Medicine and Health Sciences Commons^™

Application Of Lean Six Sigma Strategies To Improve Diagnostic Imaging Departmental Performance Metrics: A Literature Review, Obinna Newman Osuji

Radiologic Sciences

Purpose To systematically evaluate the effectiveness of Lean and Six Sigma quality improvement approaches in enhancing diagnostic imaging workflows and departmental financial performance.

Method Literature for this review was retrieved from Scopus, CINAHIL Plus, PubMed, and Healthcare Administration Database in February and March 2026. Empirical studies and literature reviews were included if they addressed the utilization of Lean Six Sigma, Lean, or Six Sigma as a method of quality improvement within a diagnostic imaging departmental setting.

Results Database searches generated 1,624 articles, and 17 were deemed suitable for inclusion in the study. There were four studies that directly measured patient …

Assault Vs. Assistance: Radiologic Technologist Decision-Making When Fall-Risk Patients Decline Assistance, Pamela O'Dowd

Radiologic Sciences

Purpose To explore how radiologic technologists experience and respond to situations involving fall-risk patients who decline assistance during imaging procedures.

Method A cross-sectional survey design was used to collect data from practicing radiologic technologists recruited through the American Society of Radiologic Technologists. Descriptive statistics, including frequencies and percentages, were analyzed using SPSS to summarize participant responses, and a thematic analysis was conducted on open-ended responses.

Results A total of 87 respondents completed the survey. Results indicated that encounters with fall-risk patients who refuse assistance are common in clinical imaging practice. Sixty-three (72.4%) technologists reported having experienced situations in which a …

Magnetic Resonance In Pregnancy: Safety Considerations, Contrast Risks, And Imaging Modality Alternatives, Lizzette Valdez

Radiologic Sciences

Purpose To examine the safety of magnetic resonance (MR) during pregnancy by evaluating fetal outcomes, contrast agent risks, and the comparative roles of MR, ultrasound, and computed tomography (CT) in prenatal imaging.

Method A literature review was conducted using PubMed and peer-reviewed radiology journals to identify studies evaluating MR safety during pregnancy. The review examined fetal and neonatal outcomes following prenatal MR exposure, trimester-specific imaging considerations, risks associated with gadolinium-based contrast agents, and comparisons among MR, ultrasound, and CT.

Results Three primary themes emerged: (a) noncontrast MR demonstrated a strong safety profile with no consistent association with adverse fetal or …

Comparing Ai-Generated And Human-Written Radiology Reports: Evidence From The Literature, Lakenya Webb

Radiologic Sciences

Purpose To evaluate the current evidence comparing artificial intelligence (AI)-generated radiology reports with radiologist-written reports, emphasizing diagnostic accuracy, clinical reasoning, workflow efficiency, and patient safety.

Method A literature review was performed using peer-reviewed articles identified through The University of Texas MD Anderson Cancer Center Research Medical Library. Studies evaluating AI-generated radiology reports were analyzed using AI-assisted thematic synthesis to identify recurring patterns related to report quality, diagnostic performance, and clinical implementation.

Results The literature consistently identified three overarching themes: (a) AI-generated reports demonstrated improvements in structured reporting and factual consistency but exhibited variable diagnostic accuracy; (b) current AI systems had …

Deep Learning Reconstruction In Pediatric Ct Imaging, Cody Wyatt

Radiologic Sciences

Purpose To synthesize current evidence on dose optimization using deep learning reconstruction (DLR) with emphasis on computed tomography (CT), pediatrics, contrast to noise ratio (CNR), signal to noise ratio (SNR), and radiation dosage.

Method The methodology was a systematic literature review, synthesizing peer-reviewed literature on the use of DLR in pediatric CT. Databases searched included Scopus, IEEE Xplore, and Web of Science. Keywords include combinations of deep learning reconstruction, DLR, CT, pediatric, dose, and optimization. Boolean operators were used to refine search results.

Results Three themes emerged: dosage reduction, noise reduction, and improved spatial resolution with the use of DLR …

National Pacs And Electronic Health Records: Considerations, Challenges, And Implications For Radiomics, Darchelle Scott

Radiologic Sciences

Purpose To examine the considerations, challenges, and implications of implementing a national picture archiving and communication system (PACS) integrated with electronic health records (EHRs), with particular emphasis on interoperability, radiomics, and patient-centered data sharing.

Method A systematic literature review was conducted using books, peer-reviewed articles, original research studies, and government publications addressing radiomics, TEFCA, blockchain technology, PACS, and EHR integration. Literature was analyzed to evaluate national health information exchange, radiomics applications, and implementation challenges associated with a connected healthcare infrastructure.

Results Three primary themes emerged: (a) interoperable national PACS and EHR systems have the potential to improve continuity of care …

Quality Improvement Project: Experienced Nurse To Novice Adjunct Educator: Bridging The Gap, Karen Liddy

Doctor of Nursing Practice Projects

A formal mentoring program is an effective approach for enhancing mentee satisfaction and self-efficacy and decreasing turnover rates. Although evidence supports the benefits of mentoring, many universities lack formal mentoring programs for adjunct faculty. Utilizing the PDSA framework, this quality improvement Doctor of Nursing Practice (DNP) project executed and evaluated a structured adjunct faculty mentoring program to improve faculty self-efficacy and mentee satisfaction. The project was led by Bandura's Social Cognitive Theory and the Theory of Change and used a pre- and post-test design involving adjunct nursing faculty members with fewer than three years of academic teaching experience. Mentors and …

Improving Implementation Of The Cmqcc Obstetric Hemorrhage Risk Assessment Tool To Improve Maternal Hemorrhage Response And Outcomes, Emily Hobbs, Karla Beiswenger

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to …

Aquatic Therapy And Its Impact On Perceived Caregiver Strain, Amanda J. Carter, Cynthia Haynes, Katherine O'Hara

Summer 2026 OTD Capstone Symposium

Children with Autism Spectrum Disorder (ASD) frequently experience sensory dysregulation that significantly impairs their participation in daily occupations and increases caregiver strain (Lawson et al., 2020; Passarello et al., 2022). Although aquatic therapy has shown promise in improving sensory processing, motor skills, and social participation, there is limited research examining its specific impact on the caregivers’ ability to provide support at home (Butzman et al., 2022; Caputo et al., 2018; Güeita-Rodríguez et al., 2021).

This study is a mixed-methods, quasi-experimental pre/post-design. This study sought to investigate the impact of six weeks of aquatic therapy intervention on sensory regulation and its …

Program Development: Integration Of Occupation In Adaptive Fitness, Havyn A. Isaac, Lakeisa Boykin

Summer 2026 OTD Capstone Symposium

This project was a program development and implementation of an adaptive fitness program for individuals with physical disabilities that integrates occupation. This was done to bridge the gap between adaptive fitness and occupational therapy and highlight the role of occupational therapy in adaptive fitness settings. A needs assessment and activity analysis were completed and used to develop the weekly sessions throughout implementation. The implementation phase was over 6 weeks, with 3 sessions a week. Each week had an occupational focus that was identified and broken down with the activity analysis. The program highlighted the role of occupational therapy in adaotive …

Evaluation Of Unconventional Bolus Materials For Radiation Therapy: A Study Of Sand, And Rice, Brooke Benson

Masters Projects

Abstract

Purpose: Research easily accessible substitutes for Superflab which conform better to the patient surface and are more conformal in an attempt to increase efficacy of bolus for clinical use.

Methods: For this experiment, sand and rice were measured based on Hounsfield units (HU) and relative electron density (RED) and placed into bags to be formed to a patient surface, securing their shape through the use of a vacuum sealer. After repeated CT scans with the chosen materials, plans were calculated on each scan followed by measurement of HU, air gap volume, bolus volume, and dosimetric parameters including monitor units …

Belonging & Whole Person Formation In Graduate Education: A Conceptual Framework For Student Flourishing, Cynthia L. Hickman

Posters

Graduate students experience substantial academic, personal, and professional demands that can negatively affect well-being and persistence. For students enrolled in professional programs, belonging may develop within two overlapping communities: the academic institution and the emerging profession. Institutional and professional belonging can provide connection, support, engagement, and opportunities for identity and professional development. This paper synthesizes literature on these two forms of belonging and proposes a conceptual framework describing their potential relationship with whole-person formation and flourishing. Whole-person formation extends graduate education beyond knowledge acquisition and professional competence to include development across interconnected dimensions of the person. Within the proposed framework, …

Psychosocial Experiences Of Secondary School Students Living With Sickle Cell Disease While In School In Lagos State, Nigeria, Toluwalope Yetunde Onuwe

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is a lifelong genetic condition significantly impacting the physical, emotional, and social health of those affected. Nigeria has one of the highest global burdens of SCD, yet there is limited research on the psychosocial experiences of secondary school students living with SCD in educational settings. This qualitative study explored these experiences among students in Lagos State, Nigeria. Using the social ecological model and interpreted through the social model of disability, the study examined how school environments, educational practices, and institutional support influenced students' psychosocial well-being and perceived health. Twenty secondary school students participated in 4 in-person …

Improving Recognition And Communication Of Early Patient Condition Changes Through An Evidence-Based Staff Education Program, Raymond Mwanje

Walden Dissertations and Doctoral Studies

This doctoral project is a staff education project aimed at enhancing recognition and communication of early changes in patients' conditions in a long-term care rehabilitation environment. Delayed recognition of patient deterioration is a major challenge in nursing practice, as subtle changes in a patient's condition may go unnoticed, leading to delayed intervention, avoidable complications, and unnecessary hospital transfers. Poor communication among staff can also hinder the escalation of care, impacting patient safety and quality of care. There is evidence that structured communication strategies and education interventions can help enhance communication between clinicians and aid earlier detection of patient deterioration. Resolving …

Clinical Practice Guideline For A Capstone‑To‑Residency Transition Program, Rebecca Ginika Chinonso

Walden Dissertations and Doctoral Studies

The transition from student nurse to professional practice remains a vulnerable period marked by role ambiguity, stress, and early turnover. At a large medical center, the lack of a structured bridge between the final capstone experience and the residency program contributed to inconsistent onboarding, reduced confidence, and diminished resilience among new graduates. Addressing this gap is essential for strengthening retention, supporting workforce stability, and improving patient outcomes within nursing practice. An evidence‑based clinical practice guideline (CPG) outlining best‑practice recommendations for a new graduate transition program from capstone to residency was developed for the facility. The practice‑focused question asked whether the …

Standardized Proactive Glp-1 Prior Authorization Workflow, Ebote Etape

Walden Dissertations and Doctoral Studies

Summary This quality improvement project evaluated an organizational process change from a reactive, pharmacy-initiated prior authorization (PA) process to a standardized, proactive PA workflow for glucagon-like peptide-1 (GLP-1) receptor agonists in an outpatient primary care clinic. The evidence-based practice PICOT question was: In adult primary care patients prescribed GLP-1 receptor agonists (P), does a standardized, proactive prior authorization workflow (I), compared with a reactive pharmacy-initiated process (C), reduce time to approval and improve approval rate (O) over a 4-week period (T)? Baseline data showed that 3 of 19 PA requests were approved, while 16 were denied, resulting in a 15.8% …

Reducing Hospital-Acquired Pressure Injuries In Acute Care Using Structured Prevention Strategies, Yemisi Adesuyi Akinfenwa

Walden Dissertations and Doctoral Studies

Pressure injuries that patients develop while hospitalized continue to be a major safety concern in hospitals treating very sick patients. These wounds hurt, make infections more likely, keep people in the hospital longer, and increase expenses. On many units, the steps meant to stop these injuries, like checking each patient's risk level and turning patients regularly are not carried out the same way for everyone. Because of this inconsistency, some patients develop preventable pressure injuries. The purpose of this Doctor of Nursing Practice (DNP) project was to create a clinical practice guideline (CPG) for organized pressure injury prevention and to …

Prevention Of Hypotensive Adverse Events Utilizing Structured Home Blood Pressure Monitoring In Patients On Glp-1 Agonists, Alexandrya M. Tran

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement intervention was to assess whether a structured home blood pressure (BP) monitoring program with weekly check-ins would help decrease hypotensive episodes and associated adverse events in patients who have lost weight after GLP-1 agonist initiation.

Background: This project was implemented in an outpatient multidisciplinary clinic in Houston Texas. 

Methodology: A total of 13 patients were ask to monitor their BP daily and keep a log. Weekly telephone calls were conducted to monitor the patients and collect the data for a period of eight weeks. Weekly BP logs, hypotensive symptoms, and any antihypertensive medication …

A Measeles Susceptibility Screening Strategy For Perinatal Women, Sandra N. Davidson

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to implement a standardized measles susceptibility screening strategy for perinatal patients at a large academic teaching hospital in Texas. The project aimed to improve provider compliance with routine measles immunity screening and laboratory ordering by integrating screening into existing prenatal workflows. Background: Measles remains a highly contagious disease, and ongoing outbreaks in Texas showed gaps in prenatal measles immunity screening. The absence of standardized screening increases the risk of missed opportunities to identify non-immune patients and provide appropriate follow-up. Methodology: Using the Plan-Do-Study-Act (PDSA) quality improvement model, provider education, electronic medical record (EMR) workflow …

Reducing Seclusion In Inpatient Psychiatric Units Through Staff Education, Amaka Nkala

Walden Dissertations and Doctoral Studies

Seclusion remains a restrictive intervention used in inpatient psychiatric settings despite evidence linking it to psychological trauma, physical harm, and adverse patient outcomes. This Doctor of Nursing Practice (DNP) staff education project evaluated the effectiveness of a trauma-informed care and de-escalation education program in improving nurses' confidence in managing patient escalation. The project used a pre- and post-intervention quality improvement design with 24 inpatient psychiatric nurses. Participants completed a 10-item, 5-point Likert-scale confidence survey before and after a 30-minute educational session delivered via PowerPoint. Descriptive statistics were used to compare pre- and post-intervention confidence scores. Mean confidence scores increased from …

Staff Education To Increase Knowledge For Reducing Hospital-Acquired Pneumonia, Tenika Monique Mcmillan

Walden Dissertations and Doctoral Studies

The purpose of this Doctor of Nursing Practice (DNP) project was to address a critical gap in nursing knowledge regarding oral care and its role in preventing hospital-acquired pneumonia (HAP) through staff education. Although the relationship between oral care and pneumonia is well established, staff knowledge at the site varied, leading to inconsistencies in oral care practices. To address this problem, a targeted educational session using a pre- and post-test design was delivered to nursing staff. The practice-focused question was “Among nursing staff working in community living centers, does the implementation of targeted education on evidence-based oral hygiene guidelines, compared …

Staff Education Project To Teach Mobility And Sensory Aid Optimization Delirium Prevention Bundle For Older Patients In A Hospital Health System, Lerato Catherine Modise

Walden Dissertations and Doctoral Studies

Delirium is a preventable and manageable neuropsychiatric condition characterized by acute fluctuations in attention, awareness, and cognition. The burden of this acute confusion syndrome among older adults aged > 65 years is disproportionate higher, due to age-related neurocognitive vulnerabilities. Nurse-led delirium prevention interventions can reduce incidence from 70% to 20% following structured education, gaps persist in nursing knowledge around evidence-based prevention strategies. The purpose of this project was to evaluate whether a structured nursing education intervention on enhanced mobility and sensory aid optimization strategies, as components of the ABCDEF bundle, improved nursing knowledge compared to standard care practices. Nineteen registered nurses …

Staff Education On Improving Staff Knowledge Of Medication Adherence In An Outpatient Psychiatric Facility, Okechukwu Chidiadi

Walden Dissertations and Doctoral Studies

This project was a staff education initiative designed to improve staff knowledge of medication adherence at an adult psychiatric outpatient clinic. Addressing this matter is critical because it directly impacts the quality of patient care. The practice focus question was: Among psychiatric mental health staff in a behavioral health facility, what is the impact of a staff educational program on teaching medication adherence to patients on the staff’s knowledge? The purpose of this staff education project was to improve staff knowledge of medication adherence by equipping them with the tools and strategies needed to help patients manage their treatment plans …

Reducing No-Show Rates In An Outpatient Behavioral Health Clinic Through A Multimodal Patient Engagement Intervention, Gwendoline Osong

Walden Dissertations and Doctoral Studies

Reducing No-Show Rates in an Outpatient Behavioral Health Clinic Through a Multimodal Patient Engagement Intervention

Development And Implementation Of A Clinical Practice Guideline To Standardize Social Determinants Of Health Screening And Social Services Referrals In Primary Care, Patricia Pottinger

Walden Dissertations and Doctoral Studies

Social determinants of health (SDOH) significantly influence health outcomes, yet many primary care organizations lack a standardized, evidence-based process for identifying patients' social needs and facilitating referrals to appropriate community resources. The purpose of this Doctor of Nursing Practice executive leadership project was to develop and implement a clinical practice guideline (CPG) to standardize SDOH screening and social services referrals in a primary care setting. The practice-focused question asked whether a CPG designed to standardize social services referrals would be approved by a panel of subject matter experts using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. …

Improving Outpatient Staff Job Satisfaction With Implementation Of Structured Educational Focus Groups Program: A Quality Improvement Project, Breanna Aromire

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to improve self-reported job satisfaction among outpatient pulmonary clinic staff through structured educational focus group sessions using iterative Plan-Do-Study-Act (PDSA) cycles.

Background

Job satisfaction among clinical staff is a key factor in retention, engagement, and quality of care. Outpatient specialty clinics often face workflow constraints that limit opportunities for structured professional development, which may negatively affect staff satisfaction. Educational and team-based interventions have been shown to improve workplace engagement.

Methodology

Six structured educational focus group sessions were conducted over three months, addressing key clinical and workflow topics. Two PDSA cycles guided real-time modification, …

Understanding And Supporting Youth Affected By Trauma And Stress, Cara Murray, Anna Gilliam, Jared Hawkins, Christina Pay

All Current Publications

Adults who work with youth are central to creating environments where young people feel safe, supported, and able to succeed. However, some youth have experienced stress, adversity, or trauma that can make it more difficult for them to feel safe, connected, and successful. By learning how to support youth with compassion and consistency, caring adults can help buffer the effects of adversity and promote resilience.

Premarket Clinical Evidence Strength And Recalls Of High-Risk Therapeutic Medical Devices, Maryam Mooghali, Faaizah Arshad, Vinay K Rathi, Kushal T Kadakia, Alexander O Everhart, Joseph S Ross, Sanket S Dhruva

2020-Current year OA Pubs

IMPORTANCE: High-risk medical devices approved through the US Food and Drug Administration (FDA) premarket approval (PMA) pathway may be supported by limited premarket clinical evidence, leaving uncertainties about safety. Whether device, premarket clinical evidence, or regulatory characteristics are associated with subsequent device recalls is unknown.

OBJECTIVE: To examine the association between device, premarket clinical evidence, and regulatory characteristics and serious recalls among high-risk therapeutic devices.

DESIGN AND SETTING: This cross-sectional study reviewed 193 high-risk therapeutic medical devices approved through the FDA's PMA pathway between January 1, 2014, and December 31, 2023. Data were analyzed between August 2025 and December 2025. …

Consecuencias De La Violencia Docente: Recuentos Desde El Campo De La Formación Musical Universitaria En México, Karla M. Reynoso Vargas, Basilio Fernández-Morante

Visions of Research in Music Education

Este es un trabajo independiente, pero complementario al estudio «La violencia docente en la educación musical universitaria: una exploración en el contexto mexicano». Presenta el análisis de la información que se desprende de 53 relatos de víctimas de violencia docente en programas universitarios de música. Incorporamos reflexiones y aportaciones de estudiantes, profesionales y personas que abandonaron sus carreras de música en la República Mexicana, quienes compartieron voluntariamente sus historias. La primera categoría describe las consecuencias de la violencia docente. Por un lado, se observaron efectos interpretados como positivos, entre ellos la activación de la orientación al logro, el sobreesfuerzo y …

Utilization Of An Open-Access Markerless Motion Analysis Software For A Biomechanics Movement Analysis Project., Tamra L. Llewellyn, Michael J. Nolan

Educational Practices in Kinesiology

The movement analysis project (MAP) is a common assignment in many undergraduate biomechanics courses. The purpose of this article is to introduce kinesiology educators to an open-source, AI-enabled, markerless software for motion capture, OpenCap, which can be used in MAP and research. This tool is currently being used in an in-person, upper-level, undergraduate biomechanics course where students are required to have taken Anatomy & Physiology. There is very little time, money, or expertise needed to implement this resource. Using 2 iPads on tripods and the OpenCap app and web-based interface, movements can be quickly converted to skeleton visualization and joint …