Health and Medical Administration Commons^™

Nurse Turnover A Crisis In Healthcare, Billie Robinson

Walden Dissertations and Doctoral Studies

AbstractNurse turnover is a global, national, and local problem that impacts the ability of healthcare leaders to deliver high quality healthcare to the populations in need of healthcare services. The purpose of this study is to identify reasons nurses leave organizations. The Leader-Member Exchange Theory undergirds the quantitative research which was conducted using the Supervisor Leader Communication Inventory. Nurse leaders communicate with acute care nurses using principles of the Leader- Member Exchange Theory. The survey was distributed to members of the Georgia Nurse Association. Positive correlations were revealed between the independent and dependent variables. SPSS was used to establish the …

Associations Between Provider Type And Medicaid Overpayments, Kezia Hercules

Walden Dissertations and Doctoral Studies

Healthcare costs have been rapidly increasing in the United States and consume a significant percentage of the Gross Domestic Product (GDP). A percentage of these costs are attributed to increased incidences of healthcare overpayments to providers. This study examined the impact of these overpayments by provider type, and the underlying reasons which resulted in overpayments from the Medicaid perspective. The theoretical framework used in this study was Ostrom’s institutional analysis and development (IAD) framework. The study used all available data (N = 682) from New York State Medicaid Inspector General final audits of providers for Medicaid overpayments. A chi-square test …

Predictors Of Obesity Among Young Adults In The State Of Maryland, Kala Shahi

Walden Dissertations and Doctoral Studies

AbstractObesity has become a global wellness concern for young adults. In the past, there were very few studies conducted on predictors of obesity among young adults, even though there have been several studies on the potential predictors of obesity on the general population. The social ecological model was used to guide this quantitative cross-sectional study to identify the possible predictors of obesity among young adults. The Behavioral Risk Factor Surveillance System was used to analyze the potential predictors of obesity among young adults between the ages 18 – 34 years old in Montgomery County, Frederick County, and Princess Georges County, …

A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi

Walden Dissertations and Doctoral Studies

Fundraising and donations are the main sources of revenue for behavioral health care nonprofit organizations (NPOs) worldwide. Economic, political, social, or health crises impact fundraising and donation sources for behavioral health care NPOs. This qualitative case study addressed strategies that senior leaders of a Lebanese behavioral health care NPO could use in times of crisis. The study also addressed the behavioral health leaders’ experience managing a funding crisis. The Baldrige conceptual framework was used to assess the organization’s effectiveness in seven key areas. Interviews with the senior leaders and analysis of the organization’s archival data were used to inform the …

Nursing Home Nurse Turnover And The Association To Workload, Absenteeism, And Number Of Beds, Justin Ryan Gracieux

Walden Dissertations and Doctoral Studies

The aging population in the United States has resulted in an increased need for quality nursing home care, which includes a stable nursing staff and reduced workforce instability. The purpose of this quantitative correlational study was to examine the relationship between direct care nursing staff turnover rates for RNs, licensed vocational nurses (LVNs), and certified nursing assistants (CNAs) concerning workload, absenteeism, and number of beds in Texas nursing homes. The relational coordination theory provided the theoretical framework for understanding the underlying issues and communication needs that may relate to staff turnover. Secondary data from 11,336 direct resident care nursing staff …

Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi

Walden Dissertations and Doctoral Studies

AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …

Unmet Needs Of Children With Special Health Care Needs When Transitioning To Adult Services, Kiara Monee Moseby

Walden Dissertations and Doctoral Studies

Health care transition planning could help decrease health care disparities among those who identify as an individual on the autism spectrum; however, less than a quarter of the adolescent population living with autism spectrum disorder receive transition planning. Decreasing health care disparities could lead to an increase in health care quality and longevity. The purpose of this study was to analyze if there was a relationship between (a) the number of physician visits, (b) if the physician treats only children, (c) if the physician talks about the child seeing physicians who treat adults, (d) if the physician worked with the …

Effect Of Clinical Trial Participation On Patient Experience And Overall Hospital Scores, Bridget Tyrka

Walden Dissertations and Doctoral Studies

AbstractDespite groundbreaking advances in technology and medicine in the United States and intensive examination of health services quality initiatives, issues of quality and patient-reported experience measures in the hospital sector remain unimproved. Although evidence-based medicine has improved through innovation in clinical research, healthcare systems have reportedly struggled to implement advances in medicine and lack the skill sets to become learning health systems. As clinical practice and clinical trials (CTs) have rarely intersected in the past, a significant lack of quantitative research has been dedicated to correlate improved patient outcomes with participation in CTs. The analysis sought a correlation, if any, …

Exploring Quality Management Strategies To Mitigate Culture Shock Among Cochlear Implant Users, Victor Mulume' Ambila

Walden Dissertations and Doctoral Studies

AbstractAfter the cochlear implant (CI) activation period and therapy, adult CI users who travel overseas encounter culture shock factors that paralyze their coping capability, which need normalization through management strategies during the post-cochlear-implantation process (PCIP). In the structure of the conceptual framework, a plan is presented for addressing the management strategy. An integrated system of product-process-service-care portrays the product as an active implant within an individual bearer fostering a CI user’s physical, physiological, and psychological traits. The problematic aspects alter the end users’ coping capability in an unfamiliar host environment abroad. The qualitative research approach used was a single case …

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

Electronic Health Record Adoption, Interoperability, And Consumer Access, Edet Udofia

Walden Dissertations and Doctoral Studies

AbstractElectronic health record (EHR) adoption is necessary across many healthcare settings. The problem identified in the current study is that EHR systems and consumer access to their health records tend to be inconsistently applied across various health care settings which could have adverse effects on health outcomes in the policies, and procedure of healthcare delivery. EHR systems can improve the perceptions of patients on healthcare systems and the operation of health care facilities. More specifically, the issue of interoperability in the context of EHR system implementation was reviewed in the current project. The purpose of this study was to understand …

Strategies To Reduce Costs Caused By Medication Errors In Us Hospitals, Janice Leah Chobanuk

Walden Dissertations and Doctoral Studies

Medication errors result in patient harm, including deaths, costing American hospitals over $20 billion annually. The financial impact and reduced public confidence in safe patient care create a business problem for hospital leaders trying to contain costs, maintain a competitive edge, and sustain patient satisfaction. Grounded in the sociotechnical conceptual framework, the purpose of this generic qualitative study was to identify strategies hospital leaders use to reduce costs caused by medication errors in hospitals. Data collection involved semistructured interviews with 10 hospital leaders from various high-reliability hospitals across the United States and a review of documents related to medication management …

The Relationship Between Advanced Payment Model Providers And Patient Behavior, Harry Petaway

Walden Dissertations and Doctoral Studies

Public health initiatives include vaccination and screening efforts to reduce the burden of disease. This study addressed colorectal cancer (CRC) screening behaviors of accountable care organization (ACO) patients with different social determinants of health and providers’ ability to comply with the Medicare Shared Savings Plan (MSSP) quality measure ACO #19. This study followed the socioecological model and a cross-sectional quantitative design to assess data from the MSSP public use file 2019 across three manuscripts to expand on current literature. The purpose was to determine whether patient behavior was the primary driver to improve healthcare quality. Study results showed that performance …

Strategies Healthcare Leaders Use To Improve Patient Satisfaction, Kajon Franklin

Walden Dissertations and Doctoral Studies

For all healthcare leaders, patient satisfaction plays a key role in healthcare; poor patient satisfaction within healthcare organizations can lead to poor patient health outcomes, decreased revenue, and poor employee engagement. Grounded in Mayeroff’s theory of caring, the purpose of this qualitative single case study was to explore strategies healthcare leaders use to improve patient satisfaction. The participants consisted of five healthcare leaders in metropolitan Detroit, Michigan, who implemented strategies that improved patient satisfaction. Data was collected using semistructured interviews, archival document review, and data from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database. Yin’s five-step process …

Demographics And 30-Day Readmissions For End-Stage Renal Disease Patients, Shelia Concepcion Perez

Walden Dissertations and Doctoral Studies

End-stage renal disease (ESRD) is increasingly a problem in the United States, and factors such as race/ethnicity and gender may not only worsen the risk of the disease but also correspond to worse treatment access. This is significant because ESRD is a heavy economic burden not only on patients, but on caregivers and the health care system, especially as disparities remain between different demographic groups. The purpose of this quantitative nonexperimental, historical, correlational design was to determine the extent to which gender and race/ethnicity predict 30-day readmission rates after hospitalization for ESRD patients. The theoretical framework for the current study …

Health Care Leaders Strategies And Patient Satisfaction, Aaronn Haerr

Walden Dissertations and Doctoral Studies

Ineffective patient satisfaction strategies can negatively impact patient satisfaction scores and overall organizational performance. Health care leaders who struggle to increase patient satisfaction are at high risk of diminished organizational performance and long-term sustainability. Grounded in the transformative learning theory, the purpose of this qualitative single case study was to explore strategies health care leaders implemented to improve patient satisfaction. The participants were five health care leaders in Ohio who effectively implemented strategies to increase overall patient satisfaction. Data were collected from semistructured interviews, organizational documents provided by the participants, and the company website. Yin’s five-step method was used to …

The Impact Of Inpatient Boarding In North Carolina Emergency Departments, Miracle Howard

Walden Dissertations and Doctoral Studies

Currently, emergency department overcrowding has negatively impacted hospitals' financial, operational, and organizational performance globally. A contributing factor to emergency department overcrowding includes the delay of the throughput process for patients who have a time-sensitive diagnosis and are admitted to the emergency department. This causes adverse hospital outcomes such as longer length of stays and increase hospitalization cost. This study utilized secondary data to address a relationship between admitted patients who have time-sensitive diagnoses such as chest pain and chronic obstructive pulmonary disease within North Carolina emergency departments and length of stay, utilization of services, and overall hospital cost. The conceptual …

Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna

Walden Dissertations and Doctoral Studies

More than half of the population of the Commonwealth of the Northern Mariana Islands had not visited their primary care provider for a year in 2016. The Chamorro people are less willing to seek or access care than other ethnic groups. This qualitative study aimed to understand the Chamorro people's access and utilization of Saipan's health care services to improve their access and, ultimately, their health. The theoretical frameworks included Penchansky and Thomas's theory of access to explore the Chamorro people of Saipan's lived experiences with availability, accessibility, accommodation, affordability, and acceptability of health care services, as well as Spector's …

Impact Of Information Breaches On Health Care Records, Anton Antony Arockiasamy

Walden Dissertations and Doctoral Studies

Although there were almost 3.5 million reported information breaches of health care data in the first quarter of 2019, health care providers do not know the extent of digital and nondigital breaches of patient medical records. The purpose of this quantitative, comparative study was to identify the difference between the individual patient records affected by digital versus nondigital breaches for three types of health care entities in the United States, health care providers, health care plans, and health care clearinghouses. Allman’s privacy regulation theory, the National Institute of Standards and Technology Privacy Framework, and ecological systems theory comprised the theoretical …

Using Health Navigators To Reduce Readmission Rates Among Medicaid Or Uninsured Female Patients In The Emergency Department, Susan Renee Ibanez

Walden Dissertations and Doctoral Studies

AbstractThere has not been a significant decrease in hospital readmission rates since the 1980s, which has impacted staffing, operational, and financial resources. Unnecessary 30-day readmissions result in penalties in reimbursement, additional costs, and adverse reactions resulting from the admission for the patient. This quantitative study explored the impact of using health navigators for an emergency department (ED) patient population. The theoretical framework was based on the Donabedian model. The study focused on female patients,some of whom were covered by Medicaid, and some were uninsured. This study posed research questions targeting reducing readmission for female ED patients with no insurance or …

Evidence-Informed Health Care Transition Policy In California’S Title V Programs For Medical Complexity, Anthony Pallitto

Walden Dissertations and Doctoral Studies

Inadequate health care transition policy continues to cause interruptions or setbacks in the continuity of medical care and lapses in health insurance coverage for adolescents in California's Title V programs for individuals with medically complex cases. Yet, there is a paucity of empirical health care transition research to develop an effective health care transition policy for children with medical complexity who are enrolled in California’s Title V program. The purpose of this explanatory case study was to explore the potentiality of translating evidence from a quasi-experimental health care transition primary research project into evidence-informed health care transition policy. The research …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat

Walden Dissertations and Doctoral Studies

Research has shown that educational programs have led to developing the professional skills and behaviors of front-line health care providers who care for overweight or at-risk obese patients. The purpose of this project was to provide an educational program on best practices for weight management to health care providers at a large military clinic. The project question was developed to assess whether the educational program increased the knowledge and confidence of health care providers in the management of obesity. Utilizing Pender's health promotion model, a quasi-experimental study was conducted in which 15 health care providers, including licensed and unlicensed personnel …

The Relationship Between Health Insurance And Dialysis Utilization For Chronic Kidney Disease Patients In Saint Lucia, Anita Lilian Sydney

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) is a significant cause of disability and death in Saint Lucia. The incidence of CKD is disproportionately higher among individuals who are socially and financially disadvantaged. New evidence suggests that in resource-poor countries, government subsidization programs for dialysis treatment aid in the delay of disease progression and its associated costs. The purpose of this study was to examine the relationship between health insurance, government subsidization, employment, and dialysis utilization for CKD patients and the efficacy of subsidization for dialysis in Saint Lucia. The study included a retrospective cohort of 979 moderate-to-severe CKD patients from secondary data …

Hpv Vaccination And Cervical Cancer Prevention In Women, Ateela Duffy

Walden Dissertations and Doctoral Studies

Cervical cancer is the second most common cancer in women worldwide and is mainly caused by the human papillomavirus (HPV). The purpose of this study was to determine whether there was a statistically significant difference in the diagnosis of cervical cancer in women who received the HPV vaccine compared to women who did not receive the vaccine, while considering demographic factors (race, ethnicity, level of education, household income), personal risk factors (sexual orientation, cigarette use, diet, and type of contraception use), and factors affecting access to healthcare (type of healthcare coverage, delay in receiving medical care). This research study, guided …

Strategies For Implementing Self-Service Technologies In Supermarket Retail Operations, Ryan Christopher Gurley

Walden Dissertations and Doctoral Studies

AbstractOrganization leaders who do not adopt self-service technology (SST) are at risk of failure. The adaptation of SST can aid leaders in the supermarket industry improve checkout operations, increase efficiency, and minimize customers’ waiting experiences, reducing the customers’ shopping satisfaction. Grounded in the disruptive innovation theory, the purpose of this multiple case study was to explore strategies supermarket managers use to adapt SST practices. The participants included six supermarket managers in Jackson County of Southern Illinois. Data were collected from face-to-face interviews with managers, company documentation, and observations. Thematic analysis was used to analyze the data. Four themes emerged: cultural …

Emergency Department Utilization And Length Of Stay Among Sickle Cell Patients, Rushali Naik

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) utilize the emergency department (ED) frequently due to limited access to adult health care providers. Few providers are knowledgeable about caring for patients with sickle cell disease. This quantitative study’s purpose and research questions addressed whether there was a correlation between ED utilization and ED length of stay (LOS) pre- and post-enrollment in an adult comprehensive sickle cell clinic between the years of 2012 and 2017. The Donabedian framework was used to examine the structure, process, and outcomes related to the benefits of care in a sickle cell center. The independent variables of pre- …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

Servqual Measurement In A Healthcare Setting: Before And After Corrective Strategy Implementation, Jerome Christia, Aaron Ard, Lorraine Runion

Atlantic Marketing Journal

In the United States, the most dominant industry is services, yielding the highest volume of total employment and gross domestic product. Due to this insight, academics and business professionals continue to research and apply strategies to achieve distinctive competitive advantages in the services arena. The steady growth and increasing significance of the service sector in the United States and other developed markets has resulted in a sizeable body of related research addressing a variety of issues such as service quality and its characteristics. Healthcare is an impactful service industry that has received a considerable amount of attention. In the healthcare …

Patient Blood Management Programs And Their Association With Patient And Organizational Outcomes, Sandra L. Lamm

Theses and Dissertations

Blood transfusions are the most common hospital procedure. However, many transfusions may be unnecessary. These unnecessary transfusion may expose patients to the potential risks of transfusion without improving patient outcomes Patient blood management (PBM) programs emphasize conserving a patient’s own blood resources and only transfusing the minimum amount needed. This study examined the organizational and environmental factors associated with a hospital having a PBM program, or having processes based on PBM, and their impact on organizational and patient outcomes potentially affected by blood transfusions.

A PBM survey was created for this study and used to gather information on hospitals having …