Health and Medical Administration Commons^™

Evaluation Of House Staff Candidates For Program Fit: A Cohort-Based Controlled Study, Soo-Hoon Lee, Phillip H. Phan, Sanjay V. Desai

Management Faculty Publications

Background: Medical school academic achievements do not necessarily predict house staff job performance. This study explores a selection mechanism that improves house staff-program fit that enhances the Accreditation Council for Graduate Medical Education Milestones performance ratings.

Objective: Traditionally, house staff were selected primarily on medical school academic performance. To improve residency performance outcomes, the Program designed a theory-driven selection tool to assess house staff candidates on their personal values and goals fit with Program values and goals. It was hypothesized cohort performance ratings will improve because of the intervention.

Methods: Prospective quasi-experimental cohort design with data from two house staff …

The Impact Of A Crisis Intervention Team Program On Psychiatric Boarding, Kurtis Hooks

Counseling & Human Services Theses & Dissertations

Psychiatric boarding is the phenomenon of housing individuals in emergency departments while awaiting access to mental health services in the community. The expansion of psychiatric boarding is attributed to continued deinstitutionalization and under-resourcing of mental health services. Psychiatric boarding is also associated with deleterious outcomes for individuals in need of access to behavioral health services, facilities. There is limited research on programmatic efforts to reduce psychiatric boarding as it pertains to Crisis Intervention Team programs colocated in medical settings. Crisis Intervention Team (CIT) programs are community-based, multi-stakeholder partnerships that include dedicated assessment centers crisis response and referral. This study utilized …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

Nurse Manager Satisfaction And Retention With Compressed Schedules, Ivan Pierce, Nancy Sweeney

College of Health Sciences Posters

Problem: Despite efforts to improve organizational metrics for nurse satisfaction and retention, nurse manager satisfaction/retention remains a challenge for many hospitals.

Purpose: This study sought to explore factors that impact nurse manager satisfaction/retention by implementing an intervention that could positively influence work life balance, thereby improving satisfaction and retention in areas with high nurse manager turnover.

EBP Question: Is there a significant difference in the perception of work-life balance, job satisfaction, and intent to leave among inpatient acute care nurse managers before and after the implementation of self-directed compressed work schedules?

Method: A pilot study involving inpatient acute care …

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …

A Core Reference Hierarchical Primitive Ontology For Electronic Medical Records Semantics Interoperability, Ziniya Zahedi

Engineering Management & Systems Engineering Theses & Dissertations

Currently, electronic medical records (EMR) cannot be exchanged among hospitals, clinics, laboratories, pharmacies, and insurance providers or made available to patients outside of local networks. Hospital, laboratory, pharmacy, and insurance provider legacy databases can share medical data within a respective network and limited data with patients. The lack of interoperability has its roots in the historical development of electronic medical records. Two issues contribute to interoperability failure. The first is that legacy medical record databases and expert systems were designed with semantics that support only internal information exchange. The second is ontological commitment to the semantics of a particular knowledge …

The Determinants Of Physical Activity, Self-Monitoring Of Blood Glucose, And Poor Glycemic Control Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia: A Cross-Sectional Study Based On The Saudi Health Interview Survey (Shis), Mohammed Abdulrahman S. Alsuliman

Health Services Research Dissertations

The prevalence of diabetes and poor glycemic control in Saudi Arabia has increased that contributed to the growing number of deaths in Saudi Arabia. It is known that type 2 diabetes (T2DM) can be prevented but there is a lack information about the magnitude of the of diabetes at national level as well as the risk factors for physical activity (PA), self-monitoring of blood glucose (SMBG), and poor glycemic. Thus, through utilizing Health promotion model (HPM), the aims are to examine the personal factors, cognitive-perceptual, and behavioral determinants of three outcomes; physical activity, SMBG, and poor glycemic control. A secondary …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Risk Factors For Workplace Encounters With Weapons By Hospital Employees, James Blando, Chalsie Paul, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Objective:The specific aim of this study was to determine which risk factors were associated with frequent weapons confiscation in a healthcare facility. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.

Study design:Cross-sectional.

Methods:A cross-sectional survey was administered on-line to hospital security directors and assessed the associations of organizational factors with the frequency of weapons confiscation.

Results:It was found that hospitals with metal detectors were more than 5 times as likely to frequently confiscate weapons, suggesting this intervention is effective. It was also found that hospitals with psychiatric units were more likely to have frequent …

Strategies For Controlling Violence Against Healthcare Workers: Application Of Fuzzy Analytical Hierarchy Process And Fuzzy Additive Ratio Assessment, Fazel Rajabi, Mehdi Jahangiri, Farnaz Bagherifard, Sean Banaee, Payam Fahadi

Community & Environmental Health Faculty Publications

Objective: The present study aimed to identify and prioritize control measures of violence against Healthcare Workers (HWs) using the Fuzzy Analytical Hierarchy Process (FAHP) and Fuzzy Additive Ratio Assessment (F-ARAS).

Background: Occupational violence is a pervasive problem in healthcare centers. Reducing violence against staff is one of the challenges for healthcare managers.

Method: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were …

Survey Of Workplace Violence Perception, Prevention, Strategies, And Prevalence Of Weapons In Healthcare Facilities, James D. Blando, Marilyn Lou Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

No abstract provided.

Leader Launch: A Needs Assessment And Intervention For Effective Leadership Development In Healthcare, Candice Freeman

STEMPS Faculty Publications

This case study examines how a rural healthcare system implemented LeaderLaunch, a leadership development program specifically supporting all front-line to director-level leaders employed within the organization’s facilities. John DeJoria, the healthcare system’s Director of Organizational Development, is a seasoned instructional designer and Certified Professional in Learning and Performance (CPLP) who was charged with the opportunity of determining the system’s leadership development needs and responding with aligned performance improvement interventions, intended to build competency and capacity in current, new, and emerging leadership. This case explains how John and his team designed, conducted, and utilized a three phase needs assessment to select …

Sexual Harassment Issues Among Dental Hygienists, Amber W. Hunt, Brenda T. Bradshaw, Susan Lynn Tolle

Dental Hygiene Faculty Publications

Purpose: The "#MeToo" movement has increased awareness of sexual harassment in the workplace and its detrimental effects on the work environment. The purpose of this study was to determine the prevalence of sexual harassment in a convenience sample of dental hygienists in the state of Virginia (VA).

Methods: A cross-sectional research design was used to determine the experiences of VA dental hygienists with sexual harassment in the workplace occurring over the previous twenty-four months. The revised Sexual Experiences Questionnaire (SEQ-W) measured three constructs: gender harassment, unwanted sexual attention, and sexual coercion and was administered electronically to a convenience sample of …

Performance Improvement In Healthcare: Integrating Gilbert's Behavior Engineering Model Within A Just Culture, Candice Freeman, Jill Erin Stefaniak

STEMPS Faculty Publications

Healthcare leadership and department management personnel are tasked with the responsibility of ensuring safe, high-quality patient care delivered by competent and proficient staff. This responsibility often comes in the form of identification of discrepant and erroneous practices that result in subsequent employee disciplinary action process improvement discussions and implementation. This case study presents an example of a sentinel event and how Gilbert's Behavior Engineering Model (BEM) was utilized in the context of a Just Culture to ensure both processes and personnel were adequately supported to meet expected task outcomes.

Early Information Access To Alleviate Emergency Department Congestion, Anjee Gorkhali

Theses and Dissertations in Business Administration

Alleviating Emergency Department (ED) congestion results in shorter hospital stay which not only reduces the cost of medical procedure but also increase the hospital performance. Length of patient stay is used to determine the hospital performance. Organization Information Processing (OIPT) Theory is used to explain the impact of information access and availability on the information processing need and ability of a hospital. Technical devices such as RFID that works as “Auto Identification tags” is suggested to increase the information availability as well as the information processing capability of the hospitals. This study suggests that the OIPT needs to be further …

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

Research Agenda In Developing Core Reference Ontology For Human Intelligence/Machine-Intelligence Electronic Medical Records System, Ziniya Zahedi, Teddy Steven Cotter

Engineering Management & Systems Engineering Faculty Publications

Beginning around 1990, efforts were initiated in the medical profession by the U.S. government to transition from paper based medical records to electronic medical records (EMR). By the late 1990s, EMR implementation had already encountered multiple barriers and failures. Then President Bush set forth the goal of implementing electronic health records (EHRs), nationwide within ten years. Again, progress toward EMR implementation was not realized. President Obama put new emphasis on promoting EMR and health care technology. The renewed emphasis did not overcome many of the original problems and induced new failures. Retrospective analyses suggest that failures were induced because programmers …

Impact Of A Localized Lean Six Sigma Implementation On Overall Patient Safety And Process Efficiency, Luvianca Gil, Pilar Pazos, Mamadou Seck, Rolando Delaguila

Engineering Management & Systems Engineering Faculty Publications

Continuous quality improvement tools have caught the attention of the Health Care Industry as a solution to process efficiency, patient safety and cost reduction. This research explores the impact of a Lean Six Sigma (LSS) process improvement initiative in overall process efficiency and patient safety in two Labor and Delivery (L+D) units of two large hospital providers. This study focuses on the application of modeling and simulation methodology to investigate the influence of a localized process improvement intervention on the overall L+D unit output, by considering patient flow, system capacity and unit performance. The simulation models capacity profiles and patient …

Workplace Violence And Hospital Security Programs: Regulatory Compliance, Program Benchmarks, Innovative Strategies, James D. Blando, Maryalice Nocera, Marilyn L. Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

The authors describe the issue of workplace violence in hospitals, a New Jersey state law and regulations regarding workplace violence in healthcare, and some innovative strategies that are being utilized to help reduce the occurrence and risk of violence. The authors also discuss compliance with the New Jersey regulations.

A Test Of The Behavioral Model Of Health Services Use On Non-Emergent Emergency Department Use, Moira Crosby Mcmanus

Health Services Research Dissertations

Even though emergency departments (EDs) were created to treat trauma and emergent cases, there has been an increase in emergency department (ED) utilization for non-emergent reasons over the past half of a century. As non-emergent utilization grows as a result of the ED becoming a prevalent substitute for primary care, overcrowding of the ED and increased wait times will continue. Additionally, unnecessary cost to both the ED and the patient will be incurred. Previous research has examined and determined various reasons and risk factors driving non-emergent ED use, among them the influence of living location and the number of non-emergent …

Handoffs, Safety Culture, And Practices: Evidence From The Hospital Survey On Patient Safety Culture, Soo-Hoon Lee, Phillip H. Phan, Todd Dorman, Sallie J. Weaver, Peter J. Pronovost

Management Faculty Publications

Background: The context of the study is the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety.

Methods: The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. …

Microbiological Contamination Of Mobile Phones Of Clinicians In Intensive Care Units And Neonatal Care Units In Public Hospitals In Kuwait, Mohammed Heyba, Mohammad Ismaiel, Abdulrahman Alotaibi, Mohamed Mahmoud, Hussain Baqer, Ali Safar, Noura Al-Sweih, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

Background: The objective of this study was to explore the prevalence of microbiological contamination of mobile phones that belong to clinicians in intensive care units (ICUs), pediatric intensive care units (PICUs), and neonatal care units (NCUs) in all public secondary care hospitals in Kuwait. The study also aimed to describe mobile phones disinfection practices as well as factors associated with mobile phone contamination.

Methods: This is a cross-sectional study that included all clinicians with mobile phones in ICUs, PICUs, and NCUs in all secondary care hospitals in Kuwait. Samples for culture were collected from mobile phones and transported for microbiological …

Health Care Inflation And It's Implications For Monetary Policy, Takeshi Yagihashi, Juan Du

Economics Faculty Publications

Motivated by recent findings on the cyclical movement of both health and health spending, we construct a general equilibrium model that distinguishes health care demand from the demand for other goods. Using this model, we are able to generate inflation dynamics and cyclicality of health that match the US data. When the model is subjected to an expansionary monetary policy shock, it yields different output and inflation responses compared with a two-sector model with homogeneous demand. We show that the trade-off between leisure and health spending plays an important role in model dynamics. The model further predicts different degrees of …

Barriers To Effective Implementation Of Programs For The Prevention Of Workplace Violence In Hospitals, James Blando, Marilyn Ridenour, Daniel Hartley, Carri Casteel

Community & Environmental Health Faculty Publications

Effective workplace violence (WPV) prevention programs are essential, yet challenging to implement in healthcare. The aim of this study was to identify major barriers to implementation of effective violence prevention programs. After reviewing the related literature, the authors describe their research methods and analysis and report the following seven themes as major barriers to effective implementation of workplace violence programs: a lack of action despite reporting; varying perceptions of violence; bullying; profit-driven management models; lack of management accountability; a focus on customer service; and weak social service and law enforcement approaches to mentally ill patients. The authors discuss their findings …

Modeling Solutions For Prevention Of Medicare Insolvency For The Baby Boomer Generation (Born 1946 - 1964), Gregory Thomas Scott

Health Services Research Dissertations

Medicare, a United States social insurance program operated by the United States federal government, began operating in a deficit in the year 2010. More funding was expended than revenue received for medical care, creating significant shortfalls for the Medicare Trust Fund. This study examined possible initiatives to describe Medicare funding related to issues as financial shortfalls utilizing mathematical modeling and simulation. The Park Conceptual Model is a framework created to identify internal and external changes that influence bankruptcies related to municipalities, and this Model served as the theoretical basis for this study.

The following study addressed insolvency as negative cash …

Factors That Promote Perceived Usefulness Of And Clinical Outcomes From Sign-Outs At The National University Hospital, Soo-Hoon Lee, Wei-Ping Goh, Dale A. Fisher, Phillip H. Phan

Management Faculty Publications

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts.

OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers.

DESIGN, SETTING, AND PARTICIPANTS.

A retrospective study was conducted …

A Pilot Study On Nurse-Led Rounds: Preliminary Data On Patient Contact Time, Soo-Hoon Lee, Alice Lee, Siang-Ngim Lim, Mei-Jiao Koh, Benjamin Tan, Phillip H. Phan, Reshma A. Merchant, Aisha Lateef, Dale A. Fisher

Management Faculty Publications

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.

OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.

DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the …

Effects Of An Interprofessional Simulation Activity To Improve Students' Perceptions Of Other Healthcare Professions, Chase Raymond Poulsen

STEMPS Theses & Dissertations

Healthcare professionals have historically been educated and trained by members of their own profession within a curriculum that reinforces their individual discipline-specific strengths. This differentiation has contributed to students having little interaction with other professionals until after they have entered the workforce and consequently little formal education in collaboration or integration. The purpose of this mixed-method study was to evaluate the impact of an interprofessional (IP) collaborative activity on student's perceptions of the others discipline for the improvement in care of medical patients.

The sample population consisted of students from two programs, nursing (n=40) and respiratory therapy (n=33). Students were …

The Role Of Is Infrastructure And Organizational Context On Implementation Of Electronic Health Records Systems, Pilar Pazos, Anjee Gorkhali, Rolando Delaguila

Engineering Management & Systems Engineering Faculty Publications

This research explores the role that Information System (IS) infrastructure and organizational context play on the implementation of Electronic Health Records (EHR) Systems. A number of indicators can be used as a proxy for IS infrastructure such as: Information System (IS) Department Budget allocation, percentage of full time IS staff and the number of technical trainings provided by the IS department to the clinical staff. Data was obtained from the Healthcare Information and Management Systems Society (HIMSS) database, a non-for profit organization that evaluates the use of information technology in the health care industry. This paper reports on the development …