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Walden Dissertations and Doctoral Studies

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Full-Text Articles in Health and Medical Administration

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes Jan 2023

The Lived Experience Of Lung Cancer Patients With Psychological Health And Physical Activity, Donna Leeann Homkes

Walden Dissertations and Doctoral Studies

AbstractPhysical activity (PA) is recognized as a treatment protocol for lung cancer patients that improves physical impairments and reduces symptoms of psychological stress. This qualitative interpretive phenomenological analysis (IPA) study was conducted to explore the lived experience of lung cancer patients and how PA is influenced by anxiety, depression, and fatigue. This study was guided by Bandura’s self-efficacy theory and Engel’s biopsychosocial model. In-depth semi structured interviews were conducted with seven lung cancer participants over Zoom and in person. The data were analyzed using manual hand coding. The analysis revealed themes in patients’ experiences about how PA participation is influenced …

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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

AbstractPatient 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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Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian Jan 2023

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

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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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Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn Jan 2023

Patient-Rated Physician Compassion And Patient Compliance With Colorectal Cancer Screening, Christine Caputo Winn

Walden Dissertations and Doctoral Studies

In 2021, colorectal cancer was the second leading cause of cancer deaths in the United States, where screening prevented 46%–63% of colorectal cancer deaths. Compassionate care has been an area of study among scholars since Hippocrates. The purpose of this quantitative research study was to examine whether there was a relationship between the independent variables of provider compassion, patient gender, and length of provider patient relationship with the dependent variable of patient adherence behavior for prescribed colorectal cancer screening tests among primary care patients between 2019 and 2020 in a northeastern U.S. state. Guided by the theory of planned behavior …

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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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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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Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande Jan 2023

Evaluation Of The Implementation Of Primary Prevention Guidelines For The Treatment Of Hypertension, Aramide Alayande

Walden Dissertations and Doctoral Studies

AbstractHypertension is a chronic disease that is associated with increased risk of cardiovascular mortality. This Doctor of Nursing Practice project was a quality improvement initiative that addressed the gap in practice that the nurse practitioners (NPs) were not consistently following the American College of Cardiology (ACC) and American Heart Association (AHA) recommended guidelines for the treatment of hypertension. The purpose of the project was to evaluate whether the NPs were consistently using the guidelines to treat patients with hypertension after an educational intervention. The project used a before-after approach to evaluate the consistency of using the guidelines in treatment of …

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African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks Jan 2023

African American Women’S Experiences Coping With Stress Through Community-Based Services, Delisa V. Procks

Walden Dissertations and Doctoral Studies

Few studies have studied how community-based services (CBS) work to mitigate the strong Black woman image (SBWI) coping mechanism for Black women to improve their mental health. The purpose of this generic, qualitative study was to understand the experiences of 10 African American women, ages 18 and older, who identified with the SBWI and had received CBS to address their stress-related coping strategies. Transactional theory of coping with stress and the SBWI approach was used as the framework to help explain how stress in terms of the SBWI impacted the response of the African American women within their environment. Data …

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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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Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch Jan 2023

Practice Size And Geographical Location And Annual Merit-Based Incentive Payment System Scores In Dermatology, Issam H. Harmouch

Walden Dissertations and Doctoral Studies

Despite the transition to value-based care in the healthcare industry using the Merit-Based Incentive Payment Systems (MIPS), small and rural physician practices still score in the poor category annually. These poor performances negatively impact funding for staffing and service availability; further, little research has focused on the factors behind these poor performance scores. The purpose of this study was to examine the relationship between practice size and organization geographical location on annual MIPS scores among dermatologists in the South-Central United States. The Donabedian model was used as the theoretical framework for this study that focused on the three qualities of …

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Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb Jan 2022

Guidelines For Managing Dysautonomia Dysfunction, Angela Coleman Webb

Walden Dissertations and Doctoral Studies

Dysautonomia dysfunction (DD) is a disorder of the autonomic nervous system. Over 70 million people suffer from some type of DD, and the average length of time from symptoms to diagnosis is 6 years. Most facilities and providers choose not to treat DD due to the number of symptoms and the difficulty of being able to diagnose correctly. The purpose of this project study was to create guidelines for the diagnosis, treatment, and management of DD. The research question addressed the effectiveness of these guidelines to help nurses and providers caring for patients with DD provide better care. Watson’s theory …

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Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee Jan 2022

Effects Of Covid-19 On Maternal And Child Health In Haiti, Abbi M. Lee

Walden Dissertations and Doctoral Studies

Haiti has a history of natural disasters that have played a part in the country’s weak infrastructure, poor quality health care, and short life expectancy. The purpose of this qualitative case study was to understand the experiences of health care professionals providing prenatal, perinatal, and postpartum health care services before and during the COVID-19 pandemic in Haiti to gain an understanding of the gaps in disaster response in reproductive health care. The theoretical bases for this study were community resilience theory and reproductive justice theory. Data were collected from interviews with 10 health care professionals working in Haiti providing reproductive …

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Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield Jan 2022

Experiences Of Individuals With Opioid Use Disorder In Medication Assisted Treatment Programs, Lynda M. Maxfield

Walden Dissertations and Doctoral Studies

AbstractOpioid use accounts for many deaths each day in the United States. Although research has shown that retention in medication assisted treatment (MAT) programs increases quality of life for those individuals with opioid use disorder (OUD) and decreases premature death, there has been limited research on the perspectives of individuals with OUD in MAT programs and why they remained in or left the programs. The purpose of this qualitative phenomenological study, guided by Merleau-Ponty’s theory of perception, was to explore the lived experiences of those with OUD treated in a MAT program. An algorithm type interview was conducted to ask …

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The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina Jan 2022

The Relationship Between Length Of Stay, Hospital Characteristics, And Cost Of Care In Acute Care Hospitals In The U.S., Maria Mikhataykina

Walden Dissertations and Doctoral Studies

Rising healthcare costs make access to healthcare less accessible for many individuals. Hospital administrators, payer stakeholders, and patients are concerned with rising healthcare costs, as many patients may be hindered from receiving quality health care. Grounded in complex adaptive systems theory, the purpose of this quantitative correlation study was to examine the relationship between inpatient hospital (a) LOS, (b) bed size, (c) location, (d) region, (e) control/ownership, and cost of care. The participants were community hospitals participating in the Nationwide Inpatient Sample (NIS) data collection tool of the Healthcare Cost and Utilization Project. The results of the multiple linear regression …

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The Relationship Between Team Engagement And Physician Engagement, Lynne Miles Jan 2022

The Relationship Between Team Engagement And Physician Engagement, Lynne Miles

Walden Dissertations and Doctoral Studies

AbstractWhile physician engagement has previously been shown to be related to both turnover and burnout, there are no studies that focus primarily on the relationship between the physician and team. The purpose of this quantitative study was to examine the relationship between team engagement and physician engagement. The theoretical framework used to guide this research study is the neoclassical organizational theory. The secondary data source was from an engagement survey taken by employed team members and physicians. The independent variable is team engagement. The dependent variable is physician engagement. The instrument for the study is valid and reliable and was …

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Relationship Between Nursing Staffing Hours (Rns & Lpns) And Covid-19 Mortality In Indiana Nursing Homes, Chirag Chandrakant Patel Jan 2022

Relationship Between Nursing Staffing Hours (Rns & Lpns) And Covid-19 Mortality In Indiana Nursing Homes, Chirag Chandrakant Patel

Walden Dissertations and Doctoral Studies

During the COVID-19 pandemic, many nursing homes struggled to meet the needed staffing levels, compromising service delivery in health institutions across the United States. The disproportionate effect of COVID-19 on various health care institutions and staff-patient ratios rejuvenated discussions on the longstanding workforce challenges on quality care and outcomes. The purpose of this quantitative study was to evaluate the relationship between registered nurse (RN) staffing hours and COVID-19 deaths in Indiana private and public nursing home residents based on the data obtained in the Care Compare database and Indiana Department of health COVID-19 portals. The independent study variables were RN …

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The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson Jan 2022

The Relationship Between Nephrologist Characteristics And Home Dialysis Usage, Meagan Marie Wilson

Walden Dissertations and Doctoral Studies

Home dialysis is a cost-effective and efficient means of treating end-stage renal disease. Under-utilization of home dialysis results in higher than necessary Medicare spending and loss of quality of life for patients. The purpose of this study was to understand the relationship between a nephrologist's length of time in practice, a nephrologist's belonging to a Joint Venture (JV) financial arrangement with a home modality program, and the use of home dialysis and home modality education using a quantitative, correlational design. Roger's diffusion of innovation theory explains the varying willingness of individuals to accept innovation. Secondary data were collected from Medicare …

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Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia Jan 2022

Strategies For Hospitals After Implementation Of Reimbursement Cuts To The Outpatient Prospective Payment System, Nicole J. Boscia

Walden Dissertations and Doctoral Studies

Healthcare costs have continued to increase in the United States. The Centers for Medicare and Medicaid Services (CMS) have proposed policy changes to reduce inequities between hospital outpatient centers and independent freestanding facilities when reimbursing for the same service. The purpose of this quantitative study was to explore if there was a difference in the payments to the Outpatient Prospective Payment System between the years 2017 and 2018 to assist hospital administrators in preparing for Medicare reimbursement cuts. The study was grounded in the agency theory and aimed to determine the relationship among the provider, payer, and patient. The research …

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The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall Jan 2022

The Impact Of Telemedicine Availability On Fatal Opioid Overdose Rates In Texas, 2020, Cara W. Hall

Walden Dissertations and Doctoral Studies

AbstractSubstance use disorders (SUDs) and fatal overdoses are a significant problem in the United States. A viable and effective method for treating SUDs is through telemedicine (tele-SUD) visits. Tele-SUD visits are an effective means of meeting with patients virtually, especially in the post-COVID-19 environment; however, a problem in health care exists concerning the availability of tele-SUD services in middle America. The purpose of this study was to investigate the impact of tele-SUD availability on rates of opioid overdose deaths in the state of Texas. Donabedian’s model of health care quality evaluation was used as the theoretical framework. A quantitative, independent …

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Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick Jan 2022

Integrated Care Impact On Postpartum Visit Compliance And Readmissions, Matthew Herrick

Walden Dissertations and Doctoral Studies

The specific research problem that was addressed through this study is the low rate of postpartum visits among Medicaid-enrolled women, leading to increased postpartum complications and readmissions. The purpose of this quantitative study was to evaluate if hospital readmissions can be reduced by integrated care home visiting services relating to postpartum visit compliance. The research questions evaluated the relationships between postpartum visit compliance, hospital readmissions among Medicaid-enrolled women in Indiana, and an integrated care home visiting program. The Donabedian model for quality-of-care grounds this study and is based on structure, process, and outcome. Through this model, healthcare leaders can evaluate …

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Assessing The Relationship Between Automated Technology Expenditure And Revenue Cycle Performance, Kelsey Macapagal Jan 2022

Assessing The Relationship Between Automated Technology Expenditure And Revenue Cycle Performance, Kelsey Macapagal

Walden Dissertations and Doctoral Studies

Despite evidence that the automation of administrative processes may lead to both cost reductions and performance benefits, there was little to no empirical evidence that holistically examined the impact of technology within the healthcare revenue cycle. The purpose of the current quantitative study was to examine the relationship between automated technology expenditure and revenue cycle performance. Correlational analyses were used to determine the relationship between automated technology expenditure and labor, revenue, and denials, respectively, within the revenue cycle of a single, multi entity health system in California. Regression analysis was used to determine the relationship between variables over a 4-year …

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Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin Jan 2022

Oral Health Behaviors, Attitudes, And Dental Diseases In Native American/Alaskan Native School-Age Children, Tawanda Martin

Walden Dissertations and Doctoral Studies

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, …

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California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga Jan 2022

California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga

Walden Dissertations and Doctoral Studies

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …

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Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli Jan 2022

Experiences Of Critical Care Nurse Managers In Addressing Nurses' Work-Related Stress, Mariana Tsucuneli

Walden Dissertations and Doctoral Studies

AbstractNurses who work in the critical care unit are more likely to experience work-related stress, fatigue, understaffing, undesirable performance outcomes, and compromised workplace safety than general care nurses. Nurse managers in these units possess insights into nurses' stress-inducing challenges, in addition to managerial and administrative perspectives. Yet there is a lack of available knowledge about the experiences of critical care nurse managers in addressing nurses' work-related stress. The purpose of this study was to explore critical care nurse managers’ experiences of potential strategies to effectively address work-related stress among nurses. The job-demand resource model was the theoretical framework for the …

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Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies Jan 2022

Predicting Patient Satisfaction Using Hospital Performance Characteristics, Vanna Lombardi-Gillies

Walden Dissertations and Doctoral Studies

Performance related to patient satisfaction is becoming a significant factor in determining reimbursement for hospital-based services. Furthermore, consumers are increasingly accessing publicly available quality and patient experience information to make decisions about where to receive care. Understanding which hospital characteristics influence patient satisfaction is critical to the healthcare administrator to ensure the financial viability of the organization and to meet the needs and expectations of the community. Many studies have examined the relationship between a single performance characteristic and patient satisfaction. This secondary data quantitative study used regression analysis to analyze the relationship between three hospital performance characteristics (i.e., the …

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Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro Jan 2022

Hospital Readmission Reduction Penalties And Chronic Obstructive Pulmonary Disease Readmissions, Anthony Aduro

Walden Dissertations and Doctoral Studies

AbstractChronic obstructive pulmonary disease (COPD) is a serious disease that affects the respiratory system, creating poor patient outcomes. Additionally, persons with COPD have higher hospital readmission rates than other patient populations. Not only is hospital readmission indicative of poor patient outcomes, but hospital readmissions are costly to healthcare organizations as well. High readmission rates are associated with wasted resources and money, and negatively impact organizational performance. The Centers for Medicaid and Medicare Services (CMS) implemented the Hospital Readmissions Reduction Program (HRRP) to reduce the rate of avoidable hospital readmissions for diseases including COPD. However, how HRRP penalties have impacted readmission …

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Patient Harm And Malpractice Payments In Inpatient Settings According To Type Of Medication Administration Error, Kalyn Jo Barton Jan 2022

Patient Harm And Malpractice Payments In Inpatient Settings According To Type Of Medication Administration Error, Kalyn Jo Barton

Walden Dissertations and Doctoral Studies

While preventable, medication administration error rates surpass most estimates and result in poor quality care. Researchers have demonstrated that interventions have been identified, new technology has been deployed, and training and education have increased, yet the errors persist. Researchers have yet been able to establish the most prevalent, harmful, and costly types of medication administration errors. The purpose of this quantitative study was to identify trends in medication administration errors committed in inpatient settings, specific to the type of error, patient outcomes, and malpractice payment amounts. Donabedian’s model for healthcare quality, derived from the three categories of structure, process, and …

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Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore Jan 2022

Strategies To Prevent Medicare Claims Fraud Committed By Speech Pathologists, Joseph Densmore

Walden Dissertations and Doctoral Studies

Fraudulent business activities have the potential for adverse business outcomes. Speech pathology business owners who lack a robust fraud prevention strategy may subject their practices to severe civil and criminal penalties. Grounded in Wilhelm’s eight-stage fraud management lifecycle theory, the purpose of this qualitative multiple case study was to explore strategies speech pathologist business owners used to prevent Medicare claims fraud. The participants were five speech pathologist business owners from three practices in a western U.S. state who successfully implemented fraud prevention strategies. Data were collected using semistructured interviews and reviewing organization policies and procedures manuals. Three themes emerged using …

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Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater Jan 2022

Strategies For Retaining Nurses In Rural Healthcare Settings, Michelle Lee Pratt Yeater

Walden Dissertations and Doctoral Studies

Rural healthcare leader deficiency in implementing successful strategies to retain nurses can deleteriously impact the quality of patient care and impede the organization's financial performance. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple-case study was to explore successful nurse retention strategies used by rural healthcare leaders. Data were collected from semistructured interviews with eight pastoral healthcare leaders in the eastern region of the United States who improved nurse retention and a review of relevant supporting documentation from company websites. Coding was used for data analysis and theme determination. Three themes emerged: effective nurse retention incentives, meaningful relationships …

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