Health and Medical Administration Commons^™

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 …

Use Of Preference Signals In Family Medicine Residency Recruitment, John E. Snellings, Hanwen Miao, Daniel L. Meyer, Miranda A. Moore

Department of Family and Community Medicine Faculty Publications

Background and Objectives: Increases in graduate medical education application volume led to the introduction of preference signaling—a tool within the Electronic Residency Application Service that allows applicants to signal their sincere interest to a limited number of programs. This study aims to evaluate how family medicine program directors used preference signals during the 2023–2024 recruitment season, the first year this tool was available to family medicine programs. Understanding program director perspectives on preference signal utility is crucial for determining the tool’s impact on the residency selection process.

Methods: Data were collected through the Council of Academic Family Medicine Educational Research …

Leading The Way In Pediatric Oral Health Promotion, Denise C. Mckinney

Dental Hygiene Faculty Publications

[Introduction] Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.¹ In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and the unborn child.² In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.³ Expectant mothers …

Acceptability, Usability, And Clinical Integration Of A Clinic-Based Digital Game For Hpv Education: Qualitative Perspectives From Adolescents, Parents, And Healthcare Providers, Elizabeth Reifsnider, Satya Subedi, Nouran Ghonaim, Megan Whaley, Angela Chia-Chen Chen

Ellmer School of Nursing Faculty Publications

Background/Objectives: HPV vaccination is safe, effective, and recommended at ages 11–12, yet uptake remains suboptimal. Serious video games may offer an innovative strategy to deliver brief, engaging education during clinic visits. This qualitative paper, embedded within a mixed-methods study, examined adolescents’, parents’, and healthcare providers’ (HCPs’) perceptions of the acceptability, usability, and perceived clinical applicability of HPV Detective, a tablet-based digital game designed to provide HPV-related education to parent–child dyads during pediatric clinic wait times. Methods: Eight adolescent–parent dyads (N = 16) and three HCPs from university-affiliated pediatric clinics participated in 30–60-min semi-structured Zoom interviews. Interviews were audio-recorded, transcribed, and …

Confessions In Cases Of Child Physical Abuse - A Capnet Study, Margaret R. Russell, Antoinette L. Laskey, Henry T. Puls, Suzanne P. Starling, Joanne N. Wood, Daniel M. Lindberg, Nancy S. Harper, Caitlin R. Mcnamara, Angela N. Bachim, Farah W. Brink, Lori D. Frasier, James D. Anderst, Porcia Vaughn, Kristine A. Campbell

Department of Pediatrics Faculty Publications

Objective

Prior research on confessions of physical abuse (PA) has explored mechanisms of injury. Little is known about conditions supporting a confession of abuse or how confessions may influence case outcomes.

Methods

This cross-sectional study of suspected PA in children age < 10 years at 10 centers participating in CAPNET, a multicenter child PA research network, included children with in-person Child Abuse Pediatrics (CAP) consultations between Feb 2021-Dec 2022 and excluded children without injury. Our focus was a confession of inflicted injury known to the CAP during clinical involvement. We compared child and clinical characteristics, out-of-home (OOH) placements, and arrests between cases with and without confessions. Multivariable models using generalized estimating equations (GEE) produced adjusted predicted probabilities (APP) clustering by CAPNET site.

Results

Confessions were known to CAPs in 115/4297 (2.7%) cases, with significant site variability. In a multivariable GEE model, confessions were more likely in cases with injuries with high-specificity for abuse (APP 6.0% vs 1.5%, p< 0.001), near-fatality (APP 5.5% vs 2.3%, p< 0.001), and older children (APP 4.8% vs 2.5%, p = 0.025). OOH placements and arrests were more common in cases with confessions. CAP awareness of confessions, OOH placements, and arrests did not follow racial or ethnic patterns seen in the US child welfare system. Lower socioeconomic status was associated with OOH placements and arrests but not CAP awareness of confessions.

Conclusions

Our findings highlight differences in case characteristics and outcomes where a confession is known to the CAP and raise questions about agency …

Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

Health Literacy/Numeracy-Related Factors Affecting Interpretation In Medical Laboratory Values, Rachel L. Childs

School of Medical Diagnostics & Translational Sciences Publications

Background

Health literacy and numeracy are broad terms that relate to a patient’s understanding of their health information. While there is a substantial amount of research on this topic in a general sense as well as in relation to how deficiencies in these skills impact patients’ understanding of laboratory results, little is known regarding the extent to which underlying factors, which are impacted by health literacy/numeracy, affect how patients interpret their results. This literature review attempts to shed light on the current literature on this more focused and narrow issue, including recommendations to address these barriers.

Content

To perform this …

Maintaining Trust In Uncertain Times: Funding Pauses And The Ethical Cost To Community-Engaged Research, Brynn E. Sheehan

Department Psychiatry & Behavioral Science Faculty Publications

Federal funding pauses, once considered rare, are increasingly disrupting the stability and continuity of community‐engaged research. Even projects with active, awarded grants are experiencing the strain of funding uncertainty, raising substantive concerns among research teams and community partners. These disruptions extend beyond operational delays; they jeopardize the continuity of relationships developed through sustained, collaborative engagement. In the absence of clear information about a project's future, uncertainty undermines trust and challenges the ethical principles that guide human subjects research, particularly beneficence and justice. This paper draws on direct experience and insights from the broader field to examine the practical and ethical …

Improving Pediatric Emergency Department Lethal Means Safety Documentation Rates For Adolescents With Mental Health Concerns, Cassandra L. Stegall, Ana-Maria Mcgill, John Fanton, Paul C. Mullan

Department Psychiatry & Behavioral Science Faculty Publications

Introduction:

Lethal means safety counseling (LMSC) is recommended for children presenting to the emergency department (ED) for a mental health (MH) evaluation. Currently, no gold-standard guidelines exist for documenting LMSC in the ED.

Methods:

This quality improvement project was conducted in the ED of a tertiary children's hospital. Baseline data were analyzed for access to any LMSC documentation (ALD) for "firearms/guns," "sharps," or "medication," and for complete LMSC documentation (CLD) if access to all 3 types was documented. The first intervention period added open-ended screening questions about access to lethal means to the MH-licensed clinical social worker note template. Intervention …

Criterion Validity Of The Functional Status And Pain Assessment Scale Versus Pain And Length Of Stay In Hospitalized Adults With Scd, Wally R. Smith, Daniel M. Sop, Yue May Zhang, Margaret S. Guy, Rehan Qayyum

Department of Medicine Faculty Publications

Objectives

In prior research we demonstrated face, construct, discriminant, and preliminary convergent validity of the newly developed, 10-item Functional Status Pain Assessment (FSPA) scale (0-50) in adult SCD patients hospitalized with VOC. We aimed in this study to further demonstrate criterion validity of the FSPA.

Methods

This was a prospective observational study of 561 daily functional and pain assessments from 91 hospitalized adults with SCD from January 2018 to June of 2019. Principal Component Analysis (PCA) Partial Least Squares (PLS) models determined the relationship between LOS, pain intensity, and FSPA. A Generalized Linear Model (GLM) to quantified the impact of …

Turnover Time In Neuroangiography Suites: Comparison Between Cases Performed At An Ambulatory Neurosurgery Center Versus A Tertiary Hospital, Pui Man Rosalind Lai, Vinay Jaikumar, Erika L. Leasher, Varun Sridhar, Gustavo M. Cortez, Aimee C. Degaetano, Elad I. Levy

EVMS School of Health Professions Faculty Publications

Background:

Efficient turnover time (TOT) and adherence to first-start time (FST) in operating and angiography suites are critical for optimizing workflow, reducing costs, and maximizing patient satisfaction. Hospitals face challenges in maintaining these metrics due to operational constraints and unexpected emergent cases. Our goal was to compare TOT, FST, and total admission time for elective cases performed in angiography suites at an ambulatory neurosurgery center (ANSC) versus a tertiary hospital (TH).

Methods:

We conducted a retrospective analysis of data for patients who underwent elective diagnostic or interventional neuroendovascular procedures at the TH or ANSC from January 2024 through October 2024. …

Contextualizing The Aspe Standards Of Best Practice: Reflecting On The Past, Present, And Future Of Sp Methodology, Amelia M. Wallace, Cory Krebsbach, Janice Radway, Lou Clark

EVMS School of Health Professions Faculty Publications

As we celebrate the publication of the Association of SP Educators Standards of Best Practice (ASPE SOBP) for Physical Exam Teaching Associates (PETAs) and corresponding literature review, we, elected leaders of ASPE, offer reflections on SP methodology history, current practices, and future opportunities. Our aim is to contextualize this addition to what is now the third SOBP publication [1, 2] that guides the global simulation community on best practices of simulated participant (SP) methodology.

Thank you to the ASPE members and SP Educators who made time to share their expertise as authors on these new standards- in addition to their …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Modeling Healthcare Data With Logistic Quantile And Uniform-Based Mixture Polynomial Distributions, Mohan D. Pant, Aditya Chakraborty, Jovanna A. Tracz

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Continuous healthcare data often deviate from normality, which can substantially increase the risk of making invalid inferences, given that many inferential statistical procedures rely on normality assumption. To obviate this issue, we propose a new family of non-normal distributions based on a linear combination of the quantile functions of standard logistic and uniform (0, 1) distributions. This new family of non-normal distributions is studied within three different methods: L-moments, conventional moments, and percentiles. Its performance is compared among the three methods in the context of parameter estimation and data modeling. The results of Monte Carlo simulation and bootstrapping techniques indicate …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Frequent Emergency Department Utilization And Syphilis Case Profiles In The Sentara Healthcare System: A Retrospective Cross-Sectional Analysis In Hampton Roads, Martina Zamponi, Grace M. Tillotson, Chandler F. Knox, Mackenzie Tardif-Kunk, Thomas R. Campbell, Peter A. Mollica

Department of Medicine Faculty Publications

Background

Syphilis rates have increased substantially nationwide, disproportionately affecting marginalized populations and individuals with differing patterns of healthcare utilization. The Hampton Roads region of Virginia and North Carolina includes multiple jurisdictions with syphilis rates above the CDC screening threshold, with 7 of its 9 independent cities meeting this criterion. However, no prior study has examined the relationship between emergency department (ED) utilization patterns and documented syphilis diagnoses in this region.

Methods

A retrospective cross-sectional analysis of the Sentara Healthcare network was conducted using aggregate data from the TriNetX platform. Patients diagnosed with syphilis between 2023 and 2024 were stratified by …

Determinants Of Patient Satisfaction In An Academic Primary Care Setting: A Cross-Sectional Study Of The Postpandemic Era, Alvin Maliakal, Rajita Kanapareddy, Zooha Altaf, Janani Anbazhagan, Kristin Olson, Cynthia Avila, Rehan Qayyum

Department of Medicine Faculty Publications

Background

Patient satisfaction, a key indicator of healthcare quality, is associated with improved adherence, continuity, and outcomes. However, limited evidence describes determinants of patient satisfaction in contemporary primary care settings reflecting the postpandemic era, when care delivery models and patient expectations have evolved substantially.

Objective

To evaluate the sociodemographic and clinical factors associated with patient satisfaction in an academic primary care setting following the postpandemic era.

Methods

We conducted a cross-sectional survey of adult patients (≥18 years) attending a primary care clinic. Participants completed a self-administered questionnaire including the Visit-Specific Satisfaction Questionnaire (VSQ-9) and measures of sociodemographic and clinical characteristics. …

Pilot Study On The Use Of Multimorbidity Index In Patients Receiving Home Parenteral Nutrition, Michael M. Rothkopf, Mohan Pant, Zachary Rothkopf, Rebecca Brown Rdn, Jaime Haselhorst Rdn, Debbie L. Stevenson Rdn, Andrew Depalma Mba, Michael Saracco

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Home parenteral nutrition (HPN) patients often have multiple comorbidities. A validated multimorbidity index (MMI) could help determine resource needs and risks with HPN. We evaluated MMI scoring to determine if it predicted HPN resource use and outcomes.

Methods

We performed a secondary analysis of 60 HPN patients from a previous study based on Cumulative Illness Rating Scale (CIRS) scoring. We examined three variables: PN formula changes, hospitalizations, and hospital length of stay (LOS). Density plots were produced to select a CIRS score cutoff value. Spearman correlations among the three variables of interest were computed. The data were then subjected …

An Investigation Of Federated Gnns Under Aggregation, Data Poisoning, And Differential Privacy For Icu Length-Of-Stay Prediction, Shakib Mahmud Dipto, Soumya Banerjee, Sandip Roy, Ahmad F. Al Musawi, Preetam Ghosh, Sachin Shetty, Pratip Rana

Computer Science Faculty Publications

Accurate prediction of ICU Length of Stay (LoS) is essential for clinical decision-making and healthcare resource management. Graph Neural Networks (GNNs), such as GraphSAGE, offer a natural fit by capturing patient data from Electronic Health Records (EHRs) through graph structures. However, the distributed and sensitive nature of this data raises both privacy and legal concerns regarding the aggregation and training of GNN models. This additionally leads to issues with data imbalance and model robustness. In this study, we perform an analysis of the Federated Graph Neural Network (GNN-FL) framework to enable decentralized learning on EHRs derived from the MIMIC-III dataset. …

Schema, Stigma, And The “We-Them” Divide: Perspectives On Ageism From Everyday Life To Healthcare, Temple D. West

English Theses & Dissertations

Ageism remains a pervasive and often underexamined form of discrimination, affecting older adults across both everyday and clinical contexts. This paper explores how cognitive schemas—mental frameworks that shape perception and experience—and stigma interact to reinforce a “we–them” divide between and older patients and healthcare providers, as well as between older and younger individuals in broader society. Through focus groups and listening to the voices of older patients, this study examines how assumptions of age-based decline are embedded in society and inform schemas of ageism. It considers how those schemas shape the spoiled identity of older people as a stigmatized group, …

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 …

Why Ai Monitoring Faces Resistance And What Healthcare Organizations Can Do About It: An Emotion-Based Perspective, Karl Werder, Lan Cao, Eun Hee Park, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Continuous monitoring of patients' health facilitated by artificial intelligence (AI) has enhanced the quality of health care, that is, the ability to access effective care. However, AI monitoring often encounters resistance to adoption by decision makers. Healthcare organizations frequently assume that the resistance stems from patients' rational evaluation of the technology's costs and benefits. Recent research challenges this assumption and suggests that the resistance to AI monitoring is influenced by the emotional experiences of patients and their surrogate decision makers. We develop a framework from an emotional perspective, provide important implications for healthcare organizations, and offer recommendations to help reduce …

Readiness To The Privatization Of The Health System In Saudi Arabia: Translation And Factor Analysis Of Readiness To Organizational Change (Roc) Scale, Ahmed Ali Alasiri, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

The Kingdom of Saudi Arabia (KSA) began a major transformation as a part of version 2030 for its health system. These reform initiatives aim to privatize health services and improve efficiency. Despite this meaningful change, there is a knowledge gap in how healthcare providers prepare for or perceive this shift. Specifically, there has been a lack of validation of Arabic instruments that gauge the individual readiness to this change. This study bridges the gap by localizing and validating the Readiness to Organizational Change scale (ROC) to provide empirical evidence and to understand adaptability for the KSA context.

Method

The …

Letter Of Concern From The Association Of Academic Chairs Of Emergency Medicine Regarding Acgme Proposed Changes, Richard J. Hamilton, Lance B. Becker, Richard E. Wolfe, D. Adam Algren, Arnold Thomas, Michael Baumann, Ross P. Berkeley, Terrell S. Caffery, Chad Cannon, Theodore J. Corbin, Michael E. Chansky, Harinder S. Dhindsa, Charles L. Emerman, David A. Farcy, Chris Fox, Michael A. Gibbs, Christopher S. Goode, Steven "Andy" Godwin, Dietrich Jehle, David Johnson, Samuel M. Keim, Babak Khazaeni, Barry J. Knapp, Clint Hawthorne, John D. Hoyle Jr., Michael Christopher Kurz, Evan Leibner, Robert Mcnamara, Robert F. Mccormack, Edward A. Michelson, Chadwick Miller, Ashley Norse, Andrew Nugent, Brian J. O'Neil, David T. Overton, Edward A. Panacek, William F. Paolo, Denis R. Pauzé, Amanda L. Perez, Ralph J. Riviello, Scott W. Rodi, Peter S. Pang, Juan A. Gonzalez Sanchez, David P. Sklar, Ben C. Smith, Jeffrey R. Stowell, Marc D. Squillante, J. Jeremy Thomas, Terry Vanden Hoek, Gregory A. Volturo, E. Lea Walters, Thomas E. Wyatt, Donald M. Yealy

Department of Emergency Medicine Faculty Publications

This letter, signed by over 50 academic chairs of emergency medicine, urges the ACGME to reconsider a proposed mandate requiring all emergency medicine residency programs to adopt a four-year training model. The authors argue that current three-year programs are supported by data demonstrating equivalent educational and clinical outcomes compared to four-year formats. They criticize the flawed survey methodology underpinning the proposal, note the loss of milestone-based training flexibility, and highlight the lack of added scholarly or clinical value in the fourth year. The letter also outlines negative consequences for fellowship participation, workforce development, trainee debt, and diversity. The signatories advocate …

Ancestry-Dependent Immunologic And Prognostic Effects Characterize The Prostate Cancer Urinary Proteome, Annie Ha, Jaron Arbet, Zhuyu Qiu, Amanda Khoo, Brian P. Main, Meinusha Govindarajan, Matthew Waas, Stanley K. Liu, O. John Semmes, Julius O. Nyalwidhe, Paul C. Boutros, Thomas Kislinger

Leroy T. Canoles Jr. Cancer Research Center Faculty Publications

Urine is an attractive biomarker analyte for non-invasive longitudinal monitoring of health and disease, particularly for diseases of the genitourinary tract, like prostate and bladder cancer. The composition of an individual's urine reflects both genetic and lifestyle characteristics that differ across geographies and populations, like diet, hydration and other socio-economic factors. While men of African ancestry have elevated prostate cancer risk, it is unclear to what extent this influences urinary biomarkers. We therefore quantified the urinary proteomes of 329 localized prostate cancer patients: 135 self-identifying as White and 194 self-identifying as Black. We identified 110 proteins that significantly differed between …

"They Just Don't Have The "Doctor" In Front Of Their Name:" Dimensions Of Trust In Physician Assistants, Staci Defibaugh, Leah Onosato

English Faculty Publications

Physician assistants play a major role in healthcare delivery in the United States, yet what we know about how patients perceive the care they receive from PAs is limited. Prior research on patients’ impressions of PAs has focused primarily on survey data, limiting the scope of what we can learn about patient impressions to predetermined, quantifiable categories, and has focused on post-visit impressions of a single encounter. In an attempt to better understand patient impressions, we conducted open-ended, semi-structured interviews with 30 participants prior to their medical visit, focusing on general impressions of PAs. Through an analytic process of reflexive …

Drone-Based Medication Delivery For Rural, Flood-Prone Coastal Cities, Yin-Hsuen Chen, Amro M. El-Adle, Kevin J. O'Brien, Taylor Wentworth, Heather G. Richter

Center for Geospatial Science, Education & Analytics Faculty Publications

Access to healthcare remains a critical challenge for rural populations, particularly in flood-prone coastal communities where transportation barriers limit access to essential medical services. This study evaluates the effectiveness of drone-based medication delivery in improving healthcare accessibility for vulnerable populations on Virginia’s Eastern Shore. Compared to traditional personal vehicle travel, drone delivery reduced trip times from up to 50 minutes to under 10 minutes for more than 80% of the population, including elderly patients. Using publicly available datasets, we developed two transportation vulnerability indices that incorporate age, travel time, and flood risk to prioritize patients for drone-based pharmaceutical delivery. These …

The Impact Of Onboarding During Transition To Practice For Newly Credentialed Athletic Trainers, Ashley B. Thrasher, Stacy E. Walker, Julie M. Cavallario

Rehabilitation Sciences Faculty Publications

Context

As new athletic trainers (ATs) transition into their roles, some employers provide extensive orientation and onboarding to assist with the transition to practice (TTP); however, onboarding practices are inconsistent. Understanding how onboarding affects TTP can help employers implement impactful onboarding tactics.

Objective

Examine how the onboarding experience impacted the TTP and the effects of the process on individuals.

Design

Grounded theory.

Setting

Secondary school, hospital/clinic, college/university.

Patients or Other Participants

Seventeen newly credentialed, employed ATs who had graduated from professional masters' programs (11 female, 6 male; age = 25.6 ± 2.2 years) participated in this grounded theory study.

Data …

A Governance-Centric Framework For Strengthening Healthcare Cybersecurity: A Systems Perspective, Sujatha Alla, Sai Gireesh Komaragiri, Teresa Duvall, Satluk Karahan, Nagesh Bheesetty, Vijay Kumar Chattu

Engineering Management & Systems Engineering Faculty Publications

Healthcare systems face unprecedented security and privacy challenges due to increasing digitization and interconnectedness. This paper provides a comprehensive analysis of these challenges by examining various cyberattacks, defensive mechanisms, and governance frameworks within modern healthcare infrastructure. The research systematically categorizes prevalent security threats, such as ransomware, insider threats, and data breaches, identifying vulnerabilities specific to healthcare systems. Furthermore, the study evaluates current defensive strategies, including encryption techniques, access control systems, and intrusion detection tools, assessing their effectiveness against complex cyber threats. A key focus is placed on governance structures and their role in cybersecurity resilience. The research explores how regulatory …

A Modern Optimization Approach With Data-Driven Analytical Modeling For The Healthcare Business Segment (Hbs) From The S&P 500, Aditya Chakraborty, Chris Tsokos

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Introduction: The S&P consists of eleven business segments, which are classified according to the type of industry. The current study focuses on developing a non-linear analytical model for the Healthcare Business Segment (HBS) of the S&P 500, as a function of different economic & financial indicators. Materials and Methods: The analytical model used six financial indicators together with four economic indicators to predict the weekly average closing price (WCP) of HBS stocks. Johnson’s SB transformation corrected skewness, while desirability-based optimization identified indicator values maximizing WCP. The model’s performance and generalizability were validated through repeated 10-fold cross-validation. Results: All attributable contributors …