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Health and Medical Administration Commons™

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2022

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Articles 541 - 570 of 602

Full-Text Articles in Health and Medical Administration

Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable Jan 2022

Successful Strategies To Sustain Practice Changes In Healthcare, Erin Gable

Walden Dissertations and Doctoral Studies

Healthcare managers implement evidence-based practice to meet the growing needs of aging populations. However, many healthcare leaders fail to sustain newly implemented practices. Grounded in the promoting action on research implementation in health services conceptual framework, the purpose of this qualitative interpretative descriptive study was to explore strategies healthcare leaders use to sustain practice changes to meet increasing demands for quality care of the aging population. The participants included eight healthcare managers from Canada and the United States who led strategies to sustain practice change. The four themes that emerged using semistructured interviews and thematic analysis were staff buy-in, staff …

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Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove Jan 2022

Healthcare Management Strategies For Achieving Sustainable Departmental Productivity Improvements, Timothy Hargrove

Walden Dissertations and Doctoral Studies

Healthcare organizations’ leaders' lack of strategies to effectively deploy and monitor departments’ productivity goals affect overall organizations’ performance. Healthcare leaders who fail to deploy and monitor departmental productivity strategies effectively are limited to enhancing healthcare organizations’ performance outcomes. Grounded in transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies healthcare organizations’ leaders use to effectively identify, deploy, and monitor departments’ goals for improving their overall organization's performance. The participants were 20 healthcare leaders who successfully demonstrated success in improving their organizations’ departmental-specific productivity performance. Data were collected using semistructured interviews and a review of …

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Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott Jan 2022

Strategies To Implement An Electronic Medical Records System In Health Care Organizations, Ashley Knott

Walden Dissertations and Doctoral Studies

Despite the 2009 mandate from the U.S. Government that healthcare organizations adopt and implement electronic medical records (EMR) systems to avoid fines and take advantage of the benefits EMR systems provide, adoption of EMR systems in the United States has been low. Since 2011, medical facilities have received incentive payments if they demonstrated “meaningful use” of certified EMR systems; however, medical facilities unable to demonstrate meaningful use beginning in 2015 have faced up to 5% penalties. Grounded in the diffusion of innovation theory, the purpose of this qualitative single case study was to explore strategies that hospital project managers use …

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Strategies To Improve Quality Of Care And Increase Medicare Payments In Hospitals, Emmanuel Mendoza Jan 2022

Strategies To Improve Quality Of Care And Increase Medicare Payments In Hospitals, Emmanuel Mendoza

Walden Dissertations and Doctoral Studies

The difficulty that nurse leaders experience in administrating quality of care while increasing Medicare payments threatens the hospital's patient well-being and financial stability. Health care administrators should be concerned about these issues to ensure their hospitals meet patient and community needs. Grounded in the performance improvement model, the purpose of this qualitative single case study was to explore strategies that hospital managers use to improve the quality of care and increase Medicare payments. The participants were six nurse leaders of a medium size hospital based in Houston, Texas. Data were collected using semistructured virtual interviews and a review of company …

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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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Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar Jan 2022

Educating Nurse Practitioners On Factors Associated With Compassion Fatigue, Alicia Moonesar

Walden Dissertations and Doctoral Studies

Nurse Practitioners (NPs) across Canada continue to endure the escalating demands of increasing patient workloads, the deficiency of inadequate resources, and the paucity of leadership support. The ongoing exposure to these and other challenges often contributes to a complex work environment that may result in compassion fatigue (CF). CF can be operationally defined as a state of exhaustion and dysfunction because of prolonged exposure to compassion stress and all that it evokes. The need for education and prevention of CF is critical as the prevalence of CF is on the rise. Guided by Watson’s Theory of Human Caring and Benner’s …

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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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Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric Sarrett Jan 2022

Narrative Inquiry Into Postsecondary Transition Outcomes For Young Adults With Intellectual & Developmental Disabilities, Eric Sarrett

Walden Dissertations and Doctoral Studies

Young adults with intellectual and developmental disabilities (IDD) continue to struggle with community engagement despite decades of research and policy initiatives addressing postsecondary transition. Evidence shows that persons with IDD are engaging in employment, postsecondary education, independent living, socialization, and other roles at significantly diminished rates, yet little data exists describing this participation in the voices of those affected. The purpose of this narrative inquiry was to describe community integration of persons with IDD in the decade following postsecondary transition in their own words. Critical disability theory was used as a lens to explore the successes and failures of public …

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Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis Jan 2022

Military Health Services Impact On Patient Understanding Of The Zika Virus Within A Military Community, Gabrielle Tellis

Walden Dissertations and Doctoral Studies

AbstractThe Zika virus does not have a known treatment, despite ongoing efforts since 2016 to develop a vaccine. The Zika virus has been labeled by World Health Organization and the Department of Defense as a threat to the readiness, resiliency, and preparedness of military service members and dependents that currently travel or serve in areas where high concentrations of the virus are present. As such, it is important to understand how the military community understanding of the Zika virus is impacted by military health services and education. A phenomenological qualitative approach was utilized to conduct this study. Twenty active-duty military …

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Development And Validation Of A Clinical Practice Guideline For Telemedicine, Jennifer Johnell Upton Jan 2022

Development And Validation Of A Clinical Practice Guideline For Telemedicine, Jennifer Johnell Upton

Walden Dissertations and Doctoral Studies

Access to healthcare necessitated the utilization of telemedicine during the international pandemic of COVID 19. Telemedicine use surged in family practice in 2020 with limited resources for appropriate telemedicine patients. The problem identified for this DNP project was the lack of resources for telemedicine guidelines in family practice. The purpose of this project was to create a clinical practice guideline (CPG) to initiate screenings for appropriate patients for telemedicine. The Plan, Do, Study, Act (PDSA) concept and framework were utilized to develop the CPG. The project question identified was whether the development of a CPG on telehealth delivery in a …

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Exploring Nurse Leader Self-Efficacy, Burnout, And Intent To Leave, Donna Donova Johnson Jan 2022

Exploring Nurse Leader Self-Efficacy, Burnout, And Intent To Leave, Donna Donova Johnson

Walden Dissertations and Doctoral Studies

Nurse leader turnover is an emerging issue in healthcare services. Considerable research has been done over the last decade revealing that nurse leaders are experiencing an increased rate of burnout with an intent to leave their jobs. Less research has been done to understand how to mitigate the rate of nurse leader burnout and retain nurse leaders in the workforce. Higher levels of self-efficacy have mediated the effects of work stress on job burnout in other service related fields. The purpose of this quantitative, non-experimental, cross-sectional study was to explore the possible mediating effect of leader self-efficacy between burnout and …

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Relationship Between Healthcare Provider Communication And Preventable 30-Day Copd Readmission Rates, Jonathan Butler Jan 2022

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 …

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Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo Jan 2022

Medicine Adherence As A Determinant Of Complication Development In Diabetes And Hypertension Patients On A Medical Aid Scheme In Zimbabwe, Tsitsi Moyo

Walden Dissertations and Doctoral Studies

Pharmacotherapy is a significant component of chronic disease management; its efficacy depends on long term, correct, and consistent use; however, medicine adherence rates remain low. The cost of medicines is considered a significant barrier to adherence, especially in low-income settings. This quantitative cross-sectional study was conducted using data from Cimas Medical Aid Society collected between 2015 and 2019. The purpose of the study was to determine the extent of the association between medicine adherence, complication development, and cost of care among diabetic and hypertensive patients while controlling for age and gender on a population that does not experience cost barriers …

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Wellness Programs: Strategies For Increasing Employees’ Productivity And Reducing Health Care Costs, Lymari Rentas González Jan 2022

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 …

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Factors Of Experience And Training And Physician Intention To Adopt Telemedicine, Tina Mozhayski Jan 2022

Factors Of Experience And Training And Physician Intention To Adopt Telemedicine, Tina Mozhayski

Walden Dissertations and Doctoral Studies

Despite the increased role of telemedicine services, physicians’ intention to adopt telemedicine for the long term remains disproportionately low; further, little research has focused on the factors behind these intentions. The purpose of this study was to determine and compare the effects of two causal factors: previous experience of physicians in telemedicine and company telemedicine training, on physicians’ intention to adopt telemedicine. The Davis’s technology acceptance model was used as a theoretical framework for this study, which included analytical data of health care regulatory organizations, medical professional alliances, and secondary statistical data of a marketing company with experience in conducting …

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Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw Jan 2022

Gaps In Immunization Prevention In The State Of Ohio, Audrey Shaw

Walden Dissertations and Doctoral Studies

In the United States, the total cost for vaccine preventable diseases was $8.95 billion in 2015. The unvaccinated accounted for 80% of the total costs. This quantitative study was conducted to investigate the success and/or gaps in the implementation of the measles, mumps, and rubella (MMR) vaccine through the Vaccine for Children (VFC) Program by the Ohio Department of Health. General systems theory was chosen as a theoretical framework due to the complicated nature of the healthcare system. Healthcare is a complex system composed of multidisciplinary units that have their own structure and purpose that interact to accomplish the mission …

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Nurse Staffing And Leadership Support On In-Patient Hospital Safety, Kearia Deresa Watson-Orr Jan 2022

Nurse Staffing And Leadership Support On In-Patient Hospital Safety, Kearia Deresa Watson-Orr

Walden Dissertations and Doctoral Studies

In-patient hospital safety relates to healthcare facilities protecting patients from medical errors. The “problem of many hands” exists, where there is a gap in understanding who is responsible for in-patient hospital safety, nurse staffing, or leadership support. The purpose of this quantitative study was to determine the association between nurse staffing (nurse-to-patient ratios and hours worked) and in-patient safety (perception of in-patient safety by nurses) as well as the association between leadership support (work climate promotes patient safety and actions of hospital management to show that patient safety is a top priority) and in-patient safety (perception of in-patient safety) based …

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Sustainability Strategies Of Small Nigerian Restaurants, Omotayo A. Adeniyi Jan 2022

Sustainability Strategies Of Small Nigerian Restaurants, Omotayo A. Adeniyi

Walden Dissertations and Doctoral Studies

Fewer than half of small restaurants remain in the market after the first 5 years of operation. Small business leaders and policymakers are concerned with business failure due to the negative economic impacts on their employees and the local community. Grounded in the entrepreneurship theory, the purpose of this qualitative multiple case study was to explore strategies small restaurant owners use to sustain their operations beyond at least 5 years. Participants included four owners of small Nigerian restaurants who successfully operated their restaurants for more than 5 years. Data were collected using semistructured interviews and a review of internal documents. …

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Understanding How Healthcare Social Workers Respond To Adult Medical Trauma, Sonya Anthony Jan 2022

Understanding How Healthcare Social Workers Respond To Adult Medical Trauma, Sonya Anthony

Walden Dissertations and Doctoral Studies

Medical trauma in the hospital is a growing health disparity often accompanied by social determinants. Assisting in alleviating disparities and social determinants is a standard of care embedded in social work practice. This research was conducted to examine healthcare social workers’ experiences responding to and managing the psychosocial impacts of adult medical trauma in an acute inpatient environment. The goal of the research was to identify if a need exists for trauma-informed training among healthcare social workers. The research question examined how healthcare social workers respond to medical trauma. The model of case management, trauma-informed care, and systems theory were …

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Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler Jan 2022

Perceived Barriers To Health Care Access And Delivery Among Arkansas Medicaid Beneficiaries, Kimbra D. Butler

Walden Dissertations and Doctoral Studies

Arkansas has historically been one of the lowest ranking states in the United States in education, economy, opportunity, crime and corrections, and health care. Though more than 3 million Arkansans live in the state, nearly 1 million receive Medicaid-funded health insurance. This phenomenological study employed a constructivist paradigm and focused on the perceptions of underserved Arkansans regarding their health and their access to health care; additionally, within this study, the Health Belief Model shifted the study’s focus to individuals’ perspectives, perceptions, experiences, and opinions through interview responses. The research was intended to identify factors that may relate to the higher …

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Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant Jan 2022

Case Managers’ Perspectives Of Hospital Postdischarge Services For Patients Diagnosed With Coronary Artery Disease, Brian Alexander Grant

Walden Dissertations and Doctoral Studies

The United States lacks postdischarge services, which can negatively impact hospital readmissions within 30 days. It is important for case managers to effectively leverage outpatient services to enhance patient care and reduce readmission rates. Grounded in the practice change model framework, this qualitative single case study explores the perspectives of case managers involved with postdischarge services for patients diagnosed with coronary artery disease (CAD). Participants included 13 case managers from two metropolitan hospitals in Atlanta, Georgia. To address the research problem and study purpose, data collection techniques included semi-structured interviews, case management discharge summaries, and reflective journal notes. The thematic …

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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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U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall Jan 2022

U.S. Military Treatment Facility Reform: Decision-Based Plan Of Action And Milestones, Sean E. Marshall

Walden Dissertations and Doctoral Studies

In 2017, the U.S. Congress mandated a specific reorganization and centralized approach in military medicine. The Air Force developed a medical reform construct to organize military treatment facilities (MTFs). The leaders of each unit are required to comply with the reorganization using internal resources with no additional funding or personnel. The purpose of this study was to deliver a plan of action and milestones (POAM) suitable for workgroup implementation to achieve the mandated health unit integration at a medium-sized MTF. The practice-focused question asked how a POAM road map guides effective decision-making. A consultancy approach was used to assist leadership …

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Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe Jan 2022

Association Between Opioid-Related Emergency Department Visits And Financial Liability Of Hospitals, Mary-Zitta Muabe

Walden Dissertations and Doctoral Studies

Emergency departments (EDs) are experiencing an influx of patients with opioid-related which result in increased opioid misuse, abuse, and overdoses. The purpose of this study was to examine the relationship between opioid-related ED visits and financial liability of hospitals by evaluating if an increase in opioid-related ED visits leads to an increase in average ED visit costs. The framework used for this study was Reason’s theory of failures, which involves improving healthcare maturity in terms of risk management, achieved through enhanced efficiency. The analyzed research questions included analysis between the number of opioid-related ED visits and financial liability of hospitals …

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Completion Times For Computerized Tomography Tests And Walkout Rates In The Emergency Department, Chinyere Rumph Jan 2022

Completion Times For Computerized Tomography Tests And Walkout Rates In The Emergency Department, Chinyere Rumph

Walden Dissertations and Doctoral Studies

AbstractThe efficiency of the emergency department (ED) is important in the provision of quality patient care, which includes avoiding long wait times for tests and treatments. EDs may be overcrowded and understaffed, leading to increased wait times for tests. One of the areas overwhelmed by increased ED cases concerns the number of requests for computerized tomography (CT) scans, which may result in patients leaving the ED before care is completed. The three research questions for this quantitative study focused on the age of patients and CT scan walkout rates, completion time and CT scan walkout rates, and the number of …

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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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Exploring African American Women’S Experiences With Breastfeeding Support In Health Services, Jennifer Johnson Jan 2022

Exploring African American Women’S Experiences With Breastfeeding Support In Health Services, Jennifer Johnson

Walden Dissertations and Doctoral Studies

Breastfeeding provides complete nutrition to infants and reduces the risk of many chronic diseases among infants and their mothers, yet disparities exist. African American mothers have the lowest breastfeeding rates compared to other ethnic groups in the United States. There is limited qualitative research on health services support from the African American mother’s perspective. Understanding health behaviors may improve programming, reduce racial and ethnic disparities, and address social determinants of health. The purpose of this study was to explore African American women’s beliefs, experiences, perspectives, and opinions around breastfeeding support provided in healthcare settings by healthcare professionals. From a conceptual …

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Coping Strategies Linked To African Americans With Chronic Kidney Disease, Gabrielle Lawrence Jan 2022

Coping Strategies Linked To African Americans With Chronic Kidney Disease, Gabrielle Lawrence

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a health problem that affects African Americans more often than Whites and other ethnic groups. Individuals with CKD need to develop strategies to help with the disease and life challenges. Social support, self-management, and self-efficacy are factors that may influence how individuals with CKD cope with the disease. This quantitative correlational study examined the relationships among self-management, self-efficacy, and coping behaviors in African Americans with CKD in Stages 3 or 4. In addition, the moderating effect of social support on the extent to which self-management and self-efficacy account for the variance of coping behaviors in …

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Predictors Of Medication Alternative Cost-Saving Strategies Among Adults With Type 2-Diabetes, Olaseni Solomon Oduwaye Jan 2022

Predictors Of Medication Alternative Cost-Saving Strategies Among Adults With Type 2-Diabetes, Olaseni Solomon Oduwaye

Walden Dissertations and Doctoral Studies

Adults with type 2 diabetes (T2D) in the United States experience a significant financial burden in managing their condition due to prescription medication, higher out-of-pocket (OOP) costs, number of prescribed medications, and health insurance status to stay compliant with their medications. This study examined the association between the alternative medication cost-saving strategies, including obtaining free samples from doctors or patient assistance programs, splitting pills or changing dosage frequency, purchasing from other countries, purchasing over the internet, and the three independent variables among adults diagnosed with T2D. Reasoned action approach theory helped guide how external factors may influence an alternative medication …

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