Health and Medical Administration Commons^™

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

The Relationship Between Leadership Style, Job Satisfaction, Nurse Retention, And Patient Care Outcomes: A Systematic Review, Richard Lazarus Nwaorgu

Walden Dissertations and Doctoral Studies

Poor nurse retention, job dissatisfaction, and reduced patient health outcomes are pervasive issues at the healthcare institution of this project. Institutional data reflects a continual decline in retention and job satisfaction rates, which in 2018 showed a 20% drop in retention and a 25% drop in job satisfaction. The institution’s annual survey identified perceptions about leadership styles that gave rise to negative nursing behaviors and the negative impact on patient care outcomes. The purpose of this systematic review project (SRP) was to identify the relationship between nursing leadership styles, job satisfaction, nurse retention, and patient care outcomes within a hospital …

Interprofessional Reflective Journals: Content Themes And Self-Regulated Learning, Joan M. Tunningley

Journal of Occupational Therapy Education

Self-reflection has been linked with clinical reasoning, academic, and clinical outcomes. The purpose of this study was to examine self-reflective journal entries from thirty students for interprofessional core competencies and for self-regulated learning components. The text data was analyzed using an in-depth three cycle coding process, thoroughly described in the methods. The findings were structured into two themes confirming interprofessional content learning: collaboration, team, and communication; and respect and roles. One additional theme emerged, transformation and relatedness, which indicated self-regulated learning components as well as supporting transformative learning. This qualitative case-study contributed to the research of occupational therapy students’ self-reflection …

Factors That Determine The Place Of Childbirth In Lagos State, Nigeria, Ohiemi Emmanuel Adegbe

Walden Dissertations and Doctoral Studies

AbstractNigeria is among the 10 countries in the world with the worst maternal mortality. Though most of these deaths can be prevented using antenatal care (ANC) and having institutional deliveries, in Nigeria, ANC attendance and institutional delivery are suboptimal. Research is lacking on the reasons for the disparity between the use of antenatal services compared to deliveries at health centers. The aim of this study was to determine the associations between sociodemographic, obstetric, and health service factors and the place of delivery used by pregnant women in predominantly urban, cosmopolitan Lagos, Nigeria. Because both service delivery and demand factor categories …

Role Of Case Management In Access To Mental Health Care Among African Americans With Medicaid, Kira-Jai Jayne Taylor

Walden Dissertations and Doctoral Studies

Disparity in access to appropriate mental health care among African Americans compared to non-Hispanic Whites is growing. The purpose of this quantitative retrospective study was to examine the relationship between access to an outpatient mental health facility with case management and access to outpatient mental health services among African Americans with Medicaid compared to non-Hispanic Whites with Medicaid. The theoretical framework was based on the conceptual framework for integration created by PATH. The study addressed whether there is a difference in the number of African Americans compared to non-Hispanic White patients with Medicaid in access to an outpatient mental health …

Service-Level Factors Affecting Completion Of Antenatal Care Attendance In Uganda, Lorna Barungi Muhirwe

Walden Dissertations and Doctoral Studies

Lack of universal coverage of proven, low-cost, high-impact interventions—particularly for underserved and rural populations—remains a key reason for the high rates of maternal deaths in Uganda. Antenatal care (ANC) ensures early detection and treatment of pregnancy-related complications. Completion of recommended ANC visits remains suboptimal, particularly for rural women in Uganda. The purpose of this quantitative, cross-sectional study was to assess facility-level factors affecting completion of ANC attendance among women of reproductive age in a rural district in Uganda. The Dutton theory for initial and continued health services utilization was used to analyze the relationship between facility level factors and ANC …

Perceptions Of Healthcare Workers About Jamaica’S Health Disaster Management Plan, Terence Raphael Walters

Walden Dissertations and Doctoral Studies

Disasters cause several barriers to the provision of healthcare services in Jamaica. These include damaged infrastructure, reduced access to medical care and supplies, increased demand for healthcare services, and physical and psychosocial impacts on healthcare workers. It is not known how effective the Ministry of Health Procedures Manual No. 7, Disaster Management is and how healthcare workers in Jamaica perceive the effectiveness of the plan. The purpose of this study was to explore how healthcare workers in Jamaica perceived the effectiveness of the plan. The procedures manual requires collective actions by healthcare workers to be implemented successfully, and therefore collective …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

Servqual Measurement In A Healthcare Setting: Before And After Corrective Strategy Implementation, Jerome Christia, Aaron Ard, Lorraine Runion

Atlantic Marketing Journal

In the United States, the most dominant industry is services, yielding the highest volume of total employment and gross domestic product. Due to this insight, academics and business professionals continue to research and apply strategies to achieve distinctive competitive advantages in the services arena. The steady growth and increasing significance of the service sector in the United States and other developed markets has resulted in a sizeable body of related research addressing a variety of issues such as service quality and its characteristics. Healthcare is an impactful service industry that has received a considerable amount of attention. In the healthcare …

Patient Blood Management Programs And Their Association With Patient And Organizational Outcomes, Sandra L. Lamm

Theses and Dissertations

Blood transfusions are the most common hospital procedure. However, many transfusions may be unnecessary. These unnecessary transfusion may expose patients to the potential risks of transfusion without improving patient outcomes Patient blood management (PBM) programs emphasize conserving a patient’s own blood resources and only transfusing the minimum amount needed. This study examined the organizational and environmental factors associated with a hospital having a PBM program, or having processes based on PBM, and their impact on organizational and patient outcomes potentially affected by blood transfusions.

A PBM survey was created for this study and used to gather information on hospitals having …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

Innovations In Diabetes Care For A Better "New Normal" Beyond Covid-19., Shivani Agarwal, Michelle L Griffith, Elizabeth J Murphy, Carol Greenlee, Jeffrey Boord, Robert A Gabbay

Hospital Medicine

The coronavirus disease pandemic has created opportunities for innovation in diabetes care that were not possible before. From the lens of this "new normal" state, we have an opportunity to rapidly implement, test, and iterate models of diabetes care to achieve the quadruple aim of improving medical outcomes, patient experience, provider satisfaction, and reducing costs. In this perspective, we discuss several innovative diabetes models of care which promote collaborative care models and improve access to high-quality specialty diabetes care. We discuss ongoing threats to diabetes care innovation, and offer practical solutions to foster evolution and sustain current strides made during …

Influence Of Telephone Preoperative Evaluations On Patient Medication Compliance On Day Of Surgery, Emmanuel Magsino, Michael Jung, Olga Suarez Md

Graduate Research Posters

Patient compliance with medication instructions on day of surgery (DOS) is an important part of the preoperative assessment, as failure to comply with these may lead to serious perioperative consequences. Prior studies have shown that compliance increases with multimodal interventions. However due to the recent COVID-19 pandemic, many in-person visits transitioned to telephone visits and providers had to rely on patients to follow solely verbal instructions.

To determine medication compliance, this study compared the medication instructions provided by the VCU Preoperative Assessment Communication and Education Clinic, per chart review, with each patient’s own report of which medications they took on …

The Relationship Between Insurance And Health Outcomes Of Diabetes Mellitus Patients In Maryland: A Retrospective Archival Study, Soo-Hoon Lee, Samuel L. Brown, Andrew A. Bennett

Management Faculty Publications

Background

Past studies examining the health outcomes of diabetes mellitus (DM) patients found that social determinants of health disparities were associated with variabilities in health outcomes. However, improving access to healthcare, such as health insurance, should mitigate negative health outcomes. The aim of the study was to explore the association between four types of health insurance, namely, Medicare Fee-For-Service (FFS), Medicare Managed Care (MC), Private FFS, and Private MC plans, and the health outcomes of DM patients, controlling for patients’ social determinants of health.

Methods

This is a retrospective cross-sectional archival record study to explore the relationships between types of …