Health and Medical Administration Commons^™

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 …

Implementation Of A Multifactorial Fall Prevention Protocol, Laura Wilkerson

Evidence-Based Practice Project Reports

According to the Joint Commission Center for Transforming Healthcare (2016), moderate to severe injuries from falls on average add 6.3 days to a hospital stay and cost approximately $14,056 per patient hospitalization. The purpose of this evidence-based practice (EBP) project was to implement a multifactorial approach to identify patients at risk for falls on admission to the orthopedic/neurosurgical unit and provide individualized interventions necessary to prevent falls. The Iowa Model of Evidence-Based Practice and Orlando’s Nursing Process Discipline facilitated the implementation of this project. A total of 45 staff members on the unit were educated on the multifactorial fall protocol …

Implementation Of A Standardized Handoff During Transition Of Care From The Emergency Department To The Intensive Care Unit, Melinda Abbring

Evidence-Based Practice Project Reports

Patient safety and nursing communication are crucial to the nursing handoff during transition of care from the emergency department (ED) to the intensive care unit (ICU). The Institute of Medicine published To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2001) highlighting ED handoffs as a safety measure. In 2006, the Joint Commission recognized handoffs with the National Patient Safety Goal 2E. The purpose of this evidence-based practice project was to determine if implementation of a standardized handoff would improve nursing communication and patient safety during transition of care from the ED to the …

Evaluating Variables Of Patient Experience And The Correlation With Design, Dyutima Jha, Amy Keller Frye, Jennifer Schlimgen

Patient Experience Journal

The objective of this paper was to understand the variables of patient experience by analyzing recent and relevant evidence and to identify design solutions within the hospital environment that positively impact those variables. A systematic review of literature published from 2008-present was conducted to identify variables that contribute to patient experience benefits. Identified variables were documented and categorized into a design, organizational, and outcome variable matrix. Interviews were conducted with professionals from healthcare institutions, architecture firms and organizations committed to improving the patient experience. Data from healthcare facilities, with high patient experience scores, was also examined to derive effective design …

Improving Nursing Attitudes Toward Suicide Prevention In The Emergency Department: The Implementation Of An Adolescent Suicide Risk Screening Tool, Julie A. Simpson

Evidence-Based Practice Project Reports

The Center for Disease Control ranked suicide as the second leading cause of death for American adolescents (2015). This crisis of adolescent suicide warrants evaluation and improvement of current suicide prevention practices. The Emergency Department (ED) offers 24-hour services and may be the only organized healthcare for utilized by some individuals. Nurses are the front-line provider of care in the ED and this role offers opportunity to identify an adolescent with increased suicide risk. The purpose of this EBP project is to evaluate nursing attitudes toward suicide prevention by implementing the best practice screening tool for adolescent suicide risk assessment. …

Analisis Tatakelola Sasaran Keselamatan Pasien Pada Alur Pelayanan Penyakit Sepsis Di Rumah Sakit Tebet 2015, Rianayanti Asmira Rasam

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In the context of modern medicine, complexity hospital’s management is regarded as the primary cause of medical error (ME). The new healthcare paradigm of “Patient-Focused Care”, patient’s right to receive safe healthcare treatment is considered as main indicator in Standar Akreditasi Rumah Sakit of 2012 (SARS 2012) in Indonesia, through the implementation of 6 Patient Safety (KP) standards. In the category of emergency medical treatment, Sepsis is considered as a disease with high mortality and morbidity rate. The use of The International Classification of Diseases, based on Ninth Revision (ICD-9), have caused terminological confusion and contribute to the increase of …

Perlukah Keselamatan Pasien Menjadi Indikator Kinerja Rs Blu?, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The government which is the Ministry of Health through its regulations mandates the importance of patient safety. This can be seen from the mention of patient safety in the four articles in Undang-Undang Number 44 Year 2009 about Hospital and specifically in the Minister of Health Regulation. The importance of patient safety issues in hos pitals is not directly proportional to the performance indicators of the BLU Hospital written inPeraturan Direktur Jenderal Pembendaharaan Number 34 Year 2014 about the Guidelines for Performance Appraisal of Public Ser vice Bodies for Health Services. In this regulation, it can be seen that the …

Relationship Between Medicare Alternative Payment Methodology And Hospital Program Service Revenue, Sandra J. Gubbine

Walden Dissertations and Doctoral Studies

Medicare paid $388.7 billion to acute care hospitals in 2014 representing the largest portion of the health care sector in the United States. Medicare implemented an innovative reimbursement model called Value Based Purchasing (VBP) to ensure hospitals provide quality care for the dollars spent. This correlation study used the VBP theoretical framework developed by Dudley as the foundation for the reimbursement model implemented by Medicare in 2013. The data used for this study came from the Centers of Medicare and Medicaid, as well as from Guidestar. The data focused on acute care, nonprofit hospitals located in New Jersey, New York, …

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 …

Nonprofit Pay In A Competitive Market: Wage Penalty Or Premium?, Christian King, Gregory B. Lewis

Department of Nutrition and Health Sciences: Faculty Publications

Two competing theories argue that the nonprofit sector pays differently: Nonprofit employees may accept lower pay to be able to do meaningful work for a good cause, or they may earn higher pay due to nonprofit organizations’ tax exemptions and weaker incentives to hold down wages. To test these opposing expectations, we use the 2005-2013 American Community Surveys to examine pay differences among registered nurses working for nonprofit, for-profit, and public hospitals. We also test hypotheses that public and nonprofit hospitals have smaller pay disparities by gender, race, and relationship status. We find that pay is highest in nonprofit hospitals, …

Analisis Perencanaan Dan Pengendalian Persediaan Obat Antibiotik Di Rsud Cicalengka Tahun 2014, Gita Gilang Kencana

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Poor planning and controlling of drug in RSUD Cicalengka has resulted excess inventory and potential Hospital losses. This operational research was using ABC Critical Index Analysis Method, Safety Stock, Economic Order Quantity (EOQ) and Reorder Point (ROP). Stock evaluation using Inventory Turnover Ratio (ITOR) was also conducted. The result of ABC Critical Index Analysis showed that were seven antibiotics need to be prioritized. The estimation of antibiotic drug in group A for year 2015 was done using Single Exponential Smoothing Method. Safety stock for Cefadroxil Kaps 500 mg (5x10) as much as 344, EOQ as much as 1476 and ROP …

Impact Of Emergency Department Sepsis Policy, Lynette Rayman

Evidence-Based Practice Project Reports

Sepsis is a serious concern of key healthcare stakeholders due to high incidence, mortality, and cost. The objectives of this evidence-based project were to 1) identify potential sepsis patients early during the emergency department (ED) triage process and 2) implement Sepsis Order Sets. Kotter’s change model and the Stetler model of evidence-based practice guided this project. An extensive literature search was undertaken to find best practice evidence regarding care of sepsis patients. Recommended care includes a protocolized format utilizing a screening tool and point of care lactate levels for early identification of sepsis, and early treatment with antibiotics and fluid …

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 …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …

Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown

Walden Dissertations and Doctoral Studies

Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies …

Assessment Of Detroit Hospital Preparedness For Response To An Improvised Nuclear Attack, Sharri Suesette Andersen

Walden Dissertations and Doctoral Studies

An improvised nuclear device (IND) is considered by the DHS to be the most catastrophic terrorist incident that could befall the United States, causing severe economic damage, extensive property damage, and enormous loss of life. Effective response to an IND is best accomplished with preparation including emergency operations plans (EOP) specific to an IND and training for staff on how to respond. The literature documents several areas of weakness in U.S. health services' preparation that affects entire communities and puts lives at risk. The purpose of this study was to assess the strengths, weaknesses, and gaps in Detroit, Michigan hospitals' …

Hospital Preparedness: Effects Of Designated Preparedness Coordinators On Hospital Preparedness For Special Hazard Classes, Rodney Sinelair Jones

Walden Dissertations and Doctoral Studies

Since 9/11, little statistical rigor has been placed on identifying the correlates of hospital preparedness. This quantitative study explores the research question: Is there a correlation between the employment of a designated hospital preparedness coordinator and the reported level of preparedness for: (a) general preparedness; (b) chemical, biological, radiological, and nuclear (CBRN) events; (c) pandemic disease outbreaks; (d) mass casualty events; and (e) internal infrastructure failure, as assessed by an online survey. Alternative analysis was conducted to assess the relationship between access to resources and the 5 dependent variables. Using complexity theory as the theoretical framework, point biserial correlation and …

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …

Tweeting And Treating: How Hospitals Use Twitter To Improve Care, Christian Gomes, Alberto Coustasse

Management Faculty Research

Introduction: Hospitals that have adopted Twitter primarily use it to share organizational news, provide general healthcare information, advertise upcoming community events, and foster networking. The purpose of this study was to explore the benefits that Twitter utilization has had in improving quality of care, access to care, patient satisfaction, and community footprint while assessing the barriers to its implementation.

Methodology: The methodology used in this study was a qualitative study with a semi structure interview combined with a literature review which followed the basic principles of a systematic review.

Results: The utilization of Twitter by hospitals suggest that it leads …

The Effects Of Implementing Best Practices On 30-Day Readmission Rates In Adults Following Cabg Surgery, Linda Elaine Kline

Evidence-Based Practice Project Reports

Coronary artery bypass graft (CABG) surgery is one of the most frequent and expensive cardiac surgical procedures in the U.S. today. Complications from CABG surgery are one of the top causes of 30-day hospital readmissions. Readmissions after CABG surgery are often preventable and add to health care costs. Recent government legislation mandates penalties for hospitals with excess readmission rates. The purpose of this evidence-based practice project was to determine if implementation of best practice recommendations effected 30-day readmission rates following CABG surgery. A critical appraisal of the literature was conducted to identify best practice recommendations. The Iowa model and Lewin’s …

The Effect Of Education On Compassion Fatigue As Experienced By Staff Nurses, Kathryn L. Zehr

Evidence-Based Practice Project Reports

Historically, nursing has been perceived as a highly rewarding profession. Yet, due to the increasing complexity of today’s healthcare, nurses are faced with greater challenges in their work environments. Registered nurses who work in tertiary care settings are exposed to disturbing patient situations including trauma, death, abuse, or chronic disease. Joinson (1992) described this experience as compassion fatigue and symptoms include headaches, short attention span, or fatigue. A review of literature has identified that nurses should be educated about risk factors and coping strategies to combat compassion fatigue. Guided by the Model for Evidence-Based Practice Change and Jean Watson’s Theory …

Improving The Patient Experience Through Nurse Leader Rounds, Judy C. Morton, Jodi Brekhus, Megan Reynolds, Anna Kay Dykes

Patient Experience Journal

While providing exceptional care experiences to patients is a priority for many organizations, creating and sustaining measureable success in this area remains a challenge for many. This article examines the impact of implementing nurse leader rounds on patient perception of care in the hospitals and emergency departments of a large healthcare system. Nurse leader rounds were implemented as a system-wide improvement practice at Providence Health & Services in 2012. Analysis of Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results indicates that implementation of nurse leader rounds is associated with statistically significant improvement in patient …

Rencana Aksi Pelayanan Berkesinambungan Rawat Jalan Dalam Rangka Meningkatkan Citra Rsup Fatmawati, Andi Wahyuningsih Attas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to identify the continuous action plan in Fatmawati General Hospital outpatient services in order to increase the Fatmawati General Hospital’s image. The study is conducted through interviewing patients, health workers, managements staff, and the macro analysis is done through policy analysis. The results showed that thegap in outpatient service is in the compatibility quality (service speed, drug completeness, comfort) and communication. The dissatisfaction occured in Fatmawati General Hospitals is the cultivation of the main root problem which is the rising numbered of patients as a result of the referral system ineffectiveness. The action plan designed in a …

Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective, Christopher Bain

Theses: Doctorates and Masters

This thesis presents the results of the program of research performed in the completion of a Doctor of Philosophy (Business) entitled: Developing Effective Hospital Management Information Systems: A Technology Ecosystem Perspective.

The central contention of this thesis is that the current ecosystem models in the information technology (IT) and information systems (IS) literature can be extended and improved. In turn they can be better applied to the field of IS and the development and implementation of information systems. This research seeks to highlight an example of how these models can be extended, through an analysis of the specific context of …

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Management Faculty Research

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

A Theory-Driven, Longitudinal Evaluation Of The Impact Of Team Training On Safety Culture In 24 Hospitals, Katherine J. Jones, Anne M. Skinner, Robin High, Roni Reiter-Palmon

Psychology Faculty Publications

Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture—reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks.

Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse

Management Faculty Research

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …

Electronic Medical Records In Long-Term Care, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse

Management Faculty Research

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …