Health and Medical Administration Commons^™

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

Quality? Safety? Stop Being Naïve., Rana K. Zaban Do, Steven Istephan, Jonathan Serman Md

Clinical Research in Practice: The Journal of Team Hippocrates

The first day of our inpatient medicine rotation, the Emergency Department (ED) admitted a patient to a general medical floor without notifying our rounding team. We used the institution’s system improvement tracking software to draw attention to communication breakdown in the interest of patient safety. This piece illustrates how there is a prominent hierarchy in medicine; it is inherent to the framework of the way in which hospitals function. A discussion ensues with our attending physician supervisor on our patient medicine service. During this discussion, we ponder whether it is possible to impact quality and safety from our position as …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

MaineHealth Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Does Liberalizing State Nurse Practitioner Scope Of Practice Laws Affect The Primary Care Provider Composition And Productivity In Community Health Centers?, Jeongyoung Park, Xinxin Han, Ellen T. Kurtzman

Health Workforce Research Center Publications

The state scope of practice (SOP) laws determine the range of services nurse practitioners (NPs) can provide and the extent to which they can practice independently. This has been a hot topic amid concerns about primary care provider shortages in light of health reform coverage expansion. Many states consider liberalizing NP SOP laws in an effort to expand primary care capacity. As the demand for primary care increases, NPs are expected to have an active role in meeting primary care needs. The purpose of this study was to examine the effects of expanded nurse practitioner (NP) scope of practice (SOP) …

Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce a call for submission for its special issue scheduled for July 2018 on the topic of patient & family experience in children’s hospitals and pediatric care. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either children’s hospitals or pediatric care. It is encouraged that articles submitted deal directly with efforts in those care settings. The issue will look for pieces that address evidence-based efforts at improvement, practices that have impact on outcomes or stories that reflect …

Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr.

Patient Experience Journal

Integrating patient and family member needs, wants and preferences in healthcare is of utmost importance. However, a standardized patient and family engagement model to understand these needs, wants and preferences in order to translate into high quality improvement activities is lacking. Experience based co-design (EBCD) is an approach that enables patients, family members and healthcare providers to co-design improvement initiatives together. In this study, EBCD was employed to: 1) assess the current state of information and educational resources at a local oncology center and 2) partner with patients, family members, and healthcare providers to create quality improvement initiatives targeting identified …

Increasing Sustainability In Co-Design Projects: A Qualitative Evaluation Of A Co-Design Programme In New Zealand, Lynne Margaret Maher Dr., Brooke Hayward, Patricia Hayward, Chris Walsh Dr

Patient Experience Journal

The Health Quality & Safety Commission New Zealand commissioned Ko Awatea, an innovation and improvement centre, to deliver a co-design programme to nine teams of healthcare providers. The co-design programme was part of Partners in Care, a broader programme developed in 2012 to support and enable patient engagement and participation across the health and disability sector. Teams received training, guidance and mentorship in Experience Based Design (EBD) methodology.¹ We evaluated the co-design programme to explore barriers and facilitators to the sustainability of the co-design projects and the EBD approach. The evaluation involved seventeen semi-structured interviews with programme participants, including …

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing home. …

Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett

Patient Experience Journal

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations …

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when …

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we …

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as …

Optimizing Emergency Department Throughput Using Best Practices To Improve Patient Flow, Puneet Freibott Dnp, Rn, Nea-Bc, Ccrn-K'S

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Emergency Department (ED) crowding and bottle necks are the reality of hospitals across the country. Patients seeking care and needing inpatient beds via the emergency rooms are facing delays with attaining the right level of care. Orchestrating a patient through an ED admission requires a multidisciplinary effort to provide safe, effective and efficient care. This quality improvement project conducted in a tertiary acute care hospital focused on Centers for Medicare and Medicaid metrics to measure Emergency Department (ED) throughput. This multidisciplinary initiative focused on reducing time stamps for patient arrival to the ED through departure to hospital or home. Outcomes …

Color-Blind Racial Attitudes: Microaggressions In The Context Of Racism And White Privilege, Jared F. Edwards

Administrative Issues Journal

Interest in institutional racism, White privilege, and microaggressions appears to be growing. We are living in times when the impact of race and racism are debated—when even the existence of racism is debated along with the appropriateness of examining the worst parts of U.S. history. This special-issue invited article includes a brief examination of historical information and current context in which racism and microaggressions exist, leading to their connections to Color-Blind Racial Attitudes (CoBRAs). Reviewed research on CoBRAs addresses teacher training, educational practices, experiences on college campuses, and organizational management.

Investigation Of Factors Relating To The Web-Based Presentation Of Policy And Information On Campus Firearm Policy And Smoking Policy, Veronica F. Mcgowan

Administrative Issues Journal

In order to explore themes of privilege in regard to policy availability, language accessibility, and underlying bias, policies related to two topics of interest to higher education campus visitors, campus firearm carry policy and smoking policy, are explored to determine how Web-based information is presented to various audiences. Implications of policy accessibility are compelling; language barriers can adversely affect access to campus events and educational services. Representative samples of policies of five states that allow some form of open or concealed campus firearm carry were studied to determine possible factors of importance. Representative samples of two additional states in the …

Letter From The Editor, Aij Editors

Administrative Issues Journal

No abstract provided.

A Study Of Rural High School Principals’ Perceptions As Social Justice Leaders, Shelly Albritton, Stephanie Huffman, Rhonda Mcclellan

Administrative Issues Journal

This multisite case study explores how rural principals in high poverty schools in a Southern state that had identified themselves as social justice leaders perceived student diversity, specifically LGBTQ students, and how they sustained a socially-just school climate for all students. Using a qualitative approach lent itself to understanding the principals’ descriptions of themselves as social justice leaders in their respective school and community contexts through their conversations (Creswell, 2007; Marshall & Rossman, 2016). The investigators drew from Theoharis’ (2007, 2009) and Bishop’s (2012) studies to serve as the theoretical framework guiding this study. The results indicated that the principals …

A Faculty Woman Of Color And Micro-Invalidations At A White Research Institution: A Case Of Intersectionality And Institutional Betrayal, Doris Carroll

Administrative Issues Journal

Faculty Women of Color should be able to thrive and grow at our best research and teaching institutions. Assuring their academic and professional success requires that an institution’s academic culture shift from a White, male-dominated, meritocratic environment to a global enrichment campus, one that values the richness and diversity of talent that Faculty Women of Color can contribute as scholars. Using CRT and Institutional Betrayal Theory as a context for understanding their experiences, this paper presents a personal narrative regarding the micro-invalidations that Faculty Women of Color face at America’s White research institutions. The outcome of this discussion offers systemic …

Factors Contributing To The Persistence Of African American And Hispanic Undergraduate Males Enrolled At A Regional Predominantly White Institution, Reginal R. Hall

Administrative Issues Journal

The purpose of this study is to explore factors that may contribute to the persistence and graduation rates of African American and Hispanic undergraduate males enrolled at regional four-year public universities in Texas. African American and Hispanic males have lower graduation rates in both secondary and post-secondary education than their White peers (Harper, 2010; Swail, Cabrera, Lee, & Williams, 2013). The qualitative research investigated characteristics that exist among African American and Hispanic undergraduate males who have persisted and were retained at the university through their senior academic year. The research problem was explored through the lens of critical race theory …

A Review Of For White Folks Who Teach In The Hood…And The Rest Of Y’All Too: Reality Pedagogy And Urban Education, Jackie Mania-Singer

Administrative Issues Journal

This literature review provides a summary and analysis of Christopher Emdin’s For White Folks Who Teach in the Hood…and the Rest of Y’all Too: Reality Pedagogy and Urban Education. Emdin proposes a theory of reality pedagogy and provides a framework, the Seven Cs, for practical implementation of the approach in the urban classroom.

A Systems Theory Approach To The District Central Office’S Role In School-Level Improvement, Jackie Mania-Singer

Administrative Issues Journal

This qualitative case study used General Systems Theory and social network analysis to explore the relationships between the members of a district central office and principals of elementary schools within an urban school district in the Midwest. Findings revealed sparse relationships between members of the district central office and principals, more opportunities for higher performing schools to participate in decision making, and few opportunities for all schools to provide feedback to the district, resulting in a centralized network structure that may inhibit the transfer of knowledge and communication, and ultimately, hinder school-level improvement efforts.

Do Leaders’ Experience And Concentration Area Influence School Performance?, Kimberlin Sturgis, Brittanee Shiflett, Tyrone Tanner

Administrative Issues Journal

The purpose of this study was to examine the educational background of leaders in small, high poverty, high minority schools in an effort to determine if the leader’s concentration area and background were related to the academic success of the students. Through a causal comparative design, a modified version of the Interstate School Leaders Licensure Consortium (ISLLC) Self- Assessment (CCSSO, 2000) was used to collect data from principals and assistant principals to answer the following research questions: Is there a difference between the leader’s concentration area (counseling, mathematics, language arts, science, etc.) and school rating? Is there a difference between …

Using Business Modeling To Streamline Cost Of Anesthesia In A Cardiopulmonary Laboratory, Johnny Dang Dnp, Crna, Kristen Starnes-Ott Phd, Crna

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The Time Driven Activity Based Costing (TDABC) measurement system, a model used in the business arena, can capture clinical processes and costs that other costing models often overlook. Use of this system permitted tying costs to time and resources and identified areas of inefficiency such as depleted supplies and health care and emergency supplies placed inconveniently. A multidisciplinary team developed an anesthesia checklist for use in a remote cardiopulmonary laboratory. The compliance rate for checklist completion was approximately 85%. Checklist implementation translated to a decrease in case delays and time expenditure in patient care by 58% with a cost savings …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

Faculty Perceptions Of Communication At An Academic Medical Center: A Faculty Forward Qualitative Analysis, Brian L. Rutledge, Jessica H. Bailey

The Qualitative Report

The purpose of the study is to examine the faculty’s suggestions on how to improve communication at five schools in an academic medical center. The University of Mississippi Medical Center facilitated the administration of the Faculty Forward Engagement Survey by the Association of American Medical Colleges to faculty in the schools of medicine, nursing, dentistry, pharmacy, and health related professions. This survey included open-ended questions with narrative responses. On these responses to one question about communication, the authors performed the constant comparative method of grounded theory design, a foundational form of qualitative inquiry. In reviewing and coding the 201 responses, …

After Closure: Options For Pursuing A High Performance Rural Health System, Andrew F. Coburn Phd

Rural Hospitals (Flex Program)

Presented at the 2017 National Rural Health Association Annual Meeting. Coburn, a member of the Rural Policy Research Institute Panel, discussed the following key questions: What kind of rural health system is possible in places that cannot support a full-service hospital? How does a rural community navigate the transition from hospital-centric care toward new models that deliver high performance? What implementation support will be needed? Coburn noted that there is no single model for re-configuring the rural health system after hospital closure; local assets, affiliations and partnerships, financial and delivery flexibility and capacities must be critically assessed to determine the …

Combating Workplace Violence: An Evidence Based Initiative, Diana L. Giordano

Evidence-Based Practice Project Reports

Patient/visitor violence against healthcare (HC) employees is a type of workplace violence (WPV) and considered a dangerous hazard within HC occupations (Bureau of Labor Statistics, 2015). Lack of recognition of the true incidence and underreporting of WPV may contribute to a false sense of security within a HC facility (HCF). Therefore, fully addressing the problem may be met with administrative resistance, resulting in poor employee perceptions of support and commitment for a zero-violence environment. A retrospective analysis was conducted on the HCF’s online incident reports, security request calls, and data from a previously deployed WPV employee survey. The emergency department …

Analyzing Organizational Commitment And The Effect On Job Turnover In Nurse Residents, Cory D. Church

Nursing Theses and Dissertations

This dissertation is an exploration of psychosocial concepts related to the experiences of a vital health human resource, newly licensed registered nurses. Newly licensed registered nurses are at risk for leaving their first job within the first year due to the difficulty of transitioning to practice. The pressure to gain competence and deliver quality care, all while navigating the workplace environment, can impact their commitment to an organization and the profession. The reader will notice these concepts threaded throughout the dissertation. While these concepts are explored in other nursing workforce populations, the researcher determined a gap in the research on …