Health and Medical Administration Commons^™

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

Nonprofit Pay In A Competitive Market: Wage Penalty Or Premium?, Christian King, Gregory B. Lewis

Department of Nutrition and Health Sciences: Faculty Publications

Two competing theories argue that the nonprofit sector pays differently: Nonprofit employees may accept lower pay to be able to do meaningful work for a good cause, or they may earn higher pay due to nonprofit organizations’ tax exemptions and weaker incentives to hold down wages. To test these opposing expectations, we use the 2005-2013 American Community Surveys to examine pay differences among registered nurses working for nonprofit, for-profit, and public hospitals. We also test hypotheses that public and nonprofit hospitals have smaller pay disparities by gender, race, and relationship status. We find that pay is highest in nonprofit hospitals, …

Barriers And Perceptions Of Black American Men About Prostate Cancer In Georgia, Martins M. Nnoko

Walden Dissertations and Doctoral Studies

In 2016, prostate cancer was the second leading cause of fatality in the United States. However, the population in this study 'Black American men, ages 40 and older, in selected counties in Fulton, DeKalb, Gwinnett, Clayton and Atlanta metropolitan areas' tended to underutilize prostate cancer care. The purpose of this quantitative, nonexperimental descriptive study was to determine whether socio-economic barriers and perceptions of Black American men about prostate cancer reduce their ability to access quality care in this county in Georgia. The Health Belief Model (HBM) was used to inform the predictive validity of perceptions, attitudes, and belief on individual …

Policing The Mentally Ill In Coronado, Ca, Jennifer Susan Ayres

Walden Dissertations and Doctoral Studies

The growing number of individuals suffering from mental illnesses and their inability to access intervention methods has adverse effects on the criminal justice system. These impairments increase the likelihood that police officers will have negative attitudes about persons with mental illnesses. This study sought to understand whether police officers' empathy, education, experience outside of work as well as on the job, and officers' training in the field of mental health all related to police officers' attitudes relating to persons with mental illness. The purpose of this study was to expand the body of knowledge and determine how factors such as …

Barriers To Preventive Healthcare For Immigrants In Michigan, Sondos Ghazi Al-Hachim

Walden Dissertations and Doctoral Studies

The Affordable Care Act expanded insurance coverage to the general population; however, expanding insurance coverage to immigrants might not be sufficient to improve utilization of annual physical preventive exams. This study evaluated adult Michigan immigrants' individual demographics, perceptions, and behaviors, as well as the collective cultural and system characteristics that might act as barriers to the utilization of annual physical preventive exams. Ken Wilber's integral operating system model for medicine conceptual framework was used to create a comprehensive map of factors and bring more clarity and understanding to the barriers to annual physical preventive exam. The quantitative survey was the …

Exploring The Strategies To Implement A Sustainable Energy Program In Hong Kong Public Hospitals, Terry Ting

Walden Dissertations and Doctoral Studies

Healthcare is one of the most energy-intensive industries because of its 24 hour-a-day and 7-days-a-week operation model. Climate change, due to environmental pollution, has increased the incidence of respiratory disease, cardiovascular disease, and cancer, which further overload the financial burden of our healthcare system. The National Health Service Sustainable Development Unit suggested that a sustainable healthcare sector also requires using their resources in an efficient and responsible way. Hong Kong public hospitals are facing this problem along with high energy expenditure. The purpose of this qualitative, multiple site case study was to explore strategies for Hong Kong's public hospital leaders …

Performance Improvement Data And Staff Responsibility, Tabitha Anne Bentley

Walden Dissertations and Doctoral Studies

Improving the role the nurse plays in health care delivery should be embodied in the performance improvement initiatives to successfully improve the quality of care that is delivered. The purpose of this evidence-based practice project was to collect performance improvement data and present it to staff who, in turn, used the information to improve practice and influence patient safety outcomes. The practice-focused question addressed what would occur if a tool that allowed frequent data trending was used to measure effectiveness of care and thereby influence key outcome measures. Duffy's quality caring model provided a framework for the study to support …

Medical Laboratory Managers Success With Preanalytical Errors, Huong Q. Ly

Walden Dissertations and Doctoral Studies

Clinicians rely heavily on accurate laboratory results to diagnose and treat their patients. Laboratory errors can occur in any area of total testing phases, but more than half of the errors occur in the preanalytical phase. Framed by the total quality management theory, the purpose of this multiple case study was to explore medical laboratory managers' strategies to reduce preanalytical errors. A purposive sample of 2 organizations with laboratories in southern California participated in semistructured face-to-face interviews. Company A had 2 participants and 3 participants participated in the study from Company B. Each participant had at least 5 years of …

Human Resource Strategies For Improving Organizational Performance To Reduce Medical Errors, Dr. Mary Ellen Taylor-Hyde

Walden Dissertations and Doctoral Studies

Preventable medical errors are the third leading cause of death in the United States. Healthcare leaders must consistently promote the delivery of quality and safe care of patients to reduce unnecessary errors and prevent harm. The purpose of this case study was to explore human resource strategies for improving organizational performance to reduce medical errors. The study included face-to-face interviews with 5 healthcare clinical managers who work within a multifaceted health system in the Midwestern region of the United States. Complex adaptive systems theory was used to frame this study. Interview notes, publicly available documents, and audio recordings were transcribed …

Impact Of Emergency Department Patient Flow Model And Triage Level On Patient Wait Times, Joann Lynn Featherstone

Walden Dissertations and Doctoral Studies

Some hospital emergency departments (EDs) are negatively affected by extended patient wait times, resulting in reduced hospital profitability. Therefore, it is critical hospital leaders understand factors impacting ED average patient wait times. Grounded in the business process improvement theoretical framework, the purpose of this causal comparative study was to examine the impact of an ED rapid evaluation unit (REU) patient flow model and emergency severity index (ESI) on average weekly patient wait times. Data collection comprised a census of 26 archival data records pre and postimplementation of an ED REU patient flow model from a hospital ED in Upstate New …

Effects Of Authentic Leadership Style And Nurse Engagement On Patient Satisfaction, Kimberly Dawn Washburn

Walden Dissertations and Doctoral Studies

Ineffective leadership and disengaged nurses reduce the quality of care and patient satisfaction in healthcare organizations. Healthcare leaders can benefit from understanding the factors that improve leadership ability and nurse engagement to improve healthcare outcomes. The purpose of this correlational study was to examine the relationship between the demonstration of authentic leadership characteristics and nurse engagement. The study's population comprised acute care registered nurses in a rural hospital in central Washington State. Authentic leadership theory and engagement theory constituted the theoretical framework. Independent variables were the 4 constructs of authentic leadership theory, self-awareness, balanced information processing, relational transparency, and internalized …

Experiences And Barriers For Patient Safety Officers Conducting Root Cause Analysis, Cynthia Lightner

Walden Dissertations and Doctoral Studies

Research shows that, when unintentional harm to patients in outpatient and hospital settings occurs, root cause analysis (RCA) investigations should be conducted to identify and implement corrective actions to prevent future patient harm. Executives at a small healthcare consulting company that employs patient safety officers (PSOs) responsible for conducting RCAs were concerned with the low quality of RCA outcomes, prompting this postinvestigation assessment of PSOs' RCA training and experiences. Guided by adult learning theory, the purpose of this study was to assess PSOs' RCA training and investigation experiences by examining self-reported benefits, attitudes, barriers, and time since training, and the …

Leadership Styles And Leadership Effectiveness Of Outpatient Physical Therapy Clinic Managers, Adedolapo Ibiyemi Oyefeso

Walden Dissertations and Doctoral Studies

Outpatient physical therapy clinics (OPTC), like many other healthcare organizations, face an array of challenges in meeting the needs of the growing elderly population. The leadership behavior of OPTC managers is a key component to secure employee loyalty, accommodate increased patient demand, and implement positive organizational change. The purpose of this nonexperimental quantitative survey designed study was to investigate the relationship between the leadership styles perceived by OPTC healthcare managers and nonmanagerial employees, as measured by the Multifactor Leadership Questionnaire Short. The primary research question examined the difference between the OPTC managers' self-perceived leadership style and the nonmanagerial subordinates' perceptions …

Strategies Hospital Leaders Use In Implementing Electronic Medical Record Systems, Shaunette Miller

Walden Dissertations and Doctoral Studies

Some hospital leaders lacked strategies for implementing electronic medical record (EMR) systems. The purpose of this case study was to explore successful strategies that hospital leaders used in implementing EMR systems. The target population consisted of hospital leaders who succeeded in implementing EMR systems in a single healthcare organization located in the Los Angeles, California region. The conceptual framework used was Kotter's (1996) eight-step process for leading change, and data were collected from face-to-face recorded interviews with 5 participants and from company documents related to EMR design and development. Data were analyzed through methodological triangulation of data types, and exploring …

Deep Sequencing Transcriptome Analysis Of Murine Wound Healing: Effects Of A Multicomponent, Multitarget Natural Product Therapy-Tr14, Georges St. Laurent Iii, Bernd Seilheimer, Michael Tackett, Jianhua Zhou, Dmitry Shtokalo, Ian Toma, +Several Additional Authors

Clinical Research and Leadership Faculty Publications

Wound healing involves an orchestrated response that engages multiple processes, such as hemostasis, cellular migration, extracellular matrix synthesis, and in particular, inflammation. Using a murine model of cutaneous wound repair, the transcriptome was mapped from 12 h to 8 days post-injury, and in response to a multicomponent, multi-target natural product, Tr14. Using single-molecule RNA sequencing (RNA-seq), there were clear temporal changes in known transcripts related to wound healing pathways, and additional novel transcripts of both coding and non-coding genes. Tr14 treatment modulated >100 transcripts related to key wound repair pathways, such as response to wounding, wound contraction, and cytokine response. …

Doodle Health: A Crowdsourcing Game For The Co-Design And Testing Of Pictographs To Reduce Disparities In Healthcare Communication, Carrie Christensen, Doug Redd, Erica Lake, Jean P. Shipman, Heather Aiono, Roger Altizer Jr., Bruce Bray, Qing Zeng

Clinical Research and Leadership Faculty Publications

Supplementing patient education content with pictographs can improve the comprehension and recall of information, especially patients with low health literacy. Pictograph design and testing, however, are costly and time consuming.

We created a Web-based game, Doodle Health, for crowdsourcing the drawing and validation of pictographs. The objective of this pilot study was to test the usability of the game and its appeal to healthcare consumers. The chief purpose of the game is to involve a diverse population in the co-design and evaluation of pictographs.

We conducted a community-based focus group to inform the game design. Game designers, health sciences librarians, …

Researchers', Stakeholders', And Investors' Perceptions Of U.S. Stem Cell Research Policy, Dorothy King-Moore

Walden Dissertations and Doctoral Studies

Federal support and funding for human embryonic stem cell (hESC) research in the United States lags behind stem cell programs in many countries because of the divisive debate over hESC research and the continually evolving federal policies that have hindered research efforts. The purpose of this phenomenological study was to explore the perceptions of stem cell researchers, stakeholders, and investors in the United States about the effects of the current federal stem cell policy on stem cell research in the United States, the moral disagreement with stem cell research, and their recommendations to improve stem cell research policy in the …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Initial Findings Of A Medicare Annual Wellness Visit Program, Hesper B. Nowatzki

Walden Dissertations and Doctoral Studies

Despite the emphasis of benefits on preventive health, many older adults are not receiving the recommended age specific, evidence based screenings and vaccinations. The Medicare Annual Wellness Visit (AWV) is designed to address modifiable risk factors with aging adults and close gaps in care not captured in routine office visits. Although a free Medicare benefit to patients, and a reimbursable service to health care providers, participation in the AWV is low nationwide. The purpose of the project is to introduce an AWV program to a rural health clinic in Northwest Illinois that has a population consisting of over 25% of …