Medicine and Health Sciences Commons^™

Developing Strategies Of Organizational Sustainability For Solo And Small Business Medical Practices, Gerald Lloyd Anderson

Walden Dissertations and Doctoral Studies

Recent trends point toward a decline in solo and small business medical practices, yet, the need and demand still exists for this model of health care. The purpose of this case study was to explore effective approaches to help physicians in solo practice and small medical group primary care practitioners (PCPs) retain their small business medical practices. The study included purposive sampling and face-to-face interviews: 11 physicians, predominately primary care practitioners, in the Baltimore-Washington metropolitan region, were interviewed until data saturation was reached. A component of systems theory (strategic thinking) and the dynamic capabilities concept were used to frame the …

Perceived Effects Of The Affordable Care Act On Emergency Preparedness, Tanya Marie Scherr

Walden Dissertations and Doctoral Studies

National healthcare as executed through the Patient Protection and Affordable Care Act (ACA) was introduced in 2010, but was discussed for several decades prior to its enactment. Section 5210 of the ACA established funding for a Regular and Ready Reserve Corps (RRRC) to provide support to local healthcare entities with emergency preparedness. It is unknown what impact Section 5210 of the ACA has had on local emergency preparedness, as well as what obstacles are encountered with implementing this piece of legislation at the local level. The purpose of this case study was to understand the obstacles encountered at a local …

Emotional Labor And Employee Engagement Within A Pediatric Hospital, Michele Louise Mitchell

Walden Dissertations and Doctoral Studies

High levels of emotional work, staffing shortages, high turnover rates, low workforce engagement levels, and complex healthcare reforms are common problems in healthcare settings. Healthcare leaders are increasingly aware of the vital impact an engaged workforce can have on patient outcomes and an organization's ability to survive despite current challenges in the healthcare setting. It is important for leaders to understand what factors may influence the ability to engage with their organization, such as emotional labor. The purpose of this correlational quantitative study was to test whether emotional labor is related to employee engagement within a large Midwestern pediatric hospital. …

Leadership Strategies To Influence Employee Engagement In Health Care, John David Vizzuso

Walden Dissertations and Doctoral Studies

Hospitals are in a precarious financial position with declining reimbursement, eroding profit margins, and low patient satisfaction. The Patient Protection and Affordable Care Act of 2010 reform may decrease hospital reimbursement by $500 billion from 2010 to 2020, while low patient satisfaction may decrease profitability for hospitals by 27%. Employee disengagement may decrease patient satisfaction and consumer loyalty. The purpose of this phenomenological study was to explore the lived experiences of health care leaders as they worked to engage employees and provide better patient care. Improving patient care provides opportunities to capture new market shares, which increases sustainability of health …

Mental Health Therapists' Attitudes On Adoption Of Evidence-Based Practices And Organizational Culture, Jennifer Guerguis

Walden Dissertations and Doctoral Studies

Evidence-based practice (EBP) in mental health was initiated in the United States due to state legislation. The EBP implementation process is complex due to multiple factors related to organizational culture. Mental health agencies implementing EBP processes can expect significant personnel changes due to higher turnover rates, which may have a negative effect on the quality of services. The purpose of this study was to investigate the relationship between providers' attitudes toward the adoption of EBPs and organizational culture. The theoretical framework for this study was organizational culture theory and the Denison organizational culture model. This correlational and predictive study examined …

Exploring Recruiting Challenges Of The Insurance Industry, Hema Chaurasia

Walden Dissertations and Doctoral Studies

Insurance companies provide financial protection to the general population, but their workforce challenges may destabilize the companies to the point of financial distress. Senior insurance company leaders lack effective strategies to recruit skilled professionals. With contingency theory and resource-based view theory as the framework, the focus in this multicase study was the exploration of the recruiting strategies of human resources (HR) managers in New York City area insurance companies. Four insurance company HR managers were recruited via a purposeful and snowball sampling method for semistructured interviews. These interviews were analyzed through a reflective interpretation process, which was guided by the …

Internal Attributes That Mitigate Perceived Job Insecurity: Improving Employee Satisfaction, Shelly Leigh Rogers-Sharer

Walden Dissertations and Doctoral Studies

Employee satisfaction has been found to have a strong relationship with perceived job security. This study explored job insecurity in an unstable global economy. Specifically, it examined internal attributes of employees, hypothesizing that such attributes would enable employees to better cope with work-related stressors such as job insecurity. Specific attributes of personality and employability were assessed as potential moderators of job satisfaction and security, utilizing the theory of work adjustment and person-environment correspondence as theoretical frameworks. The specific attributes included facets of conscientiousness and neuroticism as well as dispositions of employability including openness to change at work, work and career …

Racism Vs. Social Capital: A Case Study Of Two Majority Black Communities, Bruce W. Strouble

Walden Dissertations and Doctoral Studies

Several researchers have identified social capital as a means to improve the social sustainability of communities. While there have been many studies investigating the benefits of social capital in homogeneous White communities, few have examined it in Black homogeneous communities. Also, there has been limited research on the influence of racism on social capital in African American communities. In this dissertation a comparative case study was used within a critical race theory framework. The purpose was to explore the role of racial oppression in shaping social capital in majority African American communities. Data were collected from 2 majority Black communities …

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 …

Work Group Composition Effects On Leadership Styles In Aircraft Manufacturing Organizations., Monica Lynn Dunnagan

Walden Dissertations and Doctoral Studies

leadership styles

homogeneous versus heterogeneous

manufacturing leaders

contractor workforce

A Correlational Analysis Of Empowerment And Experience With Resistance To Change, Rita Elizabeth Burgess

Walden Dissertations and Doctoral Studies

Despite more than 60 years of research about the nature of change, resistance to change remains a problem across industries. Health care leaders have limited knowledge of how health care managers' perceptions of empowerment, years of experience, and resistance to change (RTC) relate. The purpose for this nonexperimental correlational study was to examine the relationship between empowerment, years of experience, and RTC among managers via an online survey. The theoretical framework incorporated Kanter's structural empowerment theory and Kotter's change theory. The sample included 245 out of 1,181 health care managers from Veterans Administration (VA) hospitals in the New York metropolitan …

Acceptance And Usage Of Electronic Health Record Systems In Small Medical Practices, Ritu Tannan

Walden Dissertations and Doctoral Studies

One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based practices. The purpose of this study was to explore opinions and beliefs on the barriers to the diffusion of an ERH system using Q-methodology. Specifically, the research questions examined the subjectivity in the patterns of perspectives at the preadoption stage of the nonusers and at the postadoption …

Exploration Of The Project Management Practitioner's Emotional Intelligence Competencies, Linda A. Hooper

Walden Dissertations and Doctoral Studies

The success rate of information technology projects is on a downward trend, with reported losses in the billions of dollars. Recent studies indicate a 50--56% project success rate based on quality, budget, and on-time criteria. Building upon the conceptual framework of the emotional intelligence and knowledge management theories, the purpose of this phenomenological study was to explore how project management practitioners apply self- and cultural-awareness competencies to affect project outcomes. Using a purposeful sampling method, 24 experienced U.S.-based project management practitioners participated in a web-based questionnaire. Following Giorgi's data reduction process resulted in numeric data coding. Thematic analysis revealed themes …

Prediction Of Air Traffic Controller Trainee Selection And Training Success Using Cognitive Ability And Biodata, Karen D. Fox

Walden Dissertations and Doctoral Studies

The Federal Aviation Administration (FAA) has experienced decreased return on investment caused by hiring too many air traffic controller specialists (ATCSs) who performed poorly in field training, thus failing to become certified professional controllers (CPCs). Based on Schmidt and Hunter's theory of job performance and biodata theory, this quantitative, archival study examined whether factors of cognitive ability and biodata could predict job performance status of 2 generations of ATCSs, poststrike (PS) and next generation (NG) controllers. For each generation of controllers, binary logistic regression analysis was conducted to determine if any of the independent variables---transmuted composite (TMC) score for PS …

The Relationship Between The Associated Symptoms Of First Nation Peoples' Historical Losses And Organizational Commitment In The Canadian Workplace, Justin W. Wilson

Walden Dissertations and Doctoral Studies

Researchers have found that minorities suffering from traumatic stress report increased levels of stress in the absence of supportive and committed work environments; however, a paucity of empirical research exists for First Nations Peoples (FNP). The purpose of this quantitative correlation study was to examine the nature of the relationship between FNP's associated symptoms of historical loss, assessed by the Historical Loss and Associated Symptoms Scale, and organizational commitment, as measured by the Three Component Employee Commitment Survey. A total of 118 residential school survivors completed surveys. Correlation analysis was used to determine the significance of historical loss in relation …

Transformational Leadership Influence On Rapid Organizational Change In Procter And Gamble Global Manufacturing Operation, Timothy M. Williams Sr.

Walden Dissertations and Doctoral Studies

Most companies lack the ability to implement organizational change; over 70% of Organization Change Initiatives (OCIs) fail. This inability has negative economic and survival implications for companies. OCIs must be effective and rapid to match the high pace of change in the business environment. Transformational leadership (TL) has been linked to successful OCIs through its positive influence on employee commitment and reduced resistance to change, yet little research has been done to identify its association with OCI implementation speed. This study tested TL and change theory and their association with change implementation. It sought to determine if a relationship exists …

The Relationship Between Top Leaders' Observed Narcissistic Behaviors And Workplace Bullying, Deborah A. Regnaud

Walden Dissertations and Doctoral Studies

Workplace bullying is a global problem that leaves workers emotionally harmed and organizations financially strapped; yet in many cases, business leaders fail to adequately address the problem. The purpose of this research was to determine if the top leader had a direct impact on the presence of bullying within the workplace. Based on personality trait theory as a theoretical foundation, the key issue this study explored was the relationship between the presence of workplace bullying and observed narcissistic behaviors exhibited by the top leader. Participants consisted of 84 human resources professionals reporting directly to the CEO/president of companies located in …

Effect Of Political Skill On Perception Of Organizational Politics And Work Withdrawal Among Community College Employees, David John Ross

Walden Dissertations and Doctoral Studies

Community college student support services are an important aspect of success among community college students. Theoretical and empirical models of organizational politics and withdrawal guided the expectation that community college employees who perceive their organizations as political may withdrawal from their organization, diminishing the services delivered to students at the institution. A multisite cross-sectional survey design was utilized to gather quantitative data via Survey Monkey from national professional organizations. Two-hundred seventeen usable surveys from community college administrators (executive, mid-level managers, and administrators) were gathered. Data were analyzed via correlation and regression models to examine if political skill reduced or moderated …

Generational Cohort Differences In Types Of Organizational Commitment Among Nurses In Alabama, April Lavette Jones

Walden Dissertations and Doctoral Studies

In hospitals in the United States, the ratio of nurses to patients is declining, resulting in an increase in work demands for nurses. Consequently, organizations face challenges with nurses' organizational commitment. Studies have revealed generational differences, as determined by birth year, in employee levels of organizational commitment in a number of organizational settings. However, there is a gap in the literature regarding the impact of generational cohorts on the organizational commitment of nurses. The purpose of this quantitative, nonexperimental, cross-sectional design was to address whether generational cohorts of nurses differed in their levels of organizational commitment, and to investigate whether …

A Correlational Study Of Telework Frequency, Information Communication Technology, And Job Satisfaction Of Home-Based Teleworkers, Shana P. Webster-Trotman

Walden Dissertations and Doctoral Studies

In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction has been found to have a significant impact on voluntary turnover. The purpose of the study was to assess the relationship among telework frequency, information communication technology (ICT), and job satisfaction. The research questions were designed to answer whether correlational relationships exist among telework frequency, ICT, and job satisfaction and …

Job Satisfaction, Job Involvement, And Perceived Organizational Support As Predictors Of Organizational Commitment, Jennifer Parker Ayers

Walden Dissertations and Doctoral Studies

The purpose of this study was to determine whether or not there is a significant relationship between job satisfaction, job involvement, perceived organizational support, and organizational commitment among educators. A review of the literature revealed there is limited research that examined organizational behaviors among educators. Organizational commitment has been identified as a leading factor impacting an employee's level of success in various organizations. There remains a gap in the current literature regarding specific attitudinal behaviors influencing organizational commitment across various levels of education. Organizational commitment among educators employed at the primary, secondary, and postsecondary levels was examined. The sample for …

Who Shares? Managerial Knowledge Transfer Practices In British Columbia's Ministry Of Health Services, Gwendolyn Elizabeth Lock

Walden Dissertations and Doctoral Studies

The British Columbia government's Ministry of Health Services will experience significant loss of operational knowledge from an aging managerial workforce, increased staff turnover, and difficulties in recruitment. The purpose of this study is to provide the ministry's Strategic Human Resources Planning branch staff with a map and description of knowledge transfer practices used by approximately 40 managers within the ministry's Health Sector Information Management/Information Technology division and its Vital Statistics Agency. The study is a mixed-methods case study of knowledge retention and transfer practices founded on a knowledge management and social network theoretical foundation. To understand the ministry's complex nature …

The Responses Of Bamenda Disability Organizations To Hiv And Aids: A Multiple Case Study, Lynn Cockburn

Walden Dissertations and Doctoral Studies

In Cameroon, many disabled people (an estimated 10-20% of the population) have inadequate access to education and health care, and disabled people's organizations (DPOs) are advocating for social change. Yet, there is a scarcity of information regarding how African DPOs address HIV and AIDS. The purpose of this study was to assess how DPOs in Cameroon have responded to AIDS in the disabled population and to identify strategies to enable DPOs to manage AIDS issues. This study was guided by the complex adaptive systems theory as the theoretical framework. The research questions focused on what DPOs have done to develop …

Perceptions Of Leadership Effectiveness In The Management Of Intergenerational Work-Values Conflict: An Antecedent Of Organizational Citizenship Behavior Of Perioperative Registered Nurses, Patricia G. Wright

Walden Dissertations and Doctoral Studies

Studies reveal a progressive net decrease in the nursing profession across four generations, creating a shortage that poses a critical threat to the health care delivery system and to the health and safety of patients within that system. Research also suggests that generational cohorts reflect social change in attitudes toward work-life balance, organizational commitment, personal-professional relationships, autonomy, focus on career advancement, and actions that represent organizational citizenship behavior (OCB). Previous research grounded in theoretical frameworks of organizational behavior, leadership, and social capital indicates that leadership support of workforce diversity and effectiveness in conflict management influence OCB. However, little research explores …