Health and Medical Administration Commons^™

Effect Of Bundled Payments As A Care Improvement Initiative On Hospital Care Of Total Joint And Sepsis: A Perspective On Organizational Effectiveness, Pearl Kim

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study investigates the potential impact of the Bundled Payments for Care Improvement (BPCI) initiative from Center for Medicare and Medicaid Services on hospital performance and behavior related to effectiveness and efficiency. The BPCI is under the Affordable Care Act and provides hospitals with a fixed amount of reimbursement for a total episode of care. Building on the agency theory, I argue that the BPCI initiative has the potential to enhance the effectiveness and efficiency of hospital care. This quasi-experimental study examines the changes in hospital care outcomes of patients with replacement of the lower extremity or sepsis in BPCIparticipating …

Compounding Effects Of Reducing Nurse Burnout And How It Can Produce An Increase In Patient Safety And Satisfaction, Alexander Mua

Master's Projects and Capstones

The reduction of nurse burnout has shown to have an increase in patient satisfaction and quality of care. It also has shown a decrease in patient-related or sentinel events. Accordingly, with the reduction of nurse burnout, there has also been a reduction of compassion fatigue. This project has illuminated the benefits of acuity-based caseload at the micro-level, including the cost-effective nature of overtime pay, including HCHAPS benefit score. The method of obtaining, planning, and implementing was based on the Plan, Do, Study, Act (PDSA), which required collaboration amongst multiple disciplines, groups, departments, and executives. The process and goals concluded to …

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Affordable Care Act And Preventive Care Usage: A Mixed Method Analysis Of Cardiovascular Care, Brit Peek

Theses & Dissertations

It is a commonly held belief that access to health insurance affects the level of utilization of preventive care services, and thus plays a crucial role in the effective management of avoidable chronic illnesses, decreasing levels of premature mortality, and enabling individuals to live wholesome long lives. Based on this belief, among other goals, the Affordable Care Act (ACA) was designed to increase access to health insurance and related medical services for the population of the United States. This dissertation attempts to identify whether this belief is valid or not by testing whether the usage of preventive care changed between …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

The Impact Of The 2010 Affordable Care Act On Reducing Racial/Ethnic Disparties In Primary Care Acess And The Delivery Of Diabetes Preventive Care In The United States, Adrianna Nava

Graduate Doctoral Dissertations

A key focus of the 2010 Patient Protection and Affordable Care Act (ACA) was to improve access to healthcare services in the United States (U.S.) (Stolberg & Pear, 2010). The research purpose was to assess the impact of the ACA’s Medicaid expansion and insurance subsidies on reducing racial/ethnic disparities in coverage, access and the delivery of primary care services, specifically diabetes prevention. Diabetes disproportionately affects minority populations, with inequities reported in the delivery of diabetes care to minorities (Chow, Foster, Gonzalez & McIver, 2012). The Modified Quality Health Outcomes Model was used to guide this research. Statistical analyses were conducted …

My Healthcare Administration Experience At Lifecare Alliance, Ayat Al Jbour

Masters Theses/Capstone Projects

My practicum site was LifeCare Alliance, "Nourishing the Human Spirit. It is a not-for-profit organization that provides a comprehensive array of health and nutrition service to residents of Central Ohio.

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

Dissertations

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

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

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

Coronavirus And Journalism In Pakistan, Syed Osama Ali

MSJ Capstone Projects

The lockdown caused by the Coronavirus pandemic in 2019 made the reporting process extremely challenging for journalists. In this dire situation, Pakistani journalists like other journalists around the world, ensured the implementation of Coronavirus SOPs while fulfilling their duty as journalists and reporting problems they faced in the process, this is my subject of writing.

The Implementation Of An Open Source Electronic Medical Record At A Faith-Based Community Clinic, Gabri Warren

Graduate Theses, Dissertations, and Capstones

Faith-based nursing and healthcare is increasingly gaining popularity as the industry looks to minimize costs and improve health outcomes. Historically, qualitative studies have not shown the extent to which individuals and communities are impacted by health initiatives initiated by faith institutions. Healthcare technology can help support the specialty by providing increased quantity and quality data to analyze. Traditional, proprietary EMRs are too costly; however, open source systems offer a low cost, and easily modifiable option to non-profit, or smaller organizations. The data collected by an open source system allows organizations to improve the care that patients receive, and helps guide …

Relationships Between Social Determinants Of Health And Patient Readmissions To An Acute Care Hospital Within 30 Days Of Discharge, Wren Mosee Lester

Seton Hall University Dissertations and Theses (ETDs)

Background: The Hospital Readmission Reduction Program (HRRP) is a part of the Affordable Care Act (ACA), which addresses the cost and quality of health care. The HRRP and policy penalizes hospitals for excessive readmission rates. The overall purpose of the program is to improve the quality of care, reduce costs and improve operational efficiency in hospitals. (Zhang, 2014).

Purpose: The purpose of this study was to identify and examine what social determinants of health, at an individual level and community level, were associated with the likelihood of being readmitted into the hospital, within 30 days of discharge, for patients …

Increasing Patient Satisfaction Survey Response Rate At An Ambulatory Surgery Center, Carlee Nicholson

Doctoral Projects

In an effort to increase distribution rate and response rate of the patient satisfaction survey at this ASC, adjustments were made to current processes. These interventions included accentuating the option of a paper or emailed survey, providing pre-operative and post-operative response prompts, as well as adding a cover letter to the existing survey. The purpose of these interventions was to ensure a 100% distribution rate of the survey as well as to increase the response rate by 20%.

Results were obtained by collecting forms to monitor distribution of the survey. The response rate was calculated by the number of responses …

Abroad View Of Wellness, Patrick Kunkel, Megan Mills, Seth Clark

Masters Theses/Capstone Projects

A presentation on a Study Abroad trip taken to Hungary.

Journey Of The State Budget, Karina Carmichael

Masters Theses/Capstone Projects

In attempts to make government fair and equitable, the process of any bill but especially the budget bill can be extremely convoluted and difficult to follow. I was able to learn how to navigate the system and understand the processes by which things happen at the statehouse.

The statehouse is filled with representatives of countless interest groups all fighting for their opinion of how things should be done. As demonstrated by this budget cycle, government can be a push and pull directed by politics, personal opinions, and countless other factors, which may result in nothing getting done.

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

Optimizing Intraprofessional Communication At Patient Handover, Allison Crabtree

Doctor of Nursing Practice Projects

This performance improvement project aimed to increase the communication competency of nurses during intraprofessional interactions at patient handover. An educational program focused on optimizing communication among nurses was implemented in a community-based, not-for-profit, rural hospital. The course was designed to incorporate a variety of instructional strategies to meet learner needs. Consistency and standardization of the patient handover process was a central theme. Topics of the course focused on the use of a standardized communication tool, the relationship of communication on patient safety, the importance of clear and effective communication, the role of the nurse as gatekeeper and facilitator of patient-specific …

Early Information Access To Alleviate Emergency Department Congestion, Anjee Gorkhali

Theses and Dissertations in Business Administration

Alleviating Emergency Department (ED) congestion results in shorter hospital stay which not only reduces the cost of medical procedure but also increase the hospital performance. Length of patient stay is used to determine the hospital performance. Organization Information Processing (OIPT) Theory is used to explain the impact of information access and availability on the information processing need and ability of a hospital. Technical devices such as RFID that works as “Auto Identification tags” is suggested to increase the information availability as well as the information processing capability of the hospitals. This study suggests that the OIPT needs to be further …

Death By Contamination, Syeda Sana Batool

MSJ Capstone Projects

This research was conducted by Centre for Excellence in Journalism, IBA, Karachi during 2019 as a capstone project for Master of Science in Journalism. The data and information regarding water contamination was obtained and compiled through a thorough reporting, researched articles and documents provided by concerned organization.

The water which is used for the drinking purpose in Karachi is the most polluted and contaminated one as compare to the other cities of Pakistan. The reason behind this water contamination is the industries disposition of waste, which has ruined the environment by polluting the water bodies with its toxic effluent.

The …

Working With Youth As Stakeholders In Mental Health System Transformation: An Institutional Ethnography Of A Service Organization In Access Open Minds, Eugenia Canas

Electronic Thesis and Dissertation Repository

As national system- and research-agendas invest heavily in the improvement of youth mental health services delivery, the discursive and policy impetus for the inclusion of youth as advisors has increased. However, we know little about the work of youth engagement (YE) in the everyday realities of a care-delivery organization. Does the engagement of youth advisors ultimately inform care?

This dissertation addresses the knowledge concerns of YE with a detailed account of the experiences of youth advisors, service providers, and an organization in the process of services reform. I used institutional ethnography to (1) reveal the day-to-day work of engaging young …

The Lived Experience Of Healthcare Leadership Dyads: Perceptions Of Agency, Susan Murphy Campanelli

All Theses And Dissertations

Healthcare leadership is evolving in response to recommendations from the Institute of Healthcare Improvement (IHI). Physicians and administrators are partnering to form leadership dyads. These leadership dyads are focusing on improving healthcare quality, decreasing costs, and improving access. Existing literature on healthcare dyads explores leadership training needs for physicians, focuses on the differences between physicians and administrators, and emphasizes the need to develop role clarity for dyad leaders. There is a lack of empirical literature exploring how the physician and the administrator develop into a leadership team and extend shared leadership into their organization.

This phenomenological study applies Bandura’s (1986) …

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

Dissertations

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

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

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

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

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

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

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

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

Aims/ …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

The Relationship Between Human Trafficking And An Occupational Therapy Career, Lexie France

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

Occupational therapy crosses physical-mental health boundaries. It has been stated that occupational therapists have an innate duty to work with not only individuals, but society as a whole when individuals experience social and occupational injustices. An example of a social/occupational injustice that an individual may experience is human trafficking. Human trafficking not only affects the individual physically and emotionally, but it also has a pervasive impact on the individual’s ability to function as an occupational being. These experiences have the potential to affect the individual in varied contexts and environments, and over the lifespan. Due to an occupational therapist's proficiency …

Provider Suicide, Amy Quinn

Physician Assistant Scholarly Project Papers

The purpose of this research and systematic literature review is to determine the risks factors for, the identification of and repercussions of provider suicide. In this review, databases searched included Pubmed, Cochran Database of Systematic Reviews, PsycInfo, National Institute of Health, Medscape and Google Scholar from September 8, 2018 to January 13, 2019. A variety of key terms were used when searching include suicide, provider suicide, suicide, costs of suicide, physician burnout, physician assistant burnout, nurse burnout, doctor suicide, physician assistant suicide, and nurse practitioner suicide. Works chosen for review were published between 1979 and 2018, as the topic has …

A Framework For Learning During An Honors Internship: Embold Health Inc., Haley Haldeman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Embold Health Inc. is a health care analytics start-up company that identifies top performing providers using large data sets and clinically nuanced measurement. A comprehensive assessment of quality, appropriateness, and cost is what Embold Health delivers. Embold allows payers more control in choosing providers within their region. Being able to identify top provider behaviors through rigorous data driven measurement is significant both clinically and commercially; it provides the opportunity to increase value of care, decrease waste, and drive down cost.

Over the past year as an intern, I’ve had a first-hand look into the complexity that surrounds data driven health …

Evidence-Based Practice Guide And Workflows: Improving Hospital Throughput And Reducing Emergency Department Overcrowding, Maulah Halley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hospitals in the United States are experiencing disruptions to patient throughput. These disruptions create barriers to patients who seek emergent care in the Emergency Department (ED) and who must be moved to hospital inpatient beds after the decision to admit has been made. As a result, patients requiring hospital admission via the ED may have long wait times, which, in turn, contribute to ED crowding and overcrowding. The root causes of ED overcrowding are inefficiencies within the system and the inability of hospitals to meet demand. Although bed capacity on any given unit may not be altered, ED patient’s arrival …

Leadership Development In Nursing: Planning From The Bedside To The Executive Suite, Janet C. Wright

UNLV Theses, Dissertations, Professional Papers, and Capstones

Nurses comprise the largest portion of the healthcare sector workforce over 4 million professional nurses licensed in the United States (National Council of State Boards of Nursing, 2019). Leading within a vast workforce such as nursing requires the nurse leader to have the expertise of the nursing profession along with leadership and business skills to maintain competitiveness in the complex healthcare industry. Consequences of effective leadership include improved patient outcomes, decreased staff turnover, and decreased costs to the organization related to patient outcomes and turnover costs. These results suggest the importance for organizations to ensure their leaders are properly trained …

Healthcare’S Responsibility To Care: The Call To Support Both Patients And Their Families Through Illness, Madeline Merwin

Honors Capstone Projects - All

The contemporary healthcare institution operates on the philosophy of patient-centered care [PCC], growing from the medical culture of the past: care centered around an omniscient provider, defining the patient by their illness versus their identities. While this widely practiced philosophy succeeds in meeting the chief complaint and needs of a patient, it neglects to care for the patient in the context of his or her broader life constituents: the family and loved ones. Health care providers and their institutions are stopping short of adequate, all-encompassing healthcare when the family is not regarded as an equal member of the care team. …

Ohes: Bringing Wellness To You, Marissa Rezes

Masters Theses/Capstone Projects

No abstract provided.