Health and Medical Administration Commons^™

Competition And Technical Efficiency For General Medical And Surgical Hospitals In Georgia, Nathan Ekow Davies

Walden Dissertations and Doctoral Studies

The primary aim of this study was to enhance understanding of the fundamental socioeconomic problem associated with inefficient hospital competition in the United States in terms of demand and supply of services as well as the efficiency of hospitals. The relationship between market competition and hospital efficiency was investigated among general medical and surgical hospitals in Georgia. The X-efficiency theory was used which defines efficiency as the degree of effectiveness that an organization can maintain while operating in imperfect competition. The theory is most applicable in terms of addressing imperfect market characteristics of the healthcare industry. Correlations between efficiency and …

State Consent Policies And The Meaningful Use Of Electronic Health Records Among Nonfederal Acute Care Hospitals In The United States, Adetoro Kafilat Longe

Walden Dissertations and Doctoral Studies

The less-than-nationwide use of electronic health record (EHR) systems to send, receive, and integrate (SRI) patient summary of care (PSC) records limits the ability of hospital administrators to maximize efficiency and improve quality in the continuum of care. Despite obvious differences in state health information exchange (HIE) consent policies, there is no known research that has determined if and what aspects of state-level HIE legislation affect the use of EHR systems to SRI PSC records. Guided by the unified theory of acceptance and use of technology (UTAUT), the purpose of this quantitative cross-sectional research study was to examine the relationship …

Unmet Needs Of Children With Special Health Care Needs When Transitioning To Adult Services, Kiara Monee Moseby

Walden Dissertations and Doctoral Studies

Health care transition planning could help decrease health care disparities among those who identify as an individual on the autism spectrum; however, less than a quarter of the adolescent population living with autism spectrum disorder receive transition planning. Decreasing health care disparities could lead to an increase in health care quality and longevity. The purpose of this study was to analyze if there was a relationship between (a) the number of physician visits, (b) if the physician treats only children, (c) if the physician talks about the child seeing physicians who treat adults, (d) if the physician worked with the …

Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis

Walden Dissertations and Doctoral Studies

Ineffective implementation of electronic medical record systems (EMRS) among health care outpatient clinics results in substantial financial loss. Health care managers (HCMs) in outpatient clinics who fail to implement EMRS adversely affect employee usage and performance. Grounded in fayolism theory, the purpose of this qualitative multiple case study was to explore the strategies health care managers used to implement EMRS in their organizations. The participants were six HCMs in a U.S East Coast city. Thematic analysis was used to analyze the data from semistructured interviews and internal company documents. Five themes emerged: internal communication, overcoming barriers, time management, compensation improving …

Healthcare Leader Strategies For Leveraging Electronic Heath Records, Danessa Thomas

Walden Dissertations and Doctoral Studies

AbstractHealthcare organizations may incur significant losses of productivity and profit because of the absence or incomplete implementation of Electronic Health Records (EHRs). EHRs are important to healthcare leaders because they enhance communication between providers and patients, reduce unnecessary costs, and increase adherence to clinical guidelines. Grounded in the transformational leadership theory, the purpose of this qualitative multiple case study was to explore strategies that some successful healthcare leaders used to leverage EHRs in their organization to increase profit and productivity. The participants were nurse managers from four healthcare organizations that successfully implemented an EHR system in Georgia. Thematic analysis was …

The Impact Of Telehealth Services Offered By Home Care Agencies On Patient Safety, Moyna Temple

Walden Dissertations and Doctoral Studies

There is little available research about how home care agencies attempt to address patient safety during the nurse virtual healthcare visit. The purpose of this quantitative correlational study was to determine, during the delivery of telehealth care by a home care agency, to what extent the level of education of the registered nurse, the level of education of the director of the home care agency, and the clinical decision support system (CDSS) impact patient safety. The framework for the study was the complex sociotechnological systems model. Data from the 2007 National Home and Hospice Care Survey were analyzed using logistic …

Current Effects Of U.S. Preventive Care Quality Narratives On Preventive Health Services, James Fisher

Walden Dissertations and Doctoral Studies

In the interest of improving patient outcomes, significant investments in operationalized quality of care within the Medicare space have promulgated a low-resolution narrative predicated on conflation of higher quality scores with improved population health. Concomitant financial incentivization of Medicare Advantage plans through aligned Star Measures places contracts as the fundamental unit of most care quality analyses, but no studies have considered how present incentivization schema have impacted physician use and associated quality scores over time for breast cancer screening (BCS), colorectal cancer screening (CCS), and annual flu vaccination (AFV) at a county level. Guided by the Evidence Based Model framework, …

Relationship Between Faculty Age, Stress, And Intent To Leave Academic Medical Institutions, Susan Christian Atterton

Walden Dissertations and Doctoral Studies

Faculty intent to leave academic medicine affects clinical productivity, patient and teaching service quality, and institutions' profitability. Understanding factors associated with faculty intent to leave is critical for healthcare and human resources leadership within academic medical institutions in efforts to reduce faculty intent to leave. Grounded in Graves’ spiral dynamics theory, the purpose of this correlational study was to examine the relationship between faculty age, faculty stress, and faculty intent to leave academic medical institutions. The data were collected and analyzed for 125 faculty physicians with an M.D., Ph.D., D.O., or M.B.B.S. degree in an academic medical institution in the …

The Relationship Between Health Insurance And Dialysis Utilization For Chronic Kidney Disease Patients In Saint Lucia, Anita Lilian Sydney

Walden Dissertations and Doctoral Studies

AbstractChronic kidney disease (CKD) is a significant cause of disability and death in Saint Lucia. The incidence of CKD is disproportionately higher among individuals who are socially and financially disadvantaged. New evidence suggests that in resource-poor countries, government subsidization programs for dialysis treatment aid in the delay of disease progression and its associated costs. The purpose of this study was to examine the relationship between health insurance, government subsidization, employment, and dialysis utilization for CKD patients and the efficacy of subsidization for dialysis in Saint Lucia. The study included a retrospective cohort of 979 moderate-to-severe CKD patients from secondary data …

Program Evaluation Of A Hospital Patient Transportation Service, James Dion Washington

Walden Dissertations and Doctoral Studies

A hospital inpatient transportation process may decrease the time it takes patients to receive care and improve hospital quality and safety outcomes by providing timely and efficient patient handling. Grounded in agency theory, the purpose of this program evaluation was to evaluate the efficacy of the request for transport to measure against hospital objectives. Two specific program goals were to achieve an average 19-minute transport request-to-completion time and a 10-minute response from the time transport request is received when the transporter arrives. Data were collected from a survey, semistructured interviews, focus groups, and archival data analysis. The one sample t-test …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

Foresight Leadership Theory: A Grounded Theory Study Of The Conflict Management Experiences Of Healthcare Managers With Remote Employees, Desiree Nichole Van Campen

Department of Conflict Resolution Studies Theses and Dissertations

Healthcare managers of remote employees are faced with unique challenges as they relate toconflict prevention and management. The Covid-19 pandemic further complicated this issue when, because of social distancing mandates and employee health concerns, a large volume of healthcare managers and their employees were forced to transition to a remote working environment. Managers had to then develop personal strategies to successfully lead their now- remote workforce. This qualitative Grounded Theory study revealed that intentional communication, engagement, and planning are ways in which managers have been able to minimize the effects that conflict has on their employees. From the research, the …

Influence Of Telephone Preoperative Evaluations On Patient Medication Compliance On Day Of Surgery, Emmanuel Magsino, Michael Jung, Olga Suarez Md

Graduate Research Posters

Patient compliance with medication instructions on day of surgery (DOS) is an important part of the preoperative assessment, as failure to comply with these may lead to serious perioperative consequences. Prior studies have shown that compliance increases with multimodal interventions. However due to the recent COVID-19 pandemic, many in-person visits transitioned to telephone visits and providers had to rely on patients to follow solely verbal instructions.

To determine medication compliance, this study compared the medication instructions provided by the VCU Preoperative Assessment Communication and Education Clinic, per chart review, with each patient’s own report of which medications they took on …

Covid-10, Healthcare Interior Design + Provider Experience - How Does Your Space Work For You?, Ruth E.P. Deibler

Graduate Research Posters

The lack of research on healthcare staff experience and interior design of the spaces they work in is evident. A focus on staff perspective is needed, particularly staff who navigated the COVID-19 pandemic. This research seeks to capture those stories to develop further research in order to improve staff experience. The initial phase of this mixed-methods approach is a survey. Hypothetically, by placing providers at the center of qualitative research related to healthcare interior design, we can better understand existing healthcare spaces. Ideally, we can develop additional evidence-based, human-centered solutions to transform interior environments in healthcare.

The 20-year Women’s Health …

The Medicalisation Of Gender Nonconformity Through Language: A Keywords Analysis, Angelo Cosma Galluzzo

sprinkle: an undergraduate journal of feminist and queer studies

Language is an important part of the way gender nonconformity is legislated and medicalised. In 2012, the American Psychiatric Association (APA) changed the nomenclature of the ‘gender identity disorder’ (GID) to ‘gender dysphoria in the ‘Diagnostic and Statistical Manual of Mental Disorders (DSM) to reduce the social stigma attached to transgender identities. While the recognition of gender nonconformity by the medical authorities has led to some beneficial consequences, scholars have shown that the language of pathology has narrowed the definitions of gender nonconformity and has created social stigma. I use the web pages of five major health providers of English-speaking …

Exploring The Influence Of Self-Efficacy And Autonomy On Outdoor Recreation Behaviors During The Covid-19 Pandemic, Katheryn E. Carpenter

Graduate Theses/Dissertations

Outdoor Recreation (OR) provides the benefits of physical activity and traditional leisure along with the addition of the benefits associated with an outdoor environment. Self Determination Theory (SDT) and Social Cognitive Theory (SCT) state that self-efficacy (SE) and autonomy can increase depending on the physical and social environment. The purpose of this study was to explore the relationship between self-efficacy and autonomy on OR behaviors during the COVID-19 pandemic. It was hypothesized there would be a correlation between individuals who participate in OR activities and self-efficacy as well as autonomy. The research also explored barriers and facilitators to OR via …

Evaluating Integration In Collaborative Cross-Disciplinary Fda New Drug Reviews Using An Input-Process-Output Model., Kevin Bugin, Gaetano R. Lotrecchiano, Michael O'Rourke, Joan Butler

Clinical Research and Leadership Faculty Publications

Background/Objectives: The US Food and Drug Administration (FDA) is responsible for assessing safety (risks) and effectiveness (benefits) of new drug products using the data provided in a Sponsor's new drug product marketing application before they can be marketed. The FDA forms cross-disciplinary review teams to conduct these assessments. Recently, the FDA began implementing more interdisciplinary approaches to its assessments, reducing redundancy in review processes and documentation by increasing team integration around review issues.

Methods: Through a phenomenological descriptive comparative case study, the impact of FDA's new interdisciplinary approach on review team integration was compared with its traditional multidisciplinary review approach. …

Educating Staff To Reduce Hospitalization Of Individuals Living In A Group Home, Caroline Aina Ibijemilusi

Walden Dissertations and Doctoral Studies

AbstractPersons with intellectual and developmental disabilities (IDD) have significant health disparity in terms of high numbers of hospitalizations compared to the general population. The purpose of the project was to improve staff ability to recognize and respond to the changes in the health status of intellectually and developmentally disabled individuals living in a group home. The project utilized Knowles’s theory of adult learning to develop a curriculum suitable for adult learners and the Kirkpatrick model to guide the assessment of the training. Pre- and post-perception of learning and satisfaction surveys were provided to the participants online. A paired t test …

The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore

Walden Dissertations and Doctoral Studies

AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …

Reducing The Readmissions Through Multidisciplinary Rounds In Older Adults, Fatima Rajapathy Tisseverasinghe

Walden Dissertations and Doctoral Studies

Hospital readmissions are a reflection of poor quality of care. The readmission rate in an acute care for the elderly (ACE) unit was above the national benchmark in 2017. The specific problem includes lack of communication, collaboration, and coordination among the interdisciplinary team. Further, in older adults, the problem is accentuated by health illiteracy, comorbidities, cognitive impairment, polypharmacy, and unclear discharge and follow-up care instructions. Poor care transition costs Medicare 17.4 billion dollars a year. Multidisciplinary rounds (MDRs) have been adopted by many hospitals as evidence-based interventions to reduce readmissions within 30 days. This Doctor of Nursing Practice (DNP) project …