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Articles 1 - 14 of 14
Full-Text Articles in Medicine and Health Sciences
The Efficacy Of Analgesic Subdissociative Dose Ketamine In Trauma Casualties Treated By U.S. Military Special Operations Medical Professionals In A Prehospital Environment, Darin Schwartz
Theses & Dissertations
Research Focus. This study’s main objective was to determine the efficacy of sub-dissociative ketamine to reduce the pain of trauma casualties treated by U.S. military medical professionals in a prehospital environment evidenced by the 0–10 numeric rating scale (NRS) for pain. Research Methods. This quantitative study was accomplished using a pragmatic approach integrating social cognitive theory complemented by mixing methods using qualitative phenomenological influence through narrative inquiry. This exploratory retrospective, cross-sectional study, utilizing a quasi-experimental pretest-posttest design, used deidentified sample data (N = 47) for secondary analysis from U.S. Special Operations medical providers and were included in a casualty …
Medicare Shared Savings Performance: Three-Year Pandemic Analysis, Bryan Adams
Medicare Shared Savings Performance: Three-Year Pandemic Analysis, Bryan Adams
Theses & Dissertations
The Centers for Medicare and Medicaid's (CMS) Office of Actuary predicts that U.S. national health expenditures will surpass U.S. gross domestic product per capita by 1.1% annually until 2028, totaling $6.2 trillion in healthcare spending. A significant portion of this spending, 36%, is attributed to Medicare and Medicaid. To address this issue, CMS has implemented the Medicare Shared Savings Program (MSSP) to assist Accountable Care Organizations (ACOs) in reducing healthcare costs and improving the quality of care for beneficiaries. The main objectives of this dissertation are twofold. Firstly, it aims to investigate the relationship between various factors, such as quality …
U.S. Army Physician Assistant Retention: A Latent Class Analysis, Robert Greener
U.S. Army Physician Assistant Retention: A Latent Class Analysis, Robert Greener
Theses & Dissertations
Introduction: Retaining employees is crucial to the success of organizations. While significant effort has been made to model employee retention, models have been unable to significantly predict retention. The purpose of this quantitative, non-experimental, cross-sectional study was to develop an improved employee retention model which could be used as a practical guide to improve employee retention. Materials and Methods: The study analyzed a survey created, implemented, and collected by the Statistical Cell at the U.S. Army Center of Excellence. In September of 2020, all 864 active-duty PAs were sent a link to the survey and 290 completed the survey, …
Reach, Effectiveness, Adoption, And Maintenance Of Mobile Electronic Clinical Decision Support Tools Deployed As Part Of National Quality Improvement Projects, Ellen K. Kerns
Theses & Dissertations
Electronic clinical decision support (ECDS) tools are often developed within quality improvement (QI) projects to increase adherence with the latest clinical practice guidelines. However, the potential reach and maintenance of ECDS use beyond the time and location of their associated project are very limited. Deploying ECDS using a mobile app (mECDS) has shown the potential to be a viable method of overcoming these limitations. However, it is unclear what pattern the reach and adoption of such a tool might follow and what effect this use has on clinical practice. Our team developed an app which contained two different mECDS tools …
The Evolving Management Of Aortic Valve Disease: Trends In The Utilization And Cost Of Savr, Tavr, And Medical Therapy, Andrew Goldsweig
The Evolving Management Of Aortic Valve Disease: Trends In The Utilization And Cost Of Savr, Tavr, And Medical Therapy, Andrew Goldsweig
Theses & Dissertations
Aortic stenosis (AS) and regurgitation (AR) may be treated with surgical aortic valve replacement (SAVR), transcatheter AVR (TAVR), or medical therapy (MT). Data are lacking regarding usage and cost of SAVR, TAVR, and MT for patients hospitalized with aortic valve disease. From the Nationwide Readmissions Database, we determined utilization and cost trends for SAVR, TAVR, and MT in patients with aortic valve disease admitted 2012-2016 for valve replacement, heart failure, unstable angina, non-ST-elevation myocardial infarction, or syncope. From 2012 through 2016, there was a 48.1% increase in the number of patients hospitalized for aortic valve disease annually. Overall, 19.9%, 6.7%, …
Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek
Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek
Theses & Dissertations
It is a commonly held belief that access to health insurance affects the level of utilization of preventive care services, and thus plays a crucial role in the effective management of avoidable chronic illnesses, decreasing levels of premature mortality, and enabling individuals to live wholesome long lives. Based on this belief, among other goals, the Affordable Care Act (ACA) was designed to increase access to health insurance and related medical services for the population of the United States. This dissertation attempts to identify whether this belief is valid or not by testing whether the usage of preventive care changed between …
Essays On The Patient-Centered Medical Home In The United States Military Health System, Glen N. Gilson
Essays On The Patient-Centered Medical Home In The United States Military Health System, Glen N. Gilson
Theses & Dissertations
The Patient-Centered Medical Home has been endorsed by the primary care community as the model of the future, with hopes that it will increase quality of care and the patient and provider experience while decreasing costs. Many aspects of the implementation of the Patient-Centered Medical Home model remain unexplored. This dissertation comprises three independent studies examining Patient-Centered Medical Home implementation in the Military Health System, including (1) the effects of environmental correlates on the time to implement the model, (2) the impact of differences in implementation on preventive care quality outcomes, and (3) the effect of differences in implementation on …
The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout
The Impact Of Electronic Health Records On Healthcare Service Delivery, Patient Safety, And Quality, Kate Elizabeth Trout
Theses & Dissertations
The HITECH Act has provided over $30 billion of support through the Meaningful Use program to implement Electronic Health Records (EHRs) with aims to improve healthcare service delivery, efficiency, quality, and patient safety. New healthcare models, such as pay-for-performance and value-based purchasing, were envisioned to aligning quality with reimbursement mediated with the use of EHRs. It is unclear of how EHRs and Meaningful Use have impacted health service delivery, patient safety, and quality of care. Thus, making it difficult to determine if the specific set of objectives for Meaningful Use have had a positive impact on outcomes, which ultimately is …
Quality Improvement Programs’ Contribution To Successful Clinical Practice Changes, Erika O. Bowen
Quality Improvement Programs’ Contribution To Successful Clinical Practice Changes, Erika O. Bowen
Theses & Dissertations
There is a great deal of healthcare literature on the importance of QI programs and the significant contributions they make toward patient safety and patient satisfaction; however, documentation of outcome measures and predictors of success remains challenging. This study examined the experiences of physician participants who attended a state supported South Texas medical school’s CSE course to gain an understanding of QI education, demonstrate the need for formal QI education, and determine if a change in clinical practice occurred as a result of attending a structured QI course. Kirkpatrick’s (1967) four-level evaluation model was used as a framework to guide …
Duty Hour Limitations And Educational Outcomes: Perspectives From A Community Hospital-Based Family Medicine Residency Program, Maria Eliza Marquise
Duty Hour Limitations And Educational Outcomes: Perspectives From A Community Hospital-Based Family Medicine Residency Program, Maria Eliza Marquise
Theses & Dissertations
In 2003, the Accreditation Council for Graduate Medical Education and the American Osteopathic Association introduced new models that established limits on residents’ duty hours in training programs across the United States (Miulli & Valcore, 2010; Philibert & Taradejna, 2011); more stringent limitations were implemented in 2011. If these physician training programs decreased the time residents’ spent in a formal learning environment and utilized experiential learning as one teaching method, did the duty hour limitations affect the residents’ learning outcomes? The purpose of this ex post facto, quantitative study was to determine if there were differences in ITE (In-Training Examination) scores …
Mentoring, Job Satisfaction, Job Dissatisfaction, And Organizational Commitment Among Graduate Nurses, Abisola Adeyomibo Santos
Mentoring, Job Satisfaction, Job Dissatisfaction, And Organizational Commitment Among Graduate Nurses, Abisola Adeyomibo Santos
Theses & Dissertations
Shortage of bedside nurses has been researched for a long time. Many researchers have referred to different shortage percentages, but the American Nurse Association stated that the shortage of bedside nurses would increase in the range of 29% to 36% by 2020. It is also reported that a large number of newly graduated, newly hired nurses leave within one year as compared to newly hired experienced nurses. The purpose of this correlational study was to evaluate the influence of mentoring, mediating job satisfaction, job dissatisfaction, and, therefore, organizational commitment, on nurses who completed the nurse residency program between January 2010 …
Mental Health Clinical Managers And Their Multicultural Leadership Practices, Christie Marie Melonson
Mental Health Clinical Managers And Their Multicultural Leadership Practices, Christie Marie Melonson
Theses & Dissertations
There is a general recognition that the United States has historically failed to provide adequate mental health services to ethnic minorities. The American Counseling Association has mandated multicultural competence of counseling professionals in today’s context of dramatic demographic change. Despite numerous studies on practitioners, organizations, models, and interventions geared toward minorities, disparities in access, usage, and outcomes in still exist. Simultaneously, counseling fields have emphasized leadership development as a key factor in improving services, yet training or research on leadership remains scarce. In response to these conditions, this basic interpretive qualitative study focused on exploring clinical managers’ perceptions of their …
An Assessment Of The Relationship Between The Hospital Chief Executive Officer’S Leadership Behaviors And Hospital Success, Newton J. Courtney
An Assessment Of The Relationship Between The Hospital Chief Executive Officer’S Leadership Behaviors And Hospital Success, Newton J. Courtney
Theses & Dissertations
The health care delivery system in the United States has received increased attention over the last 2 decades. Concerns of access, choice, cost, and quality have been in the forefront. This study was conducted to assess the leadership behaviors of hospitals’ chief executive officers and how they impact the performance of hospitals. Two instruments were used to collect the data for the study: the Multifactor Leadership Questionnaire (MLQ-5X; Avolio & Bass, 2004) and a demographics questionnaire. A correlational research design was used to measure the degree of association between variables related to hospital CEOs, the hospitals they represented and hospital …
Correlating Coworker Relations, Employee Involvement, And Leadership With Associate Commitment In Select Healthcare Companies Using A Mixed Sequential Explanatory Design, Kimberly Ann Lee
Theses & Dissertations
Increasing patient demands and decreasing reimbursement require better efficiency and effectiveness in health care systems and, subsequently, in health care teams. These environmental and societal factors are further complicated by the complex initiatives set forth by the Affordable Care Act (2010). In this study, the researcher sought to examine and identify the strongest variables of health care teaming and to explore resulting themes through the perception of groups of health care associates. This mixed sequential explanatory design first examined the relationships between coworker relations, employee involvement, and leadership with associate commitment and with each other. An existing database of associate …