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Health and Medical Administration Commons™
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Articles 391 - 420 of 744
Full-Text Articles in Health and Medical Administration
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Exploring The Mechanisms Of Racial Disparity In Infant Mortality: A Grounded Theory Approach, Barry Chukwugekwu Eneh
Walden Dissertations and Doctoral Studies
Infant mortality (IM) is a critical health-disparity problem in the United States. Of the 23000 infants who die each year, the highest number occurs among African Americans. Previous studies implicated a mix of health determinants and risk factors, but no study has explored the mechanisms by which IM predictably persists among African Americans. This study uncovers the complex network of risk factors that underlies racial death disparities in infants. Two theoretical lenses chosen for this study were social systems theory (SST) and critical race theory (CRT). SST explains human behavior as an intersection of interrelated systems. CRT interrogates inherent social …
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 …
Caregivers' Challenges In Accessing Services For Children With Autism, Anita Payne Jones
Caregivers' Challenges In Accessing Services For Children With Autism, Anita Payne Jones
Walden Dissertations and Doctoral Studies
The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall …
Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb
Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb
Walden Dissertations and Doctoral Studies
Implementation of electronic health records (EHRs) is a driver for the improvement of health care and the reduction of health care costs. Developing countries face substantial challenges in adopting EHRs. The complex adaptive system conceptual framework was used to guide this single case study to explore strategies that health care leaders used to successfully implement the EHR system. Data were collected from 6 health care leaders from an island in the Caribbean using a semistructured interview technique. Data were analyzed using the Bengtsson's 4-stage data analysis process, which includes decontextualization, recontextualization, categorization, and compilation. The results of the study yielded …
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 …
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 …
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Integrating Health Care Systems To Maintain Quality Care And To Manage Cost, Marilynn Noble
Walden Dissertations and Doctoral Studies
The rising cost of health care in the Philippines is a concern for the Department of Defense and TRICARE beneficiaries. The purpose of this quantitative cross-sectional research study was to determine the efficacy and acceptability of a different method to deliver health care to increase access to health care and decrease out-of-pocket costs while maintaining quality of care for TOP Standard beneficiaries who receive health care under the Philippine Demonstration. Secondary data was used to determine the acceptability of an alternative reimbursement methodology to decrease cost but maintain access to quality care. The Andersen's behavioral health care model and the …
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young
Walden Dissertations and Doctoral Studies
Approximately 25% of those hospitalized with congestive heart failure are readmitted within 30 days after discharge. Because researchers and policy makers consider hospital readmission within 30 days for patients with heart failure to be a quality of care issue, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare revenue for 1 year for excessive readmissions, potentially impacting the financial sustainability of some organizations. The purpose of the study was to address the research gap regarding the outcome quality measure of hospital admissions from the emergency department (ED) and 2 each …
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Social Workers And Early Intervention With Diabetic Clients, Rievu Agiri
Walden Dissertations and Doctoral Studies
Social workers are uniquely positioned to facilitate early intervention services that minimize the impact and burden of Type 2 diabetes. There is little evidence on the specific role that social workers play in addressing the psychosocial factors that exacerbate the condition or impact treatment outcomes. The purpose of the study was to examine the role of social workers in facilitating early interventions for clients with Type 2 diabetes. The theories of role and organizational systems provided the conceptual framework. Data was collected from interviews with eight participants with Master's degrees in Social Work in a large Southwestern state in the …
Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison
Understanding The Lived Experiences Of Counselors Who Have Been Assaulted By Clients, Cynthia S. Ellison
Walden Dissertations and Doctoral Studies
Assault of community-based mental health professionals is a worldwide phenomenon, and current extant literature examines the prevalence of client assault on counselors, social workers, and psychiatric personnel. While there is significant quantitative scholarship on the incidence of this phenomenon on social workers and psychiatric personnel, there are limited statistical data on client-perpetrated violence against community-based counselors and no qualitative studies found that examined how these professionals experience this occupation risk. Therefore, the purpose of this study was to explore how counselors who work in community-based settings make sense of these experiences. Through semi structured interviews, 6 community-based counselors living in …
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon
Walden Dissertations and Doctoral Studies
Extended hospital length of stay (LOS) causes increased health care costs and incidence of never events, such as hospital-acquired infections, pressure ulcers, and falls, which are not reimbursed by Medicare. This study examined if there would be a statistically significant decrease in the LOS of patients after the implementation of a discharge process improvement initiative (DPII), The model for improvement and small tests of change concept were used to guide the DPII at a hospital in northern California. Sources of data included archival data obtained from the hospital's quality improvement department that showed LOS prior to and after the implementation …
Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster
Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster
Walden Dissertations and Doctoral Studies
Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and …
Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem
Perceptions Of Access To Healthcare In Cameroon By Women Of Childbearing Age, Wenceslaw Chap Chapnkem
Walden Dissertations and Doctoral Studies
Increased poverty and unemployment rates, minimal investment in social amenities, a shortage of healthcare professionals, poor infrastructure, inadequate social services, and poor institutional and political leadership have weakened the healthcare status of Cameroon's women who have reached the age of childbearing. The World Health Organization expressed increased urgency for healthcare providers and patients to develop new healthcare policies to eliminate health-related disparities. The aim of this phenomenological study was to examine the perceptions of women of childbearing age living in Mamfe rural community in regard to Cameroon's healthcare system and its impact on their lives. The theoretical foundation of the …
Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George
Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George
Walden Dissertations and Doctoral Studies
Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach …
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Social And Cultural Factors Influencing The Management Of Type 2 Diabetes Among African American Men, Lavetta W. Lopez
Walden Dissertations and Doctoral Studies
African American men are more likely to have diagnosed or undiagnosed diabetes than non-Hispanic White Americans and are less likely to adhere to treatment. Culture in the African American community plays a key role in how this community copes with illness and the health care system. The purpose of this study was to examine the lived experiences of social and cultural determinants of Type 2 diabetes self-management among African American men. Bandura's social cognitive theory provided the theoretical framework for the study. The research question sought to identify cultural and social factors that contribute or protect how African American men …
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
African American Parents' Perceptions Of Childhood Obesity In Broward County, Kenol Aris
Walden Dissertations and Doctoral Studies
Children may become overweight or obese for different reasons, and childhood obesity may have health consequences such as Type 2 diabetes and asthma. The purpose of this qualitative phenomenological study was to describe the perceptions of African American parents of elementary-age children with obesity living in Broward County, Florida about the causes and consequences of childhood obesity. The health belief model (HBM) guided this study. Interview data were gathered from 9 participants who met the criteria of being African American parents of elementary-age children with obesity living in Broward County, Florida. Moustakas- steps to analyze the data collected led to …
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 …
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, …
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, And Quality Of Care, Gloria Glover
Walden Dissertations and Doctoral Studies
The value-based purchase requirement of the Patient Protection and Affordable Care Act puts pressure on hospital leaders to control cost while improving quality of care. The resource dependency theory was the theoretical framework for this correlational study. Archival data from the Centers for Medicare and Medicaid Services collected from 166 acute care urban hospitals for the Fiscal Year 2016. Multiple linear regression analysis was used to determine the relationship between nursing salaries per patient day, cost of uncompensated care as a percentage of net patient revenue, percentage of net income from patient services, and overall patient satisfaction for quality of …
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Psychosocial Consequences Of Parental Wrongful Conviction On Children, St.Jean Jeudy
Walden Dissertations and Doctoral Studies
This qualitative multiple-case study sought to provide an in-depth understanding of how children living in broken families-due to the wrongful conviction of parent(s)-developed psychosocial issues. The theoretical frameworks applied to this study were the social learning theory, the social control theory, the role-modeling theory, and the general theory of crime. A purposeful sample of 13 adults who were children at the time of their parents’ wrongful incarceration were drawn for phone and in-person interviews. The data were transcribed and analyzed to code, sort, and organize; to analyze connections in the information, and to compare and contrast cases. The multiple-case study …
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Recruiting Strategies For Increasing The Number Of Emergency Medical Technician Personnel, Carolyn Denise Mack
Walden Dissertations and Doctoral Studies
Demand for the emergency medical technician (EMT) is 2 times greater than that of all other occupations. Sustainability of ambulance services (AS) personnel is dependent upon the recruitment of EMTs into the industry. The purpose of this multiple case study was the exploration of the recruiting strategies that AS administrators used to increase the number of EMTs. Herzberg's 2 factor theory of motivation was the conceptual framework for this study. The data collection instrument included semistructured interviews with 6 AS company executives in southeastern New Mexico and southwestern Texas. Secondary data and document from each state's emergency medical services personnel …
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Medication Reconciliation, Competency, Timely And Effective Care, And Hospital Readmissions, Perry Theodore Nichols
Walden Dissertations and Doctoral Studies
Hospital readmissions within 30 days of discharge result in significant multimillion-dollar penalties to thousands of Medicare-eligible hospitals throughout the United States and are indicators of suboptimal patient healthcare leading to less than ideal health outcomes for previously hospitalized patients. The purpose of this correlation study was to examine the relationship between medication reconciliation, nursing workforce competency, timely and effective care, and Medicare-eligible hospital 30-day readmission rates. The sample of 269 hospitals came from the population of Medicare-eligible hospitals throughout the United States. Complexity theory and the general model of readmission were theoretical frameworks grounding this study. Secondary data were from …
Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee
Exploring Strategies For Reducing Patient Failure To Keep Scheduled Appointments, Charlene Denise Kesee
Walden Dissertations and Doctoral Studies
High no-show rates in the ambulatory setting lead to underutilized resources, decreased clinic revenue, and lower productivity. The purpose of this single case study was to explore strategies that administrators used to maintain acceptable no-show rates and maintain the sustainability of the healthcare practice. The target population for this study included local chapter members of a professional healthcare organization that provided access to practice managers and administrators in the Las Vegas, Nevada regional area where there are a large number of practices that are not part of a health system; the sustainability of these practices is dependent on allocation of …
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 …
Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward
Involving Patient/Family Advisors And Advisory Councils With Patient And Family Engagement, Cortney D. Forward
Walden Dissertations and Doctoral Studies
Health care consumers are under-represented in literature when defining patient and family engagement. The proportion of people living longer is rapidly growing. Future research is needed to evaluate which strategies of patient and family engagement are most useful in real-world health care settings for patient and families. The purpose of this study was to describe the lived experiences of patient/family advisors working within patient family advisory councils at an academic medical center in the Midwestern United States. The conceptual framework is based on Greenleaf's servant leadership and Bass's transformational leadership. The research questions examined how patient/family advisors describe patient and …
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 …
The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez
The Effect Of Maternity Care Practices On The Duration Of Breastfeeding, Lisette Rodriguez
Walden Dissertations and Doctoral Studies
The natural practice of breastfeeding has been strongly noted as one of the most cost-effective, health promoting, disease-prevention strategies of the 21st century. Although primary health organizations recommend exclusive breastfeeding for the first 6 months of life with added complementary foods and continued breastfeeding up to 2 years of age or longer, many mothers do not breastfeed their infants for the recommendation length of time. Applied policies and health practices, such as those described under the 10 Steps to Successful Breastfeeding and The International Code of Marketing of Breast Milk Substitutes, have been noted as contributing factors that can considerably …