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Articles 151 - 180 of 284
Full-Text Articles in Medical Humanities
The Relationship Of Lean Implementation And Patient Satisfaction (Hcahps) Scores In Acute Care Hospitals, Charles V. Hagood
The Relationship Of Lean Implementation And Patient Satisfaction (Hcahps) Scores In Acute Care Hospitals, Charles V. Hagood
All ETDs from UAB
THE RELATIONSHIP OF LEAN IMPLEMENTATION AND PATIENT SATISFACTION (HCAHPS) SCORES IN ACUTE CARE HOSPITALS CHARLES V. HAGOOD DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT Background: The purpose of the study was to better understand the relationship of Lean implementation and patient satisfaction (HCAHPS) scores in acute care hospitals. Hospitals are under significant pressure to improve patient satisfaction, thus a number of hospitals are increasingly using Lean improvement methodologies to do so. However, the results that have been achieved are often reported as mixed at best and lack empirical proof, specifically the relationship of Lean methodologies and their impact on …
The Effect Of Cultural Competency Training Programs On Expatriate Nurses' Levels Of Cultural Competence In Saudi Arabia As Measured By The Inventory For Assessing The Process Of Cultural Competence (Iapcc-R), Naof Faiz Saleem Al-Ansary
The Effect Of Cultural Competency Training Programs On Expatriate Nurses' Levels Of Cultural Competence In Saudi Arabia As Measured By The Inventory For Assessing The Process Of Cultural Competence (Iapcc-R), Naof Faiz Saleem Al-Ansary
All ETDs from UAB
The study examined the relationship between cultural competence training programs and the levels of cultural competence among expatriate nurses in Saudi Arabia. Cultural competence training programs are believed to increase the awareness of expatriate nurses in Saudi Arabia in regards to issues that might arise from cultural differences between patients and healthcare providers. Healthcare professionals, and healthcare organizations, emphasize the importance of culturally competent healthcare environments in providing optimum healthcare services to individuals from different cultural backgrounds. Findings from the study suggested that participation in cultural competency training is associated to higher cultural competency scores. Additionally, age was positively associated …
A Comparative Multiyear Assessment Of Care Utilization Between Existing And Newly Enrolled Medicaid Populations Within Washington State, Preston M. Simmons
A Comparative Multiyear Assessment Of Care Utilization Between Existing And Newly Enrolled Medicaid Populations Within Washington State, Preston M. Simmons
All ETDs from UAB
A COMPARATIVE MULTIYEAR ASSESSMENT OF CARE UTILIZATION BETWEEN EXISTING AND NEWLY ENROLLED MEDICAID POPULATIONS WITHIN WASHINGTON STATE ABSTRACT The study looks at 2012 through June of 2016 Medicaid data from the Washington State Health Care Authority, comparing claims utilization for newly enrolled patients each calendar year to continuously enrolled members. Mean number of emergency department, hospital, and ambulatory (office) claims per Medicaid member are compared to ascertain if they are the same or different between the groups. Differences in the mean number of ambulatory care sensitive conditions (ACSC) were additionally assessed between those continuously and newly enrolled. The results of …
Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste
All ETDs from UAB
Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …
High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley
High-Intensity Interval Training With Energy Restriction Preserves Lean Tissue And Improves Glucose Tolerance In Obesity, Rachel Ann Harley
All ETDs from UAB
Calorie restriction (CR) reduces body weight (BW) and adiposity, but is often less than expected due to hypometabolism produced by reductions in lean body mass (LBM). A comparable energy deficit created by combining CR and exercise energy expenditure (EE) has been shown to attenuate the reduction in EE produced by CR. Continuous moderate-intensity training (MIT) is commonly used to sustain energy balance or expedite weight loss, but high-intensity interval training (HIIT) may produce greater results. The purpose of this investigation was to determine if HIIT preserves LBM and improves energy metabolism to a greater extent than MIT in the presence …
Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman
Examining The Relationship Between Surgical Profiles And Financial Performance Of Hospitals, Lucas Higman
All ETDs from UAB
Hospitals operate in turbulent and complex environments with limited resources. Consequently, administrators need to understand how to best use resources and improve a hospital’s positioning in a market. Surgical services is a key operational activity for hospitals, thus, a better understanding of how these services are organized by hospitals likely has important implications for a hospital’s performance and potentially survival. Given the potential importance of surgical services to hospitals, the purpose of this study was three-fold. First, the study identified different surgical profiles of hospitals based on the type and volume of surgical services provided by hospitals. Second, the study …
The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen
The Relationship Between Hospital Interdepartmental Transfers And Patient Experience, Betty O. Mortensen
All ETDs from UAB
This study examined the potential relationship between interdepartmental transfers and perceptions of adult patients who were admitted and discharged from a 300-bed, not-for-profit community tertiary hospital in the Midwest. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a publically reported comparative data tool measuring hospital patient experiences. As consumers, patients are more informed about their own health and are challenging the quality and service of care provided by hospitals. The value-based purchasing reimbursement model has become a new challenge for hospitals. Historically, hospitals were reimbursed through a volume driven model. Comparatively, the value-based model focuses on …
Hospice Performance: Environmental And Organizational Correlates, Mengying He
Hospice Performance: Environmental And Organizational Correlates, Mengying He
All ETDs from UAB
The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not …
Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan
Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan
All ETDs from UAB
The purpose of this dissertation was to examine the antecedents and outcomes of hospital vertical integration into Sub-Acute Care (SAC). Using a sequential quanqual mixed methods design, we examined why hospitals adopt a vertical integration strategy and the relationship this strategy has to performance. Findings from this dissertation are important to hospital administrators as they seek to find ways to respond to the changing payment structures established during the Affordable Care Act. The results of this dissertation suggest that not all market and organizational factors are associated with vertical integration strategies toward SAC. They also suggest that vertical integration into …
Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek
Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek
All ETDs from UAB
ABSTRACT This research used a Delphi methodology to solicit challenges that significantly impact the operational success of pediatric long-term care facilities. Further, this study sought to understand the ability of pediatrics administrators to impact, affect, overcome, or resolve these challenges. Round 1 accomplished the desired goal of eliciting a substantial amount of new qualitative information regarding administrative challenges in pediatric long-term care, which previously had been extant in the literature. In Round 2, data were distilled into categories and unique exemplars which in turn were validated by participants. In Round 3, administrators ranked and rated categories and individual challenges in …
Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson
Dietary Patterns, Insulin Resistance, And Cognitive Outcomes In A Cohort Of Black And White Americans, Keith Pearson
All ETDs from UAB
As life expectancy continues to increase and the number of elderly Americans rises, public health initiatives are seeking to identify modifiable risk factors to preserve cognitive function and increase quality of life in advanced ages. The primary objective of this dissertation was to investigate dietary patterns, carbohydrate consumption, and insulin resistance as modifiable risk factors that may contribute to the development of cognitive impairment and cognitive decline. Three separate studies were performed in the REasons for Geographic And Racial Differences in Stroke study, a prospective cohort containing 30,239 black and white participants. Cognitive impairment was defined using the Six-Item Screener. …
Correlating High Reliability Organization Practices With Preventable Harms Across Children’S Hospitals Participating In The Children’S Hospitals’ Solutions For Patient Safety Collaborative, Kelly H. Randall
All ETDs from UAB
Background: Despite significant effort, focus, and resources dedicated to reducing patient safety risk, the healthcare system continues to have high error rates. Approaches and strategies implemented to decrease human error have been marginally successful in achieving sustainable reduction in patient harm. Purpose: The purpose of this study was to examine the association between high reliability and patient safety outcomes by testing the following hypotheses: Organizations exhibiting more advanced high reliability practice will have fewer hospital acquired conditions (as defined by the Serious Harm Event Index (SHE) than organizations exhibiting less advanced high reliability practices; and organizations exhibiting more advanced high …
Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay
Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay
All ETDs from UAB
RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …
Examining The Impact Of Emergency Department (Ed) Registered Nurse (Rn) Staffing On Ed Patient Experience, Deana L. Nelson
Examining The Impact Of Emergency Department (Ed) Registered Nurse (Rn) Staffing On Ed Patient Experience, Deana L. Nelson
All ETDs from UAB
EXAMINING THE IMPACT OF EMERGENCY DEPARTMENT (ED) REGISTERED NURSE (RN) STAFFING ON ED PATIENT EXPERIENCE DEANA NELSON DOCTOR OF SCIENCE IN HEALTH SERVICES ADMINISTRATION ABSTRACT Patient experience ratings are important to healthcare organizations from both a clinical and financial perspective. Studies examining the relationship between patient experience and nurse staffing are prevalent in the inpatient setting, but not as much is known about how staffing affects these ratings in the Emergency Department (ED). This study examined the relationships between ED RN staffing, patient expectations and patient experience ratings, using a conceptual framework adapted from Donabedian’s structure/process/outcome model, and expectancy disconfirmation …
The Relationships Between Patient Satisfaction, Market Share, And Hospital Financial Performance, David W. Au
The Relationships Between Patient Satisfaction, Market Share, And Hospital Financial Performance, David W. Au
All ETDs from UAB
Quantitative scores enumerating patient experience with care have been introduced to healthcare via the Patient Protection and Affordable Care Act of 2010. Consumers can now compare with relative ease, different healthcare providers on the basis of standardized metrics. As government mandated transparency initiatives become commonplace as a result of the law, hospitals are more cognizant of how patient experience with care (operationalized using Hospital Consumer Assessment of Healthcare Providers and Systems: HCAHPS) has an impact on where patients decide to seek treatment. The proliferation of technological tools now enables patients to make meaningful quality and cost comparisons across providers. HCAHPS …
Hospital-Physician Vertical Integration: The Effect Of Integration On Cardiology Compensation And Clinical Productivity, Vance Mcleod Chunn
Hospital-Physician Vertical Integration: The Effect Of Integration On Cardiology Compensation And Clinical Productivity, Vance Mcleod Chunn
All ETDs from UAB
HC2.
Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham
Cultural Competence Practices Implemented In Hospitals And Health Systems By Minority Executives On The Top Management Team, John H. Cunningham
All ETDs from UAB
The study examined whether hospital implementation of cultural competence practices was influenced by the racial/ethnic composition of top management. With one-third of the U.S. population identifying with a racial or ethnic group other than non-Hispanic White, and that population continuing to grow increasingly diverse, racial and ethnic minorities are increasingly accessing health care services. Yet they represent less than 1% of the top management teams (TMT) of health care organizations. The study sought to determine the extent to which health care organizations with TMTs that are representative of the racial and ethnic compositions of the communities in which they serve …
The Role Of Ppar-Delta In Regulating Cardiomyocyte Proliferation And Angiogenesis In Post-Myocardial Infarction Adult Heart, Yishu Ding
All ETDs from UAB
immediately before, soon after, and one month after intervention. Average daily calcium
Pay For Performance In Dentistry: Is It Worth It?, Andreea Voinea-Griffin
Pay For Performance In Dentistry: Is It Worth It?, Andreea Voinea-Griffin
All ETDs from UAB
Introduction: The variability of dental care and the slow implementation of evidence-based dentistry point to the need for change. Pay for performance (P4P) programs may foster quality improvement if appropriately designed. This work demonstrates the use of modeling and simulation to evaluate such programs prior to deployment. An example is provided in the form of a P4P program for the treatment of occlusal early caries (EC) in permanent teeth. Research Design: The proposed P4P program evaluation consists of two steps. First step is to determine the optimal treatment. In this example, three non-invasive treatments (NTs), watchful-waiting (WW), sealants, and fluoride …
Patient Engagement Functionalities Facilitated By Health Information Technology: An Examination Of The Adoption Rate And Financial Performance Among U.S. Hospitals, Oghale Elijah Asagbra
Patient Engagement Functionalities Facilitated By Health Information Technology: An Examination Of The Adoption Rate And Financial Performance Among U.S. Hospitals, Oghale Elijah Asagbra
All ETDs from UAB
The Centers for Medicare and Medicaid (CMS) meaningful use requirement, as well as documented evidence suggest that health information technology (HIT) has the potential to promote patient engagement and consequently improve quality and reduce cost. This prompts a better understanding of hospital adoption of HIT for patient engagement. The purpose of the three papers presented in this dissertation is to examine hospital adoption of health information technology (HIT) to facilitate patient engagement. Emphasis is placed on the functionalities (i.e., functions or capabilities) offered by these technologies that have been determined to allow patients be more involved in their care because …
How Well Do Hospitals Budget Operating Results? The Relationship Between Budget Variances And Operating Margin, Mark F. Slyter
How Well Do Hospitals Budget Operating Results? The Relationship Between Budget Variances And Operating Margin, Mark F. Slyter
All ETDs from UAB
There is a near-universal assumption in both practice and literature that greater accuracy and management to the budget improves profitability (Libby & Lindsay, 2010; Umapathy, 1987). Prior to this study, this assumption has gone untested and we know little about the wisdom of such an assumption. The results of this study indicate greater accuracy in forecasting and/or tighter management to the budget, or favorably exceeding it, leads to improved profitability. More specifically, smaller unfavorable budget variances are associated with greater operating margins while greater favorable budget variances are associated with greater operating margins. A single standard deviation reduction in unfavorable …
Evaluation Of The Productive Efficiency Of Nurse Practitioners In A Nurse Managed Center In A Highly Restrictive Scope-Of-Practice State, Faraz Ahmed
All ETDs from UAB
The purpose of this study is to determine the productive efficiency of Nurse Practitioners (NP) in a Nurse Managed Center (NMC) in a highly restrictive Scope-of-Practice (SOP) state. NPs are skilled, cost effective and quality health care providers and are considered a highly competitive option for increasing access while reducing health care costs. However, it is not clearly known if NPs are the most productively efficient at delivering this reduced cost of health care. The theories of Complex Adaptive Systems (CAS) and Resource Based View (RBV) were used as a framework to develop the hypotheses that examined the productive efficiency …
Drivers Of Inter-Organizational Network Participation, Kimberly S. Davey
Drivers Of Inter-Organizational Network Participation, Kimberly S. Davey
All ETDs from UAB
The purpose of this dissertation was to study market and organizational drivers associated with inter-organizational network participation. Inter-organizational networks are increasingly emerging across industries as a strategy for adapting to fundamental changes in competitive market environments. Specifically, this study empirically examined the association between market and organizational drivers for a sample of U.S. hospitals relative to their participation or non-participation in Medicare ACOs as a newly emergent inter-organizational network in the healthcare sector. This was a cross-sectional study of U.S. hospitals participating in Centers for Medicare and Medicaid Services (CMS) designated ACOs as of January 1, 2014 and hospitals not …
Hospital Community Orientation: Predictors And Performance Outcomes, J'Aime Jennings
Hospital Community Orientation: Predictors And Performance Outcomes, J'Aime Jennings
All ETDs from UAB
The three publishable manuscripts contained within this dissertation examine the predictors and performance outcomes of hospital community orientation. Community orientation is the customization of hospital services to meet identified community health needs. Together, these papers fill gaps in the literature regarding the factors that assist or hinder hospitals from being community-oriented, as well as the effects of community orientation. The first paper uses longitudinal data to examine the organizational and environmental factors that may influence how engaged hospitals are in a community orientation strategy based on the number of activities performed. The remaining papers consider the performance outcomes of community …
Towards An Understanding Of Patient Satisfaction In The Military Health System, Alan Alexander Jones
Towards An Understanding Of Patient Satisfaction In The Military Health System, Alan Alexander Jones
All ETDs from UAB
The Military Health System (MHS) is the most expansive health care system in the world. The MHS provides health care services to 9.7 million eligible beneficiaries spread across six continents. The MHS budget exceeded $52 billion in 2013 or 10 percent of the total 2013 Defense budget. The cost of health care in the MHS is of great concern to the Department of Defense and the US Congress. The MHS needs a strong framework to measure the value of the health care it provides. The purpose of this study was to develop a framework to better understand Patient Satisfaction in …
Examining The Interplay Of Diet Composition, Cardiometabolic Diseases, And Economics, Kenneth Patton Kell
Examining The Interplay Of Diet Composition, Cardiometabolic Diseases, And Economics, Kenneth Patton Kell
All ETDs from UAB
Despite the invaluable contributions that both randomized controlled trials and longitudinal studies have made to our understanding of the relationships between diet and cardiovascular disease (CVD), a comprehensive understanding of these relationships does not yet exist from birth to death. Furthermore, the longest running of these longitudinal studies have not included a representative portion of racial minority participants. Lastly, given the financial impacts of CVD, as well as how socioeconomic status (SES) can influence diet, the interplay between these three merits consideration. Therefore, the objective of this dissertation was to evaluate the associations between diet and cardiovascular disease (CVD): 1) …
The Impact Of Cultural Competency On Patient Experience Of Care, Emily Lane Koudelka
The Impact Of Cultural Competency On Patient Experience Of Care, Emily Lane Koudelka
All ETDs from UAB
The impact of hospitals’ cultural competency on inpatient experience of care will be examined. Enhanced patient experience of care may alter an individual’s willingness to use health services, thereby increasing access and decreasing health disparities. As a result, to the extent that cultural competency influences patient experience of care, the integration of cultural competency into healthcare organizations has emerged as a critical issue for researchers, industry leaders, and policymakers. Findings from this study will inform policies, practices, and processes across the broad spectrum of healthcare industry stakeholders.
Linking Adiponectin And Autophagy In The Regulation Of Breast Cancer Metastatic Potential, Emily Libby
Linking Adiponectin And Autophagy In The Regulation Of Breast Cancer Metastatic Potential, Emily Libby
All ETDs from UAB
Curative approaches for metastatic breast cancer remain elusive. Adiponectin is the most abundant of the adipocyte-secreted adipokines, and there is recent interest in development of adiponectin-based therapies for this disease. Yet, while multiple epidemiological studies have indicated that low levels of circulating plasma adiponectin portend poorer prognosis, recent work has reported that elevated adiponectin expression in breast tissue correlates with advanced disease. Further, isoform-specific roles of this molecule are not well understood. Thus, the overarching purpose of this work was to elucidate how adiponectin isoforms contribute to the microenvironmental regulation of the early steps of breast cancer metastasis. We show …
Intensivists And Organizational Performance, Glenn Barthwick Liddle
Intensivists And Organizational Performance, Glenn Barthwick Liddle
All ETDs from UAB
Because of the high intensity of care and the extremely complex medical conditions being treated, intensive care units (ICUs) represent one of the most significant units within a hospital. Despite the significance of the ICU, the majority of the care provided in the ICU has historically been managed and coordinated by referring or attending physicians, who often do not have the specialized training needed to effectively care for the exceedingly acute patients in the ICU. More recently, however, a growing number of hospitals have begun staffing the ICU with intensivists. Intensivists are uniquely trained physicians that specialize in providing care …
Patient Activation: An Examination Of The Relationship Between Care Management With Patient Activation-Customized Coaching And Patient Outcomes, Cindy L. Reistroffer
Patient Activation: An Examination Of The Relationship Between Care Management With Patient Activation-Customized Coaching And Patient Outcomes, Cindy L. Reistroffer
All ETDs from UAB
As part of healthcare reform, patient engagement is becoming an important area of focus. Most recently, patient activation, as part of engagement, has been studied; however, interventions to improve activation are not well identified. The purpose of this dissertation was to empirically examine whether enrollment in care management with patient activation (PA)-customized coaching was associated with patient outcomes of utilization, medication adherence, and clinical outcomes. The study utilized the chronic care model framework and theoretical insights from social cognitive theory to examine the relationships among three hypotheses. Secondary data related to commercially-insured enrollees in Priority Health were used to test …