Health and Medical Administration Commons^™

Evaluating Electronic Health Record Intervention Efficacy In Enhancing Inpatient Initiation Of Guideline-Directed Medical Therapy, Sheraz Qamar, Trisha Sindhu, Charlotte Pirquet, Benjamin Richter, Charlotte Sacksteder, Tatianna Branch, Jeffrey Riggio, Cara Martino, Patricia C. Henwood, Alan Kubey

Department of Medicine Faculty Papers

BACKGROUND: Heart failure (HF) is a leading cause of hospitalization, morbidity, and mortality. Despite evidence supporting guideline-directed medical therapy (GDMT), prescribing remains suboptimal, particularly at hospital discharge.

PROJECT RATIONALE: Hospitalization provides an opportunity to initiate or optimize GDMT, but workflow barriers and practice variation limit implementation. To address this gap, our system implemented a system-wide HF quality improvement initiative featuring evidence-based order sets and an electronic health record smart phrase ("HFNOTE") to centralize and standardize documentation and encourage GDMT use.

PROJECT SUMMARY: We analyzed 2,859 HF hospitalizations across 10 hospitals between December 1, 2024 and June 30, 2025. Use of …

Ehr-Based Quality Interventions Associated With Differential Gdmt Prescribing In Community Versus Academic Hospitals, Trisha Sindhu, Charlotte Pirquet, Sheraz Qamar, Tanay-Veer Gandhi, Patricia C. Henwood, Cara Martino, Jeffrey Riggio, Jared Vanderzell, Charlotte Sacksteder, Alan Kubey

Department of Medicine Faculty Papers

BACKGROUND: Institutional barriers are associated with suboptimal guideline-directed medical therapy (GDMT) prescribing at heart failure discharge.

PROJECT RATIONALE: Practice variations between academic medical centers (defined as "teaching" hospitals with residents) and community hospitals are poorly understood. Evaluating how diverse settings respond to quality improvement strategies is vital.

PROJECT SUMMARY: A multicenter study across 10 electronic health record-unified hospitals evaluated 3,535 heart failure encounters. Phase 1 implemented educational work groups and financial incentives; phase 2 introduced clinical decision support systems. Community hospitals responded significantly to phase 1 education/incentives, with mean discharge of GDMT agents rising from 2.19 to 2.44 (P = …

Exploring Which Ehr Interventions Improve Heart Failure Hospitalization Outcomes Across 10 Hospitals, Sheraz Qamar, Andres Alvarado, Thomas Buckwalter, Patricia C. Henwood, Dana Jordan, Cara Martino, Jeffrey Riggio, Charlotte Sacksteder, Jared Vanderzell, Alan Kubey

Department of Medicine Faculty Papers

BACKGROUND: Heart failure (HF) remains a major cause of mortality and hospitalization despite advances in guideline-directed medical therapy (GDMT). Electronic health record (EHR)-based clinical decision support tools may improve care delivery, but their impact on outcomes remains ill-defined.

PROJECT RATIONALE: As part of a system-wide HF quality improvement initiative, we evaluated 2 EHR interventions: an evidence-based HF admission order set promoting early diuresis and GDMT optimization, and a templated HF documentation tool (HFNOTE) designed to capture clinical complexity.

PROJECT SUMMARY: We analyzed 4,865 HF hospitalizations across 10 hospitals between December 2024 and June 2025. Overall risk-adjusted mortality index was 0.83 …

Post-Pandemic Telebehavioral Health: Sustaining And Regulating Remote Mental Health Care As A Core Modality, Weiqiao Dong

Dartmouth College Master’s Theses

The United States continues to face a persistent mental health crisis after the COVID-19 pandemic, raising a policy question about the long-term role and regulation of telebehavioral health as a core modality of care. This thesis examines that question through a case study of New York State, an early center of the pandemic and a leader in telehealth policy reform.

Guided by the Health Policy Triangle framework, this thesis integrates longitudinal data from all 62 New York counties for 2010-2025 with a 2025 cross-sectional dataset covering 61 counties. Seventeen standardized indicators are organized into four dimensions: geographic, economic, demographic, and …

A Longitudinal Analysis Of Hospital Consumer Evaluation In Virginia, Tulay Akmandor Inac

Health Services Research Dissertations

Suboptimal patient experience signals a need to improve clinical efficacy, patient safety, and healthcare quality. The COVID-19 pandemic intensified hospital resource and staffing demands, reducing hospitals’ capacity to invest in patient experience improvement. Prior studies remain limited because many lack longitudinal structure and organized theoretical models, making temporal inference difficult and weakening analyses of patient experience disparities. To address these limitations, this dissertation incorporates three studies examining patient experience and pandemic-related effects.

In state-level markets comparable to Virginia, limited research has examined longitudinal patient experience trends across regional hospital systems using HCAHPS scores. The first study uses descriptive trend analysis …

The Power Of Proximity: Driving Hand Hygiene Compliance Through Sanitizer Placement, Jennifer E. Jones, Eric Van Middendorp, Leanne Wendt

Posters

Hand hygiene is the cornerstone of infection prevention in healthcare settings and is particularly critical in the Neonatal Intensive Care Unit (NICU) where patients are highly vulnerable due to immature immune systems and frequent exposure to invasive procedures. Healthcare associated infections (HAIs) remain a significant cause of morbidity and mortality among neonates. Evidence consistently identifies proper hand hygiene as the single most effective intervention to reduce HAIs in NICUs. Despite its simplicity, compliance among healthcare workers is often suboptimal, influenced by factors such as workload and accessibility of hand hygiene resources.

From Scenario To Safety: Simulation As A Catalyst For Infection Prevention, Brianne M. Bachman, Jennifer E. Jones, Jessica L. Mcclusky, Mallory Davis

Posters

Simulation-based education has emerged as a transformative tool in healthcare, bridging the gap between theoretical knowledge and clinical practice.

In the realm of infection prevention, simulation offers a controlled, risk-free environment to reinforce essential protocols, build competency, and identify system level vulnerabilities before harm occurs.

The Role Of Project Managers And Pmp Principles In Improving Operational Efficiency In Healthcare Organizations, Karan Thakkar

Harrisburg University Dissertations and Theses

Healthcare organizations operate in increasingly complex, regulated, and resource-constrained environments while managing a growing volume of projects tied to digital transformation, process improvement, regulatory compliance, and infrastructure development. Despite the project-intensive nature of healthcare operations, many organizations do not formally employ trained project managers or consistently apply Project Management Professional (PMP) principles; project responsibilities are frequently absorbed by clinical or administrative leaders whose primary expertise lies outside formal project management. This qualitative study examined how the project manager role and PMP principles contribute to operational efficiency in healthcare organizations. The study was conducted as a qualitative document analysis and thematic …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Exploring Practicing Registered Eeg Technologies' Opinions And Preferences Regarding Electroencephalographic Scope Of Practice Standard Forms Of Occupational Regulations, Richard A. Steer

Seton Hall University Dissertations and Theses (ETDs)

Abstract Background: Neurodiagnostic (NDT) is the study and recording of electrical activity in the central and peripheral nervous systems, it is essential for providing critical information that can aid in the diagnosis and treatment of neurological disorders. EEGs are the most frequently performed NDT procedures. The proportion of hospitalizations involving EEG use increased by 122.7% from 2003 to 2014, an average increase of 11.2% annually and continues to grow. The rate of rEEG use increased by 49.4% over 11 years (4.5% annually), while cEEG use increased by 302.3% (27.5% annually) (Bernheimer et al., 2018). Under existing law, the EEG profession …

The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.

Rowan-Virtua Research Day

Introduction: This research project "Comparing timing of care for skin cancer patients with limited English proficiency who require interpretation during medical visits to patients with English proficiency" was accepted under the CREATE Grant. The hypothesis was that patients who require medical interpretation during their visits would show a longer period of time between noticing a skin lesion to definitive diagnosis. Previous research has shown improved health care outcomes, but has mixed results on patient satisfaction and health care experience. This poster aims to detail the limitations faced during the execution of a retrospective chart review from the perspective of a …

Addressing Substance Use Disorder In Rural Appalachia: Improving Access And Treatment Outcomes For Justice-Involved Individuals, Jessica Muldowney

Electronic Theses and Dissertations

Background: Opioid use disorder (OUD) represents a critical public health crisis disproportionately affecting justice-involved (JI) populations, with approximately 65% of incarcerated individuals having substance use disorders (James & Beatty, 2006). Rural Appalachian communities face compounded challenges due to limited healthcare access, provider shortages, and cultural stigma surrounding addiction treatment. Despite evidence demonstrating that medication-assisted treatment (MAT) reduces recidivism and overdose deaths, only 20% of correctional facilities offer these services (Klein & Seppala, 2019).

Objective: This mixed-methods study evaluated organizational readiness and infrastructure capacity for implementing evidence-based OUD interventions, specifically MAT programs across three rural counties in northwestern North Carolina.

Methods: …

Digital Touchpoints: Investigating Contact Page Accessibility And Visual Authenticity Within Medical Tourism Health Websites, Alicia Mason, Elizabeth Spencer, Kristen Livingston, Treyton Meyers, Sakshi Bhati, Himika Akram

Faculty Submissions

This study examines two critical digital touchpoints on medical tourism provider (MTP) websites: (1) the accessibility of contact pages which often function as entry points for inquiries, scheduling, and pre-travel coordination, and (2) the authenticity of visual imagery used to shape expectations about care environments, personnel, and technological capacity. A sample of 105 MTPs across all six World Health Organization regions were analyzed using quantitative web accessibility testing and qualitative visual analysis. Results indicate pervasive accessibility errors on contact-page touchpoints and extensive reliance on inauthentic imagery to depict patients, providers, and medical technologies. Together, these practices may distort user expectations …

The Cost Of Affordable Healthcare: How Brazil's Sus And Generic Drug Strtegy Produce Structural Inequality And Challenge Global Pharmaceutical Rules, Elena Kössler

Posters - 2026

Affordable healthcare is often seen as a major social achievement, but maintaining low costs involves important trade-offs. Brazil’s Unified Health System (SUS) provides universal healthcare and relies heavily on generic medicines to expand access. This raises a central question: how can a system reduce the cost of healthcare while simultaneously generating new forms of inequality and tension within global pharmaceutical markets? This paper argues that Brazil’s cost-reduction strategy, particularly its reliance on generic medicines, improves affordability but also produces structural trade-offs between equitable access, quality of care, and incentives for pharmaceutical innovation.

Eating Disorder Prevention And Early Intervention In U.S. Higher Education – A Comparative Benchmarking Study, Jake R. Arcement

Senior Theses

Eating disorders (EDs), including anorexia nervosa, have the highest mortality rate of any psychiatric illness, yet remain underrecognized relative to their severity and treatment burden. Because the period of peak onset aligns with the college years, institutions of higher education are uniquely positioned to play an important role in prevention, early identification, and referral to specialized care. However, limited research has examined how colleges and universities structure ED prevention and treatment resources. This thesis applies a comparative benchmarking framework to assess current institutional practices across U.S. colleges and universities. A national survey of student health and counseling centers examined staffing, …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Operational Factors Influencing Branch Revenue In Multi-Branch Child Therapy Services, Muhammad Luthfi

Jurnal Administrasi Bisnis Terapan

The management of multi-branch child therapy services requires a strong understanding of operational factors that contribute to revenue performance. This study aims to analyze the relationship between operational days, occupancy rate, service attendance, and the number of practitioners in relation to branch revenue within a child therapy service organization operating in urban areas in Indonesia. A quantitative cross-sectional design was employed using operational data collected from 24 child therapy services. This study employed a quantitative cross-sectional design using branch-level operational data collected in December 2025 from 24 child therapy service branches. Multiple linear regression analysis was conducted to examine the …

Community Benefit Spending Decisions At Virginia’S Nonprofit Hospitals, Zelda Hinkle

School of Professional and Continuing Studies Nonprofit Studies Capstone Projects

Nonprofit hospitals play a unique role in the healthcare system: in exchange for tax- exempt status, they are expected to provide “community benefits,” such as charity care, health programs, and community investments. While this spending represents a major opportunity to improve population health and address disparities, stakeholders debate how expectations should be set, measured, and regulated to ensure mission adherence while maintaining nonprofit autonomy. This study explores how community benefit spending allocation is actually determined, leveraging interviews with decision-makers at large nonprofit hospital systems in Virginia. Findings consider the role of factors such as Community Health Needs Assessments and strategic …

Enhancing Military Health System Organizational Efficiency And Quality Of Care Through A Social-Ecological Framework, Eric L. Peipelman

College of Graduate Studies: Theses & Dissertations

Timely and fair adjudication of incivility-related actions within the Department of Defense (DoD) and Military Health System (MHS) is increasingly crucial for maintaining accountability, mission readiness, and quality of care. Ongoing delays in resolving workplace complaints and inefficiencies in resource-heavy adjudications highlight the need to shift from reactive complaint handling toward proactive civility promotion and transparent decision-making. This Integrated Learning Experience (ILE) introduces the Peipelman Civility Discussion and Assessment Toolkit (PCDAT)—a comprehensive, evidence-based framework designed to improve civility, optimize resources, and enhance communication, even in the MHS. Based on the Social-Ecological Model (SEM) and adapted from the Workplace Power and …

Teledentistry: A Path To Minimize Emergency Department Dependency For Dental Issues, Aishwarya Joshi

Graduate Studies Theses and Dissertations 2026

Teledentistry has been promoted as a strategy to minimize emergency department (ED) visits for non-traumatic dental conditions (NTDCs). However, it remains unclear whether structural readiness or temporary policy expansion drives sustained reductions in reliance on the ED. This study integrates Andersen’s Behavioral Model of Health Services Use and Diffusion of Innovation (DOI) theory to examine determinants of Medicaid NTDC ED utilization and Tele-dentistry adoption.

Andersen’s model posits that utilization is shaped by predisposing, enabling, and need factors, whereas DOI theory emphasizes structural attributes that influence adoption, including relative advantage, compatibility, complexity, trialability, and observability. Combining these frameworks allows for a …

Examining Patient Safety Culture Trends In U.S. Healthcare Through A Multi-Year Analysis, Hassan Alabdullah

Graduate Studies Theses and Dissertations 2026

Patient Safety Culture (PSC) is recognized as a cornerstone of healthcare quality and a key determinant of patient outcomes. Despite the Institute of Medicine’s early calls to establish safety-oriented systems, evidence on the long-term stability of PSC in U.S. hospitals has remained limited. This dissertation addresses this gap through a multi-year evaluation of PSC using the Hospital Survey on Patient Safety Culture (HSOPSC v1.0) and advanced statistical methods. Drawing on one of the largest national datasets—comprising over 993,000 healthcare providers from 1,601 U.S. hospitals across three survey cycles (2013–2020)—the study employed a longitudinal repeated cross-sectional design. Analyses combined descriptive statistics, …

Disaster Risk Reduction In Rural Indonesia: Evaluation Of The Japan Red Cross Program In Pujiharjo Village, Meyralda Dara Adisa, Pujo Widodo, Anwar Kurniadi, Wilopo Wilopo

Preventia: The Indonesian Journal of Public Health

Pujiharjo Village in Malang Regency, Indonesia, is highly vulnerable to natural disasters. In 2021, the Indonesian Red Cross (PMI) partnered with the Japanese Red Cross Society (JRCS) to implement a community-based disaster preparedness program. This study evaluates the program's effectiveness in terms of community participation, institutional support, and alignment with the Sendai Framework for Disaster Risk Reduction 2015–2030. Using a qualitative case study, data were collected through document analysis of Vulnerability and Capacity Assessments (VCA), Community Action Plans (CAP), and local SOPs. Thematic analysis explored disaster risk perception, governance, mitigation investment, and emergency preparedness. The program successfully improved risk awareness, …

Analisis Perbedaan Biaya Satuan Sectio Caesarea Tanpa Penyulit Dengan Tarif Ina-Cbgs Di Rumah Sakit Swasta Tipe D (X) Di Ternate Tahun 2022, Ummu Hani Mars, Prastuti Soewondo

Jurnal Ekonomi Kesehatan Indonesia

Cesarean section unit cost is an important component for hospital’s management to implement strategic efficiency steps in the future, especially for Rumah Sakit X which 90% of patients are Jaminan Kesehatan Nasional’s participant. Geographically, this hospital is one of hospitals which serve delivery and labor services in Ternate Island that can accommodate references from nearby islands. This resulting in high caesarean section rate, 55 % of all deliveries. The low JKN rate for caesarean section forced management to know the detailed cost component, so the efficiency strategies and the continuity of hospital services could be more increased. This research through …

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Opportunities To Improve Continuity In Medicines Management For Aboriginal And Torres Strait Islander People Accessing Care In South Australian Hospitals: Coverage, Quality, Monitoring And Accountability, Annabelle Cranwell, Cheyne Sullivan, Kezia Daniel, Erik Cornelisse, Brianna Kinnear

Journal of the Australian Indigenous HealthInfoNet

This paper proposes that hospital admissions, which are traditionally considered high risk transitions, can be opportunities to strengthen continuity in medicines management (CMM) for Aboriginal and Torres Strait Islander patients and across the healthcare system. There are four key areas of focus in this paper including CMM coverage, CMM quality, health system monitoring of CMM, and health system accountability for CMM to Aboriginal and Torres Strait Islander people and communities. These areas for improvement are justified by the National Agreement on Closing the Gap (The National Agreement), the Guiding Principles to Achieving continuity in medication management, and Continuity in Medication …

Effect Of Establishing A Separate Outpatient Pharmacy Counter On Reducing Waiting Time In Mayapada Hospital, Hanifan Irham, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Pharmacy waiting time is one of the quality indicators that affects patient satisfaction in hospitals. One of the various efforts to reduce drug waiting times is adding outpatient pharmacies. This study aims to see whether the addition of pharmacies based on guarantors can reduce drug waiting times for outpatients. This is an observational study with a cross-sectional design. The sample included 11,703 patients who received prescriptions at Mayapada Hospital Bogor outpatient with insurance and private coverage. Data were collected over four months, two months before and two months after the separation of pharmacies. Waiting time data were obtained from the …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Impact Of Physician Precepting On Medical Education And Healthcare Delivery: A Qualitative Secondary Analysis, Hannah E. Gutjahr, Steven A. Fasko

SIU Journal of Medical Science Scholarly Works

This qualitative study investigates the impact of physician precepting on medical education and healthcare delivery, prompted by the need for consistency in precepting practices across various institutions and specialties. Physician preceptors, who bridge the gap between theoretical learning and practical application, play a critical role in shaping competent and compassionate healthcare professionals. However, inconsistencies in precepting quality and challenges such as time constraints, inadequate training, and balancing clinical duties with teaching responsibilities necessitate a comprehensive evaluation of precepting's effectiveness.

A systematic literature review was conducted to explore these issues, focusing on secondary data from peer-reviewed journals, case studies, and policy …

Predictors Of Healthcare Providers' Readiness For Health System Transformation In Saudi Arabia, Ahmed Ali Alasiri

Health Services Research Dissertations

The healthcare system in Saudi Arabia is undergoing significant health reform to warrant sustainable welfare provision. Privatization or public-private partnerships (PPPs) were introduced in 2021 and outlined the vision for the health system for 2023. The planned initiatives aim to be comprehensive and effectively reach individuals and society, including citizens, noncitizens, and visitors. This dissertation seeks to study and explore privatization, the role of healthcare providers, and their capacity to adapt to the transformation of the healthcare system. To achieve this ambitious goal, several interrelated projects have been undertaken. The first project was a systematic review aimed at studying the …

Health Economics Perspective On Indonesian Telemedicine Platform Practices: A Qualitative Study, Yossico Ria Wibowo, Rina Djunita Pasaribu

Kesmas

Telemedicine in Indonesia has experienced significant growth since its introduction in 2014. The financing system is regulated independently by each platform, leading to disparities in teleconsultation fees and medical incentives. This qualitative study, which involved a literature review and interviews with 33 participants, offered a health economics perspective on the implementation of telemedicine. The recommended teleconsultation fee ranges from USD 0.05 to USD 2.54, with medical incentives set at USD 1,59-3.18 for general practitioners and USD 4.77-6.36 for specialists, using telephone or video calls as the preferred means of teleconsultation. Although most patients and Indonesian Medical Association administrators generally agreed …