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Full-Text Articles in Medical Humanities
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 …
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
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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 …
Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek
Administrative Challenges In Pediatric Long-Term Care, Holly Elaine Jarek
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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 …
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
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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 …
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
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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 …
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 …
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.
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 …
Emergency Department Wait Time Communication Strategies And Patient Throughput Efficiency, Tom R. Mcdougal
Emergency Department Wait Time Communication Strategies And Patient Throughput Efficiency, Tom R. Mcdougal
All ETDs from UAB
This study investigates hospital strategies used to inform patients of anticipated wait times in the Emergency Department (ED) and the association of such strategies with patient throughput efficiency. When hospitals are inefficient in ED patient throughput, conditions of overcrowding often occur. Overcrowding of the ED is a problem for many hospitals. When such conditions exist, there is evidence in the literature that it leads to lower patient satisfaction, care quality, and financial position of the hospital. Therefore, improving patient throughput efficiency is a priority for hospitals. To improve patient throughput efficiency, hospitals use a variety of strategies. This study focuses …
Impact Of Medicare Part D Coverage Gap On Medicare Beneficiaries With Copd: Adherence, Healthcare Resource Use, And Cost, Yanni Fan Yu
Impact Of Medicare Part D Coverage Gap On Medicare Beneficiaries With Copd: Adherence, Healthcare Resource Use, And Cost, Yanni Fan Yu
All ETDs from UAB
Medicare Part D provides prescription drug coverage for beneficiaries to support their pharmacological treatment; however, the complex deductible structure within benefit plans creates a major coverage gap and unexpected consequences. Some evidence has demonstrated reduced adherence resulting from the coverage gap; however, little research has evaluated the effect on healthcare resource use (HRU) and cost, and no studies have been conducted for beneficiaries with chronic obstructive pulmonary disease (COPD). This study examined the impact of the coverage gap on medication adherence as well as healthcare resource use and medical cost among beneficiaries with COPD. Claims data based on a 5% …
The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran
The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran
All ETDs from UAB
The rate of hospitals merging has increased significantly over the last few years. The number of hospital mergers between 2003 and 2009 averaged 55 per year, while mergers for 2010 and 2011 were 72 and 90, respectfully. This research moved beyond anecdotal reports and by using publicly reported data to not only evaluate the financial success of mergers, but also to look at other factors such as size, ownership, geography, environment (urban vs. rural), and market competitiveness to assess impacts on financial outcomes of mergers. This study examined the effect of joining a hospital system based on financial performance. Further, …
Difference In Recommended-To-Actual Nurse Staffing And Patient Falls, Shawn Ulreich
Difference In Recommended-To-Actual Nurse Staffing And Patient Falls, Shawn Ulreich
All ETDs from UAB
Patient falls are a serious safety concern in hospitals. Injuries from falls can be devastating to patients and are now subject to reimbursement penalties from the Center for Medicare and Medicaid Services. Patient falls have been identified by the American Nurses Association as a nursing sensitive indictor suggesting that improvements in the quality or quantity of nurses may impact this outcome. Moreover, the literature suggests that nurse staffing levels have an impact on various patient outcomes such as patient falls. Therefore, identifying appropriate nurse staffing levels to minimize patient falls is critically important to hospitals. A variety of staffing metrics …
Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian
Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian
All ETDs from UAB
ABSTRACT Patient experience scores have become important indicators of value in healthcare. This study was the first of its kind to examine CEO gender, tenure, and education in relationship with patient experience scores and all other value based purchasing scores, such as outcome, efficiency, clinical process of care, and total performance scores. This study suggested that hospitals with certain types of CEOs may perform better with respect to patient experiences and other value based purchasing scores. The primary analysis of this study was to examine the impact of hospital CEO characteristics (tenure, education, gender) on patient experience scores. A supplementary …
Safety Culture And Patient Harm, Alfonso Gatmaitan
Safety Culture And Patient Harm, Alfonso Gatmaitan
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SAFETY CULTURE AND PATIENT HARM EVENTS: A CONTINGENCY THEORY PERSPECTIVE IN THE CONTEXT OF COMPLEX ADAPTIVE SYSTEMS ALFONSO GATMAITAN ADMINISTRATION-HEALTH SERVICES ABSTRACT This study examines the correlation between a Culture of Patient Safety as measured by hospital staff surveys and actual patient harm attributed to hospital performance. It is generally accepted by health care management leaders that the presence of a strong culture of patient safety has become a critical component in reducing patient harm. However, little empirical evidence within multiple hospitals over time exists to support this belief. Healthcare managers can utilize this evidence in formulating patient safety improvement …
A Longitudinal Study Relating Patient Care Outcomes To Nurse Magnet Designation In United States Academic Medical Centers, Thomas R. Hunt
A Longitudinal Study Relating Patient Care Outcomes To Nurse Magnet Designation In United States Academic Medical Centers, Thomas R. Hunt
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The purpose of this investigation is to determine whether the addition of the structural and process elements necessary for an academic medical center to garner its initial Magnet designation is associated with improved patient care. Donabedian's linear structure-process-outcome theory serves as the framework to empirically assess the relationship between Magnet status and patient care outcomes. The influence of such organizational factors as hospital size, clinical activity, and complexity of care is investigated. Secondary data from the American Nurse Credentialing Center (ANCC) and the University HealthSystem Consortium (UHC) is used as the basis of this empirical study. This investigation identified two …
The Relationship Between Patient Complaints And Surgical Complications, Joseph Francis John
The Relationship Between Patient Complaints And Surgical Complications, Joseph Francis John
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THE RELATIONSHIP BETWEEN PATIENT COMPLAINTS AND SURGICAL COMPLICATIONS JOSEPH F. JOHN ADMINISTRATION - HEALTH SERVICES ABSTRACT Background: Patient complaints are viewed as indications of dissatisfaction with the service received or experience at a health care institution. The prediction of patient complaints is not clearly understood, and to date, very little quantitative research has evaluated the relationship between patient complaints and health care quality. Objective: The objective of this study was to examine whether (1) surgeons that operate on patients with higher perioperative surgical risk are associated with higher levels of patient complaints and (2) surgeons with higher levels of patient …
The Relationship Between Emergency Department Wait Times And Inpatient Satisfaction, Polly Jean Davenport
The Relationship Between Emergency Department Wait Times And Inpatient Satisfaction, Polly Jean Davenport
All ETDs from UAB
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Employer-Based Wellness Programs; Financial Value To The Organization, Ricky D. Wallace
Employer-Based Wellness Programs; Financial Value To The Organization, Ricky D. Wallace
All ETDs from UAB
The health and wellness of employees is of strategic importance for healthcare organizations to achieve leadership in accountable care and health reform. This study sought to discover whether an organizational program, focused on health promotion and wellness for employees, has a value to the organization. This quantitative evaluation study examines variables of a wellness program implemented at a medical facility in the United States by determining the medical costs among participants and non-participants of the facility sponsored wellness program. The results of the study provide valuation evidence concerning the program's value to the organization.
Employment Of Physician Administrators (Ceos) In Acute Care Hospitals And Their Impact On Hospital Performance, Muhammad H. Al-Midani
Employment Of Physician Administrators (Ceos) In Acute Care Hospitals And Their Impact On Hospital Performance, Muhammad H. Al-Midani
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that arribada nesting enhances the survival of eggs and hatchlings through the confusing
Assessing System Congruence By Analyzing The Relationship Between Employee And Patient Driven Outputs, Timothy J. Harlin
Assessing System Congruence By Analyzing The Relationship Between Employee And Patient Driven Outputs, Timothy J. Harlin
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Patients are at risk for employee driven preventable adverse events during hospital stays. These adverse events are varied and include such things as medication errors, pressure ulcers, hospital acquired infections, and falls. Preventable adverse events continue at alarming frequency despite significant academic, regulatory, and management attention to the topic over the past 14 years since the Institute of Medicine's (IOM) To Err is Human report. In addition to being at risk for preventable adverse events, patients experience aspects of the health care system such as ease of access, employee attitude, skill and efficiency of staff, and perceived value. Although purporting …
Assessing Patient Care Quality From Hospital Employed Physicians, Kerry Gil Gillihan
Assessing Patient Care Quality From Hospital Employed Physicians, Kerry Gil Gillihan
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ASSESSING PATIENT CARE QUALITY FROM HOSPITAL EMPLOYED PHYSICIANS KERRY GILLIHAN ADMINISTRATION-HEALTH SERVICES ABSTRACT Background: Physician employment by hospitals and healthcare systems has become a growing phenomenon in America. Also the emphasis on improving patient care quality is receiving increasing attention. Moreover, recent changes in federal regulation and reimbursement have made improving patient care quality an imperative for hospitals and their medical staffs. The purpose of this study was to determine if there is a demonstrable relationship between hospital employed physicians and the quality of their patient care. Methods: Physician quality measurements were obtained from a prominent community hospital with roughly …
The Burden Of Chronic Conditions On Self Reported Health Status In A Medicare Advantage Plan Population, Barbara Ann Guerard
The Burden Of Chronic Conditions On Self Reported Health Status In A Medicare Advantage Plan Population, Barbara Ann Guerard
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THE BURDEN OF CHRONIC CONDITIONS ON SELF REPORTED HEALTH STATUS IN A MEDICARE ADVANTAGE PLAN POPULATION BARBARA GUERARD ADMINISTRATION-HEALTH SERVICES ABSTRACT This dissertation was a multi-staged research study with two goals. The first goal was to assess survey respondents' characteristics to better understand the influence of the characteristics on the validity of self-reported survey responses. Second, the study analyzed the relationship between certain chronic conditions and survey participants' responses to questions related to their overall physical health and mental health to further understand the burden of chronic conditions on self- reported survey responses. Secondary data derived from a patient satisfaction …
The Contribution Of Intereim Executives To The Healthcare Industry, Ray Snead
The Contribution Of Intereim Executives To The Healthcare Industry, Ray Snead
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This is the first research-based study of interim executive services in the US healthcare industry. It opens a new area of inquiry for academic investigation of the role of interim executive services in the healthcare industry. The study focused on Chief Executive Officer and Board of Directors leadership in acute care hospitals of all sizes across the United States. The research survey resulted in 443 responses to over seventy-five questions addressing interim executive services from the perspective of healthcare decision makers. Ninety five percent of the respondents were CEOs and the remainder were board members, primarily chairpersons. The research is …
Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm
Patient-Centered Medical Homes: An Analysis Of The Effects Of Practice Capabilities On Costs, Mary Temm
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The purpose of this research was to examine the relationship between Patient-Centered Medical Homes (PCMH) practice capabilities and costs. Complexity science theory was used to develop a theoretical framework to address three primary and twelve secondary hypotheses. Secondary data from a consortium of physician organizations participating in Blue Cross Blue Shield of Michigan's Physician Group Incentive Program and Blue Cross Blue Shield of Michigan's administrative claims data were used to test hypothesized relationships using fixed effects panel regression models. It was found that higher levels of aggregated PCMH practice capabilities were negatively associated with certain costs, specifically average readmission costs. …
Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb
Effect Of A Faith-Based Initiative On Hospital Readmissions, Joseph Webb
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EFFECT OF A FAITH-BASED INITIATIVE ON HOSPITAL READMISSIONS JOSEPH WEBB ADMINISTRATION-HEALTH SERVICES ABSTRACT The purpose of this study was to examine the relationship between a faith-based initiative and hospital readmissions. The main data source used was the inpatient data-base of Methodist LeBonheur Healthcare System (MLH) in Memphis, TN. Data were collected from admissions that occurred during years 2008 through 2012 at four of MLH's five adult acute-care hospitals. Data from the U.S. Census Bureau's American Community Survey were also used in the study. This study uses theoretical tenets from the Social Justice and Equity Theory and the Chronic Care Model …