage and access to care who are not taking advantage of opportunities for screenings and …
Improving Gonorrhea Result Notification And Response Among African American Women, Lashonda Ouk
Improving Gonorrhea Result Notification And Response Among African American Women, Lashonda Ouk
Walden Dissertations and Doctoral Studies
Previous research has shown that 45% of malpractice claims are due to insufficient and late follow-up of test results and limited communication methods provided to patients. This study explored the preferred communication methods between a patient and a healthcare provider. The technology acceptance model served as the conceptual framework. A quantitative research design was used to examine patients’ perceived usefulness, attitude, perceived ease of use, and adaptability regarding mobile technology. The primary means of data collection was the use of a survey questionnaire. Participants included a random sample of 118 women seen in a local health department in the women’s …
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Walden Dissertations and Doctoral Studies
Most organizational change initiatives fail because managers lack effective change management strategies. The purpose of this single case study was to explore change management strategies that outpatient care facility managers used to positively affect process improvements. The population consisted of 6 managers who completed change initiatives at a military, outpatient medical facility in Texas and 6 of their team members. Data were collected using semistructured interviews and organization documents, then analyzed based on the conceptual framework of Lewin’s change theory. Rowley’s 4-step process for analysis—organizing; getting acquainted with; classifying; coding and interpreting; and presenting and writing up the data—was used …
The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon
The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon
Walden Dissertations and Doctoral Studies
Healthcare leaders must establish a just culture to mitigate preventable medical deaths that occur at 250,000 per year, making medical errors the 3rd leading cause of death in the United States. However, there is a gap in knowledge regarding the attributes of nurse manager leadership styles that contribute to promoting a just culture at the unit level. Guided by the full range leadership theory and the just culture model, the purpose of this descriptive correlational study was to determine the relationship between nurse manager transformational, transactional, and laissez-faire leadership styles and unit level just culture perceptions and the differences between …
Relationship Between Hospital Size, Staff Communication, Physician Communication, And Patient Experience Scores, Cheryl Marie Layton
Relationship Between Hospital Size, Staff Communication, Physician Communication, And Patient Experience Scores, Cheryl Marie Layton
Walden Dissertations and Doctoral Studies
Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of …
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Walden Dissertations and Doctoral Studies
Social workers are uniquely positioned to facilitate early intervention services that minimize the impact and burden of Type 2 diabetes. There is little evidence on the specific role that social workers play in addressing the psychosocial factors that exacerbate the condition or impact treatment outcomes. The purpose of the study was to examine the role of social workers in facilitating early interventions for clients with Type 2 diabetes. The theories of role and organizational systems provided the conceptual framework. Data was collected from interviews with eight participants with Master's degrees in Social Work in a large Southwestern state in the …
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Walden Dissertations and Doctoral Studies
Approximately 25% of those hospitalized with congestive heart failure are readmitted within 30 days after discharge. Because researchers and policy makers consider hospital readmission within 30 days for patients with heart failure to be a quality of care issue, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare revenue for 1 year for excessive readmissions, potentially impacting the financial sustainability of some organizations. The purpose of the study was to address the research gap regarding the outcome quality measure of hospital admissions from the emergency department (ED) and 2 each …
Strategies Outpatient Health Care Executives Use To Reduce Physician Turnover, Maureen A. Onyenacho
Strategies Outpatient Health Care Executives Use To Reduce Physician Turnover, Maureen A. Onyenacho
Walden Dissertations and Doctoral Studies
Some outpatient health care executives experience high physician turnover leading to increased costs. To retain highly productive physicians, outpatient health care executives need to understand the best strategies for reducing physician turnover. Grounded in Herzberg 2-factor theory as the conceptual framework, the purpose of this multiple case study was to explore the strategies outpatient health care executives used to reduce physician turnover. Data were collected from semistructured interviews of 4 outpatient health care executives and the review of proprietary documents from 2 outpatient health care facilities in the Southern California metropolitan area. Data analysis comprised compiling and disassembling the data …
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Walden Dissertations and Doctoral Studies
Extended hospital length of stay (LOS) causes increased health care costs and incidence of never events, such as hospital-acquired infections, pressure ulcers, and falls, which are not reimbursed by Medicare. This study examined if there would be a statistically significant decrease in the LOS of patients after the implementation of a discharge process improvement initiative (DPII), The model for improvement and small tests of change concept were used to guide the DPII at a hospital in northern California. Sources of data included archival data obtained from the hospital's quality improvement department that showed LOS prior to and after the implementation …
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Walden Dissertations and Doctoral Studies
African American men are more likely to have diagnosed or undiagnosed diabetes than non-Hispanic White Americans and are less likely to adhere to treatment. Culture in the African American community plays a key role in how this community copes with illness and the health care system. The purpose of this study was to examine the lived experiences of social and cultural determinants of Type 2 diabetes self-management among African American men. Bandura's social cognitive theory provided the theoretical framework for the study. The research question sought to identify cultural and social factors that contribute or protect how African American men …
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Walden Dissertations and Doctoral Studies
Many drug overdoses in the United States are from prescription drugs, most of which are classified as opioid pain relievers (OPRs) and commonly prescribed in emergency departments (EDs) to treat pain. OPR abuse and addiction is a major public health issue. Researchers have identified the role of various patient characteristics (race, gender, demographics, etc.) in the variation in OPR prescription rates, but the contribution of provider-type differences to that variation has not been exposed. The purpose of this study was to evaluate the strength of the association between provider type and the likelihood of an opioid prescription by ED providers …
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
Walden Dissertations and Doctoral Studies
Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Walden Dissertations and Doctoral Studies
Some owners of small to medium-sized managed care businesses lack strategies to address the effects of healthcare regulations on their businesses. The purpose of this multiple case study was to identify strategies that owners of small to medium-sized managed care businesses used to address the financial effects of healthcare regulations on their businesses. The conceptual framework for this study was profit maximization and adaptation in changing contexts. Data were gathered from company documents, observations, and semistructured interviews with 5 home healthcare business owners in Los Angeles County, California. Data were coded to identify themes from the narrative segments. Key themes …
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Walden Dissertations and Doctoral Studies
The value-based purchase requirement of the Patient Protection and Affordable Care Act puts pressure on hospital leaders to control cost while improving quality of care. The resource dependency theory was the theoretical framework for this correlational study. Archival data from the Centers for Medicare and Medicaid Services collected from 166 acute care urban hospitals for the Fiscal Year 2016. Multiple linear regression analysis was used to determine the relationship between nursing salaries per patient day, cost of uncompensated care as a percentage of net patient revenue, percentage of net income from patient services, and overall patient satisfaction for quality of …
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Walden Dissertations and Doctoral Studies
This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Walden Dissertations and Doctoral Studies
Hospital readmissions within 30 days of discharge result in significant multimillion-dollar penalties to thousands of Medicare-eligible hospitals throughout the United States and are indicators of suboptimal patient healthcare leading to less than ideal health outcomes for previously hospitalized patients. The purpose of this correlation study was to examine the relationship between medication reconciliation, nursing workforce competency, timely and effective care, and Medicare-eligible hospital 30-day readmission rates. The sample of 269 hospitals came from the population of Medicare-eligible hospitals throughout the United States. Complexity theory and the general model of readmission were theoretical frameworks grounding this study. Secondary data were from …
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Walden Dissertations and Doctoral Studies
Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …
Strategies Used By Healthcare Supervisors For Employee Retention, Serrita Chaney
Strategies Used By Healthcare Supervisors For Employee Retention, Serrita Chaney
Walden Dissertations and Doctoral Studies
Healthcare supervisors who lack effective employee retention strategies could negatively affect patient well-being, employee performance, and organizational functions. The purpose of this single case study was to explore strategies that healthcare supervisors used to improve employee retention in 1 health care organization in southeast Georgia. Vroom expectancy theory was the conceptual framework for the study. Data were collected from semistructured interviews with 5 healthcare supervisors in a medium-sized healthcare organization who had hiring responsibilities and a history of implementing successful strategies to improve employee retention. Data were analyzed using coding and word frequency to discern patterns. Three significant themes emerged …
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Walden Dissertations and Doctoral Studies
There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Walden Dissertations and Doctoral Studies
Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for …
Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey
Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey
Walden Dissertations and Doctoral Studies
Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Walden Dissertations and Doctoral Studies
Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Walden Dissertations and Doctoral Studies
Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Noncompliance With Follow-Up Visits In Primary Care, Amanda Michelle Northern
Walden Dissertations and Doctoral Studies
No-show appointments, also referred to as missed appointments, occur 23% to 34% annually in general practice care settings. Missed appointments can lead to reduction in appointment availability, decrease in provider/staff productivity, patient/provider discordance, disruption in continuity of care, and reduced quality of care. There is a gap in the nursing literature regarding effective interventions to reduce missed appointments. The purpose of this quality improvement, secondary analysis project was to determine whether implementation of an evidence-based no-show, nurse-led intervention would reduce missed appointment rates in a family medicine practice. The health belief model and the plan, do, study, act model guided …
Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb
Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb
Walden Dissertations and Doctoral Studies
Implementation of electronic health records (EHRs) is a driver for the improvement of health care and the reduction of health care costs. Developing countries face substantial challenges in adopting EHRs. The complex adaptive system conceptual framework was used to guide this single case study to explore strategies that health care leaders used to successfully implement the EHR system. Data were collected from 6 health care leaders from an island in the Caribbean using a semistructured interview technique. Data were analyzed using the Bengtsson's 4-stage data analysis process, which includes decontextualization, recontextualization, categorization, and compilation. The results of the study yielded …
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Walden Dissertations and Doctoral Studies
High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …
Successful Strategies For Implementing Health Information Technology In Primary Care Practice, Samuel O. Otoo
Successful Strategies For Implementing Health Information Technology In Primary Care Practice, Samuel O. Otoo
Walden Dissertations and Doctoral Studies
Health information technology (HIT) owner-practitioners who adopt effective strategies for HIT implementation can improve primary facility care delivery and profitability. However, some HIT owner-practitioners have ineffective implementation strategies, so they have not realized the total revenue increases of more than 8%. Grounded in general systems theory, the purpose of this multiple case study was to explore successful strategies primary care practitioners (PCPs) use to implement HIT to improve primary facility care delivery and profitability. The participants included 6 owner-practitioners located in Queens County, NY, who successfully implemented HIT to improve facility care delivery and profitability. Data were collected through face-to-face …
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Walden Dissertations and Doctoral Studies
The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Walden Dissertations and Doctoral Studies
Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Walden Dissertations and Doctoral Studies
The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization …