Health and Medical Administration Commons^™

Dental Practice Success Vol. 1 No. 2, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

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 …

Dental Practice Success Vol. 1 No. 1, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

The Changing Role Of Ancillary Health Care Service Providers: An Evaluation Of Health Diagnostic Laboratory, Inc., Steven M. Thompson, Stephen Varvel, Szilard Voros, Dawn Thiselton, Shahrzad Grami, Ralph M. Turner, John Barron

Management Faculty Publications

In an effort to reduce cost and improve quality, health care payers have enacted a number of incentives to motivate providers to focus their efforts on achieving better clinical outcomes and reducing the prevalence and progression of disease. In response to these incentives, providers are entering into new arrangements such as accountable care organizations and patient-centered medical homes to redesign delivery processes and achieve quality and cost objectives. This article reports the results of a study designed to evaluate the impact on cost and quality of care resulting from services provided by Health Diagnostic Laboratory, Inc., a clinical laboratory with …

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.

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 …

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 …

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 …

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 …

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.

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 …

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.

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 …

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. …

Effectiveness And Best Practices Of Lean And Six Sigma Methodologies In Hospitals, Daniel Branco

Honors Projects in Management

Healthcare quality and costs are a growing problem in the United States. Healthcare organizations are facing increasing costs combined with declining quality (Schoenbaum). This unsustainable trend is putting a great burden on the health care system as a whole. The improvement of quality within the healthcare system would increase the value of the care (Schoenbaum).Improving healthcare quality, and thereby lowering the costs, is critical for the sustainability of healthcare organizations.

There are many different ways that organizations can use quality to reduce costs and increase the quality of service to their patients. There are also various ways an organization can …

Financial Incentives: Pay For Performance (P4p) And The Chronically Ill Patients, David Conley, Alberto Coustasse

Management Faculty Research

P4P is the reimbursement incentive that is based on quality improvement, efficiency, which is dominating the healthcare landscape and CMS. A literature review was conducted to search for and review significant information regarding P4P and how it pertains to chronic conditions and reimbursement methods. This literature review displayed while some programs were able to display a benefit/ profit for those involved such as insurance companies, hospitals, physicians and/or patients, most programs were unable to establish quality measures, cost effectiveness and positive program outcomes worth noting.

Striving For Zero Iv Pump Errors – A Unique Approach, Kristie Lowery Rn, Bs, Cphq, Cphrm, Gwenis L. Browning Rn, Msn, Georgene Saliba Rn, Bsn, Mba, Cphrm, Leroy Kromis Pharmd

Administration & Leadership

No abstract provided.

Examining Cancer-Related Pain And Quality Of Life In Lehigh Valley Home Care Patients, Linda G. Alley Phd, Rn, Hannah D. Paxton Rn, Mph, Michelle D. Flores Bsn, Rn, Carol A. Foltz Phd, Jen Wike Mph, Mba, Vickie Cunningham Bsn, Rn, Jeffrey Etchason Md

Administration & Leadership

No abstract provided.

Operation Improvement: Enhancing Perioperative Billing, Janet Caverly

Administration & Leadership

No abstract provided.

Abdominal Compartment Syndrome Presenting As Diuretic-Refractory Cardiorenal Syndrome, Brigid Hallinan Do

Administration & Leadership

No abstract provided.

Ct Scanning Is Sufficient To Clear The Cervical Spine Of Elderly Falls Less Than 5 Feet., Douglas Lehman Md, Rovinder S. Sandhu Md, Leslie Baga Bsn, Farheen Hussain Ms, John J. Hong Md

Administration & Leadership

No abstract provided.

Transformational Leadership, Job Satisfaction, Organizational Commitment, And Non-Supervisory Nurses' Intention To Leave, Audrey E. Gregory

Graduate Student Dissertations, Theses, Capstones, and Portfolios

The United States is currently experiencing a nursing shortage. To compound the problem, hospital nurses are leaving their organizations and executives are scrambling to figure out the reasons behind the increased turnover. Many factors are associated with nurses' intention to leave their current employment. Among these factors are job satisfaction, organizational commitment, work satisfaction, work setting, control over practice, salary, nurse-physician collaboration, job stress, and leadership style. Effective nursing leadership is an integral factor in the retention of hospital nurses and nurses who perceive their nursing leadership as participative and transformational may be more likely to be satisfied with their …

Conflict Management Education In Medicine: Considerations For Curriculum Designers, Jeffery Kaufman

Online Journal for Workforce Education and Development

It is important to address conflict in the medical field for a variety of reasons ranging from reducing turnover to increasing the quality of care received by patients. One way to assist with the management of medical conflict is by teaching resolution techniques to medical personnel. There is an opportunity for conflict management curriculum to address many of the issues facing physicians, administrators, staff and patients, however, it is also necessary for those developing that curriculum to understand the nature of the environment and appropriate conflict management tools to be used in that environment as part of the design process. …

Nyc Budget Cuts: A Counter-Productive Method To Effective Government-Nonprofit Contracting Relationships?, Anna-Kay Sinclair

Wilson Center for Social Entrepreneurship

This study examines the relationship between New York City budget cuts and the expenditure of human service nonprofits specifically involved in the government contracting relationship. With a focus on the Department for the Aging (DFTA), I examine nonprofits that provide a variety of services to the aging population on behalf of the DFTA. Correlations and regressions are presented examining the relationship between DFTA budget and nonprofit spending. The results of my analysis do not indicate a positive relationship between these two variables.