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Walden Dissertations and Doctoral Studies

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Full-Text Articles in Health and Medical Administration

Effect Of Home Telehealth On Vterans With Chronic Heart Failure, Yolanda Major Jan 2016

Effect Of Home Telehealth On Vterans With Chronic Heart Failure, Yolanda Major

Walden Dissertations and Doctoral Studies

More than 5 million Americans have heart failure, with approximately 5% of those affected being veterans. As the number of patients with CHF continues to rise, new treatment options are needed to improve the quality of care. Current studies show Telehealth is one treatment option. The purpose of this scholarly project was to determine if veterans diagnosed with CHF were able to maintain optimal weight and blood pressure following participation in Care Coordination Home Telehealth (CCHT) program. The CCHT program provides care to veterans, through the use of monitoring devices placed in their home. Bandura's self-efficacy theory was used as …

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Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii Jan 2016

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …

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Strategies Technology Development Marketing Leaders Used To Commercialize A New Product Innovation, Roxie Mooney Jan 2016

Strategies Technology Development Marketing Leaders Used To Commercialize A New Product Innovation, Roxie Mooney

Walden Dissertations and Doctoral Studies

Strategies for commercialization of a new product innovation are critical for gaining a sustainable level of customer acceptance and financial performance. The purpose of this single case study was to explore the commercialization strategies used by 5 technology development marketing leaders from a healthcare company in Washington state. The conceptual framework for this study was commercialization of innovation theory (CoI). The data were collected through semistructured interviews and company documentation, and analyzed using Yin's 5-step data analysis process for case studies to identify and code themes. Analysis of data generated 3 major themes: strategies implemented during the prelaunch phase, strategies …

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Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier Jan 2016

Relationship Between Nurse Training And Physical Restraints In Nursing Homes, Terah Tessier

Walden Dissertations and Doctoral Studies

According to the Centers for Medicare and Medicaid Services (CMS), approximately 1.3 million U.S. residents are residing in nursing homes. CMS enforced regulations in the Nursing Home Reform Act. Training in the use of restraints in nursing homes is monitored through the CMS standards. The purpose of this study was to determine whether there was a correlation between training standards of health care practitioners and their use of restraints in nursing homes based on the patterns of citations by RNs and CNAs. Data were collected from Kansas, Louisiana, and Ohio within the CMS Nursing Home Data Compendium. The key research …

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Improving Patient Care Delivery In A Small Alaska Native Health Care Organization, Annette Cecile Siemens Jan 2016

Improving Patient Care Delivery In A Small Alaska Native Health Care Organization, Annette Cecile Siemens

Walden Dissertations and Doctoral Studies

Chronic diseases impose heavy burdens on the United States health care system, particularly among some ethnic/racial groups such as American Indian and Alaska Natives who experience higher incidence of these diseases than non-Native population. In an effort to improve the health status of its patients, the Ukudigaunal Wellness Center (UWC) partnered with the Improving Patient Care (IPC) Collaborative to implement changes designed to improve chronic disease care for Native Alaskans through intensive monitoring of screening for chronic disease and selected chronic disease outcomes. For this program evaluation, the units of analysis were the changes in health service delivery and the …

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Falls And Related Injuries Based On Surveillance Data: U.S. Hospital Emergency Departments, George K. Quarranttey Jan 2016

Falls And Related Injuries Based On Surveillance Data: U.S. Hospital Emergency Departments, George K. Quarranttey

Walden Dissertations and Doctoral Studies

Falls can lead to unintentional injuries and possibly death, making falls an important public health problem in terms of related health care cost, incurred disabilities, and years of life lost. Approximately 1 in every 3 Americans ages 65 years and older is at risk of falling at least once every year. Children, young adults, and middle-aged adults are also vulnerable to falls. The purpose of this study was to examine the epidemiology of falls and fall-related injuries using surveillance data from nationally representative samples of hospital emergency departments in United States. The study was guided by a social-ecological model on …

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Oral Nutritional Supplement Use In Relation To Length Of Stay In Heart Failure Patients At A Regional Medical Center, Ellen Burkhardt Babb Jan 2016

Oral Nutritional Supplement Use In Relation To Length Of Stay In Heart Failure Patients At A Regional Medical Center, Ellen Burkhardt Babb

Walden Dissertations and Doctoral Studies

Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improving nutritional status. ONS use has been associated with improved outcomes among patients with diagnoses of orthopedic injuries and pressure ulcers, mainly using prospective designs among elderly and/or malnourished patients. Less information is available for other diagnoses, and no analysis of the effects of ONS could be found that considered the epidemiological triad of person, place, and time. This study used a quantitative, retrospective …

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Evaluation Of Intervention To Increase Exercise Among A Group Of Hispanic Patients In South Florida, Rene Beltran Rodriguez Elias Jan 2016

Evaluation Of Intervention To Increase Exercise Among A Group Of Hispanic Patients In South Florida, Rene Beltran Rodriguez Elias

Walden Dissertations and Doctoral Studies

Despite knowledge regarding the need for regular physical exercise, little is known about the most effective ways to encourage and maintain regular physical activity among primary care patients. New approaches to education about and support of physical activity are needed for everyone, but especially for groups susceptible to diseases related to sedentary lifestyles. This project evaluated a web-based educational intervention guided by the health belief model to address the lack of regular physical activity among 25 Hispanic patients in a South Florida clinical practice. The physically inactive patients were identified through the clinic's electronic medical records and consented to participate. …

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Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James Jan 2016

Effects Of Education On Pressure Ulcer Prevention In Developmentally Disabled Individuals, Jasneth M. James

Walden Dissertations and Doctoral Studies

Pressure ulcers were a continuing concern among the nonverbal developmentally disabled population of a state institution. The lengthy use of wheelchairs, the inability to body shift, and physical and mental impairment were attributes of the target population that have been cited in the literature as contributing to pressure ulcer. The purpose of this quasi-experimental pretest/posttest project was to evaluate the effectiveness of an education intervention for direct care staff on the prevention treatment, and eradication of pressure ulcers among patients with developmental disabilities. Orem's self-care deficit theory, particularly the emphasis on the need for nursing staff to perform self-care activities …

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Relationship Between Nurse Staffing And Quality Of Care In Louisiana Nursing Homes, Veronica Kercado Jan 2016

Relationship Between Nurse Staffing And Quality Of Care In Louisiana Nursing Homes, Veronica Kercado

Walden Dissertations and Doctoral Studies

In 2014, Louisiana experienced substantive issues with quality of care in nursing homes. The state had the lowest nurse staffing level among all states, and 7,666 deficiencies for immediate jeopardy violations were recorded from 2011 to 2013. Despite ample research on nurse staffing and quality of care, there is no consensus on how higher nurse staffing relates to quality. The purpose of this quantitative, correlational research was to determine the relationship between nurse staffing levels and quality measures in Louisiana. Donabedian's category structure, process, and outcome was the conceptual framework used to develop the research questions. The data included the …

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The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari Jan 2016

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

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The Utility Of Health Care Performance Indicators In Evaluating Low Back Surgery, Pradeep K. Narotam Jan 2016

The Utility Of Health Care Performance Indicators In Evaluating Low Back Surgery, Pradeep K. Narotam

Walden Dissertations and Doctoral Studies

Low back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was …

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Financial Distress In The Health Care Business, Firas Fathi Musmar Jan 2016

Financial Distress In The Health Care Business, Firas Fathi Musmar

Walden Dissertations and Doctoral Studies

Sixty-four United States hospitals closed for poor organizational performance during 2010 through 2016. Because of hospital closures, community members experienced delays in obtaining needed care, reduced access to specialty care, and increased travel distances. Based on the balanced scorecard model theory, the purpose of this qualitative single case study was to explore strategies that 10 health care leaders used at a healthcare organization in central Texas to prevent financial distress. Semistructured interviews were conducted and archival organizational accounting records were reviewed, including company surveys with employees and patients. Data were thematically analyzed and triangulated to ensure the trustworthiness of interpretations. …

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Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles Jan 2016

Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles

Walden Dissertations and Doctoral Studies

Registered nurses leaving the workplace are estimated to cost healthcare organizations and society between $1.4 and $2.1 billion annually. The purpose of this multiple case study was to explore what strategies leaders of healthcare organizations from the Eastern and Northern regions of Virginia can use to mitigate the effects of nurse turnover and its cost to the organization. The target population consisted of 8 RNs who experienced turnover during their nursing careers. The conceptual framework for this study was Herzberg's dual-factor theory. Face-to-face semistructured interviews were conducted and publically available documents were garnered. Thematic reduction of participants' interviews, coupled with …

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Exploration Of Practice Managers' Decision-Making Strategies In A Managed-Care Paradigm, Lawrence Randolph Ford Jan 2016

Exploration Of Practice Managers' Decision-Making Strategies In A Managed-Care Paradigm, Lawrence Randolph Ford

Walden Dissertations and Doctoral Studies

Practice managers are facing challenging expectations when deploying a managed-care paradigm. The problem addressed in this study was a gap in knowledge regarding practice managers' decision-making strategies that affect, or could be perceived to affect, a climate of excellence with business and client relationships, primary health care, physicians, and patients in a managed-care paradigm. The purpose of the qualitative exploratory study was to explore practice managers' decision-making strategies affecting primary health care, physicians, and patients. Guided by Simon's ideology of decision-making strategies in a management environment, the overarching research question and 3 subquestions centered on how practice managers delineate their …

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Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus Jan 2016

Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus

Walden Dissertations and Doctoral Studies

Health care administrators in Ontario want to transform health care with a focus on improving efficiency and quality of care, yet they pay little attention to increasing revenue. The purpose of this qualitative case study was to explore strategies Ontario hospital administrators apply to generate nongovernment revenue to remain sustainable. The target study population consisted of 2 chief executive officers and 2 chief financial officers at Ontario academic research hospitals. The conceptual framework for this study included radical organizational change theory supported by complexity leadership theory, and grounded in an evidence-based approach. The researcher conducted open-ended semi-structured interviews and made …

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Strategies For Successful Implementation Of Change Initiatives In Health Care, Kristy Trinidad Jan 2016

Strategies For Successful Implementation Of Change Initiatives In Health Care, Kristy Trinidad

Walden Dissertations and Doctoral Studies

Changing regulations, increased competition, and evolving customers' expectations have necessitated significant organizational changes in the health care industry. This multiple case study investigated the strategies of senior managers from 3 California health care organizations to implement significant change initiatives. The participating organizations had a positive reputation for successfully implementing change. Data from interviews and a review of organizational documents were analyzed through the conceptual lens of Lewin's phases of change model and Kotter's 8-step process for implementing change. The analysis revealed 3 general themes: communications, training, and employee involvement. The managers of each participating organization emphasized the importance of keeping …

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Emergency Room Utilization Of Participants With Mental Health Conditions Enrolled In Health Home Services, Amanda Duff Jan 2016

Emergency Room Utilization Of Participants With Mental Health Conditions Enrolled In Health Home Services, Amanda Duff

Walden Dissertations and Doctoral Studies

Large numbers of individuals utilize the ER each year for mental health reasons. The health home agency in this study was designed under the Affordable Care Act with the intention of increasing patient self-management thus decreasing high-cost service utilization. The effectiveness of health homes in reducing mental health-related ER visits has remained unexplored. In this study, the relationship between participation in this program and ER utilization was examined, using the theoretical framework of the Health Belief Model. The sample of 128 health home participants with documented mental health conditions was selected using systematic random sampling. A one-way, repeated-measures t-test and …

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Leadership Strategies For Retaining Healthcare Professionals, Kimberly Hulett Jan 2016

Leadership Strategies For Retaining Healthcare Professionals, Kimberly Hulett

Walden Dissertations and Doctoral Studies

Obtaining information about employee engagement and retention practices is vital for organizations. Affective organizational commitment reflects the extent to which organizational members are loyal and willing to work toward organizational objectives. In particular, affective organizational commitment holds important implications at all organizational levels (e.g., turnover rates, performance, and citizenship behavior). Using general systems theory and transformational leadership theory, the purpose of this single case study was to explore strategies used to improve employee engagement and retention from 5 senior leaders with hiring responsibilities from a midsize hospital in Austin, Texas that have been successful with employee engagement and retention strategies. …

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Icd-10-Cm Implementation Strategies: An Application Of The Technology Acceptance Model, Judith Monestime Jan 2015

Icd-10-Cm Implementation Strategies: An Application Of The Technology Acceptance Model, Judith Monestime

Walden Dissertations and Doctoral Studies

The United States is one of the last countries to transition to the 10th edition of the International Classification of Diseases (ICD-10) coding system. The move from the 35-year-old system, ICD-9, to ICD-10, represents a milestone in the transformation of the 21st century healthcare industry. All covered healthcare entities were mandated to use the ICD-10 system on October 1, 2015, to justify medical necessity, an essential component in determining whether a service is payable or not. Despite the promising outcomes of this shift, more than 70% of healthcare organizations identified concerns related to education efforts, including lack of best practices …

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The Effect Of A Culture Of Safety On Patient Throughput, Laurie Lee Dawn Dillon Jan 2015

The Effect Of A Culture Of Safety On Patient Throughput, Laurie Lee Dawn Dillon

Walden Dissertations and Doctoral Studies

There is a national movement to create improvements in patient safety and outcomes due to evolutionary changes in the healthcare. Many health care organizations are using the framework of a culture of safety in order to create a reliable and stable work environment that emphasizes safety and improves patient outcomes. Patient throughput, defined as the active management of the supply of patient beds (rooms for occupation) to the demand of patients to beds and the length of time it takes for this action to occur, has been identified as one of the areas in need of improvement. This study considered …

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Promotion Of The Hospital's Patient Portal, Courtnie Jones Burrell Jan 2015

Promotion Of The Hospital's Patient Portal, Courtnie Jones Burrell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services wanted to ensure that electronic health records were used in a meaningful manner to improve coordination and quality of patient care. In 2011, the federal government began offering monetary incentives to help healthcare facilities and providers adopt technology that supported patient access and increased their ability to manage their own health. The hospital where this project took place encouraged patients’ involvement in their health by providing a patient portal, yet the public has underutilized it. The purpose of this project was to develop an evidence-based strategy for future implementation at the hospital that …

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Financing School-Based Health Centers: Sustaining Business Operational Services, Ingrid Monique Hayes-Burrell Jan 2015

Financing School-Based Health Centers: Sustaining Business Operational Services, Ingrid Monique Hayes-Burrell

Walden Dissertations and Doctoral Studies

School-based health centers (SBHCs) have faced challenges in securing adequate funding for operations and developing sound business systems for billing and reimbursement. Specifically, administrators often lack strategies to develop and sustain funding levels to support appropriate resources for business operations. The focus of this descriptive study was to explore best practice strategies to develop and sustain funding through the experiences of SBHC administrators. The conceptual framework included Elkington's sustainability theory, which posits that corporate social responsibility, stakeholder involvement, and citizenship improve manager's effect on the business system. Twenty full-time SBHC administrators working in separate locations throughout the state of Maryland …

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Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case Jan 2015

Providers' Knowledge Of The U.S. Health Care System And Their Medical Practice Choices: A Study Of Physicians, Residents, And Non-Physician Practitioners, Cora Case

Walden Dissertations and Doctoral Studies

The expansion of health insurance through health care reform has reduced the number of uninsured. but access to providers has not been addressed. Understanding the relationship between practice choices and aptitude of health policy and delivery is essential to determine other factors or motivators that contribute to the development of health care access policies. This descriptive study explored the value-laden elements of health care reform, such as social constructions, to learn whether there are implicit ways to address the issue of access to health care in the United States. Schneider and Ingrams's conceptualization of policy making through social construction was …

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Diabetes Self-Management Education Program, Lesa Faye Williams Jan 2015

Diabetes Self-Management Education Program, Lesa Faye Williams

Walden Dissertations and Doctoral Studies

Diabetes is a devastating disease in American. The disease can cause chronic health comorbidities, and untreated diabetes has negative consequences for individuals and on our nation's economy. Newly diagnosed diabetics often have a lack of knowledge about the disease process. The purpose of this project was to design and implement a diabetes educational program to enhance participants' knowledge about diabetes management and self-care using the Health Belief Model. Diabetes Self-Management Education (DSME) is critical in improving patient outcomes and the prevention of diabetes related complications. Participation in a standardized diabetic educational intervention will improve patient knowledge, as measured by a …

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Health Care Administration Faculty Perceptions On Competency Education, Graduate Preparedness, And Employer Competency Expectations, Wittney A. Jones Jan 2015

Health Care Administration Faculty Perceptions On Competency Education, Graduate Preparedness, And Employer Competency Expectations, Wittney A. Jones

Walden Dissertations and Doctoral Studies

Health care administration programs have transitioned to using the competency approach to better prepare graduates for workplace success. The responsibility of preparing graduates lies with the program faculty, yet little is known about faculty perceptions of the competency approach. The purpose of this cross-sectional study was to assess the perceptions of graduate-level health care administration faculty about the competency approach, the approach's effect on graduate preparedness, and employer expectations. Adult learning theory and the theory of self-efficacy were used as the theoretical foundations for the study. Faculty demographics related to personal information, workplace/teaching experience, and program information served as the …

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An Outcome Evaluation Of An Evidenced-Based Leadership Framework On Nursing Retention In A Tertiary Medical Center, Robbie Gail Robbie Jan 2015

An Outcome Evaluation Of An Evidenced-Based Leadership Framework On Nursing Retention In A Tertiary Medical Center, Robbie Gail Robbie

Walden Dissertations and Doctoral Studies

An evidence-based leadership (EBL) framework is an intervention designed to facilitate organizational changes such as the reduction of nursing turnover and the improvement of nursing job enjoyment. This project provides an overview of the effect of nursing turnover on an organization, presents the components of the EBL framework, and provides an evaluation of the influence of EBL on nursing turnover and job enjoyment. The EBL framework provided a method for reducing variance in leadership skill and behavior by outlining specific methods necessary to reduce inconsistency. The project objective was to determine if the implementation of an EBL framework for 820 …

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Factors Relating To Underrepresentation Of Black American Women In Health Care Administration, Alquietta Lavayle Brown Jan 2015

Factors Relating To Underrepresentation Of Black American Women In Health Care Administration, Alquietta Lavayle Brown

Walden Dissertations and Doctoral Studies

There is a low representation of Black American women (BAW) in health care senior leadership. With the high level of health problems found among the Black community, diversifying the executive leadership with BAW may be instrumental in increasing provider trust and reducing discriminatory action. Using critical race theory as the conceptual framework, this study examined the experiences, perceptions, and influential or deterrent factors inhibiting advancement of BAW in the health care field. Inquiry centered on factors related to lack of advancement, experiences at different stages of career progression, and strategies impacting career advancement. A qualitative research design using a transcendental …

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Regression Analysis Of Cloud Computing Adoption For U.S. Hospitals, Terence H. Lee Jan 2015

Regression Analysis Of Cloud Computing Adoption For U.S. Hospitals, Terence H. Lee

Walden Dissertations and Doctoral Studies

Industrial experts agree that cloud computing can significantly improve business and public access to low cost computing power and storage. Despite the benefits of cloud computing, recent research surveys indicated that its adoption in U.S. hospitals is slower than expected. The purpose of this study was to understand what factors influence cloud adoption in U.S. hospitals. The theoretical foundation of the research was the diffusion of innovations and technology-organization-environment framework. The research question was to examine the predictability of cloud computing adoption for U.S. hospitals as a function of 6 influential factors: relative advantage, compatibility, complexity, organizational size, structure, and …

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Diffusion Of Electronic Health Records In Rural Primary Care Clinics, Patricia Lynn Mason Jan 2015

Diffusion Of Electronic Health Records In Rural Primary Care Clinics, Patricia Lynn Mason

Walden Dissertations and Doctoral Studies

By the end of 2015, Medicare-eligible physicians at primary care practices (PCP) who do not use an electronic health record (EHR) system will incur stiff penalties if they fail to meet the deadline for using EHRs. Yet, less than 30% of rural primary clinics have fully functional EHR systems. The purpose of this phenomenology study was to explore rural primary care physicians and physician assistants' experiences regarding overcoming barriers to implementing EHRs. Complex adaptive systems formed the conceptual framework for this study. Data were collected through face-to-face interviews with a purposeful sample of 21 physicians and physician assistants across 2 …

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