Health and Medical Administration Commons^™

Mental Health Outpatient Services And Hospital Readmissions Among Adolescent Patients In Louisiana, Whitney Walker

Walden Dissertations and Doctoral Studies

Hospital admissions and readmissions among Medicaid patients significantly impact increased healthcare costs for the state of Louisiana and are associated with poor quality of care. The specific research problem under study was the relationships, if any, between mental health outpatient services in Louisiana, either individual therapy or home and community-based services post-hospital discharge, gender of the patient, and age of the adolescent patient with the number of hospital readmissions over 1 year. Secondary quantitative data analysis was performed using the Island Peer Review Organization Annual External Quality Review Technical Report and data from the managed care organization in Louisiana. No …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

How Supply Standardization Affects Non-Emergent Laparoscopic Cholecystectomy Costs And Length Of Stay, Marc Lopez

Walden Dissertations and Doctoral Studies

This study was conducted to identify if there were practices that could be implemented to decrease costs in the operating room without negatively effecting patient outcomes. With the cost of healthcare in the United States consistently increasing, studies that focus on cost-reduction measures such as this one are crucial to ensure health systems continue to operate with a neutral or positive margin to remain available to provide patient care. This was a retrospective quantitative research study built on the diffusion of innovation theory. It focused on motivating factors such as differences in cost between surgical cases that used a standardized …

Entrepreneurial Leadership Strategies For Catalyzing Innovation Performance, Jason D'Souza

Walden Dissertations and Doctoral Studies

Inadequate innovation performance has the potential for adverse business outcomes. Business leaders are concerned with inadequate innovation performance, as innovation is a significant driver of business growth. Grounded in entrepreneurial leadership, the purpose of this qualitative multi-case study was to explore entrepreneurial leadership strategies that some healthcare business leaders used to catalyze innovation performance. The participants were six business leaders within three healthcare sectors who contributed to strategic healthcare innovation decisions using entrepreneurial leadership strategies within the last 5 years. Data were collected using semistructured interviews and a review of organizational strategy documents and websites. Through thematic analysis, six themes …

Recruitment And Retention Of Health Care Workers In Rural Areas, Robbie Marie Julian

Walden Dissertations and Doctoral Studies

Health care worker shortage is a global problem and is challenging for human resources managers. Human resource managers need more strategies to recruit and retain healthcare workers in rural areas to decrease healthcare worker shortages, unemployment rates, patient morbidity, and mortality rates. Grounded by Maslow’s hierarchy of needs theory, the purpose of this qualitative multiple case study was to explore strategies human resource managers use to recruit and retain healthcare workers in rural areas. The participants were three managers from Southern Louisiana rural area medical facilities with at least 5 years of experience developing and implementing successful recruitment and retention …

Factors Influencing Newly Licensed Nurse Position Selection And Retention, Melinda S. Kidder

Walden Dissertations and Doctoral Studies

Newly licensed nurse turnover can be costly, causing a mismatch between supply and demand for nurse staffing needs, lowering quality outcomes, and decreasing patient satisfaction. This quantitative study was conducted to identify the relationship between why newly licensed nurses selected their first position and their retention in that initial position. Other factors examined in relation to retention were unit most worked, age, race, sex, and education level. Irvine and Evans’s theory of job satisfaction and Maslow’s hierarchy of needs guided the analysis of the data. Secondary data used were the Newly Licensed Registered Nurse New Cohort 3 Survey from 2016 …

Effects Of Social Determinants On Access To Care Among Patients With Diabetes In Florida, Nekeisha Latoya Walker

Walden Dissertations and Doctoral Studies

Diabetes imposes a major burden on society, especially in the state of Florida, in the form of increased medical costs, lost productivity, early mortality, and intangible costs in the form of diminished quality of life. Access to diabetic care affects health administration in Florida by impacting the overall cost of treating the condition. Limited access to care can lead to an increased risk of complications resulting in a higher cost of treatment. The purpose of this quantitative study was to determine whether access to care dependent variables (access to doctors and length of time since last routine checkup) were associated …

Increasing Organizational Value Of A Private Healthcare Education Academy, Diana Skaff

Walden Dissertations and Doctoral Studies

Amid the dynamic changes and innovations of the healthcare field, healthcare providers seek educational activities that enhance their growth and decrease their knowledge gap. Healthcare education organizations responsible for providing high-quality healthcare education, have opportunities to differentiate their programs to acquire, attract, activate, and retain healthcare providers. Grounded in the five forces of competition and the value chain theories, this mixed method formative program evaluation aimed to improve the business development program by developing a differentiation by quality strategy that will increase its competitive advantage. Participants included three decision-makers and nine leaders in a healthcare education organization in the Kingdom …

Implementation Levels Of Electronic Health Records And Their Influence On Quality And Safety, Soumya Upadhyay

Healthcare Administration and Policy Faculty Research

Improvement in quality and patient safety outcomes have been at the forefront of the United States healthcare system. Policies advocate for implementing different electronic health records (EHR) levels to support this effort. Several studies have demonstrated mixed results on the impact of EHR on quality and safety outcomes. Our study delves deeper into gaining an understanding of this influence on hospitals that have adopted various levels of EHR, especially intermediate and comprehensive. Using a longitudinal study design for general acute care hospitals within the U.S., we examine the relationship between intermediate and comprehensive EHR on quality (readmission rates for pneumonia …

Assessing The Patient Experience Evaluation Methodology: A Review Of The Hcahps Survey And Related Processes, Michael Molta

Full-Text Theses & Dissertations

The healthcare industry has undergone substantial changes that influence how hospitals evaluate success. Legislation from the Centers for Medicare and Medicaid Services (CMS.gov, 2023) that informs reimbursement levels of patient populations in all U.S. hospitals require organizations to focus on patient experiences, more specifically on scores from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, referred to as HCAHPS (pronounced H-caps). The Consumer Assessment of Healthcare Providers and Systems Survey or CAHPS® Hospital Survey or Hospital CAHPS® (CAHPS ® is a registered trademark of the Agency for Healthcare Research and Quality). This standardized survey instrument and data collection …

The Relative Contribution Of Health-Care Points Of Service To Overall Patient Satisfaction At A University Health Center, Jay M. Parikh

Honors Undergraduate Theses

Throughout the process of receiving healthcare, a patient is affected by several factors and processes. To just name a few, how long a patient must wait at the clinic, how friendly the front desk is, how the nurse treats the patient, how effective the physician is with his or her communication, what the cost of a patient's healthcare is, and how clean the clinic is all affect the patient's experience. When clinics excel in these factors, it promotes a favorable relationship between the patient and the clinic. Patients trust the healthcare provider and desire to continue attending that clinic when …

Clustering Hospital Performance Using Group-Based Multi-Trajectory Modeling With Singular Bayesian Information Criterion, Gaixin Du

Theses and Dissertations--Epidemiology and Biostatistics

Hospital performance is complex and patient-experience oriented. Currently, the Centers for Medicare and Medicaid Services (CMS) evaluate hospitals yearly with a single score of one to five ("Star Rating") using composite measures from five domains. However, a single composite score cannot fully describe it, and alternative measures should be considered. Healthcare quality improvement needs long-term data to validate effectiveness. Group-based multi-trajectory modeling (GBMTM) estimates probabilities of latent group membership based on longitudinal profiles from multiple outcomes. We use GBMTM to identify groups of hospitals with similar performance in SAS PROC TRAJ.

We downloaded Medicare-eligible hospitals (N=5,111) that provided patient care …

Management Of Opioid Use Disorder In Primary Care, Carolyn Jeffries

Capstone Showcase

The prevalence of opioid use disorder (OUD) in the United States, and worldwide, has drastically increased in the span of 2-3 years. OUD is considered chronic condition and as such requires routine care over a lifetime. This makes OUD patients excellent candidates to be managed by primary care providers (PCPs). This article discusses the various barriers to treatment of OUD in a primary care setting as well methods and models that aim to mitigate these barriers. We will also review how to take a detailed assessment of an OUD patient, mainstays of medication assisted treatment (MAT), and management of side …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Improving Provider Retention Through Addressing Burnout At A Federally Qualified Health Center: A Quality Improvement Initiative, Emily Grattan

DNP Scholarly Projects

Background: Primary care providers employed by federally qualified health centers (FQHC) working with underserved populations experience high levels of burnout as patients are often medically complex, face healthcare disparities and societal stigmas. The aim of the project was to alleviate burnout and improve provider retention through introduction of organizational support measures. Participants involved were healthcare providers, as well as nurse management and senior leadership.

Methods: The quality improvement approach for this project utilized the Plan-Do-Study-Act (PDSA) cycle and a driver diagram to guide the selected interventions. Interventions were based on categories from Mayo’s Clinic’s Nine Organizational Strategies to Promote Engagement …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …

Generalized Anxiety Disorder Symptoms Stratified By Age In Primary Care, Robin E. Mccoy

Walden Dissertations and Doctoral Studies

Little is known as to the age-related presentation of somatic complaints of those diagnosed with generalized anxiety disorder in primary care settings. A retrospective medical records review sought to identify the affective symptoms of generalized anxiety disorder (GAD) by age as recorded by primary care providers and to test the association of these symptoms by age. Guided by Engle’s (1977) biopsychosocial (BPS) model, a large administrative claim database system was used to derive a sample of 1,336, including 500 patients diagnosed with generalized anxiety disorder between 2018 to 2021. Binary logistics regression, one-way ANOVA, chi-square, correlation, and logistical regression with …

Organizational Factors Of Emergency Room Fast-Track Admission Duplicate Data Entry Errors In An Alabama Health System, Shannon Harris

Walden Dissertations and Doctoral Studies

Inaccurate patient information resulting from duplicate record data entry errors can compromise patient safety. Emergency room (ER) visits in the United States have increased by 15% over the last decade, and the increase has prompted hospitals to implement fast-track admissions in the ER to mitigate overcrowding and expedite the admission process for patients with low-acuity symptoms. Although duplicate record data entry errors occur frequently in ER admissions, there is a lack of information about fast-track ER admissions and the predictors of different types of confirmed duplicate record data entry errors. This correlational quantitative study examined the associations between work shift …

Strategies To Mitigate Inappropriate Test Utilization By Physicians To Improve Efficiency In A Healthcare Setting, Christine C. Wood

Walden Dissertations and Doctoral Studies

Inappropriate test utilization by physicians for clinical decision-making in patient care is a significant problem facing some healthcare leaders. Healthcare leaders are concerned about inappropriate test utilization because it can increase healthcare costs and degrade patient outcomes. Grounded in the complex adaptive system and Lean Six Sigma conceptual frameworks, the purpose of this qualitative single-case study was to identify strategies seven hospital leaders in Maryland and Washington, DC. who implemented successful test utilization strategies for physicians. Data were collected from semistructured virtual interviews and organizational reports and analyzed using Yin’s 5 step process. Five themes emerged: (a) continuing physician education, …