Public Health Commons^™

Empathy And Human-Centered Leadership In Community Health Center Dental Clinics, Pamela S. Alston Dds, Mpp, Facd

Journal of the American College of Dentists

A person-centered approach, with empathy toward patients, can improve satisfaction among both patients and dental health professionals. A dental director with a human-centered leadership style can improve the well-being of oral health team members. This article describes the role that empathy, a core value of humanism and professionalism, plays in accomplishing these improvements in community health center dental clinics. This article also describes the risks of empathy, as experienced by the author in her role as a dental director and practitioner, as well as documented in the literature. It further focuses on dental directors’ human-centered approaches to supporting oral health …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

Teledentistry: A Path To Minimize Emergency Department Dependency For Dental Issues, Aishwarya Joshi

Graduate Studies Theses and Dissertations 2026

Teledentistry has been promoted as a strategy to minimize emergency department (ED) visits for non-traumatic dental conditions (NTDCs). However, it remains unclear whether structural readiness or temporary policy expansion drives sustained reductions in reliance on the ED. This study integrates Andersen’s Behavioral Model of Health Services Use and Diffusion of Innovation (DOI) theory to examine determinants of Medicaid NTDC ED utilization and Tele-dentistry adoption.

Andersen’s model posits that utilization is shaped by predisposing, enabling, and need factors, whereas DOI theory emphasizes structural attributes that influence adoption, including relative advantage, compatibility, complexity, trialability, and observability. Combining these frameworks allows for a …

Optimalisasi Rekam Medis Elektronik Berbasis Artificial Intelligence, Ikhwan Rinaldi, Wahyu Sulistiadi

Jurnal Penyakit Dalam Indonesia

Electronic medical records (EMRs) are essential to modern healthcare systems, yet their implementation continues to face challenges such as disruption of doctor–patient communication, administrative burden, and documentation structures misaligned with clinicians’ clinical reasoning processes. This narrative review aims to assess the limitations of conventional EMRs and examine the potential of artificial intelligence (AI) to improve documentation efficiency, accuracy, and overall clinical performance. The literature indicates that AI technologies, including machine learning, deep learning, and natural language processing, can automate documentation, streamline workflows, enhance decision support, and reduce physician burnout, thereby allowing clinicians to devote more attention to patient care. Nevertheless, …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Developing Nlp-Based Open-Source Tools To Improve Titratable Infusion Order Interpretation In Ehr Systems, Benjamin Brewer, Jay Dorris

Student Scholar Symposium

This study evaluates the feasibility of using natural language processing (NLP) tools to identify errors in titratable infusion orders for Joint Commission readiness. Titratable infusions are adjusted at the bedside by nurses based on predefined parameters, such as monitoring goals, titration rate, conditions for adjustment, and maximum dose. These parameters are often documented as free text within order sets but can be inadvertently removed during the verification process. Some electronic health records (EHRs) may not prominently display this critical information, leading to potential Joint Commission violations. A synthetic dataset was generated using artificial intelligence to simulate one year’s worth of …

Exploring The Association Between Nurse Characteristics And Intent To Leave Their Current Position In Counties With Rural Hospital Closures, Caroline A. King

2025 Fall Honors Capstones Projects - Archive

Increased rural hospital closures and nursing burnout may lead to greater morbidity/mortality for rural residents. Current literature fails to capture whether rural hospital closures influence nurses’ intent to leave their current position. In this cross-sectional study, descriptive and correlational statistical analyses were conducted on survey responses from a sample of nurses who lived in a rural county that experienced a hospital closure. 66% of nurses stated that, at one point, they had considered leaving their primary nursing position. Logistic regression model results revealed that nurse-reported age and gender were significant predictors of a nurse’s intention to leave their current position. …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

From Fear To Familiar: Alleviating Technology Anxiety In Older Adults Through A Community-Based Mentorship Program, Inyoung Jang

Master's Projects and Capstones

This quality improvement project was implemented in a senior residential facility in Richmond, California, catering to older low-income adults who frequently experience elevated levels of technology anxiety. Aim This project aims to reduce the mean modified technology-anxiety score among residents aged 65 and older by at least 25% from baseline by November 5, 2025. Methods The Abbreviated Technology Anxiety Scale (MTAS) was modified to consider the cognitive, linguistic, and experiential differences among target population. The original 11-item instrument, which was validated primarily within college-aged populations, used terms and repeated items irrelevant to older people. The adapted tool included five simplified …

Disaster Risk Reduction In Rural Indonesia: Evaluation Of The Japan Red Cross Program In Pujiharjo Village, Meyralda Dara Adisa, Pujo Widodo, Anwar Kurniadi, Wilopo Wilopo

Preventia: The Indonesian Journal of Public Health

Pujiharjo Village in Malang Regency, Indonesia, is highly vulnerable to natural disasters. In 2021, the Indonesian Red Cross (PMI) partnered with the Japanese Red Cross Society (JRCS) to implement a community-based disaster preparedness program. This study evaluates the program's effectiveness in terms of community participation, institutional support, and alignment with the Sendai Framework for Disaster Risk Reduction 2015–2030. Using a qualitative case study, data were collected through document analysis of Vulnerability and Capacity Assessments (VCA), Community Action Plans (CAP), and local SOPs. Thematic analysis explored disaster risk perception, governance, mitigation investment, and emergency preparedness. The program successfully improved risk awareness, …

Pxj Volume 12 – Key Theme Summary And Article Index, Patient Experience Journal

Patient Experience Journal

Volume 12 of the Patient Experience Journal showcases a global dedication to advancing human experience in healthcare, illuminating both existing challenges and crucial emerging practices. The content, spanning three issues, emphasizes that improving the human experience is not a temporary initiative but rather the essential foundation for building trust, ensuring safety, facilitating healing, and sustaining organizational resilience. The overarching message of Volume 12 is that human experience is the heart of healthcare. It is actively shaped through shared purpose, design, empathy, communication, and partnership. The journal calls for a future where every voice is heard, every story matters, every …

Analisis Perbedaan Biaya Satuan Sectio Caesarea Tanpa Penyulit Dengan Tarif Ina-Cbgs Di Rumah Sakit Swasta Tipe D (X) Di Ternate Tahun 2022, Ummu Hani Mars, Prastuti Soewondo

Jurnal Ekonomi Kesehatan Indonesia

Cesarean section unit cost is an important component for hospital’s management to implement strategic efficiency steps in the future, especially for Rumah Sakit X which 90% of patients are Jaminan Kesehatan Nasional’s participant. Geographically, this hospital is one of hospitals which serve delivery and labor services in Ternate Island that can accommodate references from nearby islands. This resulting in high caesarean section rate, 55 % of all deliveries. The low JKN rate for caesarean section forced management to know the detailed cost component, so the efficiency strategies and the continuity of hospital services could be more increased. This research through …

Engaging Ukrainian Tf-Cbt Therapists In A Practice Skills Course To Support Their Wellbeing, Elisabeth Pollio, Esther Deblinger, Beth Cooper, Maike Garbade, Julie P Harrison, Elisa Pfeiffer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background: Burnout and secondary traumatic stress (STS) are common among therapists working with trauma-exposed clients, which can negatively impact them professionally and personally. The shared trauma of war exposure may put therapists at greater risk. To help support their wellbeing, an eight-session course was offered to Ukrainian therapists following training in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This course involves therapists personally utilizing the PRACTICE skills taught to clients in TF-CBT for professional and personal benefit.

Objective: The objective was to gather preliminary evidence on the potential impact of implementing the course with Ukrainian therapists providing TF-CBT during a period of …

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Opportunities To Improve Continuity In Medicines Management For Aboriginal And Torres Strait Islander People Accessing Care In South Australian Hospitals: Coverage, Quality, Monitoring And Accountability, Annabelle Cranwell, Cheyne Sullivan, Kezia Daniel, Erik Cornelisse, Brianna Kinnear

Journal of the Australian Indigenous HealthInfoNet

This paper proposes that hospital admissions, which are traditionally considered high risk transitions, can be opportunities to strengthen continuity in medicines management (CMM) for Aboriginal and Torres Strait Islander patients and across the healthcare system. There are four key areas of focus in this paper including CMM coverage, CMM quality, health system monitoring of CMM, and health system accountability for CMM to Aboriginal and Torres Strait Islander people and communities. These areas for improvement are justified by the National Agreement on Closing the Gap (The National Agreement), the Guiding Principles to Achieving continuity in medication management, and Continuity in Medication …

Band-Aids And Backroads: Surviving Rural Healthcare In South-Central Mississippi, Cambry L. Craft

Honors Theses

Health is more than the absence of disease—it is the product of opportunity, trust, and access. Yet for millions living in rural areas of the United States, equitable healthcare remains out of reach. This thesis seeks to amplify the voices of rural residents in Mississippi and uncover how their experiences, beliefs, and cultural values shape their perception of their local hospital and the care that is provided there. This qualitative research study examines the experiences and opinions of a rural community in south-central Mississippi regarding their local hospital, as well as their perceptions of the most effective approach to prevent …

Co-Designing A Patient-Facing Version Of A Mental Healthcare Pathway For People Receiving Dialysis, Alexandra Albers, Charlotte Berendonk, Julie Robison, Richard Sawatzky, Loretta Lee, Monika Bolin, Jeff Costley, Sandy Johnstone, Kevin Kemp, Justin Leroux, May Tourangeau, Sabiha Zaman, Kara Schick-Makaroff

Patient Experience Journal

A Community Advisory Committee comprised of nine members with lived experience of kidney failure, identified the need for a patient-facing version of a mental healthcare pathway for people receiving dialysis in Alberta, Canada. Recognizing that healthcare tools to support person-centred care practices should be available in lay language, our team (comprised of Community Advisors and healthcare clinicians and researchers) co-designed a patient-facing pathway: “Your Journey: Coping with and Adjusting to Dialysis.” The Provincial Pathways Unit provided a template for the pathway, and the content was adapted through multiple online and in-person meetings with the Community Advisors. Adaptations were informed by …

Leading Through Partnership: Development Of A Hospital-Wide Family-Centered Care Collaborative, Jessica T. Fry, Naomi Shapiro, Barbara Lawlor Burke, Kalee Ryan, Kerri Z. Machut

Patient Experience Journal

Though it has been widely recognized that systematic patient and family engagement plays a critical role in strengthening the provision of family-centered pediatric healthcare, significant gaps in knowledge remain regarding how to develop and build a successful model of engagement. As a group of pediatric health care professionals invested in improving the patient and family-centered care provided by our children’s medical center, we saw the opportunity for family and organizational collaboration as a needed “first step” in model development. In this case study, we describe our institutional journey to build connections and resources though the development of a Family Centered …

Virtual Nurse Discharge: Improving Patient And Nurse Experience, Dina Flihan, Christine Odell, Stacey Davis, Carolyn Oates, Fay Wright

Patient Experience Journal

This case study reviews the virtual discharge nurse (VDN) process and its impact on patient experience and nursing workflow as an exemplar of an effective telehealth innovation at a community hospital 23-bed Short Stay Unit (SSU). At the SSU, the daily turnover rate of more than 50% of the unit census challenged the nurses’ ability to provide comprehensive individualized discharge education. SSU patient experience scores measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reflected opportunities to improve the discharge process. Therefore, the direct care nurses on SSU suggested a trial innovation of a VDN to improve …

Triad: A Novel Team Structure Pilot And Its Impact On Patient Experience In The Pediatric Emergency Department, Walter Palmer Md, Joseph R. Mijares Iii, Md, Sephora Morrison Mbbs, Msci, Mba

Patient Experience Journal

Introduction: Patient experience is inextricably tied to effective communication between the care team and patient. Published trials designed to improve communication and therefore patient experience in the pediatric emergency department setting are lacking. Methods: This is a novel care team reorganization in a single tertiary care pediatric emergency department. A Triad team consisted of a nurse, emergency technician (Tech), and physician or advanced practice practitioner (APP). The team was designed and trained with an emphasis on closed loop communication with the team and patient to test whether improving effective communication can subsequently improve the patient experience. Using a real-time survey, …

Empowering Frontline Staff In Service Recovery, Sarah E. Duncan, Brianna Camera, Iva Ervin-Stanberry, Heather L. Pezzullo

Patient Experience Journal

Objective: This study aimed to develop and implement a standardized service recovery training program within the VA healthcare system to enhance patient experiences and address grievances effectively. The purpose of the training was to equip VA employees with the necessary skills and knowledge to resolve service issues promptly and empathetically, adhering to the principles of the VA’s SALUTE model for service recovery. Method: The training program was designed based on feedback from anonymous pre-surveys to identify knowledge gaps and incorporate industry best practices. The VA’s SALUTE model, which emphasizes six key actions—saying hello, apologizing, listening, understanding, taking action, …

A Case Report On Meeting The Spiritual Need Of Intubated Conscious Patient, Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said

Patient Experience Journal

Nurses are showing more interest in including spiritual health to prevent and treat illnesses. For patients who can speak may ask for their spiritual need to the health care provider. But for intubated patients it.s difficult to express such needs. Most of the time caregivers focus on the physical parameters only for intubated patients. Apart from physical symptoms these patients also experience a variety of bio-psycho-socio-spiritual sensations. Research has shown that spiritual therapies can reduce distress, assist in preparing the patient for end-of life care, and enhance overall wellbeing along with improving their quality of life. The purpose of this …

A Systematic Review Of The Literature On The Validity, Reliability, And Utility Of The Nhs Friends And Family Test As A Method For Gathering Feedback On And Improving The Experiences Of Patients, Miss Jenny King, Catherine Davidson, Miss Hannah Wade, Chris Graham

Patient Experience Journal

The NHS Friends and Family Test (FFT) is widely used across the National Health Service to collect patient feedback on care experiences. Given its scale and cost, there is strong public and organisational interest in the validity, reliability, and utility of the FFT. This study aimed to systematically review the literature on the validity, reliability, and utility of the FFT as a method for gathering feedback on and improving patient experiences. PubMed and ProQuest databases were searched in September 2024. Studies were included if they met the inclusion criteria. Information extracted included study information (e.g., title, authors, publication year, research …

Reliability And Validity Of A Modified Version Of The Consumer Assessment Of Healthcare Providers And Systems (Cahps®) Clinician And Group Visit Survey 4.0 (Beta) For Ambulatory Behavioral Health Care, Jessica K. Jeffrey, Ron D. Hays, Randi Hissom, Mark Grossman, Samuel A. Skootsky

Patient Experience Journal

Patient experience is a fundamental indicator of healthcare quality. A patient experience survey that assesses telemedicine and in-person ambulatory behavioral health care is needed. This study aims to adapt the CAHPS Clinician and Group Visit Survey 4.0 (beta) to assess adult patient experience with ambulatory behavioral health services and its reliability and validity. Seven behavioral health subject matter experts (psychiatrists, therapists with master’s degrees, and primary care physicians) at an integrated delivery system aligned with an academic institution provided input to select a subset of items and make minor wording adjustments to the CAHPS survey. The adapted survey was administered …

Assessing Patient Satisfaction With The Services Provided Under The National Health Insurance Scheme At The Outpatient Department Of The Levy Mwanawasa University Teaching Hospital In Lusaka, Zambia, Wesley Kapaya Mwambazi, Mubanga Mpundu

Patient Experience Journal

The National Health Insurance Scheme (NHIS), introduced in Zambia in 2019 to enhance healthcare financing and service delivery, still faces challenges impacting patient satisfaction. This study assesses and investigates the factors influencing patient satisfaction with NHIS-provided services at a third-level tertiary public hospital. The study was conducted at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, deliberately chosen as one of the largest publicly financed tertiary referral hospitals and among the first NHIS-accredited facilities. A cross-sectional survey was conducted with 270 respondents using a modified SERVQUAL 5-point Likert scale questionnaire, whose reliability was assessed …

Using Patient Experience Data With Impact: A Framework For Healthcare Improvement, Corey Adams, Ramesh Walpola, Reema Harrison

Patient Experience Journal

Background: Despite major investment in patient experience measurement, healthcare organizations often struggle to translate patient feedback into lasting improvements. Existing knowledge translation frameworks provide useful concepts, but often lack the practical detail or contextual relevance needed to improve patient experiences. Objective: To develop and present the IMPACT Framework, an evidence-informed approach designed to bridge the gap between patient experience measurement and meaningful improvement in healthcare. Methods: This framework was informed by a systematic review of patient experience measurement and analysis of barriers to feedback use. Findings from contemporary patient experience research were combined with key principles of knowledge translation, change …

Enhancing System-Level Quality Improvement Through Patient-Inclusive Teamwork: A Review, Shaik Mohiuddin

Patient Experience Journal

Engaging patients in quality improvement (QI) initiatives offers significant advantages, including increased patient satisfaction, improved outcomes, and the integration of creative insights from patient perspectives. This review synthesizes findings from 14 peer-reviewed articles retrieved from PubMed and Google Scholar, focusing on patient-inclusive teamwork in healthcare settings. Despite the recognized benefits, patient involvement remains limited due to cultural and professional barriers, logistical challenges, and the need for structured training programs. The review contrasts conventional provider-centered approaches with patient-centered models, emphasizing the importance of policy reform, organizational culture change, and supportive training to enhance patient engagement. Traditional QI strategies often overlook patient …