Health Services Administration Commons^™

Evaluation And Continuation Of Oncology Nurse Mentorship Program, Gurpreet K. Kang

Master's Projects and Capstones

Problem: Newly hired nurses on a busy inpatient leukemia and lymphoma subspeciality unit experienced challenges after transitioning into specialty oncology practice. This resulted in decreased confidence, increased risk of medication errors, and a 40% unit-based annual turnover rate. The cost of replacing one staff nurse is $61,000.  Exit interviews determined root causes of turnover rates, nurse confidence.

Context: A quality improvement program was envisioned to optimize patient and organizational outcomes on a 25-bed inpatient unit to evaluate and sustain an oncology nurse mentorship program.

Interventions: Over one year, cohort 1 (n=8) and follow up 2^nd cohort (n=7) was implemented …

Addressing Informal Caregiver Burnout In The United States: Policies, Interventions, And Recommendations, Michael Blampye

Master's Projects and Capstones

Informal caregiver burnout has been and will continue to be a significant public health concern in the United States, necessitating a comprehensive analysis of initiatives and policies to reduce its negative impacts. This paper provides an overview of existing approaches to address caregiver burnout at the individual, community, and national level, identifying critical gaps in policies and programs. By highlighting successful approaches in other developed countries, this paper presents comprehensive program and policy recommendations to strengthen informal caregiver support systems in the United States. Prioritizing these proposals can guide policymakers in creating a more supportive environment that values the crucial …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …

Whistleblowing As An Anti-Corruption Strategy In Health And Pharmaceutical Organizations: A Scoping Review Protocol., Taryn Vian, Brianna Agnew Mph, Keith Mcinnes Jr

Nursing and Health Professions Faculty Research and Publications

Background

Whistleblowing can bring suspected wrongdoing to the attention of someone who is in the position to rectify the problem. Whistleblowing research can help improve effectiveness of anti-corruption efforts in the health sector.

Objective

The objective of this scoping review is to understand the extent and type of evidence on whistleblowing as an anti-corruption strategy in health and pharmaceutical organizations in low- and middle-income countries (LMICs).

Methods

This scoping review searched the PubMed, Scopus, and EMBASE databases from 2005 to 2020, limited to English language. We also searched websites of multilateral agencies or international non-governmental organizations for policy documents, guidance …

Observational Study Of The Clinical Performance Of A Public-Private Partnership National Referral Hospital Network In Lesotho: Do Improvements Last Over Time?, Nancy A. Scott, Jeanette L. Kaiser, Brian W. Jack, Elizabeth L. Nkholongo, Allison Juntunen, Tshema Nash, Mayowa Alade, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Public-private partnerships (PPP) may increase healthcare quality but lack longitudinal evidence for success. The Queen ‘Mamohato Memorial Hospital (QMMH) in Lesotho is one of Africa’s first healthcare PPPs. We compare data from 2012 and 2018 on capacity, utilization, quality, and outcomes to understand if early documented successes have been sustained using the same measures over time. In this observational study using administrative and clinical data, we assessed beds, admissions, average length of stay (ALOS), outpatient visits, and patient outcomes. We measured triage time and crash cart stock through direct observation in 2013 and 2020. Operational hospital beds increased from 390 …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …

Identifying And Structuring Long-Term Community Engagement Platforms For San Francisco's Ending The Hiv/Hcv/Sti Epidemics Initiative, Adam Landeros

Master's Projects and Capstones

Purpose: The primary objective for this project was to develop recommendations for a long-term community engagement structure and process for the ten-year implementation of the San Francisco Department of Public Health’s Ending the HIV/HCV/STI Epidemics initiative.

Background: Community engagement offers public health practitioners, researchers, and policymakers the opportunity for open, respectful dialogue with community members in pursuit of a common goal. This project was designed to explore different community engagement coordinators’ experiences with undertaking such initiatives, in order to inform a large-scale funding proposal being pursued by the San Francisco Department of Public Health (SFDPH).

Methods: Phase 1 of the …

Promoting Community Engagement Through Basic User Tutorial Of Epa Geospatial Screening Tools, Jonas Nguyen

Master's Projects and Capstones

Social inequalities are riddled with health disparities and outcomes leading toward lower life expectancy. Communities of color, low income, and rural neighborhoods lack the voice and resources to effectively oppose industrial settlement which would likely lead to the release of toxic wastes into the water, air and ground ultimately affecting residential health. Empowering members through community engagement is a relatively new strategic process where researchers are finding mutual benefits in design, implementation, and results. This study aims to identify and promote tools for community engagement within the scope of environmental justice by working with EPA geospatial screening tools and designing …

Anti-Corruption, Transparency And Accountability In Health: Concepts, Frameworks, And Approaches, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: As called for by the Sustainable Development Goals, governments, development partners and civil society are working on anti-corruption, transparency and accountability approaches to control corruption and advance Universal Health Coverage.

Objectives: The objective of this review is to summarize concepts, frameworks, and approaches used to identify corruption risks and consequences of corruption on health systems and outcomes. We also inventory interventions to fight corruption and increase transparency and accountability.

Methods: We performed a critical review based on a systematic search of literature in PubMed and Web of Science and reviewed background papers and presentations from two …

Promoting Anti-Corruption, Transparency And Accountability To Achieve Universal Health Coverage, Theadora Koller, David Clarke, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Anti-corruption, transparency and accountability measures are often missing from efforts to promote universal health coverage. Yet, if unchecked, corruption represents a significant drain on domestic health resource and a major barrier to achieving universal health coverage and the sustainable development goals. The World Health Organization is promoting a coordinated public health approach to anti-corruption, transparency and accountability, working with global partners to create new internal control and assurance models, increase monitoring and evaluation; develop capacity for multiple stakeholders to address corruption; and strengthen normative guidance to integrate anti-corruption, transparency and accountability into WHO’s work on health systems strengthening. The articles …

A Review Of The Literature On Corruption In Healthcare Organizations, Vincenzo Sforza, Riccardo Cimini, Alessandro Mechelli, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

This paper provides a systematic and bibliometric review of 80 research articles on corruption in healthcare published in peer-reviewed journals between 2006 and 2017. Findings suggest that the number of studies has increased over time with a focus on low- and middle-income countries; academic researchers have published papers in a large variety of journals and have investigated different types of corruption with various methodologies. The interest is especially focused on low- and middle-income countries where corrupt behaviors are more common. The paper suggests future research directions to a dynamic research community to facilitate anticorruption actions by public authorities.

Paging Dr. Strong: A Call To Action Towards Addressing Occupational Stress And Burnout Among Primary Care Health Professionals, Carmen Olmedo

Master's Projects and Capstones

Purpose: Within a rapidly evolving industry, occupational stress and burnout among healthcare clinicians and staff is becoming a pervasive public health crisis across all subspecialties. The purpose of this project was to use the Compassion Satisfaction-Compassion Fatigue (CS-CF) Theory as a method to assess burnout among primary care health professionals, in addition to developing recommendations to assist the promotion of a staff wellness initiative at an urban community clinic.
Methods: A needs assessment was conducted at a Community Health Center (CHC) in San Francisco. Data collection consisted of anonymous distribution of the Professional Quality of Life (ProQOL) Survey and semi-structured …

High Stakes Require More Than Just Talk: What To Do About Corruption In Health Systems, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Reluctance to talk about corruption is an important barrier to action. Yet the stakes of not addressing corruption in the health sector are higher than ever. Corruption includes wrongdoing by individuals, but it is also a problem of weak institutions captured by political interests, and underfunded, unreliable administrative systems and healthcare delivery models. We urgently need to focus on corruption as a health systems problem. In addition to supporting research to better understand the context and implications of corruption in health systems, this article suggests actions that public health professionals can do now to fight corruption.

Elevating Communities Into Self-Sufficiency Through Federally-Funded Health Partnerships, Nalleli Martinez

Master's Projects and Capstones

Purpose: This qualitative study is to identify programing that encourages increased self-sufficiency in SNAP recipients. The goal was to identify themes related to successful self-sufficiency programming at federally-funded health centers/health programs (HCHPs). The study also investigated the role of social determinants of health in relation to achieving self-sufficiency.

Method: A series of 45-minute to 1-hour-long interviews were conducted to explore the perspectives of seven total staff at seven federally-funded HCHPs across the U.S. western region. Using Nvivo, a qualitative data analysis software, responses were categorized into six themes: patient-centered care, one-stop-shop/integrated care model, community partnerships, organizational and staff support, leadership …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects and Capstones

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern …

Chna: The Role Of The Hospital In Addressing Specific Community Health Needs, Yesmina L. Zavala

Master's Projects and Capstones

The Patient Protection and Affordable Care Act (ACA) added a requirement for nonprofit hospitals to keep their tax-exempt status under the Internal Revenue System Code 501(c) 3. This code requires all nonprofit hospitals to complete Community Health Needs Assessment (CHNA) reports every three years and must include input from community stakeholders and underserved individuals representing the low-income, minority and chronically ill population.

In addition to the CHNA, implementation strategies are required to be executed in the geographic areas served in order to meet the identified prioritized needs from the CHNA. Oftentimes, CHNAs are difficult to conceptualize and operationalize within the …

Strategic Community Healthcare Management, Stephanie Penrod

Master's Projects and Capstones

Federally Qualified Health Centers(FQHC) and Community Health Centers are growing with the Affordable Care Act. This paper introduces literature that supports the need for Community Health Centers and management of low income patients with chronic illnesses. This paper also reviews the fieldwork experience at a FQHC. It reviews the goals, project, methods and findings of the fieldwork. This paper also elaborates on the scope of the project and a quality improvement report for the FQHC in observation. It discusses the future potential implementation of the recommendations and the benefits for both employees and patients. This paper concludes with follow up …

Trauma Informed Practices For Oakland Unite Service Providers, Maereg D. Haile

Master's Projects and Capstones

Oakland, California - a home to almost 400,000 residents - is the top five most violent cities of the nation. There are lots of factors that greatly contribute to violence including: Poverty, housing/homelessness, unemployment, food insecurity, educational attainment, substance abuse. These factors feed to greater healthy disparities and increased trauma in low-income communities – specifically in east and west Oakland. Measure Y, now called Oakland Unite, is the current violence prevention effort that is set for reauthorization in November 2014. In order for these efforts to continue, Oakland Unite has started looking at comprehensive violence prevention initiatives that includes mental …

Nutrition Education And Community Advocacy At Marin Health And Human Services, Anna C. Allison

Master's Projects and Capstones

It would be a mistake to assume that all Marin neighborhoods look the same. The life expectancy in Ross is over 88 years. Less than 10 miles away in Hamilton Novato, the life expectancy is 75 years. That is a 13 year difference in life expectancy, roughly equivalent to the difference between living in the United States and Guyana. Marin is a small county, but it holds a great deal of variation. An effective health intervention in one neighborhood will not work in another, more importantly, there may not be the same health issue from one neighborhood to the next. …

Closing The Gap: Achieving Equitable Healthcare Outcomes For Kaiser Permanente Members, Trang T. Phan

Master's Projects and Capstones

The University of San Francisco provides a comprehensive Master of Public Health curriculum to deliver a wide breadth of public health knowledge. The MPH program not only equipped me with the skills and knowledge necessary to be successful, it also allowed me to find my passion. The well-established coursework and knowledgeable professors have instilled within me a passion to achieve health equity for everyone, regardless of their social, economic, or environmental disadvantages. I incorporated this mission into my practicum experience and completed over 400 hours at Kaiser Permanente to focus on eliminating health disparities for the patients, families, and communities …