Health and Medical Administration Commons^™

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 …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

Multisociety Guidance For Infection Prevention And Control In Nursing Homes, Lona Mody, Sonali D. Advani, Muhammad Salman Ashraf, Allison H. Bartlett, Suzanne F. Bradley, Deborah P. Burdsall, Jennifer A. Hanrahan, Susan S. Huang, Robert L.P. Jump, Lindsay Nicolle, Mary-Claire Roghmann, Patricia Stone, Rekha K. Murthy

Department of Medicine Faculty Publications

This multisociety guidance was endorsed by SHEA, APIC, IDSA, PALTmed, and AGS. It provides recommendations for infection prevention and control (IPC) in the context of the complexity of nursing home care in the United States: increased medical acuity of residents, the spread of multidrug-resistant organisms, and the threat of emerging pathogens. Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining …

Exploring Institutional Stratification: Minority-Serving Institutional Pathways To Medical School Acceptance In The United States, Amanda K. Burbage, Eushekia Y. Hewitt

EVMS School of Health Professions Faculty Publications

Introduction

Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.

Method

A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …

Disparities In Cardiovascular Disease Outcomes And Economic Burdens Among Minorities In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf Alddin, Michael Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Cardiovascular diseases are the leading cause of mortality in the United States, presenting significant public health challenges and financial burdens, particularly in Southeastern Virginia, where African American and Hispanic (AA&H) populations are disproportionately affected.

Methods

This retrospective observational study analyzed data from 30,855 hospital discharges of AA&H patients across Southeastern Virginia from 2016 to 2020, focusing on individuals aged 18 to 85 with cardiovascular diseases. Utilizing the Virginia Health Information database, we examined demographic information, clinical data, and healthcare utilization patterns through hypothesis tests and regression models to explore associations between these variables and the economic impacts of cardiovascular …

Association Of Maternity Care Deserts With Maternal And Pregnancy-Related Mortality, Rula Atwani, Lindsay Robbins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To evaluate the association between the level of maternity care access and maternal and pregnancy-related mortality.

METHODS:

This was a cross-sectional analysis of county-level data in the United States from January 2018 to December 2021. Using the level of maternity care access, we categorized counties into desert, low access, moderate access, and full access. The primary outcome of interest was maternal mortality rate per 100,000 live births. A secondary outcome was pregnancy-related mortality rate per 100,000 live births. Absolute risk differences and adjusted incidence rate ratios were calculated for maternal mortality and pregnancy-related mortality with multivariable negative binomial mixed-effects …

Generating Real-World Evidence In Early Alzheimer's Disease: Considerations For Applying The Target Trial Emulation Framework To Study The Safety Of Anti-Amyloid Therapies, Xiaojuan Li, Sonal Singh, Bahareh Rasouli, Jennifer Lyons, Noelle M. Cocoros, Richard Platt, Ivan Abi-Elias, Jerry H. Gurwitz

Department of Medicine Faculty Publications

Anti-amyloid beta monoclonal antibodies (anti-Aβ mAbs) have received approval from the US Food and Drug Administration for the treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer's disease (collectively known as early AD) based on evidence from clinical trials. However, whether findings from these trials are generalizable to the real world is uncertain. We need reliable evidence on the real-world safety of these treatments to inform decision making for clinicians, patients, and caregivers. Using lecanemab as an exemplar, we outline the key considerations in designing and implementing an observational study on safety and utilization outcomes using …

Forecasting Covid-19 Cases, Hospital Admissions, And Deaths Based On Wastewater Sars-Cov-2 Surveillance Using Gaussian Copula Time Series Marginal Regression Model, Hueiwang Anna Jeng, Norou Diawara, Cynthia Jackson, Rekha Singh, Kyle Curtis, Raul Gonzalez, David Jurgens, Sasanka Adikari

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Modeling efforts are needed to predict trends in COVID-19 cases and related health outcomes, aiding in the development of management strategies and adaptation measures. This study was conducted to assess whether the SARS-CoV-2 viral load in wastewater could serve as a predictor for forecasting COVID-19 cases, hospitalizations, and deaths using copula-based time series modeling. SARS-CoV-2 RNA load in wastewater in Chesapeake, VA, was measured using the RT-qPCR method. A Gaussian copula time series (CTS) marginal regression model, incorporating an autoregressive moving average model and Gaussian copula function, was used as a forecasting model. Wastewater SARS-CoV-2 viral loads were correlated with …

Icu-Length Of Stay Prediction On Electronic Health Records Using Graph Neural Networks And Homogeneous Similarity Graphs, Ahmad F. Al Musawi, Pratip Rana, Sibtanu Raha, Joshua Braunstein, William C. Sleeman Iv, Rishabh Kapoor, Preetam Ghosh

Computer Science Faculty Publications

Predicting the length of stay (LoS) is important for hospital administration, as it helps allocate proper resources, such as bed management and hospital staffing. Patients' Electronic Health Records (EHRs) contain highly relevant data for LoS prediction; however, their integration and effective use in predictive modeling for accurately estimating LoS remain challenging. To address this, we propose a homogeneous Graph Neural Network (GNN)-based framework for predicting LoS. This method employs a comprehensive data fusion strategy based on the hospital Visit-based Similarity Graph (VSG), which integrates diverse multi-modal clinical features into a coherent, homogeneous graph representation. Next, this VSG is fed into …

An Integrated Theoretical Socio-Technical Framework For Implementing Service Robots’ Integration In Healthcare, Sujatha Alla

Engineering Management & Systems Engineering Theses & Dissertations

Healthcare workers, either clinical or non-clinical, are obligated to serve patients. However, lack of a sufficient number of professionals leads to burnout, severe stress, and, consequently, decreased quality of services. In this context, very few countries have been successful in employing service robots to perform dull, dirty, and/or dangerous tasks related to patient wellbeing/healthcare, while most countries are still skeptical about it. As robotics advances, there is an opportunity for healthcare to take advantage of this technology to reduce personnel workload and to reduce the possibility of exposure to contagious pathogens. However, healthcare is a vulnerable environment and requires critical …

The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham

Counseling & Human Services Theses & Dissertations

COVID-19’s classification as a pandemic in March 2020 changed numerous professions as they adjusted to social distancing expectations. Mental health providers particularly encountered transitions that included higher acuity caseloads, working different hours, and increased exposure to COVID-19. Counselors-in-training (CIT) faced the dilemma of earning their clinical hours in a safe manner, especially CITs working within integrated healthcare settings, such as hospitals or clinics. Despite some research with licensed professional counselors, limited research exists examining CITs' experiences working during the COVID-19 pandemic. This study sought to understand the lived experiences of CITs who completed their clinical hours in an integrated behavioral …

Discussing Systemic Racism And Racial Privilege At A Large, Academic Health Center Using A Modified Privilege Walk, Elizabeth A. Brown, Rosemarie Jones

Community & Environmental Health Faculty Publications

Background: There is a motivation for organizations to understand race and racism from the perspective of minoritized individuals. Academic health centers (AHC) are ideal organizations to have these conversations as they educate healthcare providers, support research in health disparities, and care for diverse patients.

Methods: We piloted and evaluated a virtual Modified Privilege Walk (MPW) with faculty, staff, and students at an AHC in July 2020 to promote difficult conversations about race/racism, social class, and privilege. Each MPW session was voluntary, held virtually over Zoom, and lasted one hour and thirty minutes. Before attending, participants answered questions based on their …

The Nature And Validity Of Implicit Bias Training For Health Care Providers And Trainees: A Systematic Review, Nao Hagiwara, Conor Duffy, John Cyrus, Nadia Harika, Ginger S. Watson, Tiffany L. Green

VMASC Publications

The number of health care educational institutions/organizations adopting implicit bias training is growing. Our systematic review of 77 studies (published 1 January 2003 through 21 September 2022) investigated how implicit bias training in health care is designed/delivered and whether gaps in knowledge translation compromised the reliability and validity of the training. The primary training target was race/ethnicity (49.3%); trainings commonly lack specificity on addressing implicit prejudice or stereotyping (67.5%). They involved a combination of hands-on and didactic approaches, lasting an average of 343.15 min, often delivered in a single day (53.2%). Trainings also exhibit translational gaps, diverging from current literature …

Implementing A Holistic Review Toolkit For Faculty Recruitment And Retention, Toi Blakley Harris, Michelle Shader, Patrick O. Smith, Amelia Challender, Cleveland Piggott, Norma I. Poll, Ryan Henyard, Jeffrey M. Lyness, Erika D. Malmberg, Eva K. Pressman, Alicia D. Monroe, Negar N. Jacobs

University Administration Publications

Introduction: A diverse workforce improves health care, educational outcomes, and research agendas. Currently, faculty from historically excluded groups remain underrepresented in academic medicine. Resources are needed in academic medical centers for those charged with recruiting and retaining a diverse and talented workforce. Methods: Informed by the successful use of holistic review in medical student admissions, the Association of American Medical Colleges (AAMC) developed and piloted a toolkit for use in faculty recruitment and retention at five academic medical centers. Institutions led toolkit-guided holistic review workshops ranging from 2.5 to 3 hours in duration for leaders and faculty to identify and …

Comparative Analysis Of Machine Learning Models For Predicting Healthcare Traffic: Insights For Optimized Emergency Response, Shadman Mahmood Khan Pathan, Sakan Binte Imran, M. M. Shabab Iqbal, Muhammad Enayetur Rahman, Md. Nurul Absar Siddiky, Muhammad Rezaur Rahman, Md Rafid Hasan, Nondon Lal Dey, Md Sobuj Hossain

Electrical & Computer Engineering Faculty Publications

Efficient management of healthcare traffic is crucial for ensuring timely access to medical services, particularly in emergency situations where delays can have severe consequences. This study presents a comparative analysis of three widely used machine learning models—Linear Regression, Decision Trees, and Random Forests—aimed at predicting healthcare-related traffic volumes. A large dataset from a metropolitan traffic system was used to train and evaluate the models based on key performance indicators, including Mean Squared Error (MSE), R² Score, and computational efficiency. The results reveal that the Random Forest model offers the best performance, achieving higher predictive accuracy and faster execution times compared …

Patient Satisfaction Among Saudi Academic Hospitals: A Systematic Review, Ahmed Ali Alasiri, Saad A. Alotaibi, Eric Schussler

Rehabilitation Sciences Faculty Publications

Purpose: To systematically review the patient's satisfaction (PS) levels within academic hospitals in Saudi Arabia from January 2012 to the end of October 2022.

Data Sources: Articles were gathered from PubMed, ProQuest, Google Scholar and Web of Science.

Study selection/data extraction: This review identified studies that assessed PS in Saudi Arabian university hospitals. Articles published before January 2012, as well as commentary letters, conference papers, theses and dissertations, were excluded. The study employed the five domains of PS as outlined by Boquiren et al. Two independent reviewers independently identified qualifying studies, used the Joanna Briggs Institute tools …

Adherence To Personal Protective Equipment Practices During The Covid-19 Pandemic: A Pilot Study, Taryn Amos, Cameron Griffin, Joshua K. Schaffzin, Andrea Ankrum, Felicia Scaggs Huang

Psychology Faculty Publications

A direct observational pilot project of healthcare personnel (HCP) was conducted to validate a tool that measures personal protective equipment (PPE) adherence at a large pediatric institution. Overall unit PPE adherence for all moments ranged from 50-61%. Masking was the most adhered to PPE moment (100%); hand hygiene prior to donning PPE had the lowest adherence (13%). Using data from this standardized tool, researchers can evolve PPE standards to maximize their adherence, effectiveness, and ease of utilization.

Charting And Checking For Suicidality In A Family Medicine Residency Clinic, Bridget Murphy, Stacy Ogbeide

Journal of Human Services Scholarship and Interprofessional Collaboration

Suicide is a leading cause of death in the United States, and many individuals who die by suicide are likely to have seen a primary care physician (PCP) within the month of their death. Thus, the goal of this quality improvement (QI) project was to examine suicidality documentation practices of interprofessional clinicians within a Family Medicine residency clinic, thus providing rationale for continued research and a template for other clinics to emulate. The QI project used the Plan-Do-Study-Act cycle to survey 28 Family Medicine residents, faculty, and trainees for the Plan stage of the cycle in 2022 and assessed their …

Dental Hygiene Students Reported Physiological Symptoms Associated With Wearing An N95 Respirator Mask, Peyton Shea Butler

Dental Hygiene Theses & Dissertations

Purpose: Physiological symptoms and comfort levels while wearing an N95 respiratory mask has not been examined with dental hygienists. The purpose of this study was to investigate dental hygiene students reported physiological symptoms and comfort perception while wearing an N95 respirator mask during patient care appointments. Methods: After IRB approval (IRB #1987754-2), a 16-item questionnaire was distributed through email to a convenience sample of 65 dental hygiene students. Questions assessed respiratory, dermatologic, cardiac, mask mouth and general physiological symptoms, as well as comfort levels. Additionally, participants were asked to respond to demographic questions and one open ended question inquiring about …

Providing Family Centered Care Within Pediatric Integrated Care Settings, Emily D. Bebber

Counseling & Human Services Theses & Dissertations

Parent engagement remains critical to pediatric care. Both pediatric medical and mental health care remains dependent upon parent/guardian engagement to support successful outcomes for children and adolescents. Efforts to enhance Family Centered Care (FCC) has been spotlighted within pediatric care since the 1950s and the inclusion of counselors within integrated behavior health (IBH) teams ushers a need for an evolved understanding of the implementation of FCC, including parent/guardian engagement across professional roles. Using an explanatory mixed-method design, I examined team implementation of Family Centered Care (FCC) among different provider types (e.g., physicians, nurses, licensed mental health providers, social workers, technicians) …

Cms Emergency Preparedness Rule: Examining The Relationship Between Nursing Home Facility Characteristics And Regulatory Deficiencies, Tihara Richardson Sommers

School of Public Service Theses & Dissertations

The effects of Hurricane Katrina and other natural disasters have increased the focus on nursing homes, particularly nursing home emergency preparedness. Nursing home administrators and direct care employees have described the challenges faced when responding to an emergency event. Due to numerous emergency preparedness insufficiencies, requirements were implemented to protect the vulnerable population of older adults who reside in nursing homes. In 2016, the Centers for Medicare & Medicaid (CMS) added specific emergency preparedness requirements to the existing fire safety requirements for regulated nursing homes. These deficiency evaluations are the only routinely collected source of information detailing compliance with the …

Negotiation Practices Of Athletic Trainers Employed In The Clinical Setting, Julie M. Cavallario, Brianna L. Campbell, Bailey C. Jones, Cailee E. Welch Bacon

Rehabilitation Sciences Faculty Publications

Context

Athletic trainers (ATs) are comparatively underpaid relative to peer health care professionals. Whereas many factors contribute to the salary and benefits of a given employment position, negotiation is a factor of the final salary and benefits package that is achieved. It is unclear to what extent ATs negotiate salary or other terms of employment during the hiring process.

Objective

To explore the negotiation practices of ATs during the hiring process.

Design

Cross-sectional study.

Setting

Web-based survey.

Patients or other participants

A total of 587 ATs employed in the clinical setting who previously held at least 1 full-time employment position. …

The Impacts Of Role Overload And Role Conflict On Physicians' Technology Adoption, Eun Hee Park, Ghiyoung P. Im, Jing Zhang, Young Hwan Lee, Kyung Hee Chun, Young Soon Park

Information Technology & Decision Sciences Faculty Publications

Technology adoption is an important solution for physicians to increase work efficiency, and thus deal with role conflict among their multiple job roles. Prior studies have not investigated how multiple job roles and role conflict influence physicians’ technology adoption intentions. Based on role strain theory and role identity theory, we present a model of physicians’ technology adoption intentions to support their primary (clinical care) versus secondary (teaching or research) job roles. We test the model using surveys with 156 physicians at nine medical schools in Korea. The results of our data analysis largely support our hypotheses. Role overload in each …

Readiness For Transfer: A Mixed-Methods Study On Icu Transfers Of Care, Soo-Hoon Lee, Clarice Wee, Phillip Phan, Yanika Kowitlawakul, Chee-Kiat Tan, Amartya Mukhopadhyay

Management Faculty Publications

Objective Past studies on intensive care unit (ICU) patient transfers compare the efficacy of using standardised checklists against unstructured communications. Less studied are the experiences of clinicians in enacting bidirectional (send/receive) transfers. This study reports on the differences in protocols and data elements between receiving and sending transfers in the ICU, and the elements constituting readiness for transfer.

Methods Mixed-methods study of a 574-bed general hospital in Singapore with a 74-bed ICU for surgical and medical patients. Six focus group discussions (FGDs) with 34 clinicians comprising 15 residents and 19 nurses, followed by a structured questionnaire survey of 140 clinicians …

Response And Rebuttal To "Comment On: Risk Factors For Workplace Encounters With Weapons By Hospital Employees" In Public Health In Practice; 3 (2022) 100256 By Chidinma Okani And Carmen Black, James D. Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

No abstract provided.

Why Do Family Members Reject Ai In Health Care? Competing Effects Of Emotions, Eun Hee Park, Karl Werder, Lan Cao, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find …

Impact Of A Multidisciplinary Nutritional Support Team On Quality Improvement For Patients Receiving Home Parenteral Nutrition, Michael Rothkopf, Mohan Pant, Rebecca Brown, Jaime Haselhorst, Francine Gagliardotto, Allison Tallman, Debbie Stevenson, Andrew Depalma, Michael Saracco, Dan Rosenberg, Vladimir Proudan, Kishwar Shareef, Nudrat Ayub

EVMS School of Health Professions Faculty Publications

Introduction Home parenteral nutrition (HPN) is essential for patients with intestinal failure requiring long-term nutritional support. The Amerita Quality Improvement Project for HPN Patients (QIP-PN) explored the effect of a physician nutrition expert (PNE)-led multidisciplinary nutritional support team (MNST) on HPN care for patients under its service.

Objective To determine an MNST effect on adherence to protocols, outcomes and quality of life (QOL) in HPN.

Methods The study was divided into three phases: data review (phases 1a and 1b), observation (phase 2) and intervention (phase 3). Seven Amerita locations were selected as ‘study branches’ (population), from which all study patients …