Health and Medical Administration Commons^™

Strategies For Sustaining Small Businesses In The U.S. Health Care Sector, James Utobunwa Nwachukwu

Walden Dissertations and Doctoral Studies

In the United States, many small businesses fail within the first 5 years due to poor implementation of sustainability strategies. Researchers and business practitioners have indicated that small business owners face challenges on how to maintain their businesses beyond 5 years due to lack of sustainability strategies. The purpose of this qualitative multiple case study was to explore the strategies that health care small business owners and managers in New York State use to maintain their businesses beyond 5 years. Sustainability development theory was used for the study's conceptual framework. Semistructured face-to-face interviews were conducted with 6 purposively-selected participants who …

Advanced Cancer Patients' Medical Decision-Making While Experiencing Financial Toxicity, Heather L. Morel

Walden Dissertations and Doctoral Studies

Financial toxicity (FT) is the impact that out of pocket (OOP) costs of cancer care have on patients' well-being, leading to lower quality of life, less compliance with prescribed therapy, and poorer outcomes, including increased mortality. The purpose of this study was to understand the impact of FT on advanced cancer patients' lives and their health care decision-making. Fuzzy trace theory provided the framework for examining how patients use gist and verbatim when making health care decisions while experiencing FT. Gist refers to main ideas that are often infused with emotional overlays that people use to make risky decisions, while …

Public Health Strategies For Strengthening Prehospital Injury Responses In St. Lucia, Delwin Oliver Ferguson

Walden Dissertations and Doctoral Studies

Traumatic injuries have steadily increased during the last two decades, affecting over 5.8 million persons annually and have become a global public health issue. Since 2008, 80% of all deaths from noncommunicable diseases and trauma, approximately 29 million occurred in developing countries. Sixteen thousand young adults worldwide have died due to traumatic injuries. Additionally, injuries account for over 15% of the global burden of diseases, with approximately 90% of these injuries occurring in developing countries like St. Lucia. The purpose of this qualitative descriptive study was to examine policy gaps in prehospital traumatic injury responses and explore implementing Essential Public …

Strategies To Sustain A Physician-Led Primary Care Practice, Ashley Polidori

Walden Dissertations and Doctoral Studies

Since 2008, physician-led primary care practices have decreased as physician's encounter sustainability challenges because of government regulations and the requirements of the Affordable Care Act. The problem is that some physician-led primary care practice leaders lack strategies to sustain a medical practice longer than 5 years. The purpose of this study was to explore strategies primary-care practice leaders use to sustain a practice longer than 5 years. This study followed a case study design, including a purposeful sampling of 3 physician-led primary care practice leaders in southern Indiana. Open-ended semistructured interviews were conducted and triangulated with company policies and procedures …

Associations Between Substance Abuse And Mental Illness Among Sexual Minority Adults, Blanche O. Wright

Walden Dissertations and Doctoral Studies

Sexual minorities (lesbians, gays, and bisexuals) have a greater risk for substance abuse and mental illness than sexual majorities (heterosexuals). Associations between substance abuse and mental illness among sexual minority adults have not been widely studied. The purpose of this quantitative cross-sectional study was to use the 2015 National Survey on Drug Use and Health data from the Substance Abuse and Mental Health Administration to study the association of substance abuse (alcohol; hard drugs such as heroin, cocaine, methamphetamine; and hallucinogens), prescribed drugs (pain relievers, tranquilizers, sedatives, stimulants, psychotherapeutic, and inhalants, as well as marijuana) and mental illness (no past …

Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju

Walden Dissertations and Doctoral Studies

After the Republic of Kosovo's declaration of independence in 2008, new municipal structures were created with the charge of monitoring the delivery of health care services; yet, no mechanism for monitoring performance was ever implemented. With the public value theory as the foundation, the purpose of this multiple case study of 3 Kosovo municipalities was to understand issues surrounding the capacity of local government health department to monitor their performance related to the delivery of services. Relevant data were collected through focus-group discussions with 10 nurses, 9 directors of family medicine centers, and 12 municipal program managers. Purposeful semistructured interviews …

Seat Belt Fit A Mechanism Of Injury During A Motor Vehicle Crash, Jacoba Hendrika Viljoen

Walden Dissertations and Doctoral Studies

Seat belts save lives; however, unintentional injuries are still the leading cause of death for those between 1 and 44 years in the United States. Seat belts also cause injuries during motor vehicle crashes (MVCs) and obesity changes how seat belts fit. The purpose of this retrospective causal inference quantitative study was to reduce the knowledge gap in scholarly research on seat belt fit in relation to blunt cerebrovascular injuries (BCVI) during MVCs and seat belt compliance. The theoretical framework used was based on H.W. Heinrich's domino theory. The research questions focused on the following dependent variables: BCVI, compliance, and …

Reducing Clabsi Rate Among Icu Patients, Rita L. Walker

Walden Dissertations and Doctoral Studies

Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a …

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …

Leadership Communications Strategies For Enhancing Virtual Team Performance, Rachel Oludolapo Agbi

Walden Dissertations and Doctoral Studies

The fast-growing trend of using virtual teams comes with challenges including the lack of knowledge by some virtual team leaders for managing virtual teams. The purpose of this single case study was to explore the communication strategies that leaders use to manage virtual teams in real time to enhance team performance. The sample was composed of 4 successful virtual team leaders of a multinational accounting firm whose headquarters is in the northeastern region of the United States of America. The conceptual framework that guided this study was Tuckman's small group developmental model. Data consisted of semistructured interviews and the review …

Methods To Improve Interprofessional Collaboration In Administrative Dyads, Julie Lee Hudson

DNP Projects

Abstract

PURPOSE: The primary objective of this project was to determine if specific interventions, to include education, rounding, and regular meetings, improved collaboration and communication for nurse/physician dyads working in acute care hospital administrative roles.

METHODS: The study employed a prospective pre-test and post-test comparison of participants’ scores on a validated survey tool. This tool (JeffSATIC) measured perception of collaboration between nurses and physicians. The objective was to evaluate the differences in these scores in participants before and after an intervention.

RESULTS: This study sought to discover if specific interventions impacted scores on a tool measuring collaboration among dyad pairs. …

Characteristics Of Pediatric Antimicrobial Stewardship Programs: Current Status Of The Sharing Antimicrobial Reports For Pediatric Stewardship (Sharps) Collaborative, Chrstopher Mcpherson, Brian R. Lee, Cindy Terrill, Adam L. Hersh, Jeffrey S. Gerber, Matthew P. Kronman, Jason G. Newland

Manuscripts, Articles, Book Chapters and Other Papers

In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention’s (CDC) seven core elements of a successful ASP within a large subset of US Children’s Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a …

The Balance Between Financial And Quality Performance In For-Profit Hospitals Versus Non-Profit Hospitals, Blake Seidner

CMC Senior Theses

Recent trends of financial distress for non-profit hospitals and the uptick in acquisition of these hospitals by for-profit entities indicate different focuses from the management of each type of hospital. Using data on hospital quality and basic financial measures, this study examines shift in the balance of financial and quality performance. The dataset focuses on private non-profit and for-profit hospitals with low bed counts, ranging from 50-200 total beds. Results indicate a positive relationship between for-profit status and basic financial performance measures, such as profitability, and a negative relationship with patient experience, cost reduction for the patient, and overall quality. …

Informing Quality In Emergency Care: Understanding Patient Experiences, Esmat Swallmeh, Vivienne Byers, Amr Arisha

Articles

Purpose: Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).

Design/methodology/approach: The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. …

Exploring Student-Led Interprofessional Education Through A Community Service Project, Lindsay Ann Doerschuk

EWU Masters Thesis Collection

Purpose: The purpose of this research was to explore the effectiveness of a student-led interprofessional education (IPE) workshop in improving student attitudes and perceptions toward IPE. Students from four health science programs including Dental Hygiene, Communication Sciences and Disorders/Speech and Hearing, Health Services Administration and Occupational Therapy participated in a community service event. Students provided screenings to veteran patients including a health history intake, hearing test, and sleep screening while other students observed.

Methods: Students were asked to attend an orientation, the Vets Day IPE workshop, and a debrief session. This mixed methods approach study utilized the Readiness for Interprofessional …

An Integrated Lean Supply Chain Framework For U.S. Hospitals, Subhajit Chakraborty, Jorge A. Gonzalez

Management Faculty Publications

We apply a lean supply chain framework to the healthcare industry in the U.S., drawing support from lean systems philosophy. We conceptualize a view of the U.S. healthcare ecosystem that places a hospital and its admitted patients at the center and describes how all entities inside and outside the hospital work can implement lean principles to improve patients' quality care. This application depicts how a holistic consideration of hospital resources available in both the internal and external supply chain would increase the optimal use of such resources and ultimately serve patients. We offer propositions suggesting that an integrated supply chain …

Waste Management Minimization Strategies In Hospitals, Andrea L. Clark

Walden Dissertations and Doctoral Studies

During the delivery of healthcare services, hospital employees use enormous amounts of water, energy, and nonbiodegradable carcinogenic plastics. In the U.S., hospital staff generate an average of over 7,000 tons of waste per day at an average cost of $0.28 per pound for the disposal of regulated medical trash, which if efficiently managed or reduced, could result in substantial cost savings. Using the organizational learning and the transaction cost economics theories as the conceptual frameworks, the purpose of this qualitative case study was to explore strategies healthcare leaders used to minimize their waste management operational costs. Data were collected using …

A Diabetic Child's Impact On An African American Family, Silvanus Okeke

Walden Dissertations and Doctoral Studies

Diabetes, a chronic disease with devastating but preventable consequences, is common in the United States, especially within African American communities. Earlier research has indicated that 21.7% of African American parents have children diagnosed with Type 1 diabetes in the Mississippi Delta Region. Researchers have examined coping, stress, and behaviors of African American parents of children diagnosed with Type 1 diabetes; however, there is a gap in literature regarding how African American parents can cope with stress and how changes in health behavior due to Type 1 diabetes impact African American families. The purpose of this qualitative phenomenological study was to …

Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua

Walden Dissertations and Doctoral Studies

In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …

Determining Perceived Barriers Affecting Physicians' Readiness To Disclose Major Medical Errors, Jean-Pierre K. Folligah

Walden Dissertations and Doctoral Studies

Medical errors have been detrimental in the field of medicine. They have impacted both patients and doctors. While physicians recognized that error disclosure was an ethical and professional obligation, most remained silent when mistakes happened for different reasons. Guided by the theory of planned behavior and Kant's deontological theory, the purpose of this quantitative study was to investigate the perceived barriers affecting physicians' willingness to report major medical errors. An association was tested between the independent variables physician fear of disclosure of errors, organizational culture toward patient safety, physician apology, professional ethics and transparency, physician education, and the dependent variable …