Health and Medical Administration Commons^™

A Realistic Path Towards A More Affordable Healthcare System For The United States, James Loome

Honors Theses

This study was performed in order to try to discover ways in which the American healthcare system can improve and become more affordable for its citizens. The main focus was to see how implementing a universal healthcare system could benefit the United States. I analyzed aspects of many different universal healthcare system structures and chose aspects that I think should or should not be included in a revised version of the US healthcare system. There was a strong focus on the aspects of Japan and Costa Rica’s healthcare systems. I also pointed out weaknesses in the US healthcare system that …

05-09-2023 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Combining Frameworks To Improve Military Health System Quality And Cybersecurity, Dr. Maureen L. Schafer, Dr. Joseph H. Schafer

Military Cyber Affairs

Existing conceptual frameworks and commercially available technology could be considered to rapidly operationalize the use of Quality Measures (QM) within military health systems (Costantino et al. 2020). Purchased healthcare as well as digital healthcare services have paved the way for data collection from multiple information systems thus offering stakeholders actionable intelligence to both guide and measure healthcare outcomes. However, the collection of data secondary to Smart Devices, disparate information systems, cloud services, and the Internet of Medical Things (IOMT) is a complication for security experts that also affect clients, stakeholders, organizations, and businesses delivering patient care. We have combined three …

Medicare Shared Savings Performance: Three-Year Pandemic Analysis, Bryan Adams

Theses & Dissertations

The Centers for Medicare and Medicaid's (CMS) Office of Actuary predicts that U.S. national health expenditures will surpass U.S. gross domestic product per capita by 1.1% annually until 2028, totaling $6.2 trillion in healthcare spending. A significant portion of this spending, 36%, is attributed to Medicare and Medicaid. To address this issue, CMS has implemented the Medicare Shared Savings Program (MSSP) to assist Accountable Care Organizations (ACOs) in reducing healthcare costs and improving the quality of care for beneficiaries. The main objectives of this dissertation are twofold. Firstly, it aims to investigate the relationship between various factors, such as quality …

The Impact Of Kentucky’S Medicaid Expansion On Adult Coverage And Diagnosis Of Type 2 Diabetes Mellitus And Diabetic Peripheral Neuropathy, The Use Of Antihyperglycemics And The Role Of Social Determinants Of Health 2011-2018., Brian Mcroberts

Electronic Theses and Dissertations

Objectives: This study analyzed the impact of Medicaid expansion in Kentucky on coverage of adults aged 19-64 and the diagnosis of type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) and the use of antidiabetic medications or insulin (antihyperglycemics) for T2DM, controlling for Social Determinants of Health (SDOH). Method: This study assembled ICD-based claims and prescription drug NDC claims from all adult residents of Kentucky enrolled in Medicaid from 2011 to 2018. Three-digit zip code (Zip-3) data was appended to each case from the American Community Survey to provide SDOH variables. Tests performed included ANOVA, decision trees, varimax rotated …

Telecontraception: An Evaluative Research Study On Birth Control Accessibility Via Smart Phone Applications, Salma Yazmin Atiya

Open Access Theses & Dissertations

Birth control accessibility in the United States continues to be a growing issue. Studies have shown that barriers such as transportation to clinics, ability to obtain an appointment at a clinic, having time off work or school, cost, lack of insurance, and residing in contraceptive deserts prevents women from obtaining birth control. However, with telemedicine on the rise, new technologies are becoming available, such as telecontraceptionâ??a recent innovation, where people can obtain birth control through a website or an app on smart phone devices. Telecontraception could potentially serve as a tool to narrow the birth control accessibility gap for uninsured …

A Qualitative Survey Research Study: The United States Department Of Agriculture Commodity Supplemental Food Program: An Examination Of Operational Challenges And Recommendations, Brianna Cochran

Capstone Experience: Master of Public Health

Background

The United States Department of Agriculture (USDA)’s Commodity Supplemental Food Program (CSFP) has been nationally adopted in 60 states or Indian Tribal Organizations (ITOs) to improve the health of low-income persons at least 60 years of age by supplementing their diets with nutritious USDA Foods. Despite the potential effectiveness of the program, less is known about the operational challenges in the program implementation at the state and local health department. The goal of the study is to identify factors related to program operations including facilitators and barriers of implementation of the USDA CSFP under a national lens.

Methods

An …

Medication Errors In Pediatric Care And Preventative Solutions, Tyler Tidwell

Political Science Undergraduate Honors Theses

The research presented extensively examines previous reports covering pediatric medication errors (PMEs). Utilizing specific studies into the frequency and types of medication errors along with public surveys and policy discussion, the data and suggestions here provide commentary on the scope of PMEs, suggested institutional reform, and most importantly, legislative recommended action necessary to stymie the tide of PMEs. A significant portion of the research contained fixates on the literature review to provide ample familiarity with the background and scope of PMEs, but the subsequent sections will discuss their implication. After providing details on the magnitude of the issue, regulatory and …

Naloxone Education To Improve Distribution In Primary Care: A Quality Improvement Project, Joanna Boback

DNP Projects

Significance and Background: Opioid overdose is a major public health problem in the United States. The Centers for Disease Control and Prevention (CDC) developed guidelines for prescribing opioids which have not been widely integrated into practice. These guidelines specify co-prescribing naloxone with opioids as a form of harm reduction. A policy to reflect these recommendations was needed to guide prescribing at a Federally Qualified Health Center (FQHC) in Connecticut to increase low naloxone prescribing rates. Evidence supported the use of provider education to increase prescribing rates.

Purpose: Deliver education to providers across the health system on best practices related to …

Implementation Of The Stop-Bang Screening Tool In The Primary Care Setting: A Quality Improvement Project, Thriciana Powell

DNP Projects

Significance and Background. There are approximately 25 million adults in the United States with obstructive sleep apnea (OSA). OSA is a sleeping disorder that is caused by periodic airflow blockage during sleep. It has been linked to numerous health problems and within the primary care setting OSA is not routinely screened for at visits. This leads to delayed diagnosis of a serious health issue and the potential for poor health outcomes. The STOP-BANG questionnaire (SBQ) is a simple eight-question tool that is used to screen patients for OSA. The STOP section focuses on snoring, tiredness, observed apnea, and high blood …

Reducing Urinary Catheter Usage In The Intensive Care Unit Setting And Education Related To Preventing Cautis: A Qi Project, Kristina Diurno

DNP Projects

Significance and Background: Catheter-associated urinary tract infections (CAUTIs) are common but preventable hospital-associated infections. The inappropriate and prolonged use of indwelling urinary catheters can pose a significant risk for patients and healthcare organizations. The Centers for Disease Control and Prevention identified that the most important factor related to an increased risk of CAUTI is the length of time an indwelling catheter remains in place. This DNP (Doctor of Nursing Practice) project assessed the barriers to removing indwelling catheters in the intensive care unit (ICU) while providing encouragement of prompt removal.

Purpose: Three aims were developed for this quality improvement project: …

Use Of An Alarm Bundle To Reduce Alarm Fatigue In The Icu: A Quality Improvement Project, Blerina Petitti

DNP Projects

Significance and Background: In the critical care setting, frequent false alarms can lead to sensory overload and delayed reactions to alarms (aka, alarm fatigue). Patients are at risk because overtime staff may ignore or become desensitized to all alarm sounds, even true ones.

Purpose: The purpose of this QI project is to establish alarm management protocol in a 14-bed ICU. The goals were to reduce alarm fatigue and create a safe environment for patients and clinical staff.

Methods: The Model of Improvement (IHI, 2023) with cycles of the Plan-Do-Study-Act (PDSA) was used to implement an alarm bundle checklist that …

Evaluating The Impact Of A No-Show Policy: A Quality Improvement Project, Adrianne S. Harding

DNP Projects

Significance and Background: No- shows are a global problem that creates a significant challenge for the healthcare system. When a patient misses an appointment, it decreases health care staff productivity, creates a waste of resources and it negatively impacts revenue (Lance et. al, 2021). Current evidence supports interventions that incorporate voluminous data and artificial intelligence with strategies such as overbooking, appointment notification systems and financial incentives to reduce outpatient no-shows (Oikonomidi et al., 2022). This project will evaluate the impact of a no-show policy and provide insights to improve primary care attendance and inform decisions.

Purpose: To evaluate an outpatient …

A Comparative Analysis Of Human Insulin Versus Analog Insulin: Glycemic Control, Adherence, Utilization, And Cost-Effectiveness, Sohul Ahmed Shuvo

Theses and Dissertations (ETD)

Background: Despite being a lifesaving medicine for many patients with diabetes, insulin cost is growing out of reach for many. Of the two broad classes of insulin available in the US, analog insulin is newer, costlier, and more widely used than human insulin. The new mode of delivery with pen devices has shown promise in improving adherence and achieving glycemic control and gaining popularity. But comparing adherence to different insulins is challenging due to the lack of a validated insulin adherence method. Very little is known about the comparative benefits of different insulin types and different modes of delivery in …

A Systematic Literature Review Of Ransomware Attacks In Healthcare, Jasler Klien Adlaon

Electronic Theses, Projects, and Dissertations

This culminating experience project conducted a Systematic Literature Review of ransomware in the healthcare industry. Due to COVID-19, there has been an increase in ransomware attacks that took healthcare by surprise. Although ransomware is a common attack, the current healthcare infrastructure and security mechanisms could not suppress these attacks. This project identifies peer-viewed literature to answer these research questions: “What current ransomware attacks are used in healthcare systems? “What ransomware attacks are likely to appear in the future?” and “What solutions or methods have been used to prepare, prevent, and recover from these attacks?” The purpose of this research is …

Diversity, Equity, And Inclusion Efforts Among Healthcare Providers And Systems In The United States, Peyton Jobe

Health, Human Performance and Recreation Undergraduate Honors Theses

The purpose of this study was to compare patient experiences measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to healthcare provider’s diversity, equity, and inclusion efforts. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient survey given upon patient discharge. The results cumulate to score hospitals on patient experiences. In the sample, there were 392 hospital websites that were evaluated for the existence of policies, procedures, or statements related to diversity, equity, and inclusion efforts or stances. Of those, 121 of the hospitals received the lowest possible rating for patient experience …

Decreasing Hospital Readmission Rates Of Heart Failure Patients: An Evidence-Based Quality Improvement Project, Elizabeth Rodriguez

DNP Projects

BACKGROUND: Teach back is an evidence-based health literacy intervention that encourages patient engagement in own treatment, adherence to treatment, medications, and quality of care. Implementation of teach back method could positively impact readmissions to the hospital in patients experiencing heart failure and any other chronic diseases and it could improve patient’s outcomes.

OBJECTIVE: The objective of this project was to implement teach back method in a home care agency in the Hartford area in patients with HF to prevent readmission to the hospital.

METHODS: The IOWA model was used and PSDA as tools to support EBP project.

RESULTS: Pre and …

Lymphatic Dysfunction And Associated Systemic Inflammation In Lymphedema, Assessed By Nirf-Li Imaging And Plasma Cytokine/Chemokine Analysis, Anna Vang

Dissertations and Theses (Open Access)

Breast cancer-related lymphedema (BCRL) manifests as swelling of the upper extremities and trunk as a result of lymphatic fluid buildup due to radiation therapy (RT), surgical lymph node removal, or chemotherapy. As there is currently no cure, BCRL treatment aims to improve quality of life (QOL). First-line treatment involves specialized massage therapy and the use of compression garments. Second-line treatments include reparative lymphatic microsurgeries such as lymphovenous bypass (LVB) and/or vascularized lymph node transplant (VLNT). There is a need for better understanding of the etiology of BCRL and lymphatic microsurgery outcomes. Blood specimens and near-infrared fluorescent lymphatic imaging (NIRF- LI)data …

Health Insurance Education And Advocacy, Jacob Robante

Capstone Projects and Master's Theses

This capstone aims to highlight the benefits of health insurance for individuals and communities. Currently, at my internship at Salinas Valley Health Orthopedics, we face a large number of uninsured patients. As a result, these patients are left with extensive medical bills that may be difficult to pay since they do not have adequate health insurance to assist with some of the costs. The project's purpose is to educate the community about the importance of health insurance coverage, provide information on available options and resources, and increase enrollment in healthcare plans. The project was implemented through an outreach and educational …

Abc's Of Geriatric Trauma, Teresita Hogan

Journal of Geriatric Emergency Medicine

The ABC's approach to geriatric trauma alerts clinicians to specific important factors in emergency evaluation of an injured older adult.