Health and Medical Administration Commons^™

Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus

Walden Dissertations and Doctoral Studies

Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …

Ransomware In Healthcare Facilities: The Future Is Now, Nikki Spence, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Cybercriminals have begun to target the healthcare industry with a type of malware called ransomware, malware that encrypts an infected device and any attached devices or network drives. After encryption, cybercriminals demand a sum of money, also known as a “ransom,” to release the devices from encryption. Without adequate disaster recovery and backup plans, many businesses are forced to pay the ransom. The purpose of this study was to determine the extent of recent ransomware infections in healthcare settings, the risk liabilities and cost associated with such infections, and to determine possible risk mitigation tactics. Financial costs associated with business …

Organizational Factors Associated With Quality Perinatal Care, Lisa H. Akers

Dissertations, 2014-2019

Provisions for perinatal care are an integral part of quality healthcare and are increasingly moving to the forefront of quality care measures in the healthcare setting (Agency for Healthcare Research and Quality, 2012; National Quality Forum, 2012; & The Joint Commission, 2010). Previous literature specifically focused attention to general quality of care, but recently there has been a call for a more comprehensive approach to measuring quality in the perinatal care setting, which necessitates the need for a better understanding of what is currently being offered (Collins & Draycott, 2015). Until now the literature has remained limited on the association …

Living Space : Client - Based Design For Assisted Living, Michael K. Adams

Bachelor of Architecture Theses - 5th Year

Designing an assisted living facility with the client in mind. This project aims to create a space which encourages growth and progression for its residents by focusing on community, access to nature, sunlight, open spaces, increased living space, and flex spaces.

By working with the existing community and by emphasizing a program which focuses on the physical and mental needs of the residents, this building seeks to inspire and allow the residents to pursue their passions a manner that honors who they are and what they require.

How Healthcare Accounting Adapts To Lean Practices, Caitlin R. Duke

Undergraduate Honors Theses

Healthcare has recently begun a push towards more lean practices and management. Healthcare accounting, in an effort to reflect business practices, must change to accurately reflect reality. This research seeks to explore how healthcare providers improve their accounting systems to keep up with an ever-changing lean environment. By examining both healthcare and accounting literature, this comprehensive literature review seeks to answer the question, “How does healthcare accounting adapt to lean philosophies?”.

Long-Term Sustainment Of Rapid Improvement Events: A Case Study In “Room Readiness”, Gabriela V. Coronel

Undergraduate Honors Theses

Shifting payment models from fee for service (FFS) to pay for performance (P4P) have fundamentally changed the environment of healthcare administration in the United States (Center for Medicaid and Medicare Services (CMS), 2011). Due to this shift, there has been an increase in demand for tracking and improving quality measures to ensure not only patient safety, but optimization of utilization. Constraints on resources and capacity, coupled with increasing safety measures has developed a new study of patient flow (Miró, Sánchez, Espinosa, et al., 2003). Decreasing patient room turnover times has the potential to maximize utilization while ensuring patient safety and …

A Human Factors Approach For Identifying Latent Failures In Healthcare Settings, Tara N. Cohen

Doctoral Dissertations and Master's Theses

INTRODUCTION: The purpose of the current research was to assess the utility of the Human Factors Analysis and Classification System (HFACS), a tool that has historically been used reactively to look at accidents and incidents, for classifying observational data from various healthcare venues.

METHOD: Three studies are presented to investigate the reliability of HFACS for classifying observational data. In Study I, HFACS was applied to observational human factors data collected from the cardiovascular operating room (CVOR) at an academic medical university. Three trained analysts categorized the data using HFACS and several approaches were used to evaluate its reliability during the …

Icd-10 Implementation: Is The Workforce Ready?, David P. Paul Iii, D.D.S., M.B.A., Ph.D, Patricia A. Sacconi, Pamela Ann Glover, Robert Marriot, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

After many delays, the U.S. finally implemented ICD-10-CM/PCS on October 1, 2015, bringing the U.S. into line with other industrialized nations, most of which have been using ICD-10 for many years. We outline the benefits and challenges to the preparatory activities of the ICD-10-CM/PCS implementation for the U.S. healthcare industry. To ease the transition, CMS allowed healthcare facilities to submit test claims prior to the implementation date, and delivered feedback on the acceptability of those claims. Early results indicated a relatively smooth transition, although some questions regarding the available data remain. Additional data, especially data concerning outcomes, is required.

Medicare Fraud, Waste And Abuse, Jamie Bush, Leslie Sandridge, Cierra Treadway, Kimberly Vance, Alberto Coustasse Dr. Ph, Md, Mba

Management Faculty Research

In 2014, the U.S. spent approximately $3 trillion on health care. Medicare accounted for $554 billion of these costs and around $60 billion were squandered due to incorrect billing methods, abuse, and fraud. Types of fraud included: kickbacks, up coding, and organized fraudulent crimes. To reduce the financial burden associated with these activities, the U.S. has created various fraud prevention programs. The purpose of this study was to identify methods of Medicare fraud, examine the various programs implemented by the U.S. government to combat fraud and abuse, and determine the effectiveness of these programs. While fraud prevention strategies have proven …

Long-Term Care Policy: What The United States Can Learn From Denmark, Sweden, And The Netherlands, David P. Paul Iii, D.D.S., M.B.A., Ph.D, K. Chad Schaeffer

Management Faculty Research

Paying for long-term care consumes a substantial, and growing, part of the spending on healthcare in the U.S. We examine the components and payment systems for long-term care systems in Denmark, Sweden and the Netherlands to determine what policy makers in the U.S. can learn from these countries about how to improve long-term care provision and financing in the U.S.

Do Healthcare Professionals With High Weight Biases Provide Different Quality Of Care To Obese Compared To Normal Weight Patients?, Justine Leigh Seymour

Theses and Dissertations

Though weight bias has been acknowledged in the health field, it is less understood if and how weight bias affects quality of care. The purpose of this study was to determine if weight bias exhibited by healthcare professionals (HCPs) impacts quality of healthcare provided to obese individuals. HCPs (n=220; 88% female, 87% nurses) in the Midwest region of the United States were recruited to complete an online survey. Participants completed the Attitude Towards Obese Persons scale (ATOP) to assess weight bias and responded to hypothetical patient scenarios to evaluate quality of care. A median split was calculated for ATOP scores …

Healthcare Executive Leadership Development And Succession Planning, Robin Ford Dillard

Walden Dissertations and Doctoral Studies

Business leaders face leadership crises as executives from the baby boomer generation retire, creating a shortage of experienced and knowledgeable leaders. Some business leaders are unprepared for the replacement of retiring senior-level executives and lack strategies for succession planning. The findings of this study indicate succession planning and leadership development play a significant role in preparing future healthcare leaders in their ability to improve the quality of patient care and improve the strategic and financial health of the organization. Guided by the human capital theory the purpose of this multiple case study was to explore the strategies used by healthcare …

Healthcare Utilization Awareness And Labor Monitoring Methodology: A Theoretical I.M.S.E. Approach To Risk Minimization And Human Metrics Capturing In The Nursing Workforce, Luis Reyes

Open Access Theses & Dissertations

The healthcare industry is so complex and dynamic that the development of any tool designed to promote positive patient outcomes nearly requires the developer to be an actual healthcare practitioner. Many healthcare tools exists that initially give the perception that there will be no future requirements that may hinder the tools' integrity, but more often than not, the unexpected occurs. The future is one unpredictable element of life that most engineers wish they could capture with optimal precision. I.M.S.E. (Industrial, Manufacturing and Systems Engineering) applications do not assist with fortune telling, but they do assist with creating robust tools designed …

Profit-Bearing Administrators: Exploring The Application Of Economics And Financial Concepts In Healthcare Management, Brandon K. Riddick

Honors Undergraduate Theses

Healthcare managers face an incredible challenge today; understanding and implementing financially and economically sound decisions in the complex healthcare environment of the United States. The pressure to be profitable managers is greater than ever. Considering current research, past studies, and articles focused on the demands of healthcare managers will illuminate the state of health care administration, and the importance of real world application of accounting and economics in healthcare.

This thesis will explore and examine research about industry standards, and the need for preparedness in healthcare finance management. It will also examine the important and complex role of accounting and …

Strategies To Reduce Effects Of Organizational Stress In Health Care Workplaces, Kate Chinyere Mbidoaka

Walden Dissertations and Doctoral Studies

Workplace stress has become a frequent occurrence in the race for competitive business advantage. This stress leads to negative physiological consequences in the workplace, causing productivity and profitability to suffer. The purpose of this single case study was to explore the stress management strategies that some health care business leaders used to reduce the effects of work-related stress on their employees to improve productivity. The interview process included 3 managers employed at a health care institution in Houston, Texas, with records of implementing successful strategies for mitigating the effects of workplace stress. The conceptual framework was job demands-resources model, pertinent …

Exploring Customer Service Through Hospital Management Strategies, Delores Leonard Leonard

Walden Dissertations and Doctoral Studies

Patient demand for a better quality of healthcare and services has increased as insurance companies have decreased payments to hospitals. The purpose of this qualitative single exploratory case study was to explore hospital managers' strategies to improve customer service. Data were gathered from semistructured interviews with 5 hospital managers who implemented customer service strategies in their hospital systems, hospital policy and procedure documents, and qualitative data from the Consumer Assessment of Healthcare Providers and Systems Hospital Compare website. Expectation-confirmation theory served as the conceptual framework that grounded the study. Data were analyzed using methodological triangulation, and 3 themes emerged: the …

Managerial Strategies For Improving Employee Engagement: A Single Case Study, Ann-Marie Alcala

Walden Dissertations and Doctoral Studies

In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a

proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. …

Hospital Administrators' Strategies For Reducing Delayed Hospital Discharges And Improving Profitability, Sheree Boyd

Walden Dissertations and Doctoral Studies

Inefficiencies in leadership and limited leadership strategies in hospitals contribute to delayed hospital discharges and an increased financial burden on a hospital. Three administrators from 2 hospitals who are part of a hospital conglomerate in Chicago, Illinois were selected for interview in this qualitative multiple case study to explore how hospital discharge strategies reduce delayed hospital discharges and improve profitability. Contingency was the primary theoretical theory for this study. The purposive sampling consisted of the selections of individual who were knowledgeable and had experience to organize, manage, and implement processes in an organization. Data collection occurred using face-to-face semistructured interviews, …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

Incidence Of Student Registered Nurse Anesthetists In The United States Who Own And Use Smartphone As Supplemental Learning Tools, Ruoyu Zhao

Doctoral Projects

Background: Smartphones have a great potential for students to learn more efficiently. Students now have the ability to download applications with pertinent information in the palm of their hand for both educational and clinical duties. This descriptive correlational quantitative research examines whether student registered nurse anesthetists own and use smartphones as supplementary learning tools.

Methods: An online survey was sent through AANA to Masters and DNP student registered nurse anesthetists (SRNAs) in the United States. Respondents were asked if they owned smartphones and how often they used smartphones for educational and clinical duties. Data Analysis was conducted using a Chi-square …

Using Patient Value Statements To Develop A Culture Of Patient-Centred Care: A Case Study Of An Ontario, Canada Hospital, Erica Bridge, Madelyn P. Law, Miya Narushima

Patient Experience Journal

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario …

Why Do They Do That?: Looking Beyond Typical Reasons For Non-Urgent Ed Use Among Medicaid Patients, Cynthia J. Sieck, Jennifer L. Hefner, Randy Wexler, Chris A. Taylor, Ann S. Mcalearney

Patient Experience Journal

Barriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences …

Microchips: Technology That Can Change Medical Services, Dale H. Shao, Ralph E. Mckinney, Lawrence P. Shao

Management Information Systems Faculty Research

Healthcare costs have increased greatly over the last few years. The result is a tremendous burden for businesses and private individuals. Experts say there is no end in sight to this increase. This situation has forced the federal government, state governments, and private industry, to investigate methods to slow down and reduce this constant increase in healthcare costs. Microchip technologies have been presented as a means to ensure better patient care while a/so reducing costs and errors resulting from the current system of healthcare. This paper presents an overview of microchip technology programs, issues with implementation, and future considerations for …

The Costs Of Cancer, Jamie Mosely

Honors Papers and Posters

This poster explores the relationship between more advanced cancer-fighting technologies and the increase in healthcare costs over the last several decades, and the socioeconomic impact this has for patients with less disposable income or no health insurance.

Data Mining Twitter For Cancer, Diabetes, And Asthma Insights, Kimberly Chulis

Open Access Dissertations

Twitter may be a data resource to support healthcare research. Literature is still limited related to the potential of Twitter data as it relates to healthcare. The purpose of this study was to contrast the processes by which a large collection of unstructured disease-related tweets could be converted into structured data to be further analyzed. This was done with the objective of gaining insights into the content and behavioral patterns associated with disease-specific communications on Twitter. Twelve months of Twitter data related to cancer, diabetes, and asthma were collected to form a baseline dataset containing over 34 million tweets. As …

Improving Collaboration Between Pharmacists And Physicians, Paras Patel

BU Well

Physicians and pharmacists have differing but complementary roles that can optimize patient care when structured effectively. Unfortunately, these two professionals are not collaborating well enough, as patient outcomes, especially in relation to medication adherence, continue to decline. Coordinated care of patients can improve by expanding bidirectional communication and sharing additional patient information with each other. It will be necessary to continue to promote collaborative care in the educational and training stages of these professionals’ careers to build trust and understanding of professional scope. Ultimately, the healthcare infrastructure will have to continue to progress to make collaboration more available and valuable …

Female And Male Patients’ Perceptions Of Primary Care Doctors’ Communication Skills In Hong Kong, Vivienne Leung Dr., Kimmy Cheng Dr.

Patient Experience Journal

This study examined how female and male patients perceive primary doctors’ communication skills in the Chinese context. To do so, this study specifically investigates female and male patients’ general perceptions toward primary care doctors’ communication skills in medical consultations. Specifically, this study focused on (a) female and male patients’ satisfaction level toward primary care doctors’ communication skills in medical consultations (b) female and male patients’ perception of the types of verbal and nonverbal communication skills applied by primary care doctors in medical consultations (c) as well as which gender of doctors with whom patients prefer to communicate during primary care …

Implementation Of A Nursing Workload Tool To Reduce Nurse Burnout, Nicole K. Greives

Evidence-Based Practice Project Reports

Nursing burnout and workload is a complicated issue with far-reaching effects. Nursing burnout and inappropriate nursing workload have been linked to increased risk of urinary tract infection, respiratory infections, decreased patient satisfaction, decreased quality and safety of care, and increased mortality. The purpose of the project was to decrease nursing burnout on a Medical Progressive Care Unit (MPCU) by moving patients with high workloads and medical instability to a higher level of care. Within this project, Rosabeth Kanter’s Theory of Structural Power was used for the theoretical framework, and the Stetler Model guided the implementation. The intervention consisted of a …

Will They Read It?, William H. Lane

English Faculty Publications

The Pennsylvania Health Care Plan Saves Money, But Will Legislators Take Time to Read the Bill?

Al the new year begins, it's time to hitch up our britches and take a look at how things are going with healthcare insurance reform. [excerpt]