Health and Medical Administration Commons^™

Bringing Hospital And Community Together: Interventions To Bridge The Transitional Care Gap, Jeremy Yates

Dissertations

Abstract

Problem

As healthcare spending continues to increase and overall quality lags in comparison to other developed countries, hospital readmission has been targeted to increase quality while decreasing cost. Components of the Affordable Care Act (ACA) have placed an emphasis on preventative and transitional care which has created programs aimed at reducing readmission, including the Community Health Access Programs (CHAP). One program in St. Louis, Missouri consisted of advanced practice paramedics and an occupational therapy assistant that performed discharge follow-up through in-home, in-office, and telephone visits. An in-depth program evaluation can create a foundation to build other programs in communities …

Leader Development Of The Health Information Management (Him) Professional, Theresa Jones

Dissertations

This study contributes to the body of knowledge in leader development by examining how higher education programs in a female dominated profession assist learners in developing person-related characteristics that support leader development. A ten-part online survey was sent to directors of health information management (HIM) programs accredited by the Commission on Accreditation for Health Informatics and Information Management (CAHIIM). Results suggest an opportunity for improvement in the curriculum for development of person-related characteristics critical for leadership positions. In the interest of the progression of women these results should be taken into consideration.

Strategies For The Improvement Of Healthcare Through Simulation, Roger Lankheet

Dissertations

Title:Strategies for the improvement of healthcare through simulation

Background: Medical errors continue to plague the healthcare industry. The annual rates of morbidity are approximately 2.69 million (AHRQ, 2019), while mortality rates exceed 400,000 per annum (Makary & Daniel, 2016). There may be no panacea to combat these egregious rates. However, simulation of patient care events may better prepare healthcare professionals to prevent medical errors as it has been proven to be an effective learning strategy (Kirkham, 2018), enhancing skills while gaining experiential knowledge, without risk to actual patients.

Purpose: The purpose of this qualitative study was to gain a …

Comorbidity And Quality Of Life Of Hiv-Positive Adults Living In Supportive Housing, Rose Sharp

Dissertations

Problem: Life expectancy for people living with HIV significantly increased with widespread use of antiretroviral therapy, resulting in population increases in comorbidity prevalence. The increased burden of living with both HIV and comorbidities lowers health-related quality of life (HRQoL).

Methods: Using a descriptive, correlational, cross-sectional design, a convenience sample of HIV-positive adults was selected from seven supportive housing communities. Comorbidities were assessed using a modified Self-Administered Comorbidity Questionnaire, and HRQoL using the Patient-Reported Outcome Measurement Information System Scale v1.2 – Global Health.

Results: A sample of 17 (N = 17) adults reported a mean of 4.2 (SD = …

Effect Of Standardized Nurse Teaching On Patient Experience Using Cahps®, Julie Hake

Dissertations

Abstract

Purpose: This quality improvement (QI) project aimed to determine if a standardized nurse teaching approach improved patient understanding of diagnosis and treatment as it relates to women diagnosed with a pelvic floor disorder (PFD) after receiving a standardized nurse education (SNE) session in an urban tertiary care Urogynecology practice.

Methods: Females aged 18 and older with a newly diagnosed PFD and prescribed PFPT for the first time who agreed to receive the SNE and complete the CAHPS® survey were included in the project. Patient perception of PFPT was assessed via phone interview utilizing the Consumer Assessment of Healthcare …

Mitigating Suicide Risk Post-Discharge From Inpatient Crisis Stabilization: Safety Planning Intervention, Leighia M. Mcghee

Dissertations

Abstract

Purpose: The purpose of this program evaluation is to evaluate the effectiveness of a newly implemented safety planning intervention (SPI) tool, comparing patient outcomes relating to suicide attempt rates, emergency department (ED) encounter rates, and inpatient rehospitalizations rates pre and post its integration to care in a suburban behavioral health hospital.

Methods: A descriptive cohort design utilizing a retrospective chart review was completed over six months, three months pre, and three months post implementation of the SPI program. A convenience sample of inpatient charts was reviewed to assess the rate of suicide attempts, ED encounters frequencies, and hospitalization rates …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Patient’S Utilization Of Health Information Technologies For Disease Self-Management, Mahmoud Hamzeh Altawalbih

Dissertations

Background: The rapid growth of Health Information Technologies (HITs) provides

patients with greater opportunity to take control over their health. HITs utilization has

been proven to be a critical component of disease self-management and can result in

positive outcomes. Its widespread adoption and utilization is still relatively low among

patients with chronic disease. It is important to understand the factors that may impact

HITs utilization, such as the perceived Task-Technology Fit (TTF). A very limited

number of studies have examined the relationship between HITs utilization and the

perceived fit between task and technology in the context of TTF theory.

Aims/ …

Adventist Healthcare: A Qualitative Study Of 19th Century Founding Governing Principles In 21st Century Adventist Hospitals, Cesiah Yareth Pimentel Melendez

Dissertations

Problem and Purpose

Founding values and principles can help organizations stay focused on fulfilling their mission. This is especially true in faith-based organizations that seek to continue their founding principles as a governing commitment to their core identity. This study identified Adventist healthcare founding principles in Ellen G. White's early health visions and explored how Adventist healthcare leaders perceived these principles as governing principles applied to current Adventist healthcare practices.

Conceptual Framework and Research Design

Two metaphors and three areas of literature review guided my approach of this qualitative study of Adventist healthcare founding principles. My first metaphor of DNA …

Career Coaching: A Study Of Veterans Health Administration (Vha) Leaders', Jerelyn Dugas

Dissertations

Purpose: The purpose of this qualitative multiple case study was to explore and describe the impact of career coaching on the career performance growth and retention as perceived by healthcare’s emerging leaders who participated in selected coaching program institutes for a minimum of 1 year at VHA hospitals in Southern California.

Methodology: The researcher selected a qualitative multiple case study to explore and describe VHA leaders’ perceived impact of coaching on their career performance growth and retention. Further, the researcher conducted semi-structured, interviews with 15 participants to gain a better understanding of the lived experiences of the participants at the …

Factors That Influence Physicians To Assume Leadership Roles: A Focus On Clinical Integration, Jennifer Lynne Jackson

Dissertations

The Patient Protection and Affordable Care Act of 2010 (PPACA) drastically altered the healthcare industry in the United States. Along with multiple other directives, the PPACA mandated that physicians and hospitals work together in strategies known as clinical integration. For effective clinical integration to be achieved, interdependence among physicians and hospitals is required to provide the highest quality outcomes for patients at the best possible value. To this end, healthcare leaders have identified that the key to establishing successful clinical integration is the presence and commitment of physician leaders (Penlington & Marshall, 2016).

This study explores factors that influenced a …

Three Essays On Informal Payments In The Health Care Sector In Russia, Alexandra Polovinka

Dissertations

Health care is one of the most corrupt sectors in Russia. In 2015 twenty percent of patients paid a bribe for the health care services once or twice, and thirteen percent more than twice (Russian Public Opinion Research Center, 2015). Using data on adults from over 5,000 households in Russia, this three-essay study analyzes out-of-pocket formal (official) and informal (unofficial, bribes) payments for the health care.

In the first essay, I study whether there is a difference in the amount of unofficial pay-ments across five types of health care services (ambulance, inpatient, outpatient, dental, and medical checkups) and two types …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Emotional Intelligence And Community Healthcare Productivity, Christopher Jacob Fox

Dissertations

Economic crisis is threatening state budgets. The strain on state budgets effects pensions and the healthcare benefits to communities. Rising healthcare costs and lagging insurance reimbursement rates are forcing healthcare organizations to sustain programs with fewer financial resources. Research studies indicate that payment increases from Medicare and Medicaid will not keep pace with the historical trend in hospital cost inflation (Kaufman, 2011). Of the healthcare facilities affected by federal budget constraints are community mental healthcare centers. The strain on state budgets has taken its toll on community mental healthcare facilities in particular struggling under the healthcare reform initiatives (Simpson, 1995). …

Exploring The Relationship Between Adventist Hospital Board Chair Leadership Behaviors And Effectiveness, Anthony M. Stahl

Dissertations

Problem and Purpose. There is a lack of empirical research regarding the leadership behaviors that predict an effective community hospital board chair. Researchers indicate that an effective organization normally has a well-led board. However, the chair role has been largely neglected in the research of board functions and operations. With many hospitals facing reorganization or closing, it is important to understand and identify effective chair behaviors. Thus, the purpose of this study was to determine the relationship between hospital chair leadership behaviors and effectiveness, and the relationship of effective chairs to effective hospitals.

Method. This study used an ex post …

The Impact Of A Direct Care Training Program On The Self-Efficacy Of Newly Hired Direct Care Employees At State Mental Health Facilities, Marcus Wayne Lewis

Dissertations

Self-efficacy has been shown to be an important element in the success of individuals in a variety of different settings. This research examined the impact of a two week new employee orientation training program on the general and social self-efficacy of newly hired direct care employees at state mental health facilities. The research showed that the training program did not have a statistically significant impact on the social self-efficacy of the new employees after the training or after one month on the job. The research also showed that the two week new employee orientation program did not have a statistically …

The Health Of Patient Privacy: The Patient's Perspective On The Hipaa Protected Health Information, Deborah Lange-Kuitse

Dissertations

Problem

As healthcare entities continue to focus on HIPAA compliance, they must enforce policies that require patients to sign and express understanding of the organization’s privacy policies. It appears the patient’s perspective on healthcare privacy has not been considered within the HIPAA privacy ruling. Patients are healthcare consumers, yet little research has been done on assessing the individual consumer’s perspective on what Protected Health Information (PHI) is actually important to protect and from whom it is important to protect it.

Method

A quantitative survey was developed and distributed to the participants of the Carnegie group, an independent insurance firm in …

Identification Of Seventh-Day Adventist Health Core Convictions : Alignment With Current Healthcare Practice, Randall L. Haffner

Dissertations

Purpose. The prevailing literature suggests that organizations can sustain their vitality and longevity by preserving their core ideology. The purpose of this study is to define and articulate the core convictions of Seventh-day Adventist healthcare and then investigate how the leaders' and employees' cognitive understandings, behaviors, and affective attachments align at Florida Hospital in Orlando, Florida.

Method. This two-phased sequential exploratory study utilizes qualitative research to define the core convictions of Seventh-day Adventist healthcare through historical literature review, analysis of official Church publications, four commissioned scholarly papers, and one-on-one interviews with seasoned healthcare administrators. These findings are then used to …

Intuitive Decision Making And Leadership Style Among Healthcare Executives In The United States, Cherie Whiting

Dissertations

The purpose of this two-phased, sequential, exploratory, mixed-methods study was to survey a sample of Fellows in the American College of Healthcare Executives in the United States and then interview selected individuals who scored in the highly intuitive category on the intuition survey to explore how they made intuitive decisions. In the first phase, quantitative research questions addressed the relationship between leadership style and the potential to make intuitive decisions, as well as the relationship and interaction between the potential to make intuitive decisions and age, gender, and size of company. In the second phase, qualitative interviews were used to …

Perceived Leadership Style, Style Flexibility, And Style Effectiveness Of Government Hospital Administrators In Thailand, Pongsin Chuwattanakul

Dissertations

Problem. Many health care organizations have a great need for leaders who can handle the complex mix of health care facilities, legal and patient demands. Currently, hospital administrators of government-operated hospitals in Thailand are selected from physicians. These physicians are not directly trained to be professional hospital administrators. It was the purpose of this study to study and reveal their leadership styles.

Method. A descriptive design was used to study the leadership styles, style flexibility, and style effectiveness of hospital administrators in self-reports and as perceived by supervisors. The LBA II-Self (Leader Behavior Analysis II: Self Perceptions of Leadership Style) …

An Exploratory Study Of Nursing Personnnel Needs In Seventh-Day Adventist Hospitals In The Continental United States With A View To Educational Assessment And Planning, Robert Thompson Andrews

Dissertations

Problem. The purpose of this study was to collect, organize, and analyze data from Seventh-day Adventist hospitals, nurses, SDA church leadership, and general statistics to provide nursing-personnel resource information for Adventist hospital and nursing education planning.

Some of the objectives of this study were to obtain a descriptive profile of nurses working in Adventist hospitals, to discover personnel selection patterns, turnover rates by position, annual job openings, numbers and percentages of Adventist-educated nurses, and the supply and demand for nurses in different nursing and administrative positions.

Method. Population of this descriptive study included all nurses working in forty-seven hospitals in …

The Ethanol-Induced Loss Of Control Concept In Alcoholism, Thomas Kay Williams

Dissertations

No abstract provided.