Health and Medical Administration Commons^™

Costs, Staffing, And Services Of Assisted Living In The United States: A Literature Review, Amy Kisling, David P. Paul Iii, Alberto Coustasse

Management Faculty Research

Assisted Living Facilities (ALFs), which provide a community for residents who require assistance throughout their day, is an important part of the long-term care system in the US. The costs of ALFs are paid either out of pocket, by Medicaid or by Long-Term Care Insurance (LTCI). Monthly costs of ALFs have increased over the past five years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the US to determine the impact healthcare on costs. The methodology for this study was a literature review and a total of 32 sources …

Bundle Vs. Non-Bundle: Looking At Differences In Care And Outcomes At A Skilled Nursing Facility, Georgia Tsmasiros

Capstone Projects 2015-Present

The Centers for Medicare and Medicaid Services (CMS) introduced the Bundled Payments for Care Improvement Initiative (BPCI) in 2013 in an effort for consumers to have higher quality and more coordinated care. This research compared the care and outcomes of four individuals with bundled payment insurance plans and four non-bundle insured individuals with the same diagnosis, accessing rehabilitation services at a skilled nursing facility. The results show no observable differences between the outcomes of individuals with a bundled insurance plan and individuals without a bundled insurance plan. The financial implications are negative for healthcare agencies participating in BPCI who must …

Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek

International Journal of Applied Management and Technology

For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 …

Children's Mercy Hospital Annual Report 2015, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Workforce Planning And Development In Times Of Delivery System Transformation, Patricia Pittman, Ellen Scully-Russ

Health Policy and Management Faculty Publications

Background

As implementation of the US Affordable Care Act (ACA) advances, many domestic health systems are considering major changes in how the healthcare workforce is organized. The purpose of this study is to explore the dynamic processes and interactions by which workforce planning and development (WFPD) is evolving in this new environment.

Methods

Informed by the theory of loosely coupled systems (LCS), we use a case study design to examine how workforce changes are being managed in Kaiser Permanente and Montefiore Health System. We conducted site visits with in-depth interviews with 8 to 10 stakeholders in each organization.

Results

Both …

Attitudes Of Mothers And Daughters Towards Menstrual Suppression, Jacqueline M. Devaney

Honors Undergraduate Theses

Recent biomedical advancements, cultural practices, and individual preferences have altered the ways in which biological process such as menstruation are perceived and managed. Increasingly, women are interested in suppressing menstruation to alleviate its negative symptoms, including bloating, menstrual cramps, fatigue, and irritability. This topic is especially relevant for adolescent girls, as mothers and daughters might have to negotiate attitudes towards daughters’ menstrual suppression. Therefore this study aims to examine how this topic is discussed and understood within the mother-daughter dyad. It is also important to consider how these attitudes are shaped by cultural background, ethnicity, socioeconomic class, and religion. Through …

Relationship Between Nurse Staffing And Quality Of Care In Louisiana Nursing Homes, Veronica Kercado

Walden Dissertations and Doctoral Studies

In 2014, Louisiana experienced substantive issues with quality of care in nursing homes. The state had the lowest nurse staffing level among all states, and 7,666 deficiencies for immediate jeopardy violations were recorded from 2011 to 2013. Despite ample research on nurse staffing and quality of care, there is no consensus on how higher nurse staffing relates to quality. The purpose of this quantitative, correlational research was to determine the relationship between nurse staffing levels and quality measures in Louisiana. Donabedian's category structure, process, and outcome was the conceptual framework used to develop the research questions. The data included the …

Development And Content Validation Of An Emergency Department Ehr Safety Educational Program, Ursula Renee Jernigan

Walden Dissertations and Doctoral Studies

Emergency Department (ED) providers and staff experience challenges with using electronic health record (EHR) software to document and communicate about patient care. These difficulties are often caused by inadequate training in the use of the organization's EHR system. Challenges with EHR use have been linked to increased ED patient wait times, which impacts patient safety by delaying care and increasing the potential for medication errors. Providing education that addresses EHR software; EHR usability; and collaboration among staff, providers, and EHR system managers has been shown to reduce ED wait times and decrease the risk of medication errors. The purpose of …

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …

Falls And Related Injuries Based On Surveillance Data: U.S. Hospital Emergency Departments, George K. Quarranttey

Walden Dissertations and Doctoral Studies

Falls can lead to unintentional injuries and possibly death, making falls an important public health problem in terms of related health care cost, incurred disabilities, and years of life lost. Approximately 1 in every 3 Americans ages 65 years and older is at risk of falling at least once every year. Children, young adults, and middle-aged adults are also vulnerable to falls. The purpose of this study was to examine the epidemiology of falls and fall-related injuries using surveillance data from nationally representative samples of hospital emergency departments in United States. The study was guided by a social-ecological model on …

Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman

Walden Dissertations and Doctoral Studies

Business leaders lack strategies to implement the employer shared responsibility provision of the Patient Protection and Affordable Care Act (ACA). Small businesses pay approximately 18% more than larger companies for the same health coverage. Within a conceptual framework of management by objectives, the purpose of this qualitative multiple case study was to explore the strategies small business leaders use to implement the employer shared responsibility provision of the ACA. Data were gathered from the review of company documents, observations, and semistructured interviews with 5 senior business leaders from small business organizations in the Mid-Atlantic region of the United States. Data …

Employee Engagement In A Cardiac Catherization Lab, Rhonda J. Smith

Walden Dissertations and Doctoral Studies

Employee Engagement in a Cardiac Catheterization Lab

by

Rhonda J. Smith

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

February 2016

This study adds to the existing body of knowledge on employee engagement and workplace climate in the catheter laboratory setting. The study goals were to discover the current state of workplace satisfaction and then to share the results with the staff to determine what to improve and how to guide them through the Lean process. This study was guided by Kanter's structural empowerment theory, which holds that structural factors …

The Connection Between Wellness Programs And Employee Job Satisfaction In Higher Education, Donel J. Richemond

Walden Dissertations and Doctoral Studies

Job dissatisfaction is becoming a fundamental concern for employers. Employee engagement makes an organization more productive and can reduce absenteeism. The purpose of this quantitative study was to examine the relationship between employer-sponsored wellness-program participation and job satisfaction among for-profit college and university leaders. Data collection involved an online survey of 400 faculty members' from for-profit universities in the United States contacted using the Job Satisfaction Survey; 103 participants completed the survey. The theoretical framework was the need-satisfaction theory, which includes the factors that promote job satisfaction and job dissatisfaction. The results came from a multiple regression analysis that indicated …

Is There An Association Between Non-Va Medical Care Coordination And Utilization Of Care?, Brenda Joyce Robisnon

Walden Dissertations and Doctoral Studies

The Non-Veteran Administration Care (NVC) is a program in which the Veterans Health Administration purchases health care when it cannot provide the health services needed for eligible Veterans. The rising cost of this program led to audits by the Office of the Inspector General and other entities. The scholarly problem for this DNP Project was the lack of oversight, accountability, and management, found throughout the audits of NVC, as well as a lack of evaluation of NVC. The purpose of this project was to ascertain if there was a relationship between the Non-VA Care Coordination program (NVCC) and utilization of …

Perspectives Of Young Adults Toward Tobacco Use, Caroline Oluwatosin Omoalako-Adesanya

Walden Dissertations and Doctoral Studies

Conditions related to tobacco use constitute the single most preventable cause of death in the United States. Approximately 443,000 U.S. adults die each year from smoking-related illnesses. During young adulthood, social and behavioral changes occur; experimentation with tobacco products such as cigarettes is common and may lead to a habit of smoking. A gap was identified in the literature on the perceived impact of family communication on young adults' decisions regarding smoking. The purpose of this descriptive phenomenological study was to address this gap by gathering information on the perspectives of young adults toward tobacco use. Fifteen young adults aged …

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …

Influence Of Patient Engagement Protocol On Health Outcomes And Medication Adherence Of Patients With Metabolic Syndrome, Angela H. Mcconnell

Walden Dissertations and Doctoral Studies

August 2016

Management of metabolic syndrome (MetS) may be enhanced by promoting patient engagement. Training health care providers in the conceptual and practical application of integrative patient centered care tools may promote patient lifestyle behaviors for better management of MetS. The purpose of this quantitative quasi-experimental study was to assess the impact of training providers in integrative patient centered care for patients with MetS. The biopsychosocial construct provided the conceptual framework for the study. Two groups of physicians were included; one received training in an integrative model (IM) while the second received no training and provided usual care (UC). Following …

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …

Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles

Walden Dissertations and Doctoral Studies

Registered nurses leaving the workplace are estimated to cost healthcare organizations and society between $1.4 and $2.1 billion annually. The purpose of this multiple case study was to explore what strategies leaders of healthcare organizations from the Eastern and Northern regions of Virginia can use to mitigate the effects of nurse turnover and its cost to the organization. The target population consisted of 8 RNs who experienced turnover during their nursing careers. The conceptual framework for this study was Herzberg's dual-factor theory. Face-to-face semistructured interviews were conducted and publically available documents were garnered. Thematic reduction of participants' interviews, coupled with …

Moving Forward With Family Centered-Care: One Step At A Time, Adrianne Dunbar

UReCA: The NCHC Journal of Undergraduate Research and Creative Activity

Family-centered care is an evolving process between patients, families, and health care providers. The family centered care model emphasizes the strength families bring to the healing process. The research project was a quasi-experimental pre-and post-test study with a communication intervention phase. The study was conducted in a Surgical-Trauma Intensive Care Unit (STICU) in a university affiliated hospital in the Southeast with restricted visitation hours. The purpose of this IRB-approved study was to measure the nurses’ perceptions of communication involvement with family members before and after the intervention phase. Approximately 50% of eligible participants responded. The communication intervention phase consisted of …