Health and Medical Administration Commons^™

Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González

Walden Dissertations and Doctoral Studies

Business executives risk higher healthcare costs and absenteeism rates without implementing cost-effective strategies to support wellness within the organization. To offset rising healthcare costs and absenteeism, executives should implement wellness programs as a component of the benefits package provided to their employees and families. Grounded in the theory of planned behavior, the purpose of this qualitative multiple case study was to explore the cost-effective strategies that executives in the private and not-for-profit sectors implemented to encourage employees to adopt healthy habits for increasing productivity and decreasing organizations’ healthcare costs. Six executives from the healthcare sector within the southern region of …

Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler

Walden Dissertations and Doctoral Studies

AbstractThe Centers for Medicare and Medicaid Services implemented the Hospital Readmission Reduction Program in 2012. Ten years later, hospitals across the United States have had negligible improvement in reducing preventable 30-day hospital readmissions for COPD patients. Healthcare, specifically the hospital setting, consists of complex processes and procedures. Not one process or procedure is the sole cause of correcting excessive preventable 30-day readmissions of patients with COPD. The essential elements of provider communication were studied using the Complex Adaptive Systems theory in this quantitative study. Each fundamental element of provider communication was the independent variable, and the preventable 30-day COPD excessive …

Successful Allocation Of Funds In Managed Health Care Programs Revenue, Sherri Jean Loveall

Walden Dissertations and Doctoral Studies

Managed care leaders of independent physician associations (IPAs) lack strategies for allocating existing funds to avoid business closure. Medical providers are concerned with the quality of care for patients if the allocation of funding is not executed correctly. Grounded in the competing values framework (CVF), the purpose of this qualitative single case study was to explore strategies managed care leaders of IPAs use to allocate funds to avoid business closure. Participants were six executive leaders of an IPA in Los Angeles, the United States, who successfully managed the allocation of funds in a managed healthcare system. Data were collected from …

Healthcare Literacy Strategies To Mitigate Healthcare Utilization And Rising Costs, Stella Obiageli Maduka

Walden Dissertations and Doctoral Studies

Low health literacy can adversely affect individuals and groups without access to health information. Health insurance leaders who lack strategies to decrease low health literacy may lose their ability to provide quality health services and control care costs. Grounded in the health belief model and the Andersen health service model, the purpose of this qualitative multiple case study was to identify the strategies private health insurance leaders use to increase medical utilization to reduce healthcare costs. The three participants were from two private insurance companies in Las Vegas, Nevada. Data were gathered through semistructured, open-ended interviews via videoconferencing, a review …

Effects Of The Hospital Readmissions Reduction Program On Copd Readmissions And Costs., Heather O'Connell

Walden Dissertations and Doctoral Studies

Readmissions for chronic obstructive pulmonary disease (COPD) are a major contributor to healthcare costs and patient outcomes. The Hospital Readmissions Reduction Program (HRRP) by the Centers of Medicare and Medicaid was implemented to decrease high rates of readmissions for serious medical problems, including COPD. The purpose of this study was to determine whether HRRP resulted in reductions in readmissions and costs for COPD patients. The Donabedian model was used as the theoretical framework to investigate three research questions concerning whether there are statistically significant differences in terms of readmission rates, total charges, and primary type of insurance payment before and …

Generational Differences In Nursing Turnover, Adam Bennett

Walden Dissertations and Doctoral Studies

Nursing is currently the largest job category in U.S. health care requiring proper recruitment and retention of nurses. As the current generation of nurses ages out of the workforce due to retirement, new nurses will need to cover the gaps in the workforce. The purpose of this quantitative correlational study was to examine the relationship between voluntary turnover, involuntary turnover, and career change among nurses who were born between 1980 and 1995 (Millennials) and those born between 1965 and 1979 (Generation X). The theoretical framework was Mannheim’s theory of generations. Secondary data were collected from exit interviews with 811 respondents …

The Impact Of Electronic Health Records Meaningful Use On Patient Safety And Satisfaction, Paulette Brown

Walden Dissertations and Doctoral Studies

AbstractThe widespread adoption of electronic health records (EHRs) is encouraged because of their potential to improve the quality of care provided. It was unknown to what extent the meaningful use of EHRs would impact patient safety and satisfaction in general and specialty hospitals. The researcher’s purpose for this quantitative correlational research was to examine the impact of meaningful EHR use of EHRs on patient safety and satisfaction outcomes in general and specialty hospitals in Philadelphia (PA). The constructs of the institutional theory guided the study. The hypotheses that guided the study included (a) Meaningful EHR use positively influences patient satisfaction …

Nutrition And Physical Exercise Prevention Strategies To Reduce Obesity During The Covid-19 Pandemic, Carmesha Vajill Carter

Walden Dissertations and Doctoral Studies

Obesity has reached an epidemic level of 75 million obese adults and 15 million obese children in the United States. The research problem addressed in this study is the lack of information on how obese people manage their weight-loss strategies to prevent or reduce obesity during shut-in place restrictions for the COVID-19 Pandemic. This study included the Prochaska and DiClemente Trans-Theoretical Model of Behavioral Change and the Stage of Change Theory. The phenomenon approach using phenomenology described participants' lived experiences of being obese. The researcher completed data collection and evaluation among sixteen participants using email questionnaires to analyze participant's responses …

The Role Of Self-Efficacy Against Workplace Stress, The Intent To Leave, And Burnout In Nursing, Alexis Collier

Walden Dissertations and Doctoral Studies

Healthcare administrators must sustain the nursing workforce by minimizing workplace stress, the intent to leave, and burnout while maintaining a safe, accessible, high-quality, patient-centered care environment. This quantitative study examined the relationship between the independent variable of self-efficacy and the dependent variables of nurse burnout, workplace stress, and the intent to leave. The theory that grounded this study was the theory of self-efficacy. The research questions were formatted to determine the correlation between the self-efficacy levels of nurses and burnout, workplace stress, and the intent to leave. A quantitative, nonexperimental, cross-sectional (analytical) design addressed the research questions. The secondary data …

Relationship Between Incentive Program Costs, Incentive Payments, And Profitability, Claire Claire Turner

Walden Dissertations and Doctoral Studies

The lack of profitability among primary care businesses can have harmful impacts on business operations. Primary care businesses owners must remain profitable to remain in business and provide quality health care to patients. Grounded in Freeman’s stakeholder theory, the purpose of this quantitative correlational study was to examine the relationship between incentive program costs, incentive payments, and profitability. Data were collected from 73 primary care physician business owners in the Inland Empire region of southern California. The multiple linear regression analysis results indicated the model was able to significantly predict profitability, F(2,70) = 1343.6, p <.001, R2 = .975. Incentive payments (t = 51.837, p < .001,  = .928) was the only statistically significant predictor. Key recommendations include educating primary care physicians on the potential financial benefits of full participation in the commercial line of business pay-for-performance incentive programs and creating a campaign to bring in patients for wellness visits. The implications for positive social change include the potential for an additional revenue stream for primary care physician business owners, which could support more clinics, increasing patient access. Patients having better access to healthcare could positively affect the health and wellness of individuals in local communities.

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

Graduate Theses/Dissertations

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

The Impact Of The Mandatory Phab Accreditation Process On Environmental Health Programs At Local Health Districts In Ohio, Wesley Vins

West Chester University Doctoral Projects

Ohio has 112 local health districts and in 2013 these health districts were mandated by state law to achieve national accreditation by July of 2020 from the Public Health Accreditation Board (PHAB) that was established in 2011. To understand the impact on local health districts of the state policy approach, thirteen question paper surveys were mailed to the Environmental Health Directors at all Ohio health districts in May of 2022 and the results were analyzed.

A survey response rate of 54.5% was achieved and the Directors reported that on average they experienced 76-100 annual hours due to accreditation, as did …

Prevalence And Determinants Of Home Delivery In Urban And Rural Philippines: Evidence From The 2017 National Demographic And Health Survey, Arianna Maever L. Amit, Veincent Christian F. Pepito, Sarah J. De Los Reyes, Clinton S. Tang, Neil Andrew K. Aliazas, Lourdes S. Tanchanco

Ateneo School of Medicine and Public Health Publications

Background: Women’s choice of place of delivery has implications on maternal and child mortality. This study aims to provide an updated and detailed comparison of prevalence and determinants of home delivery in the Philippines, and in urban and rural communities.

Methods: Based on data from the 2017 Philippine National Demographic and Health Survey (NDHS), we estimated the prevalence of home delivery and determined factors influencing women’s decision to deliver at home. Analyses were restricted to data from 7229 women who were cohabiting or married, and their last-born child using logistic regression methods for survey data.

Results: There remain a considerable …

Exploring Predictors In The Receipt Of Patient/Family-Centered Care, Arami Anwell

Theses and Dissertations

Study 1

OBJECTIVES: The research aim of this study was to identify predictors associated with the receipt of PFCC among U.S. children/families

METHODS: Caregivers of 38,803 non-institutionalized children, aged 0 to 17 years, were surveyed by the National Survey of Children’s Health (NSCH) 2018–20019. Patient/family-centered care (PFCC) was measured using five components of health care delivery that were answered on a 4-point Likert scale. Logistic regression models were analyzed for the overall receipt of PFCC and each component of PFCC, with survey weighting added to adjust for complex sampling design.

RESULTS: Many predictors were associated with the receipt of PFCC. …

Why Do Family Members Reject Ai In Health Care? Competing Effects Of Emotions, Eun Hee Park, Karl Werder, Lan Cao, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Artificial intelligence (AI) enables continuous monitoring of patients’ health, thus improving the quality of their health care. However, prior studies suggest that individuals resist such innovative technology. In contrast to prior studies that investigate individuals’ decisions for themselves, we focus on family members’ rejection of AI monitoring, as family members play a significant role in health care decisions. Our research investigates competing effects of emotions toward the rejection of AI monitoring for health care. Based on two scenario-based experiments, our study reveals that emotions play a decisive role in family members’ decision making on behalf of their parents. We find …

Improving Code Status Discussion And Documentation For Patients 65 Years Or Older At Hca Fl Osceola Hospital, Taylor Murphy, Mark Duros, Faris Matanes, Keishla Garcia Fernandez, Raj Shah, Olga Karasik

North Florida Division GME Research Day 2022

No abstract available.

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 …

Providers’ Perceptions Of Chiropractic Care In Treatment Of Opioid Addiction, Rebekah Jan Khan

Walden Dissertations and Doctoral Studies

Fifteen hundred people in the United States die each week from opioid-related overdoses. In addition, the U.S. court system has been inundated with individuals facing legal proceedings, with opioid addiction, impacted competency, and recidivism. There has been a call for alternatives to address the crisis. The purpose of this qualitative study was to explore the perceptions of (addiction) providers regarding chiropractic treatment in the management of opioid addiction. The health belief theory was used to guide the study. Interview data were collected from six participants via Zoom or phone. Thematic analysis resulted in four emergent themes: lack of knowledge of …

Racial Differences Of Patient Satisfaction And Quality Of Care In Nursing Homes, Marie Chantal Lamothe

Walden Dissertations and Doctoral Studies

AbstractLong Term Care (LTC) facilities are a vital contributor to the elderly community regarding their dependent care. However, less is known about how racial disparity impacts patient satisfaction and quality of care in LTC facilities. This non-experimental retrospective quantitative study compared the racial differences of patient satisfaction levels quality of care in LTC facilities (nursing homes that include predominately non-White patients versus predominately White patients). The theoretical framework used for this study the consumer multidimensional model of nursing home care quality to analyze quality of nursing home in the view of providers and consumers. Long Term Care: Fact on Care …

Evaluation Of Action Plan Management Strategy To Improve Survey Readiness And Decrease Negative Accreditation Findings, Carla Pierson

Walden Dissertations and Doctoral Studies

This project was an evaluation of a quality improvement (QI) initiative conducted in a large medical enterprise to address the problem of poor performance of their hospitals in accreditation surveys. The desired outcome was to evaluate whether an innovative plan of correction process was impactful in reducing the negative outcomes of regulatory and accreditation surveys. The practice-focused question guiding this project addressed the effect of the pre-accreditation evaluation and a plan of correction process in this QI initiative on reducing requirements for improvement (RFI) and condition-level deficiencies (CLD) cited in a recent The Joint Commission survey review. This project was …

Leadership Relationships And Advancement Opportunities Among African American Female Nurses, Kendra Pitts

Walden Dissertations and Doctoral Studies

A healthy work environment for nurses is critical to staff recruitment, retention, patient safety, and the financial sustainability and viability of a healthcare organization. The specific research problem under study was whether a lack of advancement opportunity or a lack of good leadership has an impact on African American female nurses leaving the nursing profession. Researchers have investigated the impact of leadership and advancement opportunity on the general population, but there is a dearth of research specific to African American female nurses and their reason for leaving the profession. Secondary quantitative data analysis was performed using survey data from the …

Relationship Between Telemedicine Use And Hpsa Scores In Rural California Areas, Ziad Gerges

Walden Dissertations and Doctoral Studies

It is the purpose of this quantitative study to determine whether telemedicine has improved healthcare coverage in rural California as measured by HPSA scores, and especially for intensive care units (ICUs). This study examined the relationship between ICU length of stay, telemedicine use among ICU providers, and HPSA scores in rural California areas. This study explored whether there is a significant relationship between HPSA score of hospitals in rural California areas and ICU length of stay and if there is a significant relationship between HPSA score of hospitals in rural California areas and ICU telemedicine use. This study was guided …

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 …

Planning Patient Safety: Philosophical, Political, And Economic Changes Required For Preventable Death Abolition, Catherine Kiani

CMC Senior Theses

Preventable medical errors are an epidemic. Between 250,000 and 400,000 people die from preventable errors each year in the USA. This investigation questions mechanisms for quality care improvement to eliminate preventable fatalities. I evaluated current patient safety protocols, analyzed their shortcomings, and with additional research recommended actions for better results. Such actions to improve patient safety are explored from three different perspectives: philosophical, economical, and political aspects. In chapter one, improvements within hospitals are reviewed – namely cultural changes needed from both physicians and hospital leadership. Abolishing hierarchical systems which preclude healthy collaboration among medical teams, diverting focus to patient …

Demographic Profiles Of Clinical Research Participants In Fda-Approved Nmes, Abayomi Oladoye Ojetayo

Master's Theses and Doctoral Dissertations

Drug development is a rigorous and expensive process that takes between 10 and15 years. Recruitment and retention of human subjects in clinical trials is challenging. This study collected the demographics of trial participant in trials for New Molecular Entities (NMEs) approved by the U.S. Food Drug Administration (FDA) for 2010 and 2020 to compare demographic representation. Demographic representation of trial participants for 61 FDA-approved NMEs for 2010 and 2020 were gathered; 21 NMEs were excluded from analysis. The trends in demographic representation in trials for the 40 FDA-approved NMEs in 2010 and 2020 were similar, and White participant representation was …

Redesigning Price Setting Under The Universal Health Insurance In Egypt / إعادة تصميم التسعير في ظل التأمين الصحي الشامل في مصر, Ahmed El Agamy, Hebatalla Ahmed Ismail, Hend Hassan, Reem Gouda, Samah El Sayed

Papers, Posters, and Presentations

Since the Sustainable Development Goals were adopted by the United Nations Development Programme, Universal Health coverage became the main target for many nations. One of the main challenges facing the governments to achieve universal health coverage is maintaining adequate policies to set fair pricing for the healthcare services. Each country has different strategies to apply fair pricing and this paper is discussing the current pricing methods in Egypt and suggesting three policies to tackle its challenges.

Macro-Level Factors Impacting Colorectal Cancer Screening Behavior Among Church-Going Chinese Immigrants In The U.S.: A Convergent Mixed-Method Study, Xian Cao

Electronic Theses and Dissertations, 2020-2023

Chinese immigrants (CIs) had low colorectal cancer (CRC) screening rates. Macro-level health determinants may affect CIs' CRC screening; however, this is not well established. Thus, this research looked at the macro-level social factors of CRC screening among CIs. The POET theoretical framework guided this study, which includes four components: population (P), organization (O), environment (E), and technology (T). A convergent mixed method was used to investigate whether sociodemographic, acculturation, religious social capital, and mobile media-based cancer information seeking may predict CIs' endoscopic screening, and how these variables impact it. A validated survey and an interview covering the same factors were …

Implementation Of A Standardized Medication Reconciliation Protocol In A Psychiatric Stabilization Setting, Sara Robinson

DNP Scholarly Projects

BACKGROUND: Medication errors are a prevalent patient safety concern across healthcare settings. High-quality medication reconciliation is an intervention and expected standard of care that can help to prevent adverse drug events. This quality improvement project focused on implementing a standardized medication reconciliation protocol on a short-stay psychiatric unit.

INTERVENTION: An evidence-based toolkit supported by the Agency for Healthcare Research and Quality (AHRQ), Medications at Transitions and Clinical Handoffs (MATCH) was selected as the framework for developing and implementing this protocol.

Congruent with the evidence-based toolkit recommendations, baseline data collection and needs assessment provided context for tailoring the intervention to the …

Relationship Between Rurality, Home Telehealth, And Bed Days Of Care For Military Veterans Readmitted For Heart Failure, Storm Li Morgan

Walden Dissertations and Doctoral Studies

Heart failure (HF), the leading hospital admission diagnosis for military veteran patients discharged from a Department of Veterans Affairs (VA) hospital, is more common in patients residing in rural than urban areas. Primary care managers prioritize reducing readmissions for HF as up to 80% of health care costs for HF, projected to increase to $69.7 billion annually by 2030, incur during hospitalizations. Underpinned in Andersen’s behavioral model of health services use, the purpose of this quantitative ex post facto correlational study was to examine the relationship between residence rurality, home telehealth enrollment, and bed days of care for military veteran …

Nurse Management Education To Improve Job Satisfaction And Nurse Retention, Motunrayo Omoloye Adegorusi

Walden Dissertations and Doctoral Studies

Abstract Nurses play a critical role as primary care providers in correctional facilities, as well as custodians of security. However, there is a significant disparity in the supply of nurses in correctional settings relative to other practice settings, which is a major gap in practice. The current problem arises from the inability to retain nurses in the correctional settings. Prisons have a harsh work environment characterized by a difficult patient population and stringent policies that govern operations. Additionally, a high level of bureaucracy impedes system reforms and transformations. The purpose of the DNP project was to find out if the …