Health and Medical Administration Commons^™

Care Management And Readmission Among Elderly African American Patients With Chronic Illnesses, Vivien Lyn Salmon

Walden Dissertations and Doctoral Studies

More than 70 million Americans aged 50 years and older suffer from at least 1 or more chronic condition and use the emergency department frequently. By 2025, chronic illness will affect an estimated 164 million Americans or nearly 49% of the population. The rapid rise in chronic illness is due to a combination of an aging population, longer life expectancies, and poor lifestyle choices. This quantitative study provided a statistical analysis on the impact of care management on readmissions among African Americans between the ages of 65 and 80, with diabetes, hypertension, asthma, or multiple chronic conditions. Logistic regression was …

Mindfulness In Healthcare: Exploring The Gap Between Leadership Practice And Employee Burnout, Bryn Saunders

Walden Dissertations and Doctoral Studies

A healthcare employee’s ability to provide proficient, or quality, care to patients is impeded by burnout. Previous studies showed high levels of burnout is a common problem in healthcare, indicating there is a lack of support for employee health. The purpose of this quantitative study was to determine whether mindfulness training reduced burnout in healthcare professionals. The study focused on increasing knowledge between the leadership practices and programs used to improve healthcare proficiency by analyzing the relationship between mindfulness and three measures of burnout: sense of efficacy, depersonalization, and emotional exhaustion. The Western concept of mindfulness that emphasizes self-awareness and …

Staff Education On Type 2 Diabetes Mellitus, Joan P. Williams

Walden Dissertations and Doctoral Studies

Diabetes mellitus is a major health concern that affects the physical and financial facets of communities. During the past 4 years, a multidisciplinary health care clinic in a northern state reported an increase in the number of type 2 diabetes (T2D) patients. Forty-three percent (43%) of adults with T2D had an elevated glycated hemoglobin A1c of 7.5% or higher. Yet, the staff at the clinic lacked current knowledge of T2D, quality of care, and prevention strategies for patients with T2D. This resulted in increased serious health care issues, associated costs, and increased complications of the patients with T2D. The purpose …

Recognition, Classification, And Help-Seeking Behavior Of Nigerian Immigrants In Minnesota, Frederick Nnabuchionye

Walden Dissertations and Doctoral Studies

Immigrants from non-Western cultures are known to underutilize mental health services in the United States. Part of the problem is in the way how cultures recognize and classify symptoms as a mental disorder. A report from the Minnesota Ombudsman's Office for Mental Health showed that out of every 6 suicide-related deaths in Anoka Regional Treatment Center in Minnesota, 4 are of African descent. The purpose of this quantitative study was to investigate the cultural view of depressive symptoms as possible predictors of attitude toward seeking professional psychiatric help. The theory of reasoned action/ theory of planned behavior provided the framework …

Predictive Factors Of Determinants Of Health And Services Provided At Adult Day Service Centers, Nardia Anthonalla Aldridge

Walden Dissertations and Doctoral Studies

The National Association of Adult Day Service Centers has suggested that adult day service centers can provide services to meet the complex needs of the older adult and delay nursing home placement. Researchers have yet been able to establish the predictive nature of determinants of health in Adult Day Care Centers (ADSCs). The purpose of this correlational study was to examine the relationship between the determinants of health and the presence of therapeutic services and nursing services at ADSCs. The open system theory guided this study. Data sets from the Centers for Disease Control and Prevention, 2016 Adult Day Services …

Peers Erecting Barriers To Another Peer’S Success In The Healthcare Setting, Ricky D. Allen

Walden Dissertations and Doctoral Studies

In the healthcare workplace, bullying is shown to negatively impact patient care and safety, workflows, outcomes, interpersonal relationships, performance, mental and physical health, and cause a plethora of other secondary effects. The purpose of this qualitative phenomenological study was to explore the lived experiences of high performers or subject matter experts working in the healthcare field and had encountered peer-to-peer interference. The research questions focused on understanding the behaviors and outcomes of peer interference. Maslow’s hierarchy of needs was used as the conceptual framework. Data collection was achieved by interviewing 10 participants from a variety of healthcare backgrounds. Participants self-identified …

Motivating Factors For Nurses Aged 65 Years And Older To Extend Their Work Life, Dr. Cynthia M. Dobek

Walden Dissertations and Doctoral Studies

Nurses age 65 years and older who retire will leave a knowledge gap in the workforce unless motivated to continue working. A knowledge gap in the workforce is of concern to human resource professionals because healthcare professionals may not be able to keep pace with the increase in patients needing medical care. Grounded in Maslow’s hierarchy of needs theory, the purpose of this qualitative single case study was to explore what factors motivated nurses aged 65 years and older to extend their work life. The participants comprised 6 nurses aged 65 years and older who were still working or semiretired …

Small Business Leaders’ Strategies For Recruiting Veterans, Jamillah Deangela Stackhouse

Walden Dissertations and Doctoral Studies

Small business hiring managers who fail to implement recruitment strategies for

transitioning military veterans face hiring challenges with this population of workers.

Failed recruitment strategies are essential to small business leaders, as failure to attract

highly qualified military veterans places the organizations at a competitive disadvantage.

Grounded in recruitment theory, the purpose of this qualitative multiple case study was to

explore strategies used by leaders of small businesses to recruit, hire, and retain qualified

veterans. The participants included 3 purposefully selected hiring managers from 3 small

businesses in southeastern Virginia, who used successful strategies to recruit, hire, and

retain veterans. …

Evidence-Based Strategies For Improving Medication Adherence Among Psychiatric Patients: A Systematic Review, Omah S. Tsikada

Walden Dissertations and Doctoral Studies

Nonadherence to psychotropic medications among patients with serious and persistent psychiatric disorders, including bipolar disorder and schizophrenia, is approximately 70%. Nonadherence is a common barrier to the treatment of individuals with mental health disorders. However, there is limited awareness of evidence-based interventions and strategies to address this problem. Therefore, the question for this project asks whether a systematic review can identify strategies to improve adherence of psychotropic medications among individuals with serious and persistent mental illness. The purpose of this systematic review was to explore the evidence-based strategies that can aid in increasing medication adherence in patients with mental health …

Systematic Review Of Family Nurse Practitioner Utilization Within School Environments, Luz Elena Zapien

Walden Dissertations and Doctoral Studies

The American Academy of Pediatrics and the Institute of Medicine recommend school health screening programs to detect problems that might interfere with a student’s education and general well-being, and many U.S. states require compliance with enrollment requirements such as updated immunizations and physical exams prior to attendance. In low-income areas, however, there is often a shortage of physicians available to meet the healthcare needs of the population. Family nurse practitioners (FNPs) can be utilized in school health settings to deliver health care services that support school attendance and the well-being of school students, yet little is known about their impact. …

Disparities In The Qulaity Of Bariatric Care Among African American Women, Tracey S. White

Walden Dissertations and Doctoral Studies

Improving the quality of health care in the United States has been an ongoing challenge for decades. As health care providers seek to provide unsurpassed levels of health care, disparities continue to exist among races. Racial and ethnic disparities in the quality of health care persist that affect African American women disproportionally. The purpose of this study was to explore the lived experiences of African American women with regard to quality health care following bariatric surgery. Using a phenomenological approach, semistructured interviews were conducted with 10 African American women who had suboptimal weight loss outcomes following bariatric surgery. Data from …

Understanding Health Behavior In Caribbean Americans, Keva Alleyne

Walden Dissertations and Doctoral Studies

There has been a significant increase in the number of Caribbean immigrants to the United States with the population being over 4 million in 2014 and over 1 million of the immigrants residing in New York State. Among this population, there has been an increase in chronic diseases that has been linked to unhealthy eating behavior. Caribbean immigrants’ approach to their health behavior was examined in this qualitative, phenomenological study. With a focus on the different aspects of the acculturation theory as the theoretical foundation, 9 participants from across the United States were interviewed about their approach to health, cultural …

Competition And Services Offered Among General Hospitals In The Deep South, Vanessa Stone

Walden Dissertations and Doctoral Studies

Hospitals, along with other health care providers, are a central part of every health care system and responsible for a great share of healthcare expenditure. In the United States, the cost of health care is much higher than it is anywhere else. High expenditures for hospital services could reduce the resources available for primary care and other services that could do more for population health. The purpose of this study was to explore the competition among general medical and surgical hospitals in the Deep Southern states of Mississippi, Alabama, Georgia, South Carolina, and Louisiana to determine if increasing the level …

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

Changes In Operating Performance In Rural Hospitals From 2012 To 2019, Oluwaseyi Tami Young-Harry

Walden Dissertations and Doctoral Studies

Rural hospitals treat patients while dealing with the challenges of an inadequate workforce, limited financial resources, and an isolated geographic location, leading to difficulties in achieving financial viability. The purpose of this quantitative study was to analyze the operating performance of rural, general, medical and surgical hospitals in the United States and to determine if performance had changed from 2012 to 2019. Guided by x-efficiency theory, this study addressed whether hospital ownership explained variation in performance and if performance had changed from 2012 to 2019. A random sample of 394 rural hospitals was used, with data drawn from the American …

Impact Of Medicare Utilization On Mortality And Readmission Rates Of Heart Failure Patients 65 Years And Over, Joanna Alexander

Walden Dissertations and Doctoral Studies

Roughly 25% of individuals 65 years and over hospitalized with heart failure are readmitted within 30 days after discharge. Elderly individuals identified with heart failure possess a 5-year mortality approaching 50%. The purpose of this study was to determine if there is a relationship between Medicare-covered services for care, mortality rates, and readmission rates for beneficiaries 65 years and over with heart failure. To address this topic, the chosen approach was retrospective and quantitative. The theoretical foundation was the Chronic Care Model. The research questions sought to determine if there is a relationship between the Medicare-covered services for care and …

A Health Care Management Organization's Internal Controls Strategy For Managed Care, Elizabeth E. David

Walden Dissertations and Doctoral Studies

A lack of effective operational internal controls among health management organization (HMO) leaders could lead to poor operational practices, mismanagement of the government's health care funds, increased health care spending, and a negative impact on patient health outcomes. Grounded in transformational leadership theory, the purpose of this qualitative, single case study was to explore successful internal control strategies used by leaders at a southeastern Pennsylvania HMO. Data were collected from semistructured interviews with 5 participants who held positions of director or above within the organization for at least 3 years, had institutional knowledge, and had responsibility for overseeing the organization's …

Treatment Plans For Diabetes Management During Hurricane Maria In Puerto Rico, Joel De La Cruz Oller

Walden Dissertations and Doctoral Studies

The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare …

Telehealth Efforts To Reduce Hospital Readmissions Of Congestive Heart Failure Patients, Sirfornia L. Deasfernandes

Walden Dissertations and Doctoral Studies

Congestive heart failure (CHF) is a chronic condition that affects millions of individuals in the United States. There is no cure for CHF, but medical interventions can help treat the symptoms and improve health outcomes. The purpose of this quantitative study was to determine if telehealth services help to reduce the readmission status of patients diagnosed with CHF. The theoretical framework used in this study was the individual and family self-management theory to help focus on self-management behaviors that contribute to improving the patients' health outcomes. The research questions were focused on addressing CHF patients receiving telehealth services and whether …

The Complete Care Model: Improving Diabetic Patient Outcomes In Correctional Facilities, Chad Williams

Walden Dissertations and Doctoral Studies

Diabetes is a growing problem, becoming an increasing concern within prisons. Research suggests that as many as 4.9% of the inmate population is diagnosed with diabetes. To provide constitutionally required healthcare to the inmate population, corrections officials must identify a validated diabetes treatment modality geared toward improving diabetes outcomes. The purpose of this quantitative study was to evaluate the impact of a patient centered medical home (PCMH) based model of healthcare within the California Correctional Health Care Services (CCHCS) on diabetic prisoners. Using the social construct theory as the framework, the research questions were focused on determining whether there was …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

Impact Of Integrated Laboratory Data Transfer Portals On Patient Results And Reports, Charmane Latrece Richie

Walden Dissertations and Doctoral Studies

An operational problem exists in which some healthcare organizations cannot maintain a suitable supporting data transfer system, which impacts the integrated laboratory data transfer portals designed to receive and send secure patient laboratory results and reports. This quantitative study examined whether an association exists between patient reporting turnaround times and specific test code nomenclatures used when comparing an older referral laboratory interface (RLI) laboratory information system (LIS) to the newer electronic orders and resulting (EOR) system using the Covance expanded laboratory management services (ELMS) NexGEN database from 2016-2020. The Donabedian model served as the framework for this study. The sampling …

Sustainable Building Certification In Healthcare And Patient Satisfaction, Brian Jay Goehner

Walden Dissertations and Doctoral Studies

Eco-friendly healthcare delivery concepts are becoming more accepted as hospital leaders seek to control energy costs, mitigate contributions to climate change, and preserve scarce resources. Leadership in Energy and Environmental Design (LEED) offers healthcare leaders a framework for designing and constructing sustainable facilities that meet efficiency goals. The purpose of this quantitative cross-sectional study was to build an understanding of whether LEED certification influences Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. Using complex systems theory as the framework, the research questions were focused on exploring if higher levels of LEED certification led to greater HCAHPS overall hospital …

Process Improvement To Reduce Route Of Medication Administration Errors In Patients With Enteral Feeding Tubes, Elizabeth Scott

Doctoral Projects

Advances in health information management in the form electronic health records, computerized provider order entry systems, and clinical decision support systems and tools have enhanced the productivity, effectiveness, and efficiency of healthcare. However, the cost of these positive effects does come at the expense of other factors. Along with the introduction of Clinical Provider Order Entry (CPOE) systems, organizations have experienced new possibilities for medication errors and risks to patient safety. Factors associated with these errors should be evaluated in detail in order to mitigate the causes of these types of errors and to plan strategies for prevention. Continued research …

Strategies For Controlling Violence Against Healthcare Workers: Application Of Fuzzy Analytical Hierarchy Process And Fuzzy Additive Ratio Assessment, Fazel Rajabi, Mehdi Jahangiri, Farnaz Bagherifard, Sean Banaee, Payam Fahadi

Community & Environmental Health Faculty Publications

Objective: The present study aimed to identify and prioritize control measures of violence against Healthcare Workers (HWs) using the Fuzzy Analytical Hierarchy Process (FAHP) and Fuzzy Additive Ratio Assessment (F-ARAS).

Background: Occupational violence is a pervasive problem in healthcare centers. Reducing violence against staff is one of the challenges for healthcare managers.

Method: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were …

Survey Of Workplace Violence Perception, Prevention, Strategies, And Prevalence Of Weapons In Healthcare Facilities, James D. Blando, Marilyn Lou Ridenour, Daniel Hartley

Community & Environmental Health Faculty Publications

No abstract provided.

Leader Launch: A Needs Assessment And Intervention For Effective Leadership Development In Healthcare, Candice Freeman

STEMPS Faculty Publications

This case study examines how a rural healthcare system implemented LeaderLaunch, a leadership development program specifically supporting all front-line to director-level leaders employed within the organization’s facilities. John DeJoria, the healthcare system’s Director of Organizational Development, is a seasoned instructional designer and Certified Professional in Learning and Performance (CPLP) who was charged with the opportunity of determining the system’s leadership development needs and responding with aligned performance improvement interventions, intended to build competency and capacity in current, new, and emerging leadership. This case explains how John and his team designed, conducted, and utilized a three phase needs assessment to select …

Attitude Towards Patient Undergraduate Medical Students In The University Of Malaya, Jeevitha Rajasingam

Student Works (2020-2029)

In the last two decades, patient safety awareness has become one of the emerging themes. To prevent from doing harm to patients, safe medical practices should be implemented and followed strictly. Therefore, a basic understanding of human factor principles need to be instilled into all health care workers. Medical universities play a vital role in fostering patient safety attitudes of their students towards the importance of patient safety during their practise. However, the medical curricula still face challenges regarding the correct timing and appropriate methods of instruction in their understanding of their principles. Experiments have shown that patient safety classes …

Financial Consequences Of Covid-19 For U.S. Hospitals, Laura Petty, Trevor Mullins

Theses, Dissertations and Capstones

Introduction: The coronavirus pandemic has caused many financial issues for many businesses including putting a substantial strain on hospitals in the U.S. The impact of COVID-19 on the financial well-being of hospitals has been evaluated and the severity is still being measured as the pandemic is ongoing. The purpose of this research was to assess the financial consequences of the COVID-19 pandemic for hospitals in the United States.

Methodology: A literature review with a semi-structured interview with an expert from a local hospital was used for the methodology of this qualitative study. Five government websites and five databases …

Dental Practice Success Vol. 6 No. 4, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.