Health and Medical Administration Commons^™

Interpersonal Primary Care Continuity For Chronic Conditions Is Associated With Fewer Hospitalizations And Emergency Department Visits Among Medicaid Enrollees, A. Gaglioti, C. Li, P. Baltrus, Zhaowei She, M. Douglas, M. Moore, A. Rao, L. Immergluck, T. Ayer, A. Bazemore, G. Rust, D. Mack

Research Collection Lee Kong Chian School Of Business

Background: Interpersonal primary care continuity or chronic condition continuity (CCC) is associated with improved health outcomes. Ambulatory care-sensitive conditions (ACSC) are best managed in a primary care setting, and chronic ACSC (CACSC) require management over time. However, current measures do not measure continuity for specific conditions or the impact of continuity for chronic conditions on health outcomes. The purpose of this study was to design a novel measure of CCC for CACSC in primary care and determine its association with health care utilization. Methods: We conducted a cross-sectional analysis of continuously enrolled, nondual eligible adult Medicaid enrollees with a diagnosis …

Leveraging The Operational Excellence Platform For Improvement: Strengthening Culture Of Safety, Rebecca Brookes, Suneela Nayak, Natalia Johnson, Risk And Patient Safety

Operations Transformation

Senior leaders drive the culture change by demonstrating their own commitment to safety and providing the resources to achieve results. Their consistent and sustained messages about safety help advance a culture of safety ¹. Even with many efforts to improve patient safety, harm events continue to occur, challenging us to innovate additional ways to safeguard patients in our care. The Operational Excellence (OpEx) platform for improvement at Maine Medical Center (MMC) is well positioned to strengthen the Culture of Safety at Maine Medical Center (MMC) by leveraging the mechanism of established Daily Gemba Walks. During each Gemba Walk, leaders …

Orienting Patients To Their Own Care: Implementing Goals And Progress On Whiteboards, Grace Beer, Leah Mcgough

Scholars Week

Introduction: Goal-setting within the hospital setting can be a useful tool for health care professionals. By using a white board in a patient’s room, nurses can work with patients to create goals in their plan of care. Implementing daily goals on these boards can improve patient satisfaction, increase nurse-patient communication, and provide a sense of accomplishment.

Methods: We researched scholarly articles that discuss the use of goal-setting in clinical practice. These articles engage in the idea that patients visually seeing their goals helps them stay focused and motivated in their health care. The researchers used methods such as interviews, focus …

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis, Eric Pulice, Alberto Coustasse

Management Faculty Research

Introduction:

The World Health Organization [2019] defined burnout as a syndrome caused by chronic job stressors that are not successfully managed, characterized by exhaustion, depersonalization, job detachment, and feelings of inadequacy (WHO, 2019). According to Murthy [2022], the nursing burnout crisis was underway before COVID-19. Nurse burnout recognized pre-COVID-19 was due to systemic organizational problems such as inadequate organizational support and underinvestment in public health (Murthy, 2022).

A 2022 survey of 2500 nurses exhibited increased rates of burnout during the pandemic, with 75% of respondents experiencing burnout, while 65% of those surveyed expressed their desire to leave the healthcare field …

Effects Of The Needle Exchange Program And Its Current Status In West Virginia, Thomas Norton, Amber Graves, Anthony Uriarte, Katherine Duty, Alberto Coustasse

Management Faculty Research

Excerpt:

One of the main problems that have impacted the state of healthcare in West Virginia has been the rising costs of treatments for bloodborne infections (Bates et al., 2019). Bloodborne pathogens and their resulting diseases have commonly spread by exchanging contaminated needles (Denault & Gardner, 2021). In West Virginia, Needle Exchange Programs (NEPs) have been implemented to reduce the transmission of certain infections, such as HIV, hepatitis B, and hepatitis C, which have been more common among drug users (Beck & Kersey, 2018). In 2015, West Virginia had the second-highest rate of cases of hepatitis C Virus (HCV) in …

Improving Scheduling For Diagnostic Imaging And The Effect On Hospital Revenue: An Ex Post Facto Study, Stephen Liebowitz

MUSC Theses and Dissertations

Background and Need: Outpatient diagnostic radiology can be a substantial driver for revenue growth in health systems but without proper processes in place, health systems may not be optimizing patient access within their radiology departments health systems who are having difficulty getting patients to obtain care at their departments/centers and retain loyalty (Lu et.al 2011). To evaluate radiology patient access, patient retention, and market analysis, in 2018, Berkeley Research Group, LLC (BRG) engaged with a six-hospital faith-based health system in New York State to evaluate, create, and implement a variety of different performance improvement (PI) initiatives with the goal of …

Healthcare Facilities: Maintaining Accessibility While Implementing Security, Ryan Vilter

UNO Student Research and Creative Activity Fair

In the wake of the Tulsa, Oklahoma hospital shooting in the summer of 2022, it was made clear that more security needed to be implemented in healthcare facilities. As a result, I inquired: What is the happy balance for healthcare facilities to maintain their accessibility to the public while also implementing security measures to prevent terrorist attacks? With that base, I give recommendations in the areas of cybersecurity, physical infrastructure, and physical and mental health, based off the existing literature and data gathered from terrorist attacks against hospitals over several decades.

Harm Reduction In West Virginia: Do Needle Exchange Programs Reduce Disease And Decrease Costs?, Katie Duty, Amber Graves, Anthony Uriate, Stacie Deslich, Alberto Coustasse, Thomas Norton

Management Faculty Research

Needle Exchange Programs (NEP)s were created to help users exchange used needles for new sterile ones and become aware of treatment and rehabilitation options. This study aimed to determine the effectiveness of NEPs and their impact on reducing HIV and Hepatitis C infections in West Virginia and decreasing health care costs for the community. Based on studies conducted on the past implementation of needle exchange programs, it is suggested that there has been evidence that closing these programs can have a broad societal impact on the spread of HIV and hepatitis C and the associated costs. In addition, the community …

Magnet Hospitals: An Update On The Impact On Nursing Burnout, Jonathan Settle, Michael Davis, Alberto Coustasse

Management Faculty Research

Nurse burnout has been associated with worsened outcomes for nurses, such as increased turnover or quitting and lower job satisfaction. The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on nurse burnout, nurse turnover, and job satisfaction of nurses. This study utilized a literature review complemented by two semi-structured interviews. The results showed that Magnet hospitals kept lower levels of burnout, better job satisfaction, and less turnover than non-Magnet hospitals, but this was only the case for some studies of Magnet hospitals. Some outcomes could be attributed …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Exploration Of Data Science Toolbox And Predictive Models To Detect And Prevent Medicare Fraud, Waste, And Abuse, Benjamin P. Goodwin, Adam Canton, Babatunde Olanipekun

SMU Data Science Review

The Federal Department of Health and Human Services spends approximately $830 Billion annually on Medicare of which an estimated $30 to $110 billion is some form of fraud, waste, or abuse (FWA). Despite the Federal Government’s ongoing auditing efforts, fraud, waste, and abuse is rampant and requires modern machine learning approaches to generalize and detect such patterns. New and novel machine learning algorithms offer hope to help detect fraud, waste, and abuse. The existence of publicly accessible datasets complied by The Centers for Medicare & Medicaid Services (CMS) contain vast quantities of structured data. This data, coupled with industry standardized …

04-07-23 Hsc Committee Notice, Hsc Committee

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

No abstract provided.

Factors Associated With Suicide Mortality Among Childbearing-Aged Individuals: A Case-Control Study, Katerina A. Furman, Amy Loree Phd, Leah Hecht Phd, Katerina Furman Md Candidate, Lyuba Gavrilova Bs, Hsueh-Han Yeh Phd, Catherine Frank Md, Brian Ahmedani Phd

Medical Student Research Symposium

Purpose: Examine pregnancy-related, demographic, psychosocial and healthcare utilization factors among childbearing-aged individuals who were pregnant, postpartum or who experienced pregnancy loss

Methods: Data from nine health care systems in the Mental Health Research Network was included in this sample. A case-control study design was used in which 290 childbearing-age individuals who died by suicide (cases) from 2000-2015 were matched with 10 childbearing-age individuals from the same healthcare system and enrolled during the same time period who did not die by suicide (n=2,900). Conditional logistic regression was used to analyze associations between pregnancy/postpartum/pregnancy loss status and suicide.

Results: …

A Retrospective Chart Review Analyzing The Relationship Between Blood Pressure Rechecks And Polypharmacy, Callie M. Bartkowiak, Meghan K. Gwinn, Danielle Heidemann

Medical Student Research Symposium

ABSTRACT BODY:

Background: Hypertension (HTN) affects nearly 80 million people in the United States. A patient’s blood pressure (BP) measurement may influence the number of antihypertensives prescribed. Providers often do not recheck BP when a patient’s measurement is elevated despite research supporting that remeasuring may result in a significant decrease in BP. We hypothesized that patients who have BP remeasured in clinic would have lower BP values and thus less antihypertensive medication. In our academic general internal medicine (GIM) clinic, providers are encouraged to manually repeat BP if elevated on vitals taken by medical assistants using an automated cuff at …

Associations Of Physical Inactivity And Covid-19 Outcomes Among Subgroups, Gary N. Smith, Deborah Rohm Young, James F. Sallis, Aileen Baecker, Deborah A. Cohen, Robert E. Sallis, Claudia L. Nau

Pomona Faculty Publications and Research

Selected as the AJPM paper of the year. This paper reports additional evidence that regular physical exercise prior to COVID infection substantially reduces the chances of hospitalization, admission to intensive care units, and death.

A Scoping Review Of Digital Health Interventions For Combating Covid-19 Misinformation And Disinformation, Joseph Krocker, Sahiti Myneni

Faculty, Staff and Student Publications

OBJECTIVE: We provide a scoping review of Digital Health Interventions (DHIs) that mitigate COVID-19 misinformation and disinformation seeding and spread.

MATERIALS AND METHODS: We applied our search protocol to PubMed, PsychINFO, and Web of Science to screen 1666 articles. The 17 articles included in this paper are experimental and interventional studies that developed and tested public consumer-facing DHIs. We examined these DHIs to understand digital features, incorporation of theory, the role of healthcare professionals, end-user experience, and implementation issues.

RESULTS: The majority of studies (n = 11) used social media in DHIs, but there was a lack of platform-agnostic generalizability. …

The Association Of Foreign Phi On Ame & Death, Larry Norman

MUSC Theses and Dissertations

Background: Recent data shows at least 1.5 million people are affected by adverse medication events (AME) every year. The purpose of this study is to see if increased use of FPHI is associated with lower instances of AME’s and lower mortality rates for hospitals.

Methods: Using a retrospective analysis and logistic regression, this study examines the relationship between IT use and quality. Specific metrics include AMEs and mortality rates in hospitals in the United States. Demographic data are used to control for confounders, CPT, DRG, and AHRQ questions are used as classifying variables for High IT utilization.

Results: Unadjusted rates …

Variable Shift Lengths Negatively Affect Emergency Medicine Resident Wellness, Marcus Fazzari, Joseph Longobardi, Joseph Mccarthy, Matthew Hysell, Sidney Hann

Journal of Wellness

Introduction: Burnout is very common in emergency medicine and there has been extensive research evaluating factors that contribute to burnout. We sought to examine the contributions of post-graduate year (PGY), shifts worked per month, patients seen per shift, and length of shifts to emergency medicine resident burnout.

Methods: All emergency medicine residents were surveyed with regards to their PGY, shifts worked per month, patients seen per shift, and length of shifts. They were administered the Stanford Wellness Survey and asked to globally rate their degree of burnout. We then modeled whether consideration of the surveyed factors increased the …

Healthcare Associated Infections, Nurse Staffing, And Financial Performance, Soumya Upadhyay, Dean G. Smith

Healthcare Administration and Policy Faculty Research

Healthcare associated infections (HAIs) are a concern to patients, hospital administrators and policymakers. For over than a decade, efforts have been made to hold hospitals accountable for the costs of HAIs. This study uses contingency theory as a framework to examine the association between HAIs and hospital financial performance. We use publicly available data on 2059 hospitals in 2014 to 2016 that include HAIs, staffing financial performance, and hospital and hospital market characteristics. The key independent variables are available infection rates and nurse staffing. The dependent variables are indicators of financial performance: operating margin, total margin, and days cash on …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …