Public Health Commons^™

Addressing The Impact Of Physician Burnout On Healthcare Delivery, Hannah Gutjahr

SIU Journal of Medical Science Scholarly Works

Physician burnout has emerged as a critical issue within the healthcare industry, significantly affecting the delivery of care. This paper comprehensively reviews the existing literature on physician burnout and its impact on healthcare delivery. This study aims to shed light on the multifaceted consequences of burnout and highlight its implications for healthcare organizations, healthcare professionals, and patient outcomes. The review reveals that physician burnout has profound effects on healthcare delivery. It leads to decreased job satisfaction, higher turnover rates, and workforce shortages, resulting in inefficiencies and disruptions in healthcare organizations. Burnout also contributes to diminished productivity, increased medical errors, and …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

Cruising Speed: Our Journal's 10-Year Voyage, Dennis J. Baumgardner, Joe Grundle

Journal of Patient-Centered Research and Reviews

In this invited editorial, two long-tenured editors for the Journal of Patient-Centered Research and Reviews recount the publication’s many impactful contributions to the medical literature over its first 10 years.

Analysis Of Accessibility Of People With Sensory Disabilities In Rsud Pasar Minggu, Daffaldo Suryoputra, Masyitoh Basabih, Fify Mulyani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

People with a disability is someone who has conditions, whether physically and mentally that make a person experience difficulty in certain conditions and interact with their environment. Pasar Minggu Regional Hospital (RSUD Pasar Minggu) has achieved a general patient satisfaction indicator with satisfaction rate of 90% in 2022. This satisfaction indicator mainly comes from infrastructure and facility factors, along with the competence of service providers and costs. As a regional referral hospital, this hospital certainly has patients with physical limitations due to disabilities or illnesses. To ensure patient satisfaction can also be felt by patients with physical limitations, this study …

Strategi Optimalisasi Klaim Jaminan Kesehatan Nasional Di Unit Casemix Rumah Sakit “X” Blitar, Nurfathina Syahira, Achmad Jaelani Rusdi, Prima Soultoni Akbar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The funding for patient care of participants of the Social Security Administering Body (BPJS) Health in hospitals is carried out through a claim mechanism. This study aims to design a strategy to optimize the claims for patient care costs for BPJS participants at Hospital "X" in Blitar. The study is conducted with a descriptive qualitative approach, and data collection is done through interviews and Focus Group Discussions (FGD). The informants consist of a doctor and four coders in the casemix unit. The study begins with an analysis of the claim service system situation, focusing on strengths, weaknesses, opportunities, and threats …

Analisis Implementasi Aplikasi Mobile System Pada Sistem Informasi Manajemen Di Rumah Sakit Umum Daerah (Rsud) Budhi Asih, Annisa Apriani Safitri, Mustakim Mustakim

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospital Information System (HIS) or Hospital Management Information System (SIMRS) is important in supporting the entire hospital process through information technology. Budi Asih Regional Hospital has a Hospital Information System in its management but still has various issues and challenges in its implementation. This study uses qualitative methods, informant selection with purposive sampling, and data collection techniques through in-depth interviews, observations, and document analysis. Information systems are part of organizational resources for decision-making regarding leadership needs. The Management Information System must be designed by considering data architecture including automated codification in an integrated manner such as statistics, mapping for further …

Analisis Pelaporan Nilai Kritis Hasil Pemeriksaan Laboratorium Di Rumah Sakit Mayjend Hm Ryacudu Kabupaten Lampung Utara, Rahmat Hidayat, Entuy Kurniawan, Ira Gustira Rahayu, Wiwin Wiryanti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Critical values are abnormal values indicating high-risk/pathophysiological conditions that threaten the patient's life and require immediate medical intervention. Reporting critical laboratory values must be done quickly and accurately to the patient's responsible physician (DPJP) to ensure prompt and appropriate treatment. The aim of this study is to understand the reporting of critical laboratory values and its impact on the clinical decisions of doctors. This research uses both quantitative and qualitative methods with a descriptive analysis approach. Data collection was conducted through in-depth interviews, documentation, and observation. Informants were 15 DPJP. The results of this study show that the reporting system …

Determinan Utilisasi Layanan Wisata Kebugaran (Wellness Tourism) Di Rsup Dr. Sardjito, Yogyakarta, Firman Firman, Kartika Lestari, Citra Corneriski Garnet

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Wellness tourism have become a new trend for Indonesian people in maintaining their physical and spiritual health. Dr. Sardjito General Central Hospital is one of the hospital institutions that develops medical & wellness tourism services by utilizing Javanese culture and using traditional materials. This study aims to determine the factors that influence patients using wellness tourism. Qualitative research with a phenomenological approach and sample selection using purposive sampling with specified criteria. The total informants were 10 patients, and 5 from service providers such as management, administration and therapists at the Kalimosodo polyclinic. Data collection was carried out through in-depth interviews …

Disability Among Older Adults With Hypertension In Southeast Asia: A Scoping Review, Utoomporn Wongsin, Arnat Wannasri, Dichapong Pongpattrachai, Tuo-Yu Chen

Journal of Demography

Background: The prevalence of chronic disease and disability is expected to increase when age increases. This study aims to investigate the published articles related to disability among older adults living with hypertension in Southeast Asia.

Study Design: A scoping review

Data source: Web of science, Pubmed, CINAHL ,Cochrane and a google search, from 2000 to 2023.

Results: There were six observational studies from Indonesia, Vietnam, Malaysia, and Thailand met our inclusion criteria. The studies mainly focus on investigating the prevalence, risk factors and sex difference in risk factors associated with disabilities among the older adults.

Conclusion: Our scoping review has …

Learning From Health Care Counselors’ Perspectives On Health Care Worker Distress: A Qualitative Analysis, Nancy Downs, Judy Davidson, Angela Haddad, Sidney Zisook

HCA Healthcare Journal of Medicine

Background

Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and …

Pbpa Creating Pathways To Ensure Patients Are Using Their Inhaled Medications Effectively, Suzan Michelle Collins, Heather Blake, Chandler Blodgett, Sue Vermette, Martine Eon

Operations Transformation

Problem: Patients do not consistently know how to prepare, use and/or clean their inhalers effectively.

Impact: When patients do not consistently know how to prepare, use and/or clean their inhalers effectively they are in fact, not receiving the benefit from their prescribed medication.

They experience poor patient outcomes and overall poor patient experience.

• Increased calls to provider offices for unresolved, worsening symptoms and/or complications. (Thrush, hoarseness, cardiac symptoms etc.)
• Increased same day office visits.
• Patient crowding in Urgent Care and/or Emergency Department.
• Hospital Admissions.
• Increase in emotional and financial stress from missing school and/or work.
• Increase in referrals to specialists …

Reimagining Health: Calling For Reform Of The Canadian Healthcare System Through Afrofuturism And Speculative Design, Diane Oyedeji Ms, Stephanie J. Kiggundu Ms

Bridges: An Undergraduate Journal of Contemporary Connections

This exploratory essay addresses the health inequalities currently affecting the African/Black diaspora in Canada and proposes a healthcare system reform to address the inequalities. Despite the Canadian healthcare system’s goals of being universal and accessible, there are disparities in African/Black patient representation. This essay proposes a healthcare system reform through incorporating African/Black patient input through the implementation of collaborative design through the lens of Afrofuturism and its values such as inclusivity and empowerment. The goal is to implement a Canadian healthcare system that is equitable, and patient-centered through emphasizing African/Black voices in technological design, clinical practices, and promoting a more …

Mainehealth Medical Group Report Inventory, Holly Ward, Robin Lozinski, Stephanie Lepine, Shawn Mcglaughlin White, Tracey Shaw, Sheila Adell

Operations Transformation

Variation of Epic Quality Reports being used across MHMG following the merge of Coastal, Mountain and Southern region quality departments resulting in inconsistent workflows and processes. This can lead to inconsistent care and outcomes of Quality Data we report.

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

“Shoes Enthused”: The Application Of An Evidence-Based Practice Podiatry Consultation And Footwear Education In Older Adults Living With Diabetes, Alissa Kathleena Gray, Razel Bacuetes Milo

Doctor of Nursing Practice Final Manuscripts

Background: Poorly fitted footwear contributes to falls in older adults living with diabetes, a population that experiences a baseline increased risk for falls in the presence of diabetic peripheral neuropathy. Despite this, baseline data reveals that 72% of older adults wear poorly fitted shoes with suboptimal shoe features¹.

Purpose of Project: Adhering to current evidence-based practice guidelines, the two goals of this project were to educate older adults with diabetes on the characteristics of properly fitted footwear and to increase access to properly fitted shoes via a podiatry consultation. Subsequently, the increased number of optimal footwear will decrease …

Mainehealth Cancer Care Network Ticket Intake Process, Lauren Couture, Brett Cropp, Gavin Carr, Ashok Kunche, Heather Boulier, Evelyn Taylor

Operations Transformation

The MaineHealth Cancer Care Network informatics team is manually submitting most reporting tickets for oncology customers. The current intake ticket process includes various communication channels to the business intelligence developers [BID] when a reporting need is identified resulting in workflow deficiencies and redundancies. As of FY23, MaineHealth has moved to a new ticket reporting system called ServiceHub which includes new customer self-service tools that have not yet been utilized.

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Transition To Adult Care For Bleeding Disorders: Building A Multidisciplinary Tool, Leslie Larson, Ekaterina Funk, Dana Grass, Felicia Munster, Eric Larsen, Louise Baca, Glen Roy, Sara Artinyan

Operations Transformation

Youth with chronic illnesses often have poorer health outcomes after transitioning to adult care. Maine Health Bleeding Disorders is a Health Resources and Services Administration (HRSA) grant funded Hemophilia Treatment Center (HTC) that serves patients with congenital bleeding disorders. We provide multidisciplinary specialty care throughout the lifespan which includes pediatric and adult hematologists, family nurse practitioners, nurses, physical therapists, social worker, dietitian, genetic counselor, and research coordinator. In 2022, HRSA mandated all federally funded HTCs increase by 25 percent from baseline the number of individuals ages 12 to 26 years seen in a comprehensive clinic that have a health care …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

Unplanned Pregnancy As An Independent Risk Factor For Antepartum Si In A Post Roe Vs. Wade World, Rianna Mcnamee

Rowan-Virtua Research Day

Abstract: The objective of this literature review is to determine whether unplanned pregnancy is an independent risk factor for developing antepartum SI. Background: The Supreme Court of the United States of America recently ruled that the constitution of the United States does not confer a right to abortion to its citizens. As of October 2023, twenty-one states had developed full or partial bans on abortion, resulting in millions of Americans residing in areas where terminating unplanned pregnancy is not a viable option. There is evidence that indicates antepartum suicidal ideation (SI) is higher than that of the general population, however …

Outcomes Of Thoracic Endovascular Aortic Repair (Tevar) Procedure In Octogenarians, Nonagenarians And Centenarians: A Population-Based Study, Dakota B. Pastore, Tony Elias, Rafail Beshai, Kyrillos Girgis, Maziyar Daneshvar, Keith Anacker

Rowan-Virtua Research Day

Introduction: Limited data exists for patients undergoing a thoracic endovascular aortic repair (TEVAR) procedure who are older than or equal to 80 years old (YO). This study sought to examine the national inpatient sample (NIS) database to describe in-hospital outcomes among these older patients.

Methods: The NIS was searched for hospitalizations of adults who underwent a TEVAR procedure in 2019 and 2020. The study compared those aged 80 YO and over to those younger than 80 YO. The primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS), and total hospital charges (TOTHCG).

Results: This study included …

Evaluating The Effectiveness Of A School-Based Cognitive Behavioral Youth Depression Prevention Program In Improving Life Satisfaction, Roshani Patel, Steven M. Brunwasser, Alissa Hochman

Rowan-Virtua Research Day

Depression is the leading cause of disability worldwide, known as the global burden of disease. Incident cases from 1990 to 2017 have increased by 49.86%. Additionally, rates have been seen to dramatically rise in adolescents aged 18-25 (17%) compared to rates in individuals aged 10-14 (1.1%). This makes it beneficial to have prevention programs for middle school aged children. The Penn Resiliency Program (PRP) is a youth depression prevention program focused on cultivating healthy thinking styles and behavioral coping skills. In our study, we used archival data from a randomized control trial of PRP to evaluate whether the program led …

Accessibility To Gender Affirming Treatments For Transgender Patients In New Jersey, Tara Young, Tara Pellegrino

Rowan-Virtua Research Day

Background: The literature clearly indicates that gender affirming treatments, such as gender reassignment surgery, counseling, exogenous hormones, and feminization/masculinization surgery, are highly effective and beneficial for transgender patients.

Purpose: The purpose of this review was to assess the barriers to accessing gender affirming treatments in New Jersey.

Methods: This review utilized the PubMed database and Google searches to gather information. The search terms included LGBTQ healthcare, LGBTQ Medicaid, transgender treatment, transgender healthcare, top surgery New Jersey, New Jersey Medicare and Medicaid, and transgender Health Insurance in New Jersey.

Results: New Jersey State Medicaid covers both gender affirming surgery and …

Investigating Patient Barriers In Receiving Mammography Screenings Following The Covid-19 Pandemic, Nicole Clarke, Tara Pellegrino

Rowan-Virtua Research Day

Current literature shows reduced breast cancer mortality is associated with compliance of mammographic screenings (Duffy, 2020), specifically increasing the survival rate an estimated 1-2% every year for the past thirty years (Giordano, 2004). However, during the Covid-19 pandemic, rates of basic cancer screenings, including breast cancer, all declined (Chen, 2021). Unfortunately, even in a “post-pandemic” world, years after the height of the pandemic, the Rowan-Virtua School of Osteopathic Medicine Family Medicine Office has noticed many female patients still have not kept up with their routine basic healthcare screenings. While there are many barriers in access to healthcare, this survey-based study …

Addressing Gaps In Care Through A Medical Student-Led Cancer Screening Project, Matthew Green, Hannah Ngo, Dakota B. Pastore, Jenna Zappetti, Olivia Siciliano, Meghan Mcquade, John Sauer, Anne Jones

Rowan-Virtua Research Day

Background: Colorectal cancer (CRC), breast cancer (BrCa), and cervical cancer are three of the most preventable cancers. Despite the known significance for early detection and treatment, barriers to screening remain. We developed a medical student-led project to improve adherence to national cancer screening guidelines in patients across Rowan-Virtua Family Medicine (FM) practices. This study assesses the initiative’s efficacy in improving adherence to CRC, BrCa, and cervical cancer screenings.

Methods: Rowan-Virtua FM patients between the ages of 21-75 (n=735) were identified as due or up-to-date on cancer screenings based on chart review. Student volunteers were trained to contact patients to discuss …

A Rare Intervention: Perimortem Hysterotomy In An Obstetric Emergency In A 32-Year-Old Female, Alec Mirchandani

Rowan-Virtua Research Day

In the realm of obstetric emergencies, perimortem hysterotomy stands as a rare but crucial intervention, employed in dire circumstances to salvage both maternal and fetal lives. This procedure, involving the surgical delivery of a fetus from a mother in cardiac arrest, presents a unique set of challenges and ethical considerations for healthcare providers. This case report delves into the intricate details surrounding a perimortem hysterotomy performed under emergent conditions, exploring the clinical decision-making process, procedural intricacies, and outcomes. Through this narrative, we aim to shed light on the complexities of managing obstetric emergencies, emphasizing the critical role of timely intervention …

Case Report: A Case Of Ttp In The Ed, Brian F. Lim, Andrew Caravello, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 54-year-old female who presented with mild shortness of breath, lower chest discomfort, fatigue, and weakness ongoing for several days and was diagnosed with thrombotic thrombocytopenic purpura (TTP). TTP is characterized by microangiopathic hemolytic anemia and thrombocytopenia due to either an inherited or immune-mediated reduction in von Willebrand Factor (VWF) cleaving protease ADAMTS13.

Patients presenting with non-specific symptoms is becoming increasingly common and initial bias could be to attribute symptoms to viral syndrome or upper respiratory tract infection. However, the differential for non-specific complaints is extensive and thorough review of labs and re-evaluations of patients …

Clinical Outcomes For Cardiac Ablation In Octogenarians, Nonagenarians, And Centenarians: A Retrospective Cohort Study, Tony Elias, Mena Elmalh, Kyrillos Girgis, Michael Valderrama, Rafail Beshai

Rowan-Virtua Research Day

Background

Cardiac ablation is a therapeutic intervention aimed at correcting abnormal heart rhythms by disrupting electrical pathways in the heart, using techniques such as radiofrequency or cryoablation. Despite its effectiveness, there is a scarcity of data regarding the outcomes of cardiac ablation specifically among elderly patients. Previous studies have highlighted the complexities and challenges associated with managing cardiac arrhythmias in the elderly population, emphasizing the need for further investigation into treatment outcomes in this demographic.1,2 Therefore, this study aimed to investigate in-hospital outcomes among elderly patients who underwent cardiac ablation using data from the National Inpatient Sample (NIS) Database.

Methods …