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Walden Dissertations and Doctoral Studies

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Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii Jan 2023

Strategies To Improve Hospital Patient Satisfaction To Increase Performance-Based Reimbursements, Celso G. Silla Iii

Walden Dissertations and Doctoral Studies

Officials from the Centers for Medicare and Medicaid Services (CMS) created the hospital valued-based purchasing (VBP) program focused on controlling cost, inefficiencies, and quality-of-care. Hospital leaders are incentivized or penalized based on meeting quality outcomes and risk millions of dollars in reimbursement if they do not meet the quality-of-care standards specified in the CMS hospital VBP program. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies hospital leaders used to improve patient satisfaction to increase VBP performance-based reimbursements. Participants included eight hospital leaders from seven hospitals in California who successfully implemented …

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Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker Jan 2023

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

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Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner Jan 2023

Influence Of Behavioral Leadership Strategies On Employee Engagement In Hospital Departments, Callie Selner

Walden Dissertations and Doctoral Studies

Lack of employee engagement as a result of deficient behavioral leadership strategies has the potential for adverse business outcomes on productivity, business mission, and strategy. As a result of this qualitative single case study, hospital department managers who apply behavioral leadership strategies are more likely to promote an environment conducive to employee engagement. Grounded in the employee engagement theory, the purpose of this qualitative single case study was to explore behavioral leadership strategies hospital department managers use to promote an environment conducive to employee engagement. The participants were five hospital department managers who had been successful with employee engagement. Data …

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Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin Jan 2023

Perceptions Of Women Of Color Improving Patient Outcomes Through Hospital Leadership Advancement, Benita A. Mclarin

Walden Dissertations and Doctoral Studies

Women of color have been underrepresented in hospital leadership positions and face challenges in advancing their careers. The benefit to hospitals providing women of color with training and support to move into leadership positions may be improved patient outcomes. Grounded in the interactional model of cultural diversity framework, the purpose of this basic qualitative study was to explore the perceptions of women of color advancing in leadership roles in hospitals and their impact on patient outcomes. The study participants included 16 women of color in leadership positions from hospitals in a western U.S. state. Data were collected through semi structured …

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Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins Jan 2023

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins

Walden Dissertations and Doctoral Studies

Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …

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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

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Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor Jan 2023

Referral Source, Visit Modality, And The Delivery Of Diabetes Education In Pennsylvania, Alan Minor

Walden Dissertations and Doctoral Studies

Diabetes education is a principal component of optimal diabetes care that is often underutilized despite the known benefits that include reductions in complications as well as improved glycemic control and self-management knowledge. The purpose of this quantitative study was to examine the association between the completion of diabetes education, referral source, and visit modality. Because the completion of diabetes education is multifaceted, Levesque’s theoretical framework of health access, which incorporates dimensions of the accessibility of services and the abilities of potential users in the utilization of health services, was used to ground the study. A retrospective chart review was conducted …

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Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood Jan 2023

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

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Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo Jan 2023

Determining Strategies For Cost Effectiveness In Sustainable Healthcare Delivery – An Emerging Market Study, Francis Ikechukwu Igbo

Walden Dissertations and Doctoral Studies

AbstractSome South African healthcare managers and physicians find sustaining quality, cost-effective healthcare services challenging. Healthcare leaders are concerned about the high cost of healthcare as it can negatively impact sustainability and patient outcomes. Grounded in the cost-effectiveness theory and complex adaptive system theory, the purpose of this qualitative multiple-case study was to explore strategies some South African healthcare leaders use to sustain healthcare delivery in lower- and middle-income countries. The participants were five healthcare practitioners in rural areas of South Africa. Data were collected through semistructured interviews and secondary data sources. Thematic analysis of the data yielded four themes: patients’ …

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Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr Jan 2023

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

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Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr Jan 2023

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

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African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser Jan 2023

African American Baby Boomers’ Lived Experiences In Skilled Nursing Facilities For Post-Acute Care Admissions, Dr. Charles A. Fraiser

Walden Dissertations and Doctoral Studies

AbstractPrevious studies have examined the quality of elderly healthcare offered in skilled nursing facilities (SNFs) among older adults, in general, but the studies have not emphasized ex-periences unique to African America baby boomers and the factors they consider when making SNF-related decisions for post-acute care. The purpose of the study was to exam-ine the lived experiences of African American baby boomers who are currently in or have been treated in SNFs for post-acute care to learn about their decisions to select an SNF. Andersen’s behavioral model of health services served as the conceptual framework. A descriptive phenomenological qualitative design was …

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The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson Jan 2023

The Correlation Between Nurse Staffing And Quality Of Care Outcomes Within Nursing Homes In Mississippi, Nyeshia Nelson

Walden Dissertations and Doctoral Studies

The U.S. population aged 65 years old and older is steadily increasing. Some of thispopulation resides in nursing homes; thus, the necessity for quality care provided in nursing homes has increased. Consistent, quality care remains a constant challenge for the government, nursing home administrators, health care consumers, and researchers. Nurse staffing has been identified as a critical structural measure that affects the quality of care and outcomes in nursing homes. The purpose of this quantitative study was to examine the relationship between nurse staffing and quality of care outcomes in Mississippi’s nursing homes. Donabedian’s structure, process, and outcome (SPO) model …

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Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg Jan 2023

Relationship Between Nurse Managers’ Cultural Humility Practices And Nurse Retention, Jessica Scharfenberg

Walden Dissertations and Doctoral Studies

Some hospital administrators experience yearly loss of human capital, resulting in economic and noneconomic consequences that require resource reallocation to sustain operations. Grounded in the cultural humility theory, the purpose of this quantitative correlational study was to examine the relationship between nurses’ perceptions of their nurse managers’ (a) openness, (b) self-awareness, (c) egolessness, (d) self-reflection and critique, (e) supportive interaction, and nurse turnover intention. Participants included 142 registered nurses working in the Midwest United States. Data were collected using Foronda’s Cultural Humility Scale and the Michigan Organizational Assessment Questionnaire. Results of multiple regression analysis indicated the model could significantly predict …

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Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris Jan 2023

Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris

Walden Dissertations and Doctoral Studies

Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …

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Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd Jan 2023

Impact Of An Outpatient Chronic Care Model On Uninsured Inpatient And Emergency Department Utilization, Jamie L. Judd

Walden Dissertations and Doctoral Studies

Healthcare systems incur significant uncompensated costs due to uninsured chronic disease patients’ overutilization of urgent and emergent emergency care. This study was important because there was very little literature addressing the impact of the chronic care model (CCM) on reducing uncompensated healthcare system costs regarding patients with chronic disease. The purpose of the study was to investigate whether the Healthy Education Lifestyles Program (HELP) was of any significance to healthcare system’s cost of uninsured chronic disease patients. The theoretical foundation for the study was the CCM espoused by Wagner and colleagues. The research questions were to determine significant differences in …

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Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy Jan 2023

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

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Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo Jan 2023

Pharmacy Manager System Implementation Strategies To Mitigate The Cost Of Prescription Errors, Tunde Abiodun Cardozo

Walden Dissertations and Doctoral Studies

AbstractOne of the most frequent medical errors in contemporary medicine is incorrect prescriptions, and the profits from retail pharmacy operations are adversely impacted by the costs associated with prescription errors. Independent pharmacy managers are interested in finding workable strategies to mitigate the cost of prescription errors and increase profit. Using the resource-based theory of competitive advantage (RBTCA), the purpose of this qualitative multiple-case study was to explore strategies some independent pharmacy managers in Texas use to mitigate the cost of pharmacy employee prescription errors and increase profitability. The participants were five independent pharmacy managers who implemented strategies to mitigate the …

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The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins Jan 2023

The Relationship Between Socioeconomic Disparities In Alabama Hospitals And Patient Experience, Phillimena Ashley Hopkins

Walden Dissertations and Doctoral Studies

Patient satisfaction has been utilized to measure healthcare quality and outcomes, which affects reimbursement. Some claim such measures could be biased as they do not consider the patient’s socioeconomic status. Measuring the quality of care, Area Deprivation Index (ADI), and patient experience has been captured and publicly reported; and the measuring indicator Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS), however, hospitals serving patients in low ADI areas generally score poorly. Grounded in the theory of Donabedian, the purpose of this quantitative correlational study was to examine the relationship between patient experience associated with socioeconomic disparities and how patients …

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Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch Jan 2023

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

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Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr Jan 2023

Improving Self-Efficacy Of Primary Care Providers With Assessment Of Diabetic Peripheral Neuropathy, Kimberly Paddock Farr

Walden Dissertations and Doctoral Studies

AbstractDiabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes. DPN contributes to significant pain, debility and injury to diabetic patients. The majority of diabetic patients are managed in the primary care practice (PCP) setting. A local chapter of a nurse practitioner association identified a lack of knowledge of current evidence-based guidelines for effective screening and assessment of DPN in the PCP environment. The practice-focused question for this project was to determine if an educational intervention on evidence-based screening and assessment would improve nurse practitioner’s knowledge with DPN screening and diagnosis in PCP. Mezirow’s transformative theory of …

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Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder Jan 2023

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

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Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi Jan 2023

Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi

Walden Dissertations and Doctoral Studies

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines …

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How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez Jan 2023

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

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Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch Jan 2023

Examination Of Exposure Types Association With Stigma And Impacts On Sharps Injury Reporting In Ambulatory Surgical Centers, Timothy William Lynch

Walden Dissertations and Doctoral Studies

Public health depends on the efficiency of work delivery among healthcare workers (HCWs) and their positive goal orientation in healthcare. Effective minimizing of needlestick and sharp injuries (NSSIs) and timely reporting are fundamental to meeting public health goals. The specific research problem addressed through this study is whether the independent variable of exposure type (needle stick injury, splash exposure injury, other sharp injuries) has an association with stigma associated with sharps injury reporting (dependent variable) among HCWs in ambulatory surgical centers. A quantitative, cross-sectional design involving secondary data analysis was used. Regression was used to analyze pre- and post-workshop survey …

Go to article

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins Jan 2023

Impact Of Type 2 Diabetes And Hypertension On Allocation Of Grant Funds In Federally Qualified Health Centers, Rhonda Mullins

Walden Dissertations and Doctoral Studies

Limited resources exist for managing the increasing cases of hypertension and type 2 diabetes, which underlines the need to continuously review reimbursement plans to ensure care affordability for chronic illness. The purpose of this quantitative study was to determine whether a correlation existed between the number of patients with type 2 diabetes, hypertension, and demographic characteristics (independent variables) seen at Federally Qualified Health Centers (FQHCs) and the allocation of grant funds from Health Resources and Service Administration (HRSA) (dependent variable) from 2016 – 2020 among adults 18 years old and older in the United States. Guided by the Transaction Cost …

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Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti Jan 2023

Hospital-Acquired Infections And Differences Between Magnet And Non-Magnet Hospitals, Linda Mary Valenti

Walden Dissertations and Doctoral Studies

Hospital-acquired infections (HAIs), specifically clostridioides difficile (CDI) and methicillin-resistant staphylococcus aureus (MRSA) bacteremia, increase mortality and length of stay and cost the United States billions of dollars each year. Though preventable, continued incidence demonstrates that infection prevention interventions remain challenging for health system administrators. The purpose of this quantitative study was to identify whether there was a significant difference between Magnet accreditation and non-Magnet accreditation and the frequency of HAIs, specifically, CDI and MRSA bacteremia. The independent variable was Magnet accreditation status; the dependent variables were CDI and MRSA bacteremia. The foundation of the study focused on Donabedian’s framework of …

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Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White Jan 2023

Exploring The Benefits Of A Collaboration Between Behavioral Health Coaches And Clinicians, Devan White

Walden Dissertations and Doctoral Studies

This case study addressed how to best use health coaches in the field of behavioral health to improve the accessibility and outreach of a new program launched by the target organization that emphasizes coaching as an intervention for improving well-being and mental fitness. The purpose of this qualitative case study was to investigate the potential influence of coaching within the behavioral health field and explore how health coaches could partner with clinicians or behavioral health leaders to allow for more collaboration and accessibility to services. The RQs centered on how health coaches might support the treatment of those who have …

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The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik Jan 2023

The Investigation Of Resilience As A Moderating Factor On Burnout And Intention To Stay In Nursing Professionals., Florina Karasik

Walden Dissertations and Doctoral Studies

The intention to stay in nursing staff working with adult patients in a hospital setting is a major concern for healthcare organizations because of its effect on patient health outcomes. Grounded in the social cognitive career theory, the purpose of this quantitative correlational study was to investigate resilience as a moderating factor in the relationship between burnout and intention to stay for licensed registered nurses with BSN degrees working with adults in a hospital setting. The participants were 80 licensed registered nurses with BSN degrees working with adults in a hospital setting in the United States of America. The results …

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Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi Jan 2023

Health Leadership And Management Practices That Support Accountability For Results, Peter Kayiira Byansi

Walden Dissertations and Doctoral Studies

Although leaders are expected to nurture and sustain a culture of accountability for results, little is known about how health leaders in developing countries perceive, interpret, demonstrate, and promote accountability in their day-to-day practices. The purpose of this generic qualitative study was to explore the management and leadership practices that leaders of public and non-profit health support organizations in Uganda utilize to embody and support accountability for key stakeholders’ results. Data from in-depths interviews with 13 participants at the governance, senior management, and middle management levels were analysed using thematic data analysis. Riggio's conceptualization of using multiple perspectives and disciplines …

Go to article

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