Health Services Administration Commons^™

Patient-Centric Culture And Implications For Patient Engagement During The Covid-19 Pandemic, Umair Majid, Aghna Wasim

Patient Experience Journal

Some consider patient engagement as the “holy grail” of healthcare because of its potential to revolutionize how we view and address health system problems. Multiple efforts around the world have attempted to cultivate a patient-centric culture whereby health services are grounded by the needs and preferences of patients. Recently, health service organizations are engaging patients in a wide array of activities including research and quality improvement. There are many ethical imperatives and economic and social benefits to patient engagement such as higher patient self-esteem and trust, and a more cost-efficient system. However, these benefits have been realized in some contexts …

Moving Forward To The Future Of Healthcare, Jason A. Wolf

Patient Experience Journal

To say this moment in our shared global history feels shaky or uncertain for so many is not a statement of despair. Rather, it is acknowledging a reality through which we can best act and hopefully step through. As of the time this editorial will publish, well over 50 million cases of COVID-19 will have been reported. This is a reality all of humanity is sharing together; it is a challenge that healthcare is being called on to tackle. The work of people around the world to care for the sick, to find the right treatments and vaccines and the …

Risky Substance Use Behaviors Among Adolescents Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen

Rural & Underserved Health Research Center Publications

Overview of Key Findings

Tobacco Use. The prevalence of any past year tobacco use was significantly higher among non-metropolitan than metropolitan adolescents (13.9% vs. 8.3%). Daily cigarette use in the past 30 days was more than 3 times more prevalent among non-metropolitan than metropolitan adolescents (1.0% vs. 0.3%) and the difference was also statistically significant.

Alcohol Use. Alcohol was the most commonly used substance among both non-metropolitan and metropolitan adolescents, although the differences in prevalence rates for past year and past 30-day alcohol use were not statistically significant. In the past year, 21.8% of non-metropolitan and 21.7% of …

Risky Substance Use Behaviors Among Adults Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen

Rural & Underserved Health Research Center Publications

Overview of Key Findings

Tobacco Use. Non-metropolitan adults had significantly higher prevalence rates of past year tobacco use (34.7% vs. 27.9%), daily cigarette use in the past 30 days (16.5% vs. 10.3%), and smoking at least 1 pack of cigarettes per day in the past 30 days (46.9% vs. 39.1%) than metropolitan adults.

Alcohol Use. Non-metropolitan adults had a lower prevalence rate of past year alcohol use (64.0% vs. 71.0%), past 30-day alcohol use (48.7% vs. 56.6%), and past 30-day binge drinking (24.5% vs. 26.7%) than metropolitan adults.

Illicit Drug Use. Overall illicit drug use was significantly …

The Impact Of Medicare Insurance Plans Upon Healthcare Services Utilization Considering Patients' Characteristics And Their Access To Medical Care, Steven Stout

Dissertations

The annual average cost of healthcare for services utilization by a Medicare beneficiary is projected to grow from about $10,000 to over $16,000 by 2023. As an ongoing initiative to address this trend, the federal government contracts with private insurance companies and other entities, called Medicare Advantage Organizations (MAOs), to develop and administer alternative health insurance plans designed to contain service utilization and costs. One feature of some Medicare Advantage plans is the presence of risk-bearing contracts with primary care physician organizations that voluntarily accept financial responsibility for the overall cost of care for patients attributed to them. In this …

Improving Healthcare Quality In The United States Healthcare System: A Scientific Management Approach, Soumya Upadhyay, William Opoku-Agyeman

School of Public Health Faculty Research

The US healthcare system has been facing pressures from stakeholders to reduce costs and improve quality. The purpose of this paper is to develop a conceptual model to illustrate the approaches used in healthcare quality management (Continuous Quality Improvement/Total Quality Management, Lean, and Six Sigma) weaved into the underlying framework of scientific management theory. This paper employs scientific management theory to explain the healthcare quality tenets that influence the quality of care in our healthcare organizations. The father of scientific management, Frederick Taylor, and other key contributors collectively created scientific management principles, which are widely used for quality improvement purposes …

Parental Concerns And Uptake Of Childhood Vaccines In Rural Tanzania – A Mixed Methods Study, Lavanya Vasudevan, Joy Noel Baumgartner, Sara Moses, Esther Ngadaya, Sayoki Godfrey Mfinanga, Jan Ostermann

Faculty Publications

Background

Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.

Methods

Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. …

Three Decades Of Research: The Case For Comprehensive Sex Education, Eva Goldfarb, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Purpose

School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.

Methods

Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving …

Bear River Health Department: Covid-19 Contact Tracing, Mike Dixon, Zach Rusk

Huntsman School of Business Teaching Scholarship Series

This case introduces students to a highly variable process that has uncertain demand and processing times. It describes the contact tracing efforts as a response to positive Covid-19 cases in a rural health district in the state of Utah during the first 9 months of the pandemic of 2020. The case puts students in the shoes of the managing director of a health department trying to decide how to best manage a team of contact tracers who are increasingly unable to timely complete their work that is vital to stopping the spread of the disease.

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

Maternal Preventive Dental Services Utilization: The Role Of Preconception Oral Health Counseling In And The Association With Birth Outcomes: Evidence From South Carolina Prams, Monique Johnette Williams

Theses and Dissertations

ABSTRACTThe purpose of this study is to examine maternal preventive dental services utilization by analyzing the role of preconception oral health counseling in utilization of dental cleaning services before or during pregnancy and the association of utilization with preterm birth (<37 weeks) and small for gestational age (SGA) (same sex newborns having birth weight for gestational age below the 10th percentile of the reference population as defined by the World Health Organization (WHO)). Studies suggest that unfavorable maternal oral conditions have significance in birth outcomes, specifically periodontal disease (periodontitis), an oral inflammatory condition which is shown to be a risk factor for preterm birth and low birth weight (Dortbudak et al., 2005; Guimarães et al., 2012; Tejada et al., 2012). Dental cleaning before and during pregnancy is effective in the prevention of oral disease including gingivitis and periodontitis (Johnson et al., 2006; Kurien et al., 2013; Steinberg et al., 2013).

Cross-sectional 2012-2015 data from the South Carolina Pregnancy Risk Assessment Monitoring System (SC PRAMS) survey, a population-based surveillance system on prenatal, perinatal and postpartum experiences of resident mothers who recently delivered a live-born infant, were analyzed using weighted analyses in SAS. Analyses included demographic univariate analyses, Rao-Scott Chi-squared tests of significance to study differences between groups, and multivariate logistic …

Examining Parental Perceptions And Decisions To Uptake Child Influenza Immunizations: Assessing Pandemic And Policy Impacts On Vaccination Rates Following The H1n1 Pandemic, And The Acip Laiv Preferential Recommendation Revocation, Amir H. Mehrabi

Theses and Dissertations

Introduction

2009 H1N1 Pandemic: The historical 2009 H1N1 Influenza pandemic, which had a CDC estimated accrued disease burden of 100.5 million illnesses, 936,000 hospitalizations, and 75,000 deaths from 2009 to 2018, resulted in a declared state of emergency nationally, with ensuing diminished vaccine confidence and amplified fears of infection, prompting some to pursue flu vaccination, and others to forego. Although the Centers for Disease Control and Prevention (CDC), and its Advisory Committee on Immunization Practices (ACIP) recommend an annual flu vaccine for individuals 6 months of age and older as the “first and best” defense against influenza, a low percentage …

Effect Of Lifestyle, Medical School Culture And Income On Medical Students' Decision To Pursue A Primary Care Career In Saudi Arabia, Ahmed Abdullah Alhussain

Theses and Dissertations

This study aims to examine the relationship of medical school students who select primary care as their career specialty. Based on extensive literature review, we focused on the three main factors that influence students to consider career specialty: lifestyle, income, and medical school culture. With a paper questionnaire of a cross-sectional study survey at ten medical schools, we were able to collect 1,006 participants from fourth and fifth year students. The clear majority of students considered lifestyle characteristics to be a significant influence in their career decision (PP<.05). Also, we found there was a significant relationship between students’ specialty choices and income variables. The result showed us that medical school culture played a notable role in terms of forming the students’ decisions in different ways. First, specialty characteristics were strongly correlated with career consideration. Second, having advising and mentoring within the medical school enhanced the probability of choosing primary care specialty. Finally, the effect of the primary care course was significant and closely related to the choice of the primary care specialty. In conclusion, the study demonstrated the impact of lifestyle, income, and medical school culture on student career selection. These results are in parallel with previous studies conducted in many countries around the world.

Regulation, Quality Reporting And Third-Party Certification Of Healthcare Providers, Amir Jahan Khan, Muhammad Ashar Malik

Community Health Sciences

The newly established provincial healthcare commissions in Pakistan have started certification of healthcare providers. The policy-makers perceive that without third-party certification or licencing the healthcare quality will be suboptimal in the country. This paper reviews the current literature on third-party certification and studies objectives and progress of the largest healthcare commission in Pakistan. It analyses the certification role of the Punjab Healthcare Commission and draw lessons for future regulation and strengthening of the quality reporting process. It also documents the short-term and long-term trade-off resulting from the enforcement of quality certification in the absence of appropriate alternative investment in medical …

Information System Policy Of Web-Based Patient Safety Incident Reporting Information System At Rsj Prof Dr. Soerojo Magelang, Setyo Purnomo, Aris Puji Widodo, Yuliani Setyaningsih

Journal of Indonesian Health Policy and Administration

To provide security to their patients, healthcare providers use a system for patient safety which includes risk reporting and analysis of incidents, identification and management of risks, and the ability to learn about events that have occurred. According to the 2017 patient safety data at Prof. Dr. Soerojo Psychiatric Hospital, 7% of patient safety incidents at the hospital required a Root Cause Analysis. To aid the process, an online information system is necessary. This research was qualitative research that used the waterfall method for the information syntax. This involved planning, analysis, design, implementation, and system. From there, the data was …

The Correlation Between The Quality Of Work Life Against The Performance Of The Employees Of Ogan Ilir District General Hosiptal, South Sumatera In 2018, Herliyanti Yadi, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

A favorable work environment will influence the quality of work life, would create quality human resources, and support the improvements in the quality of services. To discover the correlation betweem the quality of work life and the employees’ performance at Ogan Ilir District General Hospital, a study was performed in March-April 2018. The study was a cross sectional quantitative study on 315 civil servants and voluntary staff at the hospital. Univariate, bivariate, and multivariate analysis was performed using the chi-square and the double regression prediction/determinant model. We discovered that the quality of the work life at the hospital was lacking, …

Economic Burden Bore By Patients And Families Because Of Stroke: Policy Assessment, Honesty Fadhilah, Vetty Yulianty Permanasari

Journal of Indonesian Health Policy and Administration

Stroke to this day is still a disease that causes a high disability. In the future, it will require a prohibitive cost so that it has an impact on the socio-economic consequences for patients and their families. The price is prohibitive so that the impact on socioeconomic implications for patients and their families. Because of that, the purpose of the study is to estimate the cause of the cost that causes an economic burden from a stroke. The method that is used is a content analysis by doing a further literature review from various sources, from journal to textbook from …

Essential Drug Management At Rsu Karsa Husada Batu: Policy Implementation, Setya Haksama

Journal of Indonesian Health Policy and Administration

Coordination in a hospital is a necessary process needed to reach the organization’s goals. One of the processes that need coordination among cross-functional units is the essential drug procurement. The essential drug in Karsa Husada Batu Public Hospital (RSU Karsa Husada Batu) was often out of stock condition in some specific kinds of drugs. The average of the essential drug out of stock between the year of 2017 until the first semester of 2018 reached 33,73%. This number was far from the ideal standard of 0% out of stock condition. This research was aimed to recommend better coordination of essential …

Strategic Plan For The Development Of The Rs Bersalin Grha Mutiara In 2019-2023: Policy Implementation, Melsha Syarahhandi, Mieke Savitri

Journal of Indonesian Health Policy and Administration

This research discusses the Strategic Plan for the Development of the RS Bersalin Grha Mutiara in 2019-2023, using the theory of Strategic Planning to observe and evaluate external environmental opportunities and threats as well as the internal strengths and weaknesses of the hospital, to determine the right strategic plan. This study is a qualitative research using primary data, in-depth interviews with informants, observation and decision making with CDMG (Consensus Decision Making Group), and secondary data obtained from the BPS (Central Bureau of Statistics), Dinas Kesehatan Subang (District Health Office) Profile, Profile and Financial Report of RS Bersalin Grha Mutiara. From …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Louis Ehwerhemuepha, Candice D. Donaldson, Zeev N. Kain, Vivian Luong, Michelle A. Fortier, William Feaster, Michael Weiss, Daniel Tomaszewski, Sun Yang, Michael Phan, Brooke N. Jenkins

Psychology Faculty Articles and Research

Background

This study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting.

Methods

Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.

Results

There was a significant main effect of race/ethnicity on opioid and non-opioid orders. Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric …

Erratum: Increased Risk Of Tinnitus Following A Trigeminal Neuralgia Diagnosis: A One-Year Follow-Up Study (J Headache Pain (2020) 21 (46) Doi: 10.1186/S10194-020-01121-6), Yen Fu Cheng, Sudha Xirasagar Mbbs., Ph.D, Tzong Han Yang, Chuan Song Wu, Yi Wei Kao, Ben Chang Shia, Herng Ching Lin

Publications

Following publication of the original article [1], we were notified that the following affiliations need to be added for the first author Yen-Fu Cheng: Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.

Elementary Classroom Teachers’ Self-Reported Use Of Movement Integration Products And Perceived Facilitators And Barriers Related To Product Use, Roddrick Dugger, Aaron Rafferty, Ethan Hunt, Michael W. Beets, Collin Andrew Webster, Brian Chen, Jeffrey Michael Rehling, Robert Glenn Weaver

Faculty Publications

Movement integration (MI) products are designed to provide children with physical activity during general education classroom time. The purpose of this study was to examine elementary classroom teachers’ self-reported use of MI products and subsequent perceptions of the facilitators of and barriers to MI product use. This study utilized a mixed-methods design. Elementary classroom teachers (n = 40) at four schools each tested four of six common MI products in their classroom for one week. Teachers completed a daily diary, documenting duration and frequency of product use. Following each product test, focus groups were conducted with teachers to assess facilitators …

Ethics And Economics Of The Covid-19 Pandemic In The United States, Peter Hilsenrath, Tyrone F. Borders

Health Management and Policy Faculty Publications

The Covid-19 experience provides a natural experiment in personal and social ethics. Difficult decisions are routinely made to optimize lives and livelihoods. This commentary provides background and insight into the ethical and economic foundations underpinning dilemmas of this historic pandemic.

Artificial Intelligence–Powered Smartphone App To Facilitate Medication Adherence: Protocol For A Human Factors Design Study, Don Roosan, Jay Chok, Mazharul Karim, Anandi V. Law, Andrius Baskys, Angela Hwang, Moom Roosan

Pharmacy Faculty Articles and Research

Background: Medication Guides consisting of crucial interactions and side effects are extensive and complex. Due to the exhaustive information, patients do not retain the necessary medication information, which can result in hospitalizations and medication nonadherence. A gap exists in understanding patients’ cognition of managing complex medication information. However, advancements in technology and artificial intelligence (AI) allow us to understand patient cognitive processes to design an app to better provide important medication information to patients.

Objective: Our objective is to improve the design of an innovative AI- and human factor–based interface that supports patients’ medication information comprehension that could potentially …

Coh-2000 - Community Health Interventions, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of health promotion and disease prevention and management strategies used by health specialists to address community health challenges. Through readings and videos, as well as online course assignments and discussions, students learn about planning and designing interventions to improve the health of specific priority populations and communities-at-large.

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …

Lean Daily Management: Keeping Quality And Safety At The Forefront During The Covid-19 Pandemic, Suneela Nayak, Ruth Hanselman, Natalia Johnson, Sydney Green

Operations Transformation

This storyboard describes how our Operational Excellence Platform pivoted to keep quality at the forefront of the Covid-19 response. Applying the Framework for Safe Effective and Reliable Care, we implemented the following innovations:

• Daily quality huddles became virtual, with 70-100 frontline leaders sharing alerts, announcements and celebrations
• Traditional Gemba Walks transformed into daily Executive Gemba Rounds visiting all care teams and focusing on patient and workforce safety.
• Patient and Workforce safety concerns were resolved real time and those requiring coordinated response were triaged to the Hospital Incident Command System (HICS) for accelerated action.

Innovative communication strategies were adopted to clarify …

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 …

How Does The Effect Of Hurricane Katrina Influence Healthcare Infrastructure And Resilience?, Sean Y. Wei

University Honors Theses

In August 2005, Hurricane Katrina brought upon the city of New Orleans, LA one of the costliest natural disasters in U.S. history. This paper looks at how hospitals were prepared before Katrina, responded to, and grappled with the aftermath of this natural disaster. In the aftermath of Katrina, careful investigation of the healthcare system along with its hospitals, physicians, patients, and residents allow us to take innovative measures and provide guidance to create recommendations to better monitor and care for individuals in the future. Frameworks of resilience theories, studies, and recommendations display how and why disaster planning is essential. The …