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Articles 361 - 390 of 744
Full-Text Articles in Health and Medical Administration
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey
Walden Dissertations and Doctoral Studies
Many drug overdoses in the United States are from prescription drugs, most of which are classified as opioid pain relievers (OPRs) and commonly prescribed in emergency departments (EDs) to treat pain. OPR abuse and addiction is a major public health issue. Researchers have identified the role of various patient characteristics (race, gender, demographics, etc.) in the variation in OPR prescription rates, but the contribution of provider-type differences to that variation has not been exposed. The purpose of this study was to evaluate the strength of the association between provider type and the likelihood of an opioid prescription by ED providers …
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Medicare And Medicaid Regulations' Financial Effects On Home Health Agencies' Performance, Binzie Roy Davidson
Walden Dissertations and Doctoral Studies
Some owners of small to medium-sized managed care businesses lack strategies to address the effects of healthcare regulations on their businesses. The purpose of this multiple case study was to identify strategies that owners of small to medium-sized managed care businesses used to address the financial effects of healthcare regulations on their businesses. The conceptual framework for this study was profit maximization and adaptation in changing contexts. Data were gathered from company documents, observations, and semistructured interviews with 5 home healthcare business owners in Los Angeles County, California. Data were coded to identify themes from the narrative segments. Key themes …
Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins
Successful Demand Forecasting Modeling Strategies For Increasing Small Retail Medical Supply Profitability, Arica Watkins
Walden Dissertations and Doctoral Studies
The lack of effective demand forecasting strategies can result in imprecise inventory replenishment, inventory overstock, and unused inventory. The purpose of this single case study was to explore successful demand forecasting strategies that leaders of a small, retail, medical supply business used to increase profitability. The conceptual framework for this study was Winters's forecasting demand approach. Data were collected from semistructured, face-to-face interviews with 8 business leaders of a private, small, retail, medical supply business in the southeastern United States and the review of company artifacts. Yin's 5-step qualitative data analysis process of compiling, disassembling, reassembling, interpreting, and concluding was …
Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide
Cited And Underprepared; The Call For Improved Emergency Preparedness In Ltc Facilities, Dawn M. Ide
Walden Dissertations and Doctoral Studies
This research investigated the connection between the Medicare star rating system and E-tags on emergency preparedness of nursing homes for disasters in Hampton Roads, Virginia. Emergency preparedness in nursing homes has been a topic of growing interest within the past decade. Hampton Roads, Virginia, has a history of natural disasters including hurricanes and flooding, which necessitates a proper and efficient emergency preparedness plan in nursing home facilities. The primary purpose of this research was to review the secondary Centers for Medicare and Medicaid Services (CMS) data regarding the star rating system and E-tag surveys of each of the 37 nursing …
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera
Walden Dissertations and Doctoral Studies
The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …
Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins
Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins
Walden Dissertations and Doctoral Studies
Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …
Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary
Nurses' Lived Experiences Of Oppression And Power Dynamics In The Hospital Setting, Khadijatu A. Leary
Walden Dissertations and Doctoral Studies
The persistent and chronic nursing shortage presents an urgency to understand the root causes of nurses' increasing mobility and movement within and outside of the nursing workforce. A key to understanding nurses' dissatisfaction is to explore the work environment in which they practice. The purpose of this heuristic, phenomenological study was to understand nurses' experiences of oppression and the power dynamics in the hospital setting, which may provide insight to nursing turnover. The conceptual framework was Harvey's civilized oppression theory. Data were collected from semistructured interviews of 9 registered nurses by phone that met inclusion criteria of having more than …
Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush
Impact Of Queueing Theory On Capacity Management In The Emergency Department, Nina Bush
Walden Dissertations and Doctoral Studies
Hospital systems in the United States are facing a dilemma regarding capacity management in the emergency department (ED) and the inpatient care setting. The average wait time in EDs across the United States exceeds 98 minutes, which is also the point at which patients begin to abandon healthcare treatment. The purpose of this quantitative study was to examine the use of queueing theory in capacity management on length-of-stay (LOS) rates, left-without-being-seen (LWBS) rates, and boarding rates in the ED and inpatient setting. The boarding rates represent the rate in which patients were roomed in the ED but required inpatient care. …
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse
Walden Dissertations and Doctoral Studies
High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …
Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson
Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson
Walden Dissertations and Doctoral Studies
Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …
Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins
Strategies Healthcare Managers Use To Reduce Employee Turnover, Christopher Sean Atkins
Walden Dissertations and Doctoral Studies
Healthcare managers who are unaware of the various strategies that exist for reducing turnover could adversely affect patient care, organizational morale and performance, and the achievement of organizational goals. The purpose of this qualitative multiple case study was to explore strategies healthcare supervisors used to reduce employee turnover. The participants comprised 3 senior healthcare managers located in central Texas responsible for hiring, firing, training, supervising, and successfully using strategies to reduce employee turnover. Herzberg's motivation-hygiene theory provided the conceptual framework. Data were collected from semistructured interviews and a review of company documents. Thematic analysis of the data resulted in 5 …
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Reduction Of Centers For Medicare And Medicaid Services Reimbursement Penalty Risk, Christopher Douglas Poteet
Walden Dissertations and Doctoral Studies
Healthcare centers face increasing revenue risk under the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA). The purpose of this multiple case study was to explore strategies that successful leaders of healthcare centers use to mitigate the risk of reimbursement penalties under MACRA. The conceptual framework of this study was Generation 3 cultural-historical activity theory (CHAT-III), and the analysis process used was Yin's recursive and iterative phases. Participants of this study were 6 leaders of healthcare centers in the United States identified as having high quality and low cost via the Centers for Medicare and Medicaid public use …
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Rural Environmental Factors And Lesbian, Gay, Bisexual, And Transgender Mental Health Services Utilization, Terri Rorie
Walden Dissertations and Doctoral Studies
The rates of mental health issues in the lesbian, gay, bisexual, and transgender (LGBT) communities are twice that of individuals who identify as heterosexual. Research in urban communities show lower mental health services utilization rates for LGBT individuals compared to their heterosexual counterparts. The purpose of the study was to examine how rural environmental factors affect the use of mental health services by LGBT individuals and provide information to improve mental health outcomes. Andersen's healthcare utilization model and the minority stress theory were the foundations of this study. This study examined the association of mental health providers' availability/characteristics and utilization …
Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon
Strategies To Reduce Employee Turnover In Clinical Logistics, Brenda Marc Simon
Walden Dissertations and Doctoral Studies
Clinical supply chain managers who do not apply effective employee turnover strategies could negatively affect team performance, employee morale, employee well-being, patient outcomes, productivity, profitability, and the sustainability of organizational activities. The purpose of this multiple case study was to explore strategies that supply chain managers used to decrease employee turnover in clinical logistics organizations. The targeted population consisted of 6 clinical logistics supply chain managers working in 6 community hospitals located in Maryland who had experience implementing successful strategies to decrease employee turnover. The servant leadership theory served as the study's framework. Data collection included semistructured interviews and a …
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Veteran Administration Disease Model To An Interdisciplinary Healthcare Model, Bertha J. Harris
Walden Dissertations and Doctoral Studies
There is a growing need for healthcare teams within the Veterans Administration (VA) healthcare system to effectively collaborate and communicate to improve patient outcomes. The need to improve patient care in the Patient Aligned Care Team (PACT) has been well established. The scholarly literature does not provide evidence whether using the primary care PACT model on communication and teamwork by an interdisciplinary medical team ameliorates these communication breakdowns. Bronstein's design for interdisciplinary collaboration provided the overarching framework for this study. The purpose of this qualitative case study was to investigate the use of the PACT model on communication and teamwork …
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado
Walden Dissertations and Doctoral Studies
Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for …
Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey
Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey
Walden Dissertations and Doctoral Studies
Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Antibullying Definition, Policy, Surveillance, Education, And Training In The Healthcare Field, Adlene Jones Mcelroy
Walden Dissertations and Doctoral Studies
Workplace bullying in the healthcare field has contributed to decreasing productivity, decreasing employee morale, increasing workplace lawsuits, overall dissatisfaction in the workplace, and potentially compromising care to patients. Little, however, is known about how public policies related to workplace bullying impact the experiences of healthcare workers. Using Cornell and Limber's conceptualization of bullying, the purpose of this general qualitative study was to better understand the experiences of healthcare leaders and workers related to workplace bullying of a single health care facility. Data were principally collected from 9 participants representing three organizational leaders, three nurses, and three ancillary members staff. These …
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Successful Billing Strategies In The Hospital Industry, Samirah Merritt
Walden Dissertations and Doctoral Studies
Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and …
Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua
Coping Methods Of Caregivers Dealing With Patients Suffering From Geriatric Dementia, Blessing Baridakara Deemua
Walden Dissertations and Doctoral Studies
Dementia is a neurological disorder primarily diagnosed in the geriatric population. A problem for paid caregivers of patients diagnosed with stage-4 dementia is that they may experience caregiving stress while rendering care. However, there was no research that described the lived experiences of paid caregivers. Caregiving stress can be accompanied by behaviors or comorbid conditions and specific symptoms of stress can have a differential wellness impact. This phenomenological study explored the lived experiences of paid caregivers of patients with dementia through Vroom's expectancy theory. Data were gathered through interpretative interviews from a sample of 10 to 15 purposefully selected nursing …
Intraoperative Neurophysiological Monitoring Reimbursement Post International Classification Of Diseases-10, Cindy A. Akkerman
Intraoperative Neurophysiological Monitoring Reimbursement Post International Classification Of Diseases-10, Cindy A. Akkerman
Walden Dissertations and Doctoral Studies
International Classification of Diseases the 10th Revision (ICD-10) was implemented October 1, 2015, and there was little knowledge how the transition to ICD-10 would impact the revenue cycle for intraoperative neurophysiological monitoring medical practices in Oklahoma. This correlational quantitative study examined the changes in dependent variables of reimbursements due to the change from ICD-9 to ICD-10 for independent variables of intraoperative neurophysiological monitoring procedure codes. The reimbursements from 2014 were compared to reimbursements from 2016. Prices were adjusted for inflation to 2016 dollar values. Annual reimbursements decreased for all intraoperative neurophysiological monitoring procedures examined except the remote monitoring code. The …
Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp
Cancer Treatment Decision Making In Aging Minorities, Patrice Kemp
Walden Dissertations and Doctoral Studies
Cancer incidence is high for aging minority and underserved populations, yet research is limited about patient-provider communications with aging racial and ethnic minority populations. Achieving high-quality cancer care is crucial to reducing health disparities for this population. However, potential shortages in professional health personnel, the cost to treat cancer, a strained health care system, and large aging populations contribute to the problem. The purpose of this qualitative study was to understand the personal experiences of aging minorities during cancer treatment decision making when communicating with their cancer care providers. Purposive sampling methods were used to recruit 10 minority women and …
Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai
Strategies Healthcare Managers Use To Reduce Hospital-Acquired Infections, Yohannes Debesai
Walden Dissertations and Doctoral Studies
Every year, 2 million patients in the United States suffer with at least 1 hospital-acquired infection resulting in an estimated 99,000 deaths annually. The purpose of this exploratory single case study was to explore strategies healthcare managers in U.S. hospitals used to reduce hospital-acquired infections. The study included face-to-face, semistructured interviews with 5 healthcare managers from a hospital in Maryland who were successful in reducing these infections. The conceptual framework was human capital theory. Field notes, hospital documents, and transcribed interviews were analyzed to identify themes regarding strategies used by healthcare managers. The data analysis and coding process resulted in …
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Electronic Health Record Implementation Strategies For Decreasing Healthcare Costs, Christopher A. Foster
Walden Dissertations and Doctoral Studies
Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training …
Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis
Obesity Epidemic In The Military: Implications For Veterans, Tracy Lewis
Walden Dissertations and Doctoral Studies
The purpose of this study was to examine the impact of overweight and obesity on veterans' careers. Obesity, once thought unproblematic for the military, is being recognized as a health concern that has expansive implications for the health and readiness of service men and women, as well as for veterans. There is an abundance of information on obesity within the general population, but research on the impact of obesity on military careers is limited. This quantitative, cross-sectional research study investigated how obesity is a challenge throughout a veteran's career, from enlistment to retirement, using an online survey to gather data …
Successful Strategies For Implementing Health Information Technology In Primary Care Practice, Samuel O. Otoo
Successful Strategies For Implementing Health Information Technology In Primary Care Practice, Samuel O. Otoo
Walden Dissertations and Doctoral Studies
Health information technology (HIT) owner-practitioners who adopt effective strategies for HIT implementation can improve primary facility care delivery and profitability. However, some HIT owner-practitioners have ineffective implementation strategies, so they have not realized the total revenue increases of more than 8%. Grounded in general systems theory, the purpose of this multiple case study was to explore successful strategies primary care practitioners (PCPs) use to implement HIT to improve primary facility care delivery and profitability. The participants included 6 owner-practitioners located in Queens County, NY, who successfully implemented HIT to improve facility care delivery and profitability. Data were collected through face-to-face …
Relationship Between Self-Determination And Employee Retention, Tiffany Edwards
Relationship Between Self-Determination And Employee Retention, Tiffany Edwards
Walden Dissertations and Doctoral Studies
Retention of registered nurses (RNs) is essential to the sustainability of quality health care services. More than 55% of hospitals in the United States have not translated retention initiatives into a formal retention strategy. The purpose of this study was to examine the relationship between training programs, new hire onboarding processes, frozen positions, and nurse retention. The self-determination theory was the theoretical framework for this study. Secondary data were collected from the 2016 Texas Hospital Nurse Staffing Survey. Data were analyzed using multiple linear regression. The results of the multiple linear regression were statistically significant, with F(3, 251) = .602, …
Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey
Analysis Of Nurses’ Perceptions Of Their Role In A Multidisciplinary Team, Jessica Ann Dempsey
Walden Dissertations and Doctoral Studies
A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of …
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Change Management Implementation Strategies For Small Businesses, Oneeka Rena' Rivers
Walden Dissertations and Doctoral Studies
Most organizational change initiatives fail because managers lack effective change management strategies. The purpose of this single case study was to explore change management strategies that outpatient care facility managers used to positively affect process improvements. The population consisted of 6 managers who completed change initiatives at a military, outpatient medical facility in Texas and 6 of their team members. Data were collected using semistructured interviews and organization documents, then analyzed based on the conceptual framework of Lewin’s change theory. Rowley’s 4-step process for analysis—organizing; getting acquainted with; classifying; coding and interpreting; and presenting and writing up the data—was used …
Strategies To Reduce Hospital-Acquired Conditions, Steven G. Littleson
Strategies To Reduce Hospital-Acquired Conditions, Steven G. Littleson
Walden Dissertations and Doctoral Studies
Hospital-acquired conditions cause harm to patients and increase mortality. In addition to lowering the quality of patient care, hospital-acquired conditions also negatively affect financial performance, which makes them a business problem for hospital administrators. The purpose of this single case study, which was grounded in the theory of high reliability, was to explore strategies used to reduce the number of hospital-acquired conditions. The sample consisted of 13 senior leaders of a large academic medical center in the southeastern United States, who shared successful strategies used to reduce hospital-acquired conditions. Data collection took place through semistructured interviews and a review of …