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Continuation Of Midodrine Upon Icu Discharge, Fahad Hussain, Deepti S. Rao

Quality Improvement/Patient Safety Symposium

Indications for Continuation of Alpha-1 Agonist Midodrine Upon ICU Discharge

Hussain, Fahad, MSII; Rao, Deepti, MD

Introduction:

Persistent hypotension in patients affected by circulatory shock is a common barrier to discharge in the ICU. Even after these patients have been otherwise stabilized, low-level hypotension often ensures that they remain in the ICU on IV vasopressors. Midodrine, an oral α1-agonist, has shown promise as an adjunct therapy to wean patients off IV vasopressors and facilitate earlier discharge from the ICU. According to a recent study done at the Mayo Clinic ICU, Rochester, discharge on Midodrine was associated with a shorter ICU …

Office Of Equity Diversity Report Annual Report Fy2020, Children's Mercy Hospital

Equity & Diversity Annual Reports

A report on equity and diversity at Children's Mercy Hospitals & Clinics, in the care it provides, the people it serves, and in its workforce. Specifically discusses the Equity & Diversity Leadership Structure, Employee Demographics, Patient Demographics, lasting impressions from FY20, and the future of healthcare providers.

Analysis Of Platforms And Functions Of Mobile-Based Personal Health Record Systems, Byung Kwan Choi, Young-Taek Park, Lee-Seung Kwon, Phoebe (Yeon) S. Kim

Nursing Faculty Publications

Objectives
Little is known about the platforms and functionalities of mobile-based personal health record (PHR) applications. The objective of this study was to investigate these two features of PHR systems.
Methods
The unit of analysis was general hospitals with more than 100 beds. This study was based on a PHR survey conducted from May 1 to June 30, 2020 and the National Health Insurance administrative data as of March 31, 2020. The study considered the platform, Android and iPhone operation system (iOS), and types of functionalities of PHR systems. Among the 316 target hospitals, 103 hospitals had adopted PHR systems. …

Utilization Of Telepsychiatry To Combat The Opioid Crisis In The United States, Haley Tallarico

Theses, Dissertations and Capstones

Introduction: In the past five years, the United States (U.S.) has experienced an unprecedented epidemic of opioid misuse, abuse and overdose related death, leading to a national public health crisis. Telepsychiatry along with medication-assisted treatment has been proposed as a viable solution. The purpose of this research was to examine the field of telepsychiatry as a practical means to combat the rapidly increasing opioid epidemic facing America and to determine the effect of telepsychiatry utilization on access to treatment received in an outpatient medical setting.

Methodology: The methodology for this study was a literature review including the use of …

Implicit Racial Bias In Physicians: Racial Disparity In Opioid Prescriptions In United States Emergency Departments, Anjali Ta

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Over the past 30 years, a documented racial disparity in opioid prescriptions in U.S. emergency care departments has persisted despite overall prescription trends fluctuating throughout the rise and fall of the early 2000’s opioid epidemic. Consistently, Blacks and other minorities receive lower levels of opioid analgesics when presenting with conditions or characterizing pain levels similar to white patients. This study focuses on identifying the mechanisms of implicit racial bias, quantified by scores on the Implicit Bias Association Test (IAT), that influences physicians’ abilities to equitably assess and treat pain of racially diverse patient populations. Research has shown that physicians with …

Systemic Risk Management Plan For Electronic Medical Records (Emr): Why And How?, Ziniya Zahedi, Faisal Mahmud, Cesar Pinto

Engineering Management & Systems Engineering Faculty Publications

Electronic patient data use and handling are critical issues in terms of privacy, confidentiality, security, and the Health Insurance Portability and Accountability Act (HIPAA) regulations. The risks associated with electronic patient data are not limited to identity theft but rather include a person’s social, economic, and psychological well-being. However, there have not been many studies that have focused on the associated risk factors that could lead to these situations. This paper identifies those risks related to electronic patient data breaches by means of a grounded theory approach and develops a systemic risk management plan that enables engineering managers and risk …

Relationship Between Nurse Job Satisfaction Variables And Voluntary Turnover Intention, Mmayen Monday Nnah

Walden Dissertations and Doctoral Studies

Increased turnover among hospital nurses has adverse business outcomes. Hospital nurse managers are concerned with minimizing turnover to reduce hospital costs, lower risk to patients, and positively impact hospital performance. Grounded in motivation-hygiene theory, the purpose of this quantitative correlational study was to examine the relationship among nurses' views of the quality of work environments, level of management support, opportunities for promotion, and nurses' voluntary turnover intentions. Data were collected from nurses with registered nurse status or a bachelor of science in nursing degrees working in hospital settings in the United States (N = 82), who completed the Job Satisfaction …

Cybersecurity Using Risk Management Strategies Of U.S. Government Health Organizations, Ian Cornelius Wilkinson

Walden Dissertations and Doctoral Studies

Seismic data loss attributed to cybersecurity attacks has been an epidemic-level threat currently plaguing the U.S. healthcare system. Addressing cyber attacks is important to information technology (IT) security managers to minimize organizational risks and effectively safeguard data from associated security breaches. Grounded in the protection motivation theory, the purpose of this qualitative multiple case study was to explore risk-based strategies used by IT security managers to safeguard data effectively. Data were derived from interviews of eight IT security managers of four U.S. government health institutions and a review of relevant organizational documentation. The research data were coded and organized to …

Strategies To Retain Mental Health Workers In Community Mental Health Clinics, Debbie L. Young

Walden Dissertations and Doctoral Studies

In 2017, the United States employee turnover rate for mental health workers with 2 or more years of experience was more than 50%. High turnover rates among these mental health workers are associated with inadequate quality of care for patients with mental health issues in community mental health clinics. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple case study was to explore retention strategies used by health care administrators to retain their mental health workers with more than 2 years of experience. The participants consisted of 6 health care administrators who successfully implemented strategies to minimize high …

Congestive Heart Failure And Strategies To Improve Quality Of Life, Esther Akunna Okorie

Walden Dissertations and Doctoral Studies

Congestive heart failure is a global, chronic, progressive, and debilitating disease affecting mostly older adults. The multiple complications associated with the health issue led to readmissions and markedly reduced ability of heart failure (HF) patients to perform the self-care management of the problem. Nurses are responsible for providing a standardized quality education for patients; however, nurses at the project site lacked adequate skills and knowledge to bridge the gap in HF self-care management education. The project was guided by health belief model and self-care deficit with the goal of boosting the staff knowledge and confidence with providing patient HF self-care …

Strategies To Reduce Costs Associated With Hospital Readmissions, Almunzer Zakaria

Walden Dissertations and Doctoral Studies

Hospital administrators struggle to reduce hospital readmissions to improve hospital performance. Reducing costs of readmissions is important to hospital administrators because it may lead to an inability to meet budget requirements. Grounded by complex adaptive systems and business process quality management principles, the purpose of this qualitative single case study was to explore strategies nonprofit hospital administrators use to reduce costs associated with hospital readmissions. Participants included 4 successful hospital administrators at 1 hospital in Doha, Qatar, who have responsibility for overseeing readmissions. Data were collected using semistructured face-to-face interviews and organizational documents. Traditional text analysis was used to identify …

Cost Savings And Patient Satisfaction Following Implementation Of An Online Blockchain-Based Healthcare Payment Portal, Zubin Hussain, Meghan Gannon, Phd, Constantine Daskalakis, Scd

Phase 1

Introduction. Although most patients prefer e-billing, many providers use paper. On average, over three paper bills are sent before payment is received. This means wasted time, money, energy, and decreased patient satisfaction. Could the implementation of an online, blockchain-based healthcare payment portal increase cost savings and patient satisfaction while maintaining confidentiality?

Methods. Transaction data was collected by MAPay through their portal system from about 100 providers in 50 locations in the NYC area, all through IntegraConnect. This study analyzes trends in how patients pay their medical bills and how much they pay.

Results. From March through September, all electronic methods …

10-13-2020 Hsc Committee Meeting Minutes, Hsc Committee

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

No abstract provided.

An Exploration Of The Gross National Happiness Approach To Assure Patient Safety And Healthcare Quality In Bhutan, Rinchen Pelzang, Alison M. Hutchinson

Journal of Sustainable Social Impact

Although the principles of Gross National Happiness (GNH) are currently being used as the overall framework for Bhutan’s development programs (including healthcare services), little is known about how Bhutanese healthcare professionals perceive the relationship between GNH and patient safety or how the GNH principles could help in improving patient safety in Bhutan’s healthcare system. The aim of this study was to explore how Bhutanese healthcare professionals, educators, managers, and policy makers perceive the relationship between GNH and patient safety and what they believe should be done to improve patient safety in Bhutan. A qualitative exploratory descriptive study using in-depth interviews …

12-01-2020 Hsc Committee Meeting Minutes, Hsc Committee

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

No abstract provided.

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Was That In An Email? An Electronic Tool To Improve Nursing Communication Satisfaction, Jennifer A. Morgan

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Background: Nursing communication satisfaction impacts engagement and turnover as well as patient care which affects organizational profits. Although direct care nurses report dissatisfaction with nurse manager communication methods, organizations and nurse managers do not utilize best practice strategies. In addition, there is a lack of high-quality implementation studies of best practice communication methods, specifically on obstetrics units, to assist managers in improving communication methods. Methods: An electronic communication tool was implemented on an inpatient obstetrics unit at a large tertiary hospital in the Upper Midwest. The tool was accessible on all unit computers on the SharePoint site. The project leader …

Implementation Of Sbar Tool In A Rural Hospital, Molly M. Tschetter

Doctor of Nursing Practice (DNP) Practice Innovation Projects

Introduction: Patient handovers between healthcare providers during shift change or unit and interfacility transfers are a vulnerable time for inadequate communication. To ensure a handover is concise, healthcare organizations must implement and educate their staff on evidence-based communication tools.
Methods: SBAR is a communication tool commonly used during a handover. SBAR allows for a steady flow of report and a reduction of information missed. When nurses use SBAR, the efficiency of their report improves and handover time is decreased. By decreasing interfacility handover time, patients may be transferred to higher levels of care faster. By receiving more advanced care faster, …

Impact Of Performance-Based Budgeting On Quality Outcomes In U.S. Military Healthcare Facilities, Kimberly L. Decker Virginia Commonwealth University

Theses and Dissertations

Performance-based budgeting (PBB) is a variation of pay for performance that is applicable to government programs. It works by increasing or decreasing funding based on pre-established performance thresholds, which incentivizes organizations to improve performance. In late 2006, the U.S. Army implemented a PBB program in all of its healthcare facilities due to rising concerns over costs and quality in its facilities. The U.S. Army’s PBB program tied hospital-level funding decisions to performance on key cost and quality-related metrics. This study examined the impact of this program and a subsequent PBB program on quality improvement in U.S. Army healthcare facilities. Drawing …

Hospital Investment In Urgent Care: Impacts On Emergent, Outpatient, And Ambulatory Surgery Volumes, Hillary A. Linhart

Theses and Dissertations

As the popularity of urgent care centers (UCCs) has grown, hospitals have increasingly chosen to invest in this care model. Hospital interest in UCCs is largely driven by two key factors. First, hospitals aim to use UCCs to generate referrals, which generate additional patient volume for downstream hospital services. Secondly, hospital UCC investment presents an opportunity to ease the demand for non-urgent care in the emergency department (ED) by diverting low-acuity ED patients to the more appropriate UCC setting. No study to date has evaluated the impact of hospital UCC investment on referrals or downstream service volumes. A few studies …