Health and Medical Administration Commons^™

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Peers Erecting Barriers To Another Peer’S Success In The Healthcare Setting, Ricky D. Allen

Walden Dissertations and Doctoral Studies

In the healthcare workplace, bullying is shown to negatively impact patient care and safety, workflows, outcomes, interpersonal relationships, performance, mental and physical health, and cause a plethora of other secondary effects. The purpose of this qualitative phenomenological study was to explore the lived experiences of high performers or subject matter experts working in the healthcare field and had encountered peer-to-peer interference. The research questions focused on understanding the behaviors and outcomes of peer interference. Maslow’s hierarchy of needs was used as the conceptual framework. Data collection was achieved by interviewing 10 participants from a variety of healthcare backgrounds. Participants self-identified …

Motivating Factors For Nurses Aged 65 Years And Older To Extend Their Work Life, Dr. Cynthia M. Dobek

Walden Dissertations and Doctoral Studies

Nurses age 65 years and older who retire will leave a knowledge gap in the workforce unless motivated to continue working. A knowledge gap in the workforce is of concern to human resource professionals because healthcare professionals may not be able to keep pace with the increase in patients needing medical care. Grounded in Maslow’s hierarchy of needs theory, the purpose of this qualitative single case study was to explore what factors motivated nurses aged 65 years and older to extend their work life. The participants comprised 6 nurses aged 65 years and older who were still working or semiretired …

Incivility Among Nurses, The Influence Of Structural Empowerment: A Systematic Review, Jennifer Gardner

Walden Dissertations and Doctoral Studies

Workplace nurse-on-nurse bullying is a well-known phenomenon in health care organizations at both national and global levels. Healthcare organizations struggle to find effective solutions to help nurses to mitigate bullying and incivility and create safer work environments. The purpose of this systematic literature review doctoral project was to critically appraise the literature to find the best research evidence to show that higher levels of structural empowerment lead to lower levels of incivility and increase nurses’ ability to create safer and more positive work environments. Kanter’s theory of structural empowerment served as the theoretical framework for this review. The evidence-based question …

Small Business Leaders’ Strategies For Recruiting Veterans, Jamillah Deangela Stackhouse

Walden Dissertations and Doctoral Studies

Small business hiring managers who fail to implement recruitment strategies for

transitioning military veterans face hiring challenges with this population of workers.

Failed recruitment strategies are essential to small business leaders, as failure to attract

highly qualified military veterans places the organizations at a competitive disadvantage.

Grounded in recruitment theory, the purpose of this qualitative multiple case study was to

explore strategies used by leaders of small businesses to recruit, hire, and retain qualified

veterans. The participants included 3 purposefully selected hiring managers from 3 small

businesses in southeastern Virginia, who used successful strategies to recruit, hire, and

retain veterans. …

Systematic Review Of Family Nurse Practitioner Utilization Within School Environments, Luz Elena Zapien

Walden Dissertations and Doctoral Studies

The American Academy of Pediatrics and the Institute of Medicine recommend school health screening programs to detect problems that might interfere with a student’s education and general well-being, and many U.S. states require compliance with enrollment requirements such as updated immunizations and physical exams prior to attendance. In low-income areas, however, there is often a shortage of physicians available to meet the healthcare needs of the population. Family nurse practitioners (FNPs) can be utilized in school health settings to deliver health care services that support school attendance and the well-being of school students, yet little is known about their impact. …

The Relationship Between Sense Of Coherence And Coping With Stress Among Emergency Room Physicians, Melina Masihi

Walden Dissertations and Doctoral Studies

Physicians face different stressful situations daily when caring for patients in the emergency room (ER). The individual ER physician’s ability to cope with stressful situations varies considerably and affects patient care. Developing a sense of coherence (SOC) is thought to be one of the significant strategies for self-regulation in stressful conditions like those in the ER. The purpose of this research was to examine the relationship between SOC and coping abilities among emergency physicians in the United States. The study used a quantitative, cross-sectional design to assess physicians’ SOC and coping skills using an SOC scale and a coping scale, …

Fall-Related Patient Education: An Essential Feature Of A Fall Prevention Program, Immaculata Okonkwo

Walden Dissertations and Doctoral Studies

This project documented the evaluation of a voluntary patient falls prevention education

program (VPFPEP) of a rehabilitative facility in a Mid-Atlantic US state and ascertained

its sustainability. The project was designed using the customized Moore et al. evaluation

model and Lippitt’s planned theory of change to encourage patient engagement in

physical activity (PA) through fall prevention education to allay patients’ fear of falling.

The sample included patients who opted into the facility’s VPFPEP. Evaluation was

performed using run charts to visually and quantitatively monitor trends and patterns of

fall incidents over time. Run charts also facilitated comparison of injuries sustained …

Leadership And End-Of-Life Planning Among Elderly Patients With End-Stage Renal Disease, Elizabeth R. Armstrong-Fears

Walden Dissertations and Doctoral Studies

More than 8-million people in the United States possess no kidney function. The purpose of this quantitative casual-comparative research study is to examine the relationship between ethnicity status of African American and European American patients suffering from end-stage renal disease, and advanced care planning and end-of-life decision-making among patients who are 55 years of age and older. The health belief model is the selected explanatory framework used to examine (a) whether ethnicity status is a significant predictor of whether decedents had written end-of-life care instructions, (b) whether ethnicity status is a significant predictor of whether treatment decisions were made, and …

Leadership Strategies To Achieve Organizational Excellence, Cherron Lakisha Blakely

Walden Dissertations and Doctoral Studies

Inadequate quality management tools and processes can lead to inefficient hospital operations and poor organizational performance. Community hospital leaders who fail to improve operations and organizational performance risk negatively impacting patient care and profitability. Grounded in the theory of high-performance work systems (HPWS), the purpose of this qualitative single case study was to explore strategies community healthcare leaders use to effectively employ quality management approaches to improve operations and achieve organizational excellence. The participants comprised 5 community healthcare leaders in the northeast United States who effectively used quality management approaches to improve operations and achieve organizational excellence. Data were collected …

An Exploratory Study To Identify Strategies For Retaining Laboratory Professionals In Hospital Setting, Ambrose E. Ewane

Walden Dissertations and Doctoral Studies

Medical laboratory professionals have faced more than 20 years of workforce shortages. The causes of these workforce shortages include poor retention of new professionals and an insufficient number of new graduates who enter the workforce. The purpose of this qualitative case study was to explore the strategies that are used by managers in hospitals for the retention of laboratory professionals. The theoretical framework comprised Mobley’s theory of turnover and Porter’s organizational commitment theory. The research questions for this study addressed what managers perceived as the biggest challenges for the retention of laboratory professionals and what effective strategies they thought could …

Case Analysis Of Acute Care Guidelines For The Prevention Of Pressure Ulcers, Carle Ray

Walden Dissertations and Doctoral Studies

Prevention of pressure ulcers (PUs) in acute care settings is an attempt to avoid adverse events (AE). Literature shows that wounds such as PUs are the most prevalent complication for spinal cord injury patients (SCI) including quadriplegic individuals (QI). SCI and QI bring important pressure ulcer (PU) prevention knowledge to the hospital which involves teamwork and participation by nurses, organizations, and patients. The purpose of this qualitative study was to examine the effectiveness of acute care guidelines for PUs by drawing insights from multiple sources including interviews with QI, healthcare clinicians, care providers, family members, and an online search of …

Managerial Competencies Driving Successful Change Initiatives: A Multiple Case Study Of Healthcare Administrators, William King Selsor

Walden Dissertations and Doctoral Studies

Healthcare administrators’ competencies for driving successful strategic change initiatives in healthcare organizations remain outdated and limited in the management literature. The purpose of this qualitative, multiple case study was to explore the perceptions of healthcare administrators on the specific nature of management competencies needed to drive successful strategic change initiatives within healthcare organizations. To address the research problem and purpose of the study, qualitative data were collected from multiple sources of evidence, including semi-structured interviews with seven healthcare administrators, archival data, and reflective journaling notes. This study was framed by Kash, Spaulding, Johnson, and Gamm’s conceptual framework, the comparison of …

Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone

Walden Dissertations and Doctoral Studies

Hospitals, along with other health care providers, are a central part of every health care system and responsible for a great share of healthcare expenditure. In the United States, the cost of health care is much higher than it is anywhere else. High expenditures for hospital services could reduce the resources available for primary care and other services that could do more for population health. The purpose of this study was to explore the competition among general medical and surgical hospitals in the Deep Southern states of Mississippi, Alabama, Georgia, South Carolina, and Louisiana to determine if increasing the level …

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

Understanding Behavioral Health Stigma Within The Healthcare Workforce, Jason Robert Martin

Walden Dissertations and Doctoral Studies

Individuals who seek mental health treatment in the United States face significant barriers. One such barrier is the belief that those seeking mental health treatment are subpar people with some moral failure. One area where this phenomenon exists is the behavioral healthcare workforce. This study was conducted to understand the phenomenon of stigma that behavioral healthcare leaders exhibit toward behavioral healthcare patients using the Baldrige framework as its conceptual framework. Using a qualitative approach and case study design, interviews were conducted with 6 leaders within a large healthcare system in the suburbs of a major metropolitan area to evaluate their …

Influence Of Supervisor Support And Resilience On Productivity And Turnover Intentions In Pediatric Health Care, Adrienne Y. Martin

Walden Dissertations and Doctoral Studies

Workplace violence has become a critical safety issue in the health care setting, often leading to increased stress levels and employees that feel unsupported and inadequately prepared; which leads to increased turnover, and subsequently, diminished overall organizational productivity and poorer patient outcomes. The purpose of this study was to examine whether supervisor support and resilience affect productivity and turnover intent related to professional role and work experience following workplace violence in the pediatric health care setting. Organizational support theory and the framework of the resilience model provided the theoretical structure for this study. Data were collected through anonymous surveys with …

Primary Care Physicians’ Knowledge And Perception Of The Impact Of Health Literacy On Patient Care, Lutrisha S. King

Walden Dissertations and Doctoral Studies

Until recently, many health literacy studies were completed from the patient and nurse perspective, while few focused on the physician perspective, specifically the primary care physician. The purpose of this study was to provide insight into the health literacy knowledge and education of primary care physicians and determine the association, if any, between physicians’ perceptions of patients’ limited health literacy and physicians’ use of health literacy communication techniques. The knowledge, attitudes, and practice (KAP) framework directed this study. This framework posits that knowledge informs or influences attitudes, which leads to practices. The KAP framework was employed to answer the research …

Exploring Family-Centered Care From The Perspectives Of Home-Health Physical Therapists, James Mathews

Walden Dissertations and Doctoral Studies

Older adults may need, or desire, caregiver and family involvement to avoid hospitalizations and institutionalizations. The caregivers of these older adults have the highest rates of burnout, injury, and turnover. Family-centered care (FCC) involves collaboration between healthcare practitioners, patients, family members, and caregivers. FCC is both established and effective in pediatric care settings. There is a paucity of evidence on how FCC is applied to older adult populations. Home health physical therapists (HHPTs) work with older adults in their homes and train both family members on how to safely handle and manage the care-dependent older adult. The purpose of this …

Relationship Between Hospital Performance And Medicare Reimbursement Penalties, Ashley Bays

Walden Dissertations and Doctoral Studies

Medicare reimbursement penalties are a financial concern for health care leaders when hospitals underperform in the specific measures of hospital performance defined by the Hospital Value-Based Purchasing Program. Grounded in the general contingency theory, the purpose of this correlational study was to determine the relationship between the measures of hospital performance, clinical care, person and community engagement, safety, efficiency and cost reduction, and Medicare reimbursement penalties. Secondary data from the Centers for Medicare and Medicaid Services were collected from 420 acute care urban hospitals designated as teaching facilities with a bed size between 100–299 beds for the fiscal year 2019. …

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

Exploration Of Ehr Implementation Strategies: A Qualitative Study, Scot Eric Loerch

Walden Dissertations and Doctoral Studies

AbstractElectronic health record system implementations have a high failure rate when properly developed strategies are not used. These implementation failures affect healthcare workers and practitioners core roles through a lack of documentation practices, which decreases the quality of the care of the patients. Grounded in the technology acceptance model, the purpose of this qualitative multiple case study was to explore the strategies information technology systems engineers use for the implementation of Health Information Management Systems. The participants were 10 information technology systems engineers from three healthcare organizations in the greater Tennessee area. The data were collected through recorded participant interviews …

Reducing Heart Failure Readmissions Through Staff Education, Christopher Davio

Walden Dissertations and Doctoral Studies

Heart failure is a chronic health condition that can have devastating effects on thephysical and social well-being of patients. One critical component to heart failure treatment is understanding of the disease process and daily self-management for patients. The gap in practice at an acute care facility in the northwest United States was the lack of comprehensive discharge patient teaching to patients diagnosed with heart failure. The project explored if a heart failure education session for nurses would increase knowledge and competency on heart failure education. Knowle’s theory of adult learning was used to frame the project components. Thirty-one nursing staff …

The Relationship Between Program Leadership, Resident Physicians’ Wellbeing, And Quality Of Care, Fatima Msheik

Walden Dissertations and Doctoral Studies

Research studies have shown that organizational leadership and support affect organizational outcomes in many sectors, including healthcare. However, less is known about how organizational leadership influences the quality of patient care by physicians. This study was guided by the perceived organizational support theory and leader-member exchange theory that provide general understanding of how supportive leadership influences staff wellbeing and productivity. Ninety-five resident physicians residing in Lebanon participated in this cross-sectional study and completed an online survey, which consisted of demographics and five tools, namely, the Leader-Member Exchange 7, Perceived Organization Support 8, Maslach Burnout Inventory 7, Utrecht Work Engagement 9, …

Impact Of Servant Leadership Style On Customer Service And Patient Satisfaction, Chibunna E. Nwaobia

Walden Dissertations and Doctoral Studies

Patient satisfaction presents an emerging area of research for healthcare providers because major healthcare providers like Medicare/Medicaid control the finances of healthcare institutions as based on their patient and customer satisfaction. The purpose of this study was to examine the impact of servant leadership on customer service, and patient satisfaction, in the Inland Empire Region of Southern California. The theoretical framework applied to this study was the servant leadership theory. Participants consisted of 82 managerial staff within the University Health System, which is comprised of a teaching hospital, 5 behavioral health centers, 10 federally qualified health centers, and a public …

Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson

Walden Dissertations and Doctoral Studies

Seismic data loss attributed to cybersecurity attacks has been an epidemic-level threat currently plaguing the U.S. healthcare system. Addressing cyber attacks is important to information technology (IT) security managers to minimize organizational risks and effectively safeguard data from associated security breaches. Grounded in the protection motivation theory, the purpose of this qualitative multiple case study was to explore risk-based strategies used by IT security managers to safeguard data effectively. Data were derived from interviews of eight IT security managers of four U.S. government health institutions and a review of relevant organizational documentation. The research data were coded and organized to …

Strategies To Implement A Material Management Information System For Medical Device Recalls, Paul Leo Lafrance

Walden Dissertations and Doctoral Studies

Health care business executives lack strategies to implement material management information systems (MMIS) related to medical device recalls. Lacking sufficient MMIS, health care business executives face insufficient product tracking related to medical devices affecting operational efficiency. Grounded in the conceptual frameworks of the technology acceptance model and diffusion of innovation, the purpose of this qualitative single case study was to explore health care business executives’ strategies for implementing an MMIS related to medical device recalls. The participants were 6 health care executives who implemented an MMIS in an urban hospital in the northeast region of the United States. Data were …

Recognition, Classification, And Help-Seeking Behavior Of Nigerian Immigrants In Minnesota, Frederick Nnabuchionye

Walden Dissertations and Doctoral Studies

Immigrants from non-Western cultures are known to underutilize mental health services in the United States. Part of the problem is in the way how cultures recognize and classify symptoms as a mental disorder. A report from the Minnesota Ombudsman's Office for Mental Health showed that out of every 6 suicide-related deaths in Anoka Regional Treatment Center in Minnesota, 4 are of African descent. The purpose of this quantitative study was to investigate the cultural view of depressive symptoms as possible predictors of attitude toward seeking professional psychiatric help. The theory of reasoned action/ theory of planned behavior provided the framework …