Health and Medical Administration Commons^™

Setting Research Priorities Within Allied Health: What Do Clinicians Think?, Annette Davis, Den-Ching Angel Lee, Lisa-Anabell Wenzel, Terry Haines

Internet Journal of Allied Health Sciences and Practice

Background: Research activity among allied health clinicians working in publicly funded health care organisations is growing, yet little attention has been paid to how these activities are prioritised. Without a specific framework to guide research direction, it is likely that research will be conducted in areas that are prioritised by individual clinicians. However, it is presently unknown what areas are prioritised by clinicians and the reasoning behind their prioritisation. Purpose: The aims of this study were to identify what clinicians identify to be the highest priority research across personal, department, and health service levels, and the reasons why. It also …

Hospital Characteristics Associated With Hospital Acquired Condition (Hac) Reduction Program Payment Penalties Across Program Years, Emily D. Cochran

Theses and Dissertations

Objective: The primary objective of this study was to examine the relationship between hospital structural characteristics and penalization status (penalized or not penalized) in any given hospital acquired condition (HAC) Reduction Program year, FY 2015 through 2018. Structural characteristics included hospital type, case mix index, average daily census, bed size, ownership, disproportionate share percentage, location, and American Nurses Credentialing Center Magnet status. The secondary objective of the study was to determine whether a hospital's penalization status across one or more HAC Reduction Program years is related to quality performance (Total HAC Score) in subsequent years. These objectives were achieved through …

Understanding The Impact Of Choice Claims In Health Policy Among Veteran Patients, Stacie Marie Rivera

Walden Dissertations and Doctoral Studies

The patient-as-consumer has emerged as a narrative in the government health care system that cares for beneficiary veteran patients, elevating the phenomenon of choice in health care legislation and administration. The problem of the submerged state of a health policy was the issue examined within the context of access to health care and what patients experience when choice is present. The purpose of this study was to explore the motivations of beneficiary veteran patients to choose a preventive care option, a seasonal flu shot, at a private sector retail pharmacy rather than at their government health care provider, with the …

The Relationship Of Nurse Manager’S Leadership Styles In Maintaining A Just Culture, Aida Solomon

Walden Dissertations and Doctoral Studies

Healthcare leaders must establish a just culture to mitigate preventable medical deaths that occur at 250,000 per year, making medical errors the 3rd leading cause of death in the United States. However, there is a gap in knowledge regarding the attributes of nurse manager leadership styles that contribute to promoting a just culture at the unit level. Guided by the full range leadership theory and the just culture model, the purpose of this descriptive correlational study was to determine the relationship between nurse manager transformational, transactional, and laissez-faire leadership styles and unit level just culture perceptions and the differences between …

Exploring The Challenges Non-Clinical Departments Encounter During Eden Alternative Implementation, Keith George

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study …

Wellness Paradigms In Predicting Stress And Burnout Among Beginning Expatriate Teachers, Kimala Proctor

Walden Dissertations and Doctoral Studies

Research indicates that the current teacher shortage is in part due to stress and burnout. A topic that has not been examined is beginning expatriate English medium teachers (EMTs) with 5 years or less of teaching experience in the United Arab Emirates and the relationship between using individualized, self-initiated wellness paradigms and stress, job burnout, and intent to leave the teaching profession. The transactional model of stress and coping, Maslach's multidimensional theory of burnout, and the health promotion model were used to evaluate the moderating effects of the EMTs' burnout and stress levels on their wellness and intent to leave. …

Reducing Cost Of Healthcare Facilities By Decreasing Nursing Turnover, Valour Akia Richardson

Walden Dissertations and Doctoral Studies

Registered Nurse (RN) turnover is costly for hospitals and healthcare facilities. The problem that healthcare administrators face today is their inability to retain nurses for long periods of time and the detrimental effects that come from the lack of retention. The purpose of this quantitative secondary data analysis is to explore the relationship between the retention of RNs and the geographic regions in which they work. The theoretical framework for this study was Barney's concept of viewing people as resources. Deidentified secondary data of RNs was utilized from the Healthforce Center at the University of California San Francisco to probe …

Evaluating The Discharge Process Improvement Initiative In Reducing The Length Of Stay, Maria Reina Ventura Siazon

Walden Dissertations and Doctoral Studies

Extended hospital length of stay (LOS) causes increased health care costs and incidence of never events, such as hospital-acquired infections, pressure ulcers, and falls, which are not reimbursed by Medicare. This study examined if there would be a statistically significant decrease in the LOS of patients after the implementation of a discharge process improvement initiative (DPII), The model for improvement and small tests of change concept were used to guide the DPII at a hospital in northern California. Sources of data included archival data obtained from the hospital's quality improvement department that showed LOS prior to and after the implementation …

Strategies To Improve Customer Care Services In Urgent Care Businesses, Marcus Ellis Caster

Walden Dissertations and Doctoral Studies

Healthcare industry owners who have unsatisfactory customer care services may experience a financial risk and create dissatisfied patients. The purpose of this case study was to explore customer care strategies that managers of urgent care businesses used to improve customer care services and patient satisfaction. The target population consisted of 1 urgent care manager from 3 separate urgent care clinics with the highest customer satisfaction ratings in Alabama. The urgent care managers were knowledgeable about effective customer care strategies that improved customer care services and patient satisfaction. Customer loyalty theory with emphases on customer behavior, customer attitude, repeat patronage, and …

Strategies For Implementation Of Electronic Health Records, Carlene Vassell-Webb

Walden Dissertations and Doctoral Studies

Implementation of electronic health records (EHRs) is a driver for the improvement of health care and the reduction of health care costs. Developing countries face substantial challenges in adopting EHRs. The complex adaptive system conceptual framework was used to guide this single case study to explore strategies that health care leaders used to successfully implement the EHR system. Data were collected from 6 health care leaders from an island in the Caribbean using a semistructured interview technique. Data were analyzed using the Bengtsson's 4-stage data analysis process, which includes decontextualization, recontextualization, categorization, and compilation. The results of the study yielded …

Caregivers' Challenges In Accessing Services For Children With Autism, Anita Payne Jones

Walden Dissertations and Doctoral Studies

The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall …

Acuity-Based Nurse Staffing And The Impact On Patient Outcomes, Sara Kollman

Walden Dissertations and Doctoral Studies

The costs of healthcare in the United States are of national concern. The systematic review of the literature (SRL) explored the practice-focused nursing question regarding the relationship between the use of acuity-based staffing (ABS) models and positive patient outcomes. Analyzing the impact of ABS models on patient quality outcomes and the potential economic value could provide evidence essential for the healthcare executives responsible for fiscally prudent labor management and for creating an evidence-based business case for adequate, patient-centric nurse staffing. The synergy model for patient care and Covell's nursing intellectual capital theory guided the doctoral project. The Preferred Reporting Items …

Impact Of Emergency Department Prescriber Type On The Rate Of U.S. Opioid Prescriptions, Edward Worlanyo Agbevey

Walden Dissertations and Doctoral Studies

Many drug overdoses in the United States are from prescription drugs, most of which are classified as opioid pain relievers (OPRs) and commonly prescribed in emergency departments (EDs) to treat pain. OPR abuse and addiction is a major public health issue. Researchers have identified the role of various patient characteristics (race, gender, demographics, etc.) in the variation in OPR prescription rates, but the contribution of provider-type differences to that variation has not been exposed. The purpose of this study was to evaluate the strength of the association between provider type and the likelihood of an opioid prescription by ED providers …

Director Of Nursing Role Conflict And Ambiguity, Commitment, And Intent To Stay, Amy Elizabeth Thiesse

Walden Dissertations and Doctoral Studies

High rates of turnover and the limited tenure of directors of nursing (DONs) in long-term care creates instability in the nursing workforce and the quality of care provided. Organizations, industry, and stakeholders have made little progress to change this turnover crisis. The purpose of this quantitative study, guided by organizational role and social exchange theories, was to determine if there was a difference in levels of affective organizational commitment and intent to stay mediated by leader-member exchange in long-term care DONs with different levels of role conflict and role ambiguity. The key variables were measured with the Role Questionnaire, Leader-Member …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

College of Graduate Studies: Theses & Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Public Health Workforce Perceived Impact Of Emerging Issues In Public Health, Kristie C. Waterfield

College of Graduate Studies: Theses & Dissertations

Background: In an era where public health has been viewed as a global, multi-disciplinary field, the public health workforce has remained united to unfailingly holding fast to the mission of protecting, promoting, and improving the health of the public. However, the practice of public health is consistently evolving, and the workforce is continually facing a mirage of challenges. In order to overcome these challenges, practitioners need to be up-to-date on the necessary knowledge and skills to effectively deliver the core public health services.

Purpose: The purpose of this research was to explore the perceived impact of emerging trends in public …

Reducing 30-Day Readmission Rates In Chronic Obstructive Pulmonary Disease Patients, Stacey Jerrick Machado

Walden Dissertations and Doctoral Studies

Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for …

Understanding Parents' Disease-Managing Strategies For Children With Sickle Cell Disease, Michelle Noble Mackey

Walden Dissertations and Doctoral Studies

Sickle cell disease (SCD) is one of the most difficult and stressful chronic diseases for parents of afflicted children to manage. Managing SCD can be traumatic for parents particularly if they have no specific coping strategies for managing the disease or ensuring the child visits the doctor as scheduled. The use of certain coping strategies may affect the parents' and patients' perceptions of the illness and influence their decisions regarding treatment, which can have a lasting impact on their lives. Effective parental strategies such as positive thinking can aid in disease management, but there is limited research on the coping …

Hospital Admission From The Emergency Department For Patients Diagnosed With Heart Failure, Tammy Young

Walden Dissertations and Doctoral Studies

Approximately 25% of those hospitalized with congestive heart failure are readmitted within 30 days after discharge. Because researchers and policy makers consider hospital readmission within 30 days for patients with heart failure to be a quality of care issue, the Centers for Medicare and Medicaid Services has imposed financial penalties of up to 3% of a hospital's Medicare revenue for 1 year for excessive readmissions, potentially impacting the financial sustainability of some organizations. The purpose of the study was to address the research gap regarding the outcome quality measure of hospital admissions from the emergency department (ED) and 2 each …

Guardians' Experiences With Mental Health Care For Adolescents With Pediatric Bipolar Disorder, Saudia Y. George

Walden Dissertations and Doctoral Studies

Pediatric bipolar disorder (PBD) is a growing public health problem in the United States, especially among adolescent children. Despite awareness of the diagnosis and the effects that it has on the child, little attention has been given to the effects that PBD has on the guardian. The purpose of this qualitative phenomenological study was to explore the factors influencing guardians' experiences related to PBD. Penchansky and Thomas' Theory of Access and Family Systems Theory were used in this study to explore guardians lived experiences of PBD, its effects on the entire family system, and mental health service treatment. This approach …