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Articles 1 - 30 of 734
Full-Text Articles in Medicine and Health Sciences
Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd
Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd
Walden Dissertations and Doctoral Studies
Healthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Promotion To Fire Officer: Ems Is An Essential Component Of Promotional Testing, Brenda Kay Farlow
Walden Dissertations and Doctoral Studies
AbstractFor the past 25 years, the number of fire department responses to structure fires nationally has gone down. Structure fires now reflect less than ten percent of the responses of the fire service. In the same period, emergency medical services (EMS) have become the overwhelming activity of most fire departments. The problem is the promotional process focuses on firefighting knowledge and skills while ignoring the absolute need for EMS competencies, in some capacity, for a supervisory position. The lack of change in the promotional process is related to the organizational culture of the individual fire departments and the collective difficulty …
Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins
Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins
Walden Dissertations and Doctoral Studies
Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …
Strategies For Maximizing The Use Of Electronic Health Records Systems In Medical Clinics, Alexandra Nieves Rivera
Strategies For Maximizing The Use Of Electronic Health Records Systems In Medical Clinics, Alexandra Nieves Rivera
Walden Dissertations and Doctoral Studies
Ineffective leadership can negatively impact the use of electronic health records (EHR) systems in medical clinics. Healthcare managers who fail to maximize the use of EHR systems are missing out on the opportunity to optimize the quality of medical care that their clinic provides. Grounded in complexity leadership theory, the purpose of this qualitative multiple-case study was to explore strategies healthcare managers use to maximize the use of EHRs systems. Participants comprised six healthcare managers who successfully implemented strategies to maximize the use of EHRs systems. Data were collected from semistructured interviews and publicly available information. Thematic analysis was used …
Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase
Evaluating U.S. Household Telemedicine Use In Primary Care Settings, Robert Osobase
Walden Dissertations and Doctoral Studies
AbstractThe COVID-19 pandemic's arrival in the United States restricted access and use of telemedicine in primary care providers (PCPs) settings. Addressing this issue is crucial since telemedicine is a confirmed method of encouraging patients and PCPs to promote quality health care. This quantitative study investigated the association between age, gender, and race, and PCPs offering telemedicine and U.S. household adults using telemedicine during COVID-19 pandemic in 2021. The Donabedian framework, which considers aspects of an organization's structure, process, and outcome, served as the study's foundation, incorporating age, race, and gender as independent variables, and PCPs and US adults as dependent …
Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg
Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg
Walden Dissertations and Doctoral Studies
Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …
Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii
Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii
Walden Dissertations and Doctoral Studies
Officials from the Centers for Medicare and Medicaid Services (CMS) created the hospital valued-based purchasing (VBP) program focused on controlling cost, inefficiencies, and quality-of-care. Hospital leaders are incentivized or penalized based on meeting quality outcomes and risk millions of dollars in reimbursement if they do not meet the quality-of-care standards specified in the CMS hospital VBP program. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies hospital leaders used to improve patient satisfaction to increase VBP performance-based reimbursements. Participants included eight hospital leaders from seven hospitals in California who successfully implemented …
Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons
Relationship Between Type Of Health Insurance And Access To Care Among African American Males, Tiffani Simmons
Walden Dissertations and Doctoral Studies
Insurance based discrimination is a bias that has the potential to harm patients by limiting their access to care and widen health disparities between patients with private and public insurance. The purpose of this study was to examine whether there is a relationship between type of health insurance (private and public) and access to care factors (acceptability and availability) among African American males ages 25–64 with chronic conditions. The Andersen healthcare utilization model framework supported this research in focusing on the determinants that influences a patient’s ability to access to health care. The research questions examined whether a relationship existed …
Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate
Strategies To Reduce Turnover Among Black Home Healthcare Aides, Diane Allen Tate
Walden Dissertations and Doctoral Studies
AbstractMany individuals prefer to remain in their homes as they age instead of entering a long-term care facility. As the proportion of older Americans rapidly grows, the demand for delivery of nonmedical services by home healthcare aides (HHAs) is expected to increase. However, the national and local supply of HHAs is insufficient and must be rectified to meet a projected increase of older Americans by 2050. This research study involved exploring this problem for one small home healthcare organization in the Maryland suburbs outside of Washington, DC with an HHA workforce that was comprised predominantly of Black/African American and African …
The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco
The Relationship Between “Speak Up” Culture Level, Team Effectiveness, And Organizational Performance Among Clinical Laboratory Professionals, Emmanuel Udasco
Walden Dissertations and Doctoral Studies
The clinical laboratory plays a crucial role in aiding physicians to diagnose disease. With numerous studies on “Speak Up” culture well-documented among providers and nurses surrounding patient safety, gaps in literature exist concerning “Speak Up” culture that address team effectiveness and organizational performance within the clinical lab setting. The purpose of this quantitative correlation study was to investigate the relationship between “Speak Up” culture level, team effectiveness, and organizational performance among health care workers employed in the clinical lab. The high-performance work practices model was utilized as the conceptual framework to ground this study. Research questions assessed the link between …
Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti
Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti
Walden Dissertations and Doctoral Studies
Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …
Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker
Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker
Walden Dissertations and Doctoral Studies
Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …
Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker
Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker
Walden Dissertations and Doctoral Studies
Hospital admissions and readmissions among Medicaid patients significantly impact increased healthcare costs for the state of Louisiana and are associated with poor quality of care. The specific research problem under study was the relationships, if any, between mental health outpatient services in Louisiana, either individual therapy or home and community-based services post-hospital discharge, gender of the patient, and age of the adolescent patient with the number of hospital readmissions over 1 year. Secondary quantitative data analysis was performed using the Island Peer Review Organization Annual External Quality Review Technical Report and data from the managed care organization in Louisiana. No …
Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White
Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White
Walden Dissertations and Doctoral Studies
This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …
Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte
Oncology Nurses’ Experiences Dealing With And Managing Compassion Fatigue While Caring For Terminally Ill Patients, Stacey-Ann Mary Whyte
Walden Dissertations and Doctoral Studies
Compassion fatigue (CF) is a significant cause of nurse burnout (BO). Oncology nurses are particularly susceptible to CF because of the continual contact with terminally ill patients and recurrent experiences with patients’ death. A search of existing literature found no published studies that explicitly focused on interviewing oncology nurses to gain their expression of their lived experiences with CF while caring for terminally ill patients. This phenomenological qualitative study explored oncology nurses’ experiences dealing with and managing CF when caring for terminally ill patients. Figley’s compassion fatigue theory grounded this study. The research questions focused on the lived experiences of …
Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn
Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn
Walden Dissertations and Doctoral Studies
In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu
Strategies That Reduce Nurse Turnover, Trueman Chukwuemeka Atughonu
Walden Dissertations and Doctoral Studies
Nurse turnover is a significant problem that hospital managers and administrators face in delivering high-quality patient care while ensuring organizational profitability. In the United States, the average cost of replacing a nurse ranges from $40,000 to $100,000. Hospital managers are significantly challenged to reduce nurse turnover and keep costs down. Grounded in the Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore the strategies hospital managers use to reduce nurse turnover. The participants included five hospital managers at five medical centers in Arizona with successful experience in reducing nurse turnover. Data were collected from semistructured interviews …
Strategies For Clinical Managers To Reduce Nosocomial Infections, Samisha Lynn Davis
Strategies For Clinical Managers To Reduce Nosocomial Infections, Samisha Lynn Davis
Walden Dissertations and Doctoral Studies
Increasing nosocomial infection rates threaten patient safety when approximately 100 million patients annually acquire at least one nosocomial infection during their hospital stay. Some clinical managers lack strategies to reduce the incidence and costs of nosocomial infections. Clinical managers need training in proactive infection control guidelines that may reduce infection rates and increase profitability. Grounded in adaptive leadership theory, the purpose of this qualitative multiple case study was to explore successful strategies that clinical managers used to reduce incidence and costs associated with nosocomial infections. The participants were four clinical managers employed by health care organizations in the Southeast Texas …
The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire
The Relationship Between Poverty And Hospital Readmission Rates For U.S. Patients With Chronic Obstructive Pulmonary Disease, Heart Failure, And Asthma, Gardel Benz Eliazaire
Walden Dissertations and Doctoral Studies
AbstractHospital readmissions have continuously been a concern to healthcare providers and policymakers because of their negative impacts on the economy and the well-being of patients. A gap in knowledge exists in the understanding of the factors that have led to increased readmissions due to chronic cardiovascular diseases (Heart Failure) and respiratory diseases (chronic obstructive pulmonary disease [COPD] and Asthma). The aim of this study was to examine the relationship between poverty rate and hospital readmission rates for patients with COPD, Heart Failure, and Asthma in the United States using secondary data from the Healthcare Cost and Utilization Project’s (HCUP’s) Nationwide …
Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters
Influence Of Nurse Residency Programs On Turnover Intent For New Nurse Graduates, Ashley Raye Peters
Walden Dissertations and Doctoral Studies
Nursing turnover and nursing intent to leave is increasing due to burnout, retirement, and a competitive labor market. The purpose of this quantitative study was to determine whether there were statistical differences in turnover intent for nurses with new associate degrees and nurses with new bachelor’s degrees after participation in a nurse residency program. The theory of cognitive dissonance formed the foundation for the two research questions concerning whether there was a difference in turnover intent for nurses with associate degrees and nurses with bachelor's degrees after initial completion of a new nurse residency program and after a year of …
Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry
Experiences Of Hurricane-Related Events Among Campus Leadership Of Southeastern U.S. Universities, Clarissa E. Henry
Walden Dissertations and Doctoral Studies
Over the last 10 years, institutes of higher learning (IHLs) in the southeastern United States have endured natural disasters that have caused flooding, water, and wind damage and resulted in student evacuations, class disruptions, and building damage. IHLs are further challenged with resuming campus operations despite the emotional impact resulting after a natural disaster occurs. There is limited research relative to the experiences of campus leadership who share the responsibility of keeping students, visitors, and university artifacts safe during and after a hurricane-related event. This research study served as a qualitative phenomenological assessment of campus leadership experiences during a post-hurricane-related …
Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones
Lack Of Leadership Roles And Advancement Opportunities For Black Female Nurses, Mikela Jerilynn Jones
Walden Dissertations and Doctoral Studies
Underrepresentation is a significant issue for Black female nurses to secure nurse leadership positions in healthcare facilities. Leadership by Black female nurses is needed to provide culturally appropriate quality of care, to have a more diverse workplace, and to ensure that the needs of diverse patient populations are met. The purpose of this quantitative study was to explore the barriers and challenges faced by Black female nurses who failed to achieve their advancement goals into leadership roles.Using the National Sample Survey of Registered Nurses (NSSRN) database, the independent variables used were interpersonal differences with colleagues or supervisors, lack of good …
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood
Walden Dissertations and Doctoral Studies
Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …
Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris
Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris
Walden Dissertations and Doctoral Studies
Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …
Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo
Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo
Walden Dissertations and Doctoral Studies
AbstractSome South African healthcare managers and physicians find sustaining quality, cost-effective healthcare services challenging. Healthcare leaders are concerned about the high cost of healthcare as it can negatively impact sustainability and patient outcomes. Grounded in the cost-effectiveness theory and complex adaptive system theory, the purpose of this qualitative multiple-case study was to explore strategies some South African healthcare leaders use to sustain healthcare delivery in lower- and middle-income countries. The participants were five healthcare practitioners in rural areas of South Africa. Data were collected through semistructured interviews and secondary data sources. Thematic analysis of the data yielded four themes: patients’ …
How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez
How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez
Walden Dissertations and Doctoral Studies
This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …
Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy
Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy
Walden Dissertations and Doctoral Studies
Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …
Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande
Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande
Walden Dissertations and Doctoral Studies
AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …
Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo
Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo
Walden Dissertations and Doctoral Studies
AbstractOne of the most frequent medical errors in contemporary medicine is incorrect prescriptions, and the profits from retail pharmacy operations are adversely impacted by the costs associated with prescription errors. Independent pharmacy managers are interested in finding workable strategies to mitigate the cost of prescription errors and increase profit. Using the resource-based theory of competitive advantage (RBTCA), the purpose of this qualitative multiple-case study was to explore strategies some independent pharmacy managers in Texas use to mitigate the cost of pharmacy employee prescription errors and increase profitability. The participants were five independent pharmacy managers who implemented strategies to mitigate the …