Health and Medical Administration Commons^™

An Environmental Scan Of Diagnostic Practices For Children With Disabilities In El Paso, Alezandra Martinez

Open Access Theses & Dissertations

With the prevalence of developmental disabilities in the rise in the United States, it is important that these children are identified and diagnosed as soon as possible so that they may receive appropriate medical treatment and intervention. However, research suggests that there are several factors that influence screening, referral, and diagnostic practices. This study aimed to analyze key themes that arose when parents of children with disabilities and pediatric healthcare providers discussed screening, referral, and diagnostic practices for children in El Paso, a medically underserved community. Researchers conducted a 2- phase study that employed both quantitative and qualitative methodology. Results …

Organizational Complexity And Hospitals' Adoption Of Electronic Medical Records For Closed-Loop Medication Therapy Management, Ebenezer Siaw Adu

Walden Dissertations and Doctoral Studies

Over 700,000 adverse drug events (ADEs) result in emergency hospital visits annually, and many of these ADEs are preventable through the use of health information technology in hospitals. However, only 12.6% of U.S. hospitals have developed the capacity to adopt closed-loop electronic medical records (EMR). Organizational complexity may be a major factor influencing hospitals' adoption of closed-loop EMR. This quantitative study explored how organizational complexity influenced hospitals' adoption of closed-loop EMR. Diffusion of innovation theory was the foundation for this study. Logistic regression was used to establish possible relationships between organizational complexity and hospitals' adoption of EMR for closed-loop medication …

Chronic Kidney Disease Awareness And Quality Of Care In Abuja Nigeria, Patience Eze

Walden Dissertations and Doctoral Studies

Chronic kidney disease (CKD) is a non-communicable progressive disease that can lead to kidney failure or end-stage renal disease. In Nigeria, many people do not have access to health care due to extreme poverty, which means that those suffering from diabetes or high blood pressure, or both diseases, which have been identified as the 2 main risk factors, may not know their health status. The purpose of this phenomenological study was to explore the level of CKD awareness among Nigerians and if cultural beliefs affect individuals' health seeking behaviors because of the diverse nature of the Nigerian population. The protection …

The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane

Walden Dissertations and Doctoral Studies

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …

Exploring Customer Service Through Hospital Management Strategies, Delores Leonard Leonard

Walden Dissertations and Doctoral Studies

Patient demand for a better quality of healthcare and services has increased as insurance companies have decreased payments to hospitals. The purpose of this qualitative single exploratory case study was to explore hospital managers' strategies to improve customer service. Data were gathered from semistructured interviews with 5 hospital managers who implemented customer service strategies in their hospital systems, hospital policy and procedure documents, and qualitative data from the Consumer Assessment of Healthcare Providers and Systems Hospital Compare website. Expectation-confirmation theory served as the conceptual framework that grounded the study. Data were analyzed using methodological triangulation, and 3 themes emerged: the …

Influences Of Provider-Patient Communication On Health Literacy And Public Policy Relevant Outcomes, Rachel Carla Cartwright-Vanzant

Walden Dissertations and Doctoral Studies

Several artifacts of federal policy address the connection between health literacy of patients and health outcomes. These laws include The Plain Writing Act, Health Information Technology for Economic and Clinical Health, and the Health Insurance Portability and Accountability Act. Even with this policy structure, little is known about how nurses' knowledge of health literacy may influence patient understanding of medical information and health outcomes. Using Knowles' principles of effective communication, the purpose of this mixed-methods study was to concurrently examine the relationship between nurse knowledge of health literacy and communication techniques used by nurses to identify any causal relationships in …

Managerial Strategies For Improving Employee Engagement: A Single Case Study, Ann-Marie Alcala

Walden Dissertations and Doctoral Studies

In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a

proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. …

Strategies To Improve Employee Engagement In A U.S. Federal Government Agency, Patrick L. Hyde

Walden Dissertations and Doctoral Studies

Nearly half of all frontline leaders in U.S. federal agencies during 2015 were unprepared to improve employee engagement. The lack of successful strategies to improve employee engagement in federal government agencies has led to decreased operational performance. Guided by the employee engagement theory as the conceptual framework, the single case study design was selected to explore the successful strategies that frontline leaders use to improve employee engagement at a federal agency in central Maryland. Data collection involved face-to-face, semistructured interviews with 4 frontline leaders and federal agency documents indicating employee engagement. The data analysis process included Yin's 5-step method and …

Strategies For Managing The Shortages Of Registered Nurses, Jody-Kay Mcfarlane Peterson

Walden Dissertations and Doctoral Studies

The purpose of this multiple case study was to explore strategies that healthcare facility leaders in Central Minnesota use to recruit and retain qualified nurses. Participants were 6 healthcare facility leaders including 2 nursing directors, 2 human resource personnel, 1 nurse supervisor/administrator, and 1 nurse recruiter who had the knowledge and experience in recruitment and retention of Registered Nurses (RNs) in healthcare facilities in Central Minnesota. The Herzberg 2-factor theory was the conceptual framework. Semistructured interviews were used to collect data. Data were analyzed using Morse's 4 steps data analysis process. The major themes were recruitment strategies and retention incentives. …

Nurse Practitioner Navigator Policy And Procedure Protocols In Private Practice, Wendy Grose

Walden Dissertations and Doctoral Studies

In 2010, the Patient Protection and Affordable Healthcare Act (PPACA) implemented changes to reduce healthcare spending that incorporated Centers for Medicare and Medicaid (CMS) incentive programs to reduce 30-day readmission rates in seniors with heart failure. This project includes a policy and procedure for private practice using a nurse practitioner navigator (NPN) led multidisciplinary team (MDT) for the patient-centered medical home (PCMH) to improve communication between hospitals and PCMH to decrease readmission rates in seniors with heart failure (HF). This practice change will provide an implementation and evaluation plan along with plans for future expansion. Meetings were held twice weekly …

Identifying Communication Barriers And Trust Issues Of Black Women Seeking Preventive Health Services In Houston, Texas, Melissa E. Shelton

Walden Dissertations and Doctoral Studies

Black women mortality rates are perceived to be impacted by communication barriers, trust issues, and the lack of quality preventive health services. The purpose of this phenomenological study was to explore communication barriers and trust issues perceived by Black women when seeking preventive health services. HMB was used to identify public attitudes around receiving preventive health services and to construct each question based on perceived susceptibility and perceived severity of communication barriers and trust issues. An ecological model of the communication process was used as a framework to identify fundamental relationships between the Black female patients and health care providers. …

Psychological Resilience In Correctional Officers: The Role Of Demographics, Manuel Chapa Villarreal

Walden Dissertations and Doctoral Studies

Correctional officers occupy an important societal role in maintaining safety and assisting in the rehabilitation of inmates; however, both their performance and mental health are highly susceptible to fatigue because of working in a high stress environment. This study investigated the relationship between correctional officers' demographic factors (level of education, marital status, gender, and race/ethnicity) and their psychological resilience. The Connor-Davidson Resilience Scale 10 (CD-RISC-10) was used to measure correctional officers' resilience when responding and or coping with stress. This study utilized the stress-vulnerability model as a framework to investigate protective factors against and risk factors for psychopathological symptoms. Participants …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …

Effective Strategies Employed By Retail Store Leaders To Reduce Employee Turnover, Alexandro Beato

Walden Dissertations and Doctoral Studies

Employee turnover affects retail organizations in the form of lower productivity, decreased profitability, and reduced sustainability. In 2014, organizations lost over $11 billion in tangible and intangible assets as the result of employee turnover. High employee turnover rates have an adverse effect on productivity, which lead to unsustainable business practices. The number of retail employees who quit their jobs each month increased from 432,000 in December 2016 to 464,000 in January 2017, which indicates that some managers lack strategies to reduce employee turnover. Using the transformational leadership theory, the purpose of this single case study was to explore effective strategies …

Work-Family Conflict: Does Romance Matter?, Christie Marie Charles

Walden Dissertations and Doctoral Studies

Research has shown that being in a romantic relationship has related negatively with work-family conflict. Using social exchange theory, the investment model, and role theory, this study examined the relationships among the dimensions of perceived partner support, romantic relationship interdependence, and work-family conflict. A sample of 192 adults in paid employment, currently involved in a romantic relationship, were recruited from SurveyMonkey Contribute. Study participants completed online a demographic survey, the revised Support in Intimate Relationships Rating Scale (SIRRS), the Investment Model Scale, and work-family conflict scales. Correlation analyses showed that work-to-family conflict and family-to-work conflict correlated negatively with commitment and …

A Phenomenological Inquiry Of Nurses' Lived Experiences Of Implementing Evidence In Practice, Monnie Abraham

Walden Dissertations and Doctoral Studies

Research-informed practice is crucial to ensure best possible decisions are made during care delivery. In reality, research-based evidence often does not reach patient care due to many elements that impede the implementation process. The purpose of this phenomenological study was to discover the lived experiences of nurses involved in implementing evidence-based practice (EBP) in clinical settings within hospitals in United Arab Emirates. The theoretical and conceptual basis for the study was derived from Promoting Action on Research Implementation in Health Services framework for knowledge translation and Benner's Novice to Expert theory. Twelve nurses who had experience implementing evidence to practice …

Use Of Physician Credentialing Standards By U.S. Medical Services Professionals, James Allen Reeder

Walden Dissertations and Doctoral Studies

Credentialing in hospitals is the first line of defense for improving patient safety and reducing medical errors by verifying a physician's medical knowledge and skills. There is no single set of standards for physician credentialing followed by all hospitals in the United States. Using May's normalization process theory, the purpose of this quantitative study was to survey medical services professionals (MSPs) to determine which physician credentialing standards were being used, the sources being used, and the frequency of standards used. The dependent variables in this study were the 13 ideal credentialing standards developed by the National Association of Medical Staff …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

Length Of Stay And Reimbursement Rates For Medicare Patients, Wandella Ezell

Walden Dissertations and Doctoral Studies

Medicare reimbursement rates across the United States have varied by as much as 49-130% across healthcare facilities. Geographic adjustments and severity of medical diagnoses attribute to some dissimilarity; however, the source of longer hospitalization and higher re-admission rates among Medicare patients requires financial consistency. The research encompassed (N = 3000) patients with hypertension as the focus for the study because this is a critical group of Medicare patients with a chronic disease that has been identified as a silent killer. The principal goal that drove this research study was to explain the variations in length of stay for Medicare patients …

Focus Groups As A Method To Build Library Services And Partnerships Across The Institution, Courtney R. Butler, Megan Molinaro

Posters

BACKGROUND: Children's Mercy is an independent, non-profit, 367-bed pediatric health system with multiple clinic locations and a strong focus on research. It offers a pediatric residency program and over 37 subspecialty fellowship programs.

New initiatives go through many steps from conception to implementation. The focus of this case study is to describe how gathering feedback from stakeholders during proposal development provided valuable insight, secured stakeholder collateral to support requests for administrative approval and funding, and marked the beginning of new productive institution-wide partnerships.

PROJECT STAGES:
Identify Needs
Identify Stakeholders
Evaluate Software
Conduct Focus Groups
Develop Fair Market Analysis/Executive Summary
Convene …