Public Health Commons^™

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …

The Right Premtm: Rasch Analysis Of A New Patient Reported Experience Measure For Use By Older People In Hospital, Louise Heuzenroeder, Jyoti Khadka, Alison Kitson

Patient Experience Journal

Healthcare rights exist to protect older people from harm and to empower older people to participate in their care with independence, choice and control. Multiple investigations revealing abuse provide evidence that older people’s rights are being breached. Older people must have the opportunity to report on their experience of care against their rights. The Right PREM^TM is a new instrument designed to measure older people’s experience of care against their healthcare rights. The objective of this cross-sectional validation study was to assess the psychometric properties of a new instrument to measure the experience of care consistent with the healthcare …

Sociodemographic Characteristics And Patient And Family Experience Survey Response Biases, Lauren N. Brinkman, Myra S. Saeed, Andrew F. Beck, Michael C. Ponti-Zins, Ndidi I. Unaka, Mary C. Burkhardt, Jareen Meinzen-Derr, Samuel P. Hanke

Patient Experience Journal

Enhancing Patient and Family Experience (PFE) is vital to the delivery of quality healthcare services. Sociodemographic differences affect health outcomes and experiences, but research is limited on biases in PFE survey methodology. We sought to assess survey participation rates across sociodemographic characteristics. This retrospective study analyzed a health system’s ambulatory PFE survey data, collected January 1 – July 31, 2019. Outcomes of interest were rates of survey response, completion, and comments. Predictors included respondent-reported race, ethnicity, language, and measure of social deprivation attached to a respondent’s home address. Addresses were geocoded to census tracts. The tract’s degree of socioeconomic deprivation …

"When They See Someone Who Is Poor, They Step On Them": The Social Determinants Of Health Among Survivors Of Sex Trafficking In Cambodia, James P. Havey, Glenn M. Miles, Lim Vanntheary, Nhanh Channtha, Hanni Stoklosa

Dignity: A Journal of Analysis of Exploitation and Violence

Social determinants of health (SDH) are defined as the non-medical yet health-affecting conditions of a person’s life. They include such considerations as working conditions, discrimination, and access to health services. The aim of this study was to explore the SDH impacting those who have survived sex trafficking in Cambodia. This study employed a mixed methods, secondary analysis, focusing on 52 survivors of sex trafficking in the Butterfly Longitudinal Research Project from 2010 through 2019. Participants described myriad social determinants of health, including: gender, age, relationship status (marriage), ethnicity, national identification documentation (statelessness), social class, formal education, vocational training, occupation, and …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Business Cards As A Mechanism To Encourage Patient Feedback About Trainees, Marc Atzenhoefer, Jodie Ruffin, David Parewski, Nicole Deklotz, M. Fuad Jan, Ana Cristina Perez Moreno, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

This project sought to evaluate if business card distribution improved the utility of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys by serving as a feedback mechanism for trainees. Between fall 2018 and spring 2019, patient encounters for 6 cardiovascular disease fellows were tracked over two 60-day periods. Six weeks were allowed for HCAHPS surveys to be returned. Business cards were subsequently deployed and encounters similarly tracked. During the control-group monitoring period, 721 patient encounters were logged and 80 (11.1%) surveys were returned. Qualitative feedback, in the form of free-response comments, was provided in 41 (51.3%) surveys. Business …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Increasing Pneumococcal Polysaccharide Vaccination Rates In Adults Age 65 Years And Older In A Primary Care Clinic, Ashley Sandbothe

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to increase PPSV23 vaccination rates in adults over the age of 65 years in a Midwestern primary care clinic.

For this project, staff was educated regarding interventions including patient awareness, provider recommendation, staff and provider education, vaccine access, use of the immunization information systems (IIS) and appropriate use of electronic health record (EHR) reminders that have been shown to increase vaccination rates.

Prior to the intervention, data was retrieved, and it was found that between April 1^st-May 31^st 2020, there were 162 patients over the age of 65 that presented to …

Exploring Provider Perspectives To Understand How To Best Inform Patients In South Dakota, Isabelle M. Lehman

Honors Thesis

Patients in rural areas are more likely to experience worse health outcomes than patients in urban or suburban areas. The reasons for this discrepancy are multi-faceted, including inequities in resources and access, as well as differences in the environment. Rural providers understand what education and resources patients are missing as they often interact with patients in multiple contexts. We interviewed rural providers and performed an inductive thematic content analysis of the interviews to shed some insight into what information rural patients would need to be better healthcare advocates for themselves. Three themes emerged from the interview data: health education, access, …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

Preventing Complications Of Undiagnosed Diabetic Peripheral Neuropathy In Rural Healthcare Settings, Kendra Ward Harris

Doctor of Nursing Practice Projects

Background: Diabetic peripheral neuropathy (DPN) affects the lives of approximately 50% of all persons diagnosed with diabetes. Patients who are minorities, residents of rural communities, low income, or non-compliant with treatment, have a higher risk of developing DPN. The long-term effects interfere with the patient’s abilities to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Patients incur debt from medical expenses, depression from the inability to perform self- care, and became withdrawn because of their distorted body image.

Purpose: The purpose of this project was to use the Michigan Neuropathy Screening Instrument (MNSI) …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Analisis Strategi Pemasaran Pada Pelayanan Operasi Penggantian Sendi Lutut, Nining Tri Maryani, Ni Putu Deni Adi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Total knee replacement is a safe treatment to reduce pain and restore physical function in patients with severe osteoarthritis that cannot be treated with physical therapy. Every year there are more than 500,000 total knee replacement surgical procedures performed in the United States, it is estimated that by 2030 the volume of TKR surgical procedures will increase to more than 3.48 million per year due to premature aging and increasing obesity. With the opportunity for demand from the TKR service itself, the Karima Utama Special Surgery Hospital feels the need to establish a marketing strategy for knee joint replacement surgery …

Analisis Produk Layanan Rawat Inap Di Rsud Wangaya Denpasar Berdasarkan Stp Dan 4 P (Product, Price, Place Dan Promotion), Ni Putu Sri Wahyuni

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Service marketing strategy will increase the level of customer satisfaction with marketing mix consisting of 4 P (product, price, place, promotion) and supported by modern STP marketing strategies (Segmenting, Targeting and Positioning) as a technique to look for market opportunities, so that the hospital is able to provide health services according to customer needs. The research conducted is descriptive research, which is a research method that aims to describe a situation objectively, to solve the problem being faced. The data used are secondary data that includes inpatient visit data, occupancy data for inpatient rooms, and community satisfaction data in inpatient …

Pengaruh Bauran Pemasaran Sumber Daya Manusia (Sdm) Terhadap Loyalitas Pasien Rumah Sakit: Systematic Review, Elsa Primasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In today's fast-paced era of information and technology, there is also a demand for advancements in healthcare services, particularly hospitals. Currently, more and more hospitals are being established in Indonesia, resulting in increased competition among them. Therefore, hospitals must innovate by utilizing the marketing mix, especially the human resources factor, to maintain patient loyalty. This article aims to determine the influence of the human resources marketing mix on patient loyalty in hospitals. This study uses a systematic review design. The search was conducted using the keywords "Human Resources Marketing Mix," "Patient Loyalty," "Influence," AND "Hospital." The article search was accessed …

Analisis Pemasaran Produk Layanan Homevisit Pasien Gangguan Jiwa Di Rumah Sakit Jiwa : Article Review, Ivan Paulus Gunata

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In 2018, the World Health Organization (WHO), in its report titled "Mental Health Action Plan," stated that explained that around 300 million people in the world suffer from depression, 60 million people in the world suffer from bipolar affective disorder, and 23 million people have psychosis. Meanwhile, in Indonesia, based on data from Riskesdas 2018 data on sufferers of mental disorders among the Indonesian population aged 15 years and over, there are 6.1 percent suffer from depression, and there are 9.8 percent suffer from emotional mental disorders due to stress. Stressors that are handled well will provide positive emotions. There …

Literatur Review: How To Maintenance Vip, Sarah Fatimah, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

In Marketing analysis, patient is an important stakeholder of the hospital. And VIP patients can be valuable to increased demand. Caring for very important persons (VIPs), including celebrities and royalty, presents medical, organizational, and administrative challenges, often referred to collectively as the “VIP syndrome. The situation often pressures the health care team to bend the rules by which they usually practice medicine. Caring for VIP patients requires innovative solutions so that their VIP status does not adversely affect the care they receive. Caring for very important persons (VIPs), including celebrities and royalty, presents medical, organizational, and administrative challenges, often referred …

The Effect Of Nurse Case Coordination On Management Of Chronic Conditions, Aayush Mittal Ms-Hsm

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ishani A, Greer N, Taylor BC, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care. 2011;34(8):1689-1694. https://doi.org/10.2337/dc10-2121

for a patient requiring care coordination for management of hypertension, diabetes, and hyperlipidemia.

Impacts Of Covid-19 On Rural Medical Business Models, Kendra L. Stefan

Anthós

This paper is concerned with the question of how COVID-19 impacts the medical delivery system in a rural community. It presents findings from interviews of medical professionals participating in an isolated rural community and public health officials that coordinate preparedness planning. This paper reviews barriers of access to healthcare in an already constricted system. Then looks at the implications of COVID-19 as an additional strain. Interviews of professionals will survey preparedness, regulatory impacts, repercussions to the business model, impact on service capacity, and opportunities for improvement. Interested parties would include patient advocates, patients, healthcare workers, politicians, and employers.

Hr Wellness Programs At Ohiohealth Wellness Department, Yuanze Ma

Masters Theses/Capstone Projects

Goals of this project include learning and practicing related clinical skills, develop work based thinking method, gain clinical knowledge of workplace wellness programs, and expanding knowledge on program’s implementation and improvement, analyze existing programs and challenge me with innovation, learning how wellness program practice during a special environment (epidemic), learning and gain leadership skill through the process, expending vision and formulating future career plans.

There were positive and negative outcomes of this experience. I have learned the wellness program implementation and helped with several programs design and operations. I have gained leadership skills from involving in meeting discussions. I have …

Factors That Determine Comprehensive Categorical Classification Of Ehr Implementation Levels, Soumya Upadhyay, William Opoku-Agyeman

Healthcare Administration and Policy Faculty Research

Electronic Health Records (EHRs) have the potential to alleviate patient safety mistakes. Of the various levels of EHR, advanced or higher-level functionalities of EHR are designed to improve patient safety. Certain organizational and environmental factors may pose as barriers toward implementing all of the functionalities, leaving certain hospitals intermediate between basic and comprehensive levels of implementation. This study identifies a comprehensive categorical classification that includes hospitals that have functionalities between basic and comprehensive levels of EHR and determines the organizational and environmental factors that may influence hospitals to implement one or more combinations of these categories. A longitudinal panel design …

Nutrition, A Tenet Of Lifestyle Medicine But Not Medicine?, Leigh A. Frame

Clinical Research and Leadership Faculty Publications

Nutrition is a foundation of health and one of six pillars of Lifestyle Medicine. The importance of nutrition in clinical care is now widely recognized by health care professionals and the public. However, clinicians are not comfortable counselling their patients on nutrition due to inadequate or lack of training, leaving a significant need in patient care. This gap can be closed with evidence-based curricula in medical schools and in the trainings of other health care professionals. This communication presents the current state of nutrition knowledge in health care, emphasizing nutrition education for physicians, and presents a model of how pre- …

The Discrete-Event Modeling Of Administrative Claims (Demac) System: Dynamically Modeling The U.S. Healthcare Delivery System With Medicare Claims Data To Improve End-Of-Life Care, Rachael Chacko

Dartmouth College Undergraduate Theses

The shift of the U.S. healthcare delivery system from the treatment of acute conditions to chronic diseases requires a new method of healthcare system analysis to properly assess end- of-life (EOL) quality throughout the country. In this paper, we propose the Discrete-Event Modeling of Administrative Claims (DEMAC) system, which relies on a hetero-functional graph theory and discrete event-driven framework to dynamically model EOL care on multiple levels. The heat map visualizations produced by the DEMAC system enable the elucidation of not only patient-specific EOL care but also broader treatment patterns among providers and hospitals. As a whole, the DEMAC system …

Incompatibility Group I1 (Inci1) Plasmids: Their Genetics, Biology, And Public Health Relevance, Steven L. Foley, Pravin R. Kaldhone, Steven C. Ricke, Jing Han

United States Food and Drug Administration: Publications

Bacterial plasmids are extrachromosomal genetic elements that often carry antimicrobial resistance (AMR) genes and genes encoding increased virulence and can be transmissible among bacteria by conjugation. One key group of plasmids is the incompatibility group I1 (IncI1) plasmids, which have been isolated from multiple Enterobacteriaceae of food animal origin and clinically ill human patients. The IncI group of plasmids were initially characterized due to their sensitivity to the filamentous bacteriophage If1. Two prototypical IncI1 plasmids, R64 and pColIb-P9, have been extensively studied, and the plasmids consist of unique regions associated with plasmid replication, plasmid stability/maintenance, transfer machinery apparatus, single-stranded DNA …

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …

Developing A Practical Application Of The Isometric Squat And Surface Electromyography, David Phillips, Angelic Rose Del Vecchio, Kevin Carroll, Evan L. Matthews

Department of Exercise Science and Physical Education Scholarship and Creative Works

Electromyography (EMG) is a research tool used in gait analysis, muscle coordination evaluation, clinical evaluation and sports techniques. Electromyography can provide an insight into neural adaptations, cross education effects, bilateral contraction deficiencies, and antagonist activity in exercise-related movements. While there are clear benefits to using EMG in exercise-related professions, accessibility, cost, and difficulty interpreting the data limit its use in strength and clinical settings. We propose a practical EMG assessment using the isometric squat to identify compensatory activation patterns and report early observations. Ten healthy participants were recruited. Participants performed a 2-min isometric handgrip protocol and an isometric squat protocol. …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …