Health and Medical Administration Commons^™

An Indian Healthcare Company’S Foray Onto The World Stage, Singapore Management University

Perspectives@SMU

Fortis Healthcare expanded from one hospital to over 70 in a dozen years. It is now consolidating to focus on what it does best: saving lives.

A Case Study On Empowering A Non-Profit Organization To Better Help People With Disabilities Through M-Health, James Lawler, Hannah Moller, Robert Salloum

Wilson Center for Social Entrepreneurship

Local non-profit organizations are constrained in developing efficient methods for helping people with disabilities confined at their own homes. The cost of labor of physically serving such people is a continued issue at the organizations. This case study explores an entrepreneurial focus on best-in-class applications of m-Health devices for improving methods of home medication support furnished by a leading metropolitan non-profit organization. This study explores further the potential of hosted infrastructure-as-a-service (IaaS) m-Health remote monitoring systems technology. The findings of this study can benefit non-profit organizations considering economic entrepreneurial innovation in interactive managed care technology.

An Analysis Of The Effects Of The 2003 And 2011 Acgme Work Hour Rules On Medical Resident Satisfaction At An Independent Academic Medical Center, Rachael E. Trout

Theses, Dissertations and Capstones

The purpose of this research was to determine what effects, if any, the 2003 and 2011 ACGME work hour rules had on medical resident satisfaction at an independent academic medical center in the United States. This research analyzed results of a survey administered by an independent academic medical center utilizing its own instrument of measure. Items reviewed to determine self-perceived satisfaction included questions related to program director effectiveness, resident input, quality of life, and satisfaction with program. Four comparisons were reviewed and analyzed for statistical significance utilizing the Mann-Whitney U non-parametric test for independent samples. The results indicated neither the …

Early Mobilization In Icu Patients, Alex Hunter, Leslie Johnson, William Willis, Alberto Coustasse

Management Faculty Research

Introduction: Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit with critical illness. The average intensive care unit length of stay was 3.3 days and for every day spent in an intensive care unit bed, the average patient spent an additional 1.5 days in a non-intensive care unit bed. Daily costs have increased more than 30% from 2000-2005 with an average daily cost of $3518. Weaning from mechanical ventilation has been correlated with increased intensive care unit and hospital length of stay. Mechanical ventilation has been correlated with the development of intensive care …

The Role Of Social Marketing In Salt Reduction, Michael Barry

Theses

More people die from cardiovascular disease than any other cause in Ireland (Department of Health, 2013). A direct correlation exists between high salt intake and high blood pressure and ensuing cardiovascular diseases (He and MacGregor, 2010). This thesis focuses on the use of social marketing to educate people on the dangers of high salt intake with the eventual aim of making recommendations to aid in the reduction of high blood pressure. In-depth interviews were conducted with twelve leading personnel from salt reduction and social marketing fields. All interviewees reached similar conclusions suggesting that salt reduction as a health issue needs …

State Uses Financial Incentives To Fund Nursing Home–Initiated Quality Improvement Projects Through Competitive Bidding Process, Leading To Better Care, Valerie Cooke, Greg Arling, T. Lewis, Kathleen Abrahamson, Priscilla Arling, H. Davila, C. Mueller

Scholarship and Professional Work - Business

Authorized in 2006 by the State legislature, Minnesota’s Performance-Based Incentive Program funds nursing home–initiated quality improvement projects for 1 to 3 years through increases of up to 5 percent in the operating per diem rate charged to Medicaid and private-pay residents. Funding decisions are made through a competitive bidding process administered annually by the Department of Human Services, with recommendations from a review committee. Program staff provide support to nursing homes during and after the application process. Nursing homes that do not achieve project-specific performance targets can lose up to 20 percent of the incentive payments. The program has engaged …

Electronic Prescribing And Its Implementation In The United States, Kate Englebert, Amber Porterfield, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Electronic prescribing (e-prescribing) is an important part of the nation’s push to create an electronically accessible national health system. E-prescribing allows providers to send prescriptions electronically to the pharmacy and can be stand-alone systems or part of an integrated electronic health record system.

Methodology: The methodology for this study was a literature review. Electronic databases accessed include EBSCOhost, PubMED, and Google Scholar. Additionally, government websites and a semi-structured interview were used. A total of 39 sources were referenced for the review.

Results: The results of the literature review demonstrated that e-prescribing reduces prescribing errors, increases efficiency, and helps save …

Direct-To-Consumer Advertising Of Drugs And Patients' Health Care Seeking Behaviors, Patricia Elaine Kennedy-Tucker

Walden Dissertations and Doctoral Studies

Known as direct-to-consumer advertising (DTCA), pharmaceutical companies in the United States are permitted to advertise prescription drugs directly to consumers. The purpose of this quantitative study was to determine if an association exists between DTCA and health care-seeking behaviors. The theoretical framework for this study involved social learning theory, information integration theory, and prospect theory. The research questions identified if exposure to DTCA (a) is associated with physician office visits, (b) influences a patient/physician conversation regarding a prescription, (c) influences requesting a prescription, and (d) has an impact on patients' ratings of the overall interaction with the physician. Data were …

Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure

Walden Dissertations and Doctoral Studies

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with …

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 …

Potential Influences Of Compliance For Short-Term Recovery From Sports-Related Concussion, Erin R. Ewing

Open Access Theses & Dissertations

Currently, treatment of sports-related concussion dictates the prescription of physical and cognitive rest to allow the injured brain to recover and for concussion-related symptoms to subside. However, clinicians who prescribe rest are often met with resistance from athletes who do not recognize its therapeutic value in the recovery process. Research has shown that athletes often fail to comply with rest recommendations, resulting in protracted recovery and the persistence of symptoms. Method: This study employed a three-group pretest-posttest experimental design to compare the effects of three different concussion management protocols. Participants were recently concussed athletes ages 18-25 seen in the UTEP …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Factors That Promote Perceived Usefulness Of And Clinical Outcomes From Sign-Outs At The National University Hospital, Soo-Hoon Lee, Wei-Ping Goh, Dale A. Fisher, Phillip H. Phan

Management Faculty Publications

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts.

OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers.

DESIGN, SETTING, AND PARTICIPANTS.

A retrospective study was conducted …

A Pilot Study On Nurse-Led Rounds: Preliminary Data On Patient Contact Time, Soo-Hoon Lee, Alice Lee, Siang-Ngim Lim, Mei-Jiao Koh, Benjamin Tan, Phillip H. Phan, Reshma A. Merchant, Aisha Lateef, Dale A. Fisher

Management Faculty Publications

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.

OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.

DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the …

Emotional Intelligence And Community Healthcare Productivity, Christopher Jacob Fox

Dissertations

Economic crisis is threatening state budgets. The strain on state budgets effects pensions and the healthcare benefits to communities. Rising healthcare costs and lagging insurance reimbursement rates are forcing healthcare organizations to sustain programs with fewer financial resources. Research studies indicate that payment increases from Medicare and Medicaid will not keep pace with the historical trend in hospital cost inflation (Kaufman, 2011). Of the healthcare facilities affected by federal budget constraints are community mental healthcare centers. The strain on state budgets has taken its toll on community mental healthcare facilities in particular struggling under the healthcare reform initiatives (Simpson, 1995). …

The Impacts Of Change In Governance On Faculty And Staff At Higher Education Institutions: A Case Study Of Ohsu, Dana L. Director

Dissertations and Theses

In the early 1990s, Oregon Health and Science University leadership examined the political and economic landscape and determined it needed a new operational model to survive and thrive. In 1995 OHSU separated from the state higher education system and became a public corporation, with goals of increased efficiency, customer-focus, ability to attract world-class researchers and physicians, and salaries commensurate with an urban academic health center.

This research examines the internal impacts when universities undergo significant change, using OHSU's governance change as a case study. Central is the question: what effect(s) did OHSU's decision to become a unique public corporation have …

Business Ethics: The Impact On Healthcare Professionals, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

No abstract provided.

A Cross-Cultural Health Care Approach To Improve Veteran Health Services In An Academic Community Hospital, Judith Sabino Mph, Eric Johnson Mpsa, Cps, Caama, Chs, Chep, Cdp, James F. Geiger Mpa, Fache

Administration & Leadership

No abstract provided.

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Management Faculty Research

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

The Influence Of Organizational Culture On Affinity For Knowledge Management Practices Of Registered Nurses, Gregory Allen

Faculty Publications - George Fox Digital

This study addressed the problems of hospitals’ duplicated effort and ad hoc knowledge management (KM) practices. The purpose of this quantitative study was to examine the focus and type of organizational culture in order to describe and predict the relationship between organizational culture and the affinity for KM of nurses working in health care organizations in Portland, Oregon. Guided by the competing values framework and social capital theory, this research study was undertaken to illuminate the possible relationship between the affinity for and probable use of KM and organizational culture in Oregon hospitals. Data were collected from 93 registered nurses …

Do User Fees Increase Tuberculosis Notifications?, Chioma Y. Chukwumah

Economics Honors Projects

Public health sectors around the world strive to provide accessible and affordable care. Tight government budgets and growing populations lead countries to consider adding or raising charges to health care consumers. These user fees may affect the quality, equity and revenue of health care. This paper investigates the impact of user fees on notifications of tuberculosis. In the panel data composed of 176 countries from 1960 to 2012, I find no evidence that suggests user fees increase tuberculosis. In contrast, I find strong and robust evidence suggesting user fees are associated with fewer new cases of tuberculosis.

Evaluating Shared Governance For Nursing Excellence, Evette Michelle Wilson

UNLV Theses, Dissertations, Professional Papers, and Capstones

The national challenges of nursing shortages, decreased staffing levels, and increased patient acuities have contributed to nurse's increased workload and job dissatisfaction. Nurses have become frustrated with the professional practice environment. The inability to make decisions about issues that affect their nursing practice and the care provided to their patients results in nurses leaving the work environment in search of higher job satisfaction. Employers are becoming more creative in their strategies to improve the work environment and retain nurses within their organizations. Healthcare leaders have implemented management strategies such as shared governance models. These models focus on providing a satisfying …

Improving Health Outcomes For Children (Ihoc): Summary Of Pediatric Quality Measures For Children Enrolled In Mainecare Ffy 2009 - Ffy 2012, Nathaniel J. Anderson Ms, Mph, Tracey Meagher

Population Health & Health Policy

his report, authored by USM Muskie School research staff, presents the results of the 16 CHIPRA Core Measures that were collected using MaineCare claims or Vital Statistics data and reported in the State of Maine’s FFY 2012 CHIP Annual Report to the Centers for Medicare and Medicaid Services (CMS). Also included in this report are an additional three measures from the Improving Health Outcomes for Children (IHOC) project’s Master List of Pediatric Measures. In addition to presenting results in graphs and narrative, this report also provides measure definitions and background information about each measure topic.

The goal of this document …

Global Budgets, Payment Reform And Single Payer: Understanding Vemont's Health Reform, Trish Riley

Population Health & Health Policy

The Muskie School of Public Service hosted two health policy colloquia this April to promote informed discussion throughout the state regarding MaineCare coverage options under the ACA and the implications of Vermont’s move toward a single-payer system.The series, sponsored by the Muskie School Board of Visitors, offers community conversations in which experts from various disciplines and perspectives inform and engage the broader public to explore and debate critical policy issues. On April 22, community and sector leaders joined for Global Budgets, Payment Reform, and Single Payer: Understanding Vermont's Health Reform. Participants discussed Vermont's recent movie toward single payer health …

Importance Of New Technologies For Diabetes Monitoring, David P. Paul Iii, Joey Preast, Zach Garrett, Alberto Coustasse

Management Faculty Research

Diabetes and its ramifications and treatments are presented, followed by discussion of the importance of communication between patient and clinician. Improved communication approaches, including telephone consultations, blood glucose communications to a provider with feedback, and active electronic diaries on smartphones for both type 1 and type 2 diabetes mellitus, are reviewed.

A State-Sponsored Approach To Quality Improvement In Nursing Homes: Insights From Providers, Kathleen Abrahamson, Priscilla Arling, Greg Arling

Scholarship and Professional Work - Business

In 2006, the Minnesota Performance-based Incentive Payment Program (PIPP) was launched to fund provider-initiated quality improvement (QI) projects addressing a wide range of persistent quality issues in nursing homes (eg, falls, pain, mobility, psychotropic medication reduction, care transitions). In this article, the authors describe the perceptions of nursing home providers who participated in a PIPP-funded QI project and completed a survey addressing a variety of QI-related concerns. Respondents noted the importance of support from top leadership, reported being challenged by resource constraints, and generally thought that their project positively impacted quality within their facility. These findings highlight the importance of …

Shared Leadership In Six Sigma Teams From The North Shore-Lij Health System, Brian J. Galli

Engineering Management & Systems Engineering Theses & Dissertations

The main goal of the research was to identify the relationships that the internal research team environment and external coaching variables had with the degree of shared leadership in the context of Six Sigma teams from the North Shore LIJ Health System. Furthermore, the research ascertained the relationships that these variables had with two performance metrics: a team's ability to complete project deliverables and satisfy customer's requirements. This research also sought to understand additional factors that affected the five variables.

The research found that while shared leadership did not positively change as a team progressed through the phases of the …

The Governance Schema Of Regional And Rural Public Hospital Nurses: How Relevant Are The Dimensions Of Stewardship Governance And Trust In Management?, Kim Clark

Theses: Doctorates and Masters

This study broadly pertained to the issue of public health sector governance. The field of healthcare governance had been characterised as having challenges of greater intricacy and sensitivity than those found in any other sector (Philippon & Braithwaite, 2008). While increasingly regarded as important to health system performance, governance had, however, been evaluated as poorly understood in conceptual and practical terms and subject to competing ideas regarding its role and challenges (Brinkerhoff & Bossert, 2013). Specifically, the thesis elucidated frontline regional and rural hospital nurses’ cognitive schema of strategic aspects of governance practice of managers in the Western Australian Country …

Information Flow And Clinical Outcomes In A Fully Functional Perinatal Continuum Of Care, Donald Levick Md, Michael Sheinberg Md, Chad D. Meyerhoefer Phd, Mary E. Deily, Shin-Yi Chou Phd, Susan A. Sherer Phd

Administration & Leadership

No abstract provided.

Integrated Block Sharing: A Win–Win Strategy For Hospitals And Surgeons, Robert Watson Day, Robert Garfinkel, Steven M. Thompson

Management Faculty Publications

We consider the problem of balancing two competing objectives in the pursuit of efficient management of operating rooms in a hospital: providing surgeons with predictable, reliable access to the operating room and maintaining high utilization of capacity. The common solution to the first problem (in practice) is to grant exclusive “block time,” in which a portion of the week in an operating room is designated to a particular surgeon, barring other surgeons from using this room/time. As a major improvement over this existing approach, we model the possibility of “shared” block time, which need only satisfy capacity constraints in expectation. …