Health and Medical Administration Commons^™

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …

Organizational Strategies To Reduce Hospital Readmissions, Steven Warchol

Walden Dissertations and Doctoral Studies

Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

Health Insurance Literacy Impacts On Enrollment And Satisfaction With Health Insurance, Angela J. Norbeck

Walden Dissertations and Doctoral Studies

Health insurance literacy (HIL) contributes to the lack of understanding basic health insurance (HI) terms, subsidies eligibility, health plan selection, and HI usage. The study is one of few to address the existing gap in the literature regarding the exploration of the relationship between HIL, individuals' HI enrollment, and individuals' satisfaction with their HI. The theoretical framework selected for this study was the prospect theory, which describes the behavior of individuals who make decisions. In this cross-sectional correlational study, secondary data set from the third Quarter 2015 Health Reform Monitoring Survey was used. Binary logistic regression models were used to …

Implications Of An All Bsn Workforce Policy, Mary Clifford

Walden Dissertations and Doctoral Studies

Discussion continues about requiring a Bachelor of Science in Nursing (BSN) as the minimum requirement for entry into registered nursing practice. A Magnet-® recognized hospital located in the Northeast United States is requiring all registered nurses without a BSN (n=284 or 28%) to obtain their BSN by 2022 as a condition for employment. The purpose of this project was to quantify the potential number and rationale of nurses who are not planning to return to school. The 2 practice focused questions are (a) What is the rationale for nurses who do not plan to pursue their BSN degree and (b) …

Successful Project Management, Tomomi M. Horning

Walden Dissertations and Doctoral Studies

High project failure rates result in billions of wasted dollars each year. Project failure does not discriminate by type of project or the industry from which they originate. The purpose of this qualitative single case study was to explore strategies that leaders at a health care organization located in Pennsylvania use to manage projects successfully. This population was selected due to the health care organization's reputation for successful project completion. The conceptual framework for this study was Fiedler's contingency theory. Data were collected by conducting semistructured interviews with 9 project leaders and reviewing project documents provided by study participants. Interviews …

Job Satisfaction And The Effects And Influences On Nurse Retention, Burke N. Kline

Walden Dissertations and Doctoral Studies

Researchers have predicted that by 2020 the United States will experience a severe shortage of registered nurses. The purpose of this correlation study, using the National Sample Survey of Registered Nurses 2008, was to investigate the relationship between nurse job satisfaction and its effect on nurse retention nationwide. Secondary data sets from the 2008 National Sample Survey of Registered Nurses and examining relationships between the variable of nurse retention and job satisfaction. Bivariate (correlation coefficient, chi squares, and simple linear regression) and multivariate (logistic regression) analyses identified and connected associations and examined measurement levels between the dependent and independent variables, …

Reducing Sepsis Mortality: A Cloud-Based Alert Approach, Janet A. Zink

Theses and Dissertations

The aim of this study is to examine the impact of a cloud-based CDS alerting system for SIRS, a precursor to sepsis, and sepsis itself, on adult patient and process outcomes at VCU Health System. The two main hypotheses are: 1) the implementation of cloud-based SIRS and sepsis alerts will lead to lower sepsis-related mortality and lower average length of stay, and 2) the implementation of cloud-based SIRS and sepsis alerts will lead to more frequent ordering of the Sepsis PowerPlan and more recording of sepsis diagnoses. To measure these outcomes, a pre-post study was conducted. A pre-implementation group diagnosed …

A Comparison Of Quality Indicators Between Medicare Accountable Care Organizations And Health Maintenance Organizations Using Publicly Available Data, William W. Campbell Iii

Theses and Dissertations

The purpose of this study is to explore differences in quality between Medicare Accountable Care Organizations (ACO) and Health Maintenance Organizations (HMO). Three outcomes measures reported by these plans use different methodologies but possess enough alignment to permit comparison: percent of diabetic patients with last HbA1c > 9.0%, colon cancer screening rate and ER visits per 1,000. These outcomes are the dependent variables (DV). A secondary purpose is to explore differences in quality based on the size of the beneficiary population served, using the same measures.

As the Medicare program faces threats to its solvency in coming decades, with 10,000 baby …

A Framework For Development Of Android Mobile Electronic Prescription Transfer Applications In Compliance With Security Requirements Mandated By The Australian Healthcare Industry, Kyaw Kyaw Htat

Theses: Doctorates and Masters

This thesis investigates mobile electronic transfer of prescription (ETP) in compliance with the security requirements mandated by the Australian healthcare industry and proposes a framework for the development of an Android mobile electronic prescription transfer application. Furthermore, and based upon the findings and knowledge from constructing this framework, another framework is also derived for assessing Android mobile ETP applications for their security compliance.

The centralised exchange model-based ETP solution currently used in the Australian healthcare industry is an expensive solution for on-going use. With challenges such as an aging population and the rising burden of chronic disease, the cost of …

Speech Recognition Technology: Improving Speed And Accuracy Of Emergency Medical Services Documentation To Protect Patients, Tan T. Tran

Undergraduate Research Posters

Because hospital errors, such as mistakes in documentation, cause one sixth of the deaths each year in the United States, the accuracy of health records in the emergency medical services (EMS) must be improved. One possible solution is to incorporate speech recognition (SR) software into current tools used by EMS first responders. The purpose of this research was to determine if SR software could increase the efficiency and accuracy of EMS documentation to improve the safety for patients of EMS. An initial review of the literature on the performance of current SR software demonstrated that this software was not 99% …

What's Happening: December 18, 2017, Maine Medical Center

What's Happening

No abstract provided.

Letter From The Editor, Amanda Evert

Administrative Issues Journal

The Winter 2017 issue of the AIJ begins with an invited article on the evolution of a bridge-to-college program at Idaho State University.

Invited Article: Bridging The Gap – Supporting The Transition From High School To College, Julie A. Frischmann, Kelly S. Moor

Administrative Issues Journal

Idaho State University’s Bengal Bridge is a summer program designed to help students successfully transition from high school to their first year of college at Idaho State University. All Bridge students at ISU take two general education courses, plus an additional credit of supplemental instruction focused on academic strategies specific to the disciplines represented by those general education courses, as well as a First Year Transition (ACAD) course to facilitate engagement with and acculturation to the university community—a total of nine to 10 credits in just seven weeks. Bridge students are also supported by one-to-one academic coaching, supplemental tutoring, peer …

Classical Literature Gives Life To Business Paradox And Systems Integration, Robert A. Page, Samuel K. Andoh, Robert A. Smith

Administrative Issues Journal

Professors bemoan the great difficulty students have understanding the complexity of their disciplines or functional specializations. Many non-traditional students have work and family commitments that limit the time needed to reflect professionally and to master these concepts. This disconnect has persisted despite decades of work developing more integrated, interdisciplinary curricula. One potential, partial solution is to simply start sooner and partner with liberal arts courses to introduce business students to complexity and paradox before they arrive at the business school. Grounding these concepts in the Classics embeds them in great stories of passion, betrayal, commitment, and emotion normally absent in …

Addressing Uncertainty During Workplace Change: Communication And Sense-Making, Rich Parsells

Administrative Issues Journal

Change is a commonplace occurrence in today’s organizations. A number of scholars suggest that communication strategies during organizational change are an important element to the success of a change initiative, yet such strategies are not given primacy in the research literature. The purpose of this paper is to add to the discourse on communication and workplace change initiatives by reporting on a research project that explored communication actions which were employed and viewed as useful by those experiencing a change in the workplace. This paper presents the findings that emanated from the study and explore their meaning in relation to …

How Managers Use The Stockdale Paradox To Balance “The Now And The Next”, C. W. Von Bergen, Martin S. Bressler

Administrative Issues Journal

Recent discussions of leadership paradoxes have suggested that managers who can hold seemingly opposed, yet interrelated perspectives, are more adaptive and effective. One such paradox that has received relatively little attention is the “Stockdale Paradox,” named after Admiral James Stockdale, an American naval officer who was held captive for seven and one-half years during the Vietnam War and survived imprisonment in large part because he held beliefs of optimism about the future, while simultaneously acknowledging the current reality of the desperate situation in which he found himself. This contradictory tension enabled him and his followers to emerge from their situation …

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …

Authentic Leadership—Is It More Than Emotional Intelligence?, Phyllis Duncan, Mark Green, Esther Gergen, Wenonah Ecung

Administrative Issues Journal

One of the newest theories to gain widespread interest is authentic leadership. Part of the rationale for developing a model and subsequent instrument to measure authentic leadership was a concern that the more popular theory, the full range model of leadership and its instrument, the Multifactor Leadership Questionnaire (MLQ) (Bass & Avolio, 1985), did not sufficiently emphasize aspects of leader emotional intelligence (EI), such as self-awareness (Avolio & Gardner, 2005).

In its current configuration, the Authentic Leadership Questionnaire (ALQ) (Walumba, Avolio, Gardner, Wernsing & Peterson, 2008) measures four dimensions of leadership: relational transparency, internal moral perspective, balanced processing, and self-awareness. …