Health and Medical Administration Commons^™

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 …

American Urologists’ Concerns With Nonclinical Activities Moderating Burnout, Nichele Lynn Greer

Walden Dissertations and Doctoral Studies

As burnout continues to increase in the healthcare field and specifically in the specialty of urology, gaining knowledge of certain risk factors associated with burnout can potentially help prevent further increases. Intervention programs may also be developed as a result of understanding these relationships. The purpose of this quantitative correlational analysis was to determine whether hours worked on nonclinical activities moderated the relationship between age and burnout as well as gender and burnout in American urologists. The theoretical foundations utilized in this research were the jobs demands resources model, which suggested that burnout occurs as a result of job demands …

Website Accessibility Strategies, Gary W. Hrezo

Walden Dissertations and Doctoral Studies

Most websites cannot be readily used by people with disabilities, despite the internet being an essential component for people to be part of a community. Applying web accessibility strategies means that people with disabilities can better interact with the web. Grounded in Davis’s technology acceptance model, the purpose of this qualitative multiple case study was to examine strategies used by web designers to make websites accessible for people with disabilities. The participants were experienced web developers from organizations in Florida with websites that have a Web Content Accessibility Guidelines Level 2 of three levels, i.e., AA- rating. The data collection …

Qualitative Comparison Of The United States And United Kingdom Healthcare Systems, Rachel Cazzaniga

Graduate Theses/Dissertations

The United States and United Kingdom healthcare systems vary based on their public access, financial dependence, health outcomes, gross domestic product, and much more. The systems have continued to grow with different focuses of importance in the quality of care that is being distributed to their populations. The U.K. universal healthcare system represents their value of accessibility and affordability, while the U.S. privatized system(s) represents their value of economic growth. The study provided a qualitative analysis of the systems' differences by integrating real world experiences and perceptions of the systems from individuals that have encountered and interacted as a patient …

Health Workers On The Political Frontlines, Gideon Lasco

Development Studies Faculty Publications

No abstract provided.

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

Queer Patients: An Underserved And At Risk Population, Joshua Schmidt

Capstone Showcase

Queer patients in America have faced a history of discrimination as both a community and as individuals. As such, this marginalization acts as a barrier to resources, including healthcare. Clinicians must be aware of said barrier and actively work towards dismantling it within their interactions with queer patients. This article makes a case for increasing sexual health conversations in order to assess queer patients and encourage a stronger patient-provider relationship for a community that is reluctant to seek medical attention, and also more likely to participate in higher risk behaviors.

Policy Analysis Of Foreign Trials Needed For Fda-Approved Inds For Devices And Drugs From 2016 To 2020, Rebekah Tilley

Master's Theses and Doctoral Dissertations

Any new drug or medical device requires testing before it can be commercialized. Although there are many paths a product can follow during preclinical testing to bringing it to the market, the need for multinational data is more necessary for drugs in comparison to medical devices. Since drugs do not always need additional data, there is a need to investigate why medical devices are more easily approved than drugs. The use of foreign data is fairly recent, and even though there are advantages to executing clinical trials in foreign countries, some companies do not want to run their studies outside …

Medication Usage In Independent Living: A Continuing Care Retirement Community Aging In Place Initiative, Aarti Deshpande, Carrie B Rubenstein, Ruth Benfield, Lee Burnside

All Poster Presentations

Purpose: The purpose of the study was to identify medication use concerns in this community.

Background: In this study, Swedish Geriatric Medicine Fellow partnered with this community to identify medication use concerns in this population.

Continuing Care Retirement Communities (CCRCs) are intended to support residents as they age in place. These communities tend to be well resourced but less studied. This survey attempts to identify medication use concerns in this population. Mirabella CCRC has 324 Independent living (IL) residents, 82 of which are couples. The average age is 85 years. The current cost of an IL unit is from $4673- …

The Correlation Between Staffing Hours And Nursing Home Resident Fall Rate, Nduka Ikpo Eke

Walden Dissertations and Doctoral Studies

AbstractHealthcare administrators and researchers have had the burden of determining best practice protocols that minimize falls among older adults living in nursing homes for several years. Several studies have investigated, and identified intrinsic and extrinsic factors that lead to falls among other adults and made recommendations along the lines of their findings. However, researchers are yet to establish the impact of staffing hours on nursing home resident fall rate. The purpose of this study was to determine the correlation if any, between nursing home residents fall rate and the staffing hours they receive daily from certified nursing assistants (CNAs), licensed …

Developing An Evaluation Process For Telehealth In A Copd Clinic, Jodi H. Biller

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool.

Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) …

Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block

Honors Theses

An investigation into the relationship between environmental toxins and environmental racism in Baltimore City, Maryland.

Rising Cost Of Medicare And Its Effect On Recipients 65 And Older, Williesa Toomer

Walden Dissertations and Doctoral Studies

The rising cost of Medicare is a growing concern for recipients. Beneficiaries are often forced to implement a host of strategies to meet rising out-of-pocket expenses. This qualitative study was conducted to address a research gap in methods used by senior citizens to manage rising Medicare coverage costs. Garmezy’s resilience theory was used to contextualize the rising costs of Medicare premiums and copays and strategies used to manage healthcare needs. The purposive sample of 12 socioeconomically diverse respondents included eight women and four men ranging in age between 65 and 77, for an average age of 70.2 years. Participants completed …

Strategies To Implement Effective Succession Planning, Michelle Chapple

Walden Dissertations and Doctoral Studies

Most U.S. hospitals do not engage in succession planning at the executive level to account for retirees aging out of the workforce. The potential loss of institutional knowledge transfer threatens leadership development and organization stability. Guided by the leadership model succession theory, the purpose of this qualitative program evaluation was to offer a formative assessment to understand better strategies needed for effective succession planning by healthcare leaders. Five healthcare leaders from a single healthcare facility in Oklahoma City, Oklahoma, in the United States participated in semistructured, face-to-face interviews and provided company documents for review. Data were analyzed using descriptive and …

Strategies For Achieving Sustainability Of Home Healthcare Agencies, Robert J. Gagnon

Walden Dissertations and Doctoral Studies

AbstractSome organizational leaders of home healthcare agencies (HHA) experience financial pressures to sustain within the changing regulatory landscape. Organization healthcare leaders who develop sustainability strategies remain competitive and employ the community. Grounded in the balanced scorecard framework, the purpose of this descriptive, qualitative multiple case study was to identify strategies home healthcare agency (HHA) leaders used to maintain sustainability. The participants were five organizational leaders of three HHA and two home health industry consultants in the Northeast United States who implemented sustainability. Data collected came from semistructured interviews, archival records, and organizational documentation. Three themes emerged from the thematic analysis: …

Challenges For Hospital Leadership In Obtaining Urology And Otolaryngology Community Preceptors, Donna Orsatti

Walden Dissertations and Doctoral Studies

Healthcare organizations are becoming more complex and medical education is constantly evolving in response to healthcare needs. These changes have an impact on community preceptors that supervise and train medical residents. Physicians willing to engage in community-based precepting are decreasing, thereby making it difficult for students to complete medical specializations. The purpose of this qualitative study was to understand the challenges healthcare leaders face when attempting to secure practicums or residencies in urology and otolaryngology. This case study used the Baldrige Excellence Framework as a lens to understand the organization’s functioning within the educational healthcare sector. In-depth, semi-structured interviews were …

Employee Engagement In A Clinical Ambulatory Setting, Paulette Zolicoffer

Walden Dissertations and Doctoral Studies

Low employee engagement can result in adverse business outcomes. Healthcare managers who lack strategies to increase employee engagement risk lower employee productivity and overall profitability. Grounded in organizational support theory, the purpose of this qualitative single case study was to explore strategies healthcare ambulatory managers use to increase employee engagement successfully. The participants were four mobile clinic managers from one organization in the northwest suburban region of Illinois who successfully implemented strategies to increase employee engagement. Data were collected using semistructured interviews and reviewing company documents and reports related to employee engagement. Through thematic analysis, three themes were identified: perceived …

Initial Steps For Integrating Academic Electronic Health Records Into Clinical Curricula Of Physical And Occupational Therapy In The United States: A Survey-Based Observational Study, Stephen C. Burrows, Lola Halperin, Eric C. Nemec, Wendy Romney

Healthcare Informatics Faculty Publications

Training programs must be designed to prepare physical and occupational therapy students for using Electronic Health Records (EHR) and interprofessional collaboration. This report aims to describe physical and occupational therapy students' perceptions of integrating Academic EHR in their Problem-Based Learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an Academic EHR (AEHR). Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR …

Nurse Managers' Patient Safety Communication, Christine Deatrick

Electronic Theses and Dissertations, 2020-2023

Medical errors are a continuing issue for healthcare organizations and can lead to patient harm or death. To bring about organizational learning and therefore reduce medical errors, information must successfully flow through an organization. Nurse managers play an essential role as the conduit of information between frontline staff and the organization. The primary purpose of this study is to describe the decision-making process of how nurse managers actively select and transmit information on patient safety concerns. A qualitative constructivist grounded theory approach was used. Nineteen unit-level nurse managers, working full-time in an acute care hospital with a minimum of one-year …

Blood Administration Documentation Audit Automation, Tonya Lawson, Harriette Lober, Andrea Nordmark

All Poster Presentations

Background: Blood administration is a high risk, low volume, complex procedure. It has strict regulatory requirements for documentation of at least 15 elements over the course of the procedure. There are frequently findings for deficient documentation during survey. Manual audits are time consuming and inaccurate. Every facility in the Providence system faces the same challenges to audit for compliance.

Problem: Detecting the rate of compliance for documentation of blood administration manually is difficult. Nursing documentation for blood administration is often incomplete. Manual audits are labor-intensive and have proven to have limited impact to increase documentation compliance.

Methods: We created an …

Implementation Of New Policy Software To Enable Quick Access To Best Practice Resources, Mary Alice Duthie, Debbie Shuster

All Poster Presentations

Purpose: Transition to a new policy software that would enable staff to quickly as easily locate Swedish policies and provide policy authors with a practical tool to work more efficiently on policy revisions.

Background/Significance: Existing policy software for Swedish had limited search functionality that caused issues with staff not being able to locate policies quickly or easily. This outdated software had been in place from 2007 – 2021 and contained only basic operations that remained unchanged during this time. If staff had difficulty finding policies in the software then there was the potential for either relying on others on the …

The Importance Of Violence Prevention Coordinators To Your Trauma Program, Carol Fox Rn, Ma, Ccrn, Melissa Mee

Administration & Leadership

No abstract provided.

Understanding Challenges And Solutions With Systemigrams: Application To Electronic Medical Record Systems, Amit Malhan, Laquanda L. Johnson, Robert Pavur

Journal of International Technology and Information Management

The medical field is becoming bigger and more complex in the 21st century, diseases both emergent and re-emergent are on the rise and are costing lives around the world. Evolution of many diseases has made people find a reason to seek medical care in healthcare centers. This has led to increased development of health care facilities as peoples’ urge to get quality diagnosis and treatment rises. However, in the past patients ended up waiting a long time in their efforts to obtain these services. These wait times were due to the lack of proper documentation and recording of the personal …

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 …

A Qualitative Investigation Of Organizational Challenges And Facilitators To Screening Individuals Experiencing Homelessness For Hepatitis C Virus (Hcv) In Houston, Texas, Alane Celeste-Villalvir, J Michael Wilkerson, Christine Markham, Lourdes Rodriguez, Vanessa Schick

Faculty, Staff and Student Publications

BACKGROUND: Individuals experiencing homelessness may be at a disproportionately high risk for hepatitis C (HCV) because they may be more likely to engage in HCV risk behaviors. Community organizations that provide services to these vulnerable individuals can effectively screen, diagnose, and navigate them into HCV care. However, screening people experiencing homelessness for HCV at such organizations is limited by various challenges that remain understudied, including budgetary considerations and strategies to improve teamwork and communication. Accordingly, this study investigated the organizational challenges and facilitators to HCV screening of individuals experiencing homelessness as reported by homeless services providers.

METHODS: Staff (N = …