Health and Medical Administration Commons^™

Health Information Technology Implementation Strategies In Zimbabwe, Nixjoen Mandaza Mapesa

Walden Dissertations and Doctoral Studies

The adoption rate of health information technology (HIT) remains low in developing countries, where healthcare institutions experience high operating costs and loss of revenue, which are related to systems and processes inefficiency. The purpose of this case study was to explore strategies leaders in Zimbabwe used to implement HIT. The conceptual framework of the study was Davis's technology acceptance model (TAM). Data were gathered through observations, review of organizational documents (i.e., policies, procedures, and guidelines), and in-depth interviews with a purposive sample of 10 healthcare leaders and end-users from hospitals in Zimbabwe who had successfully implemented HIT. Transcribed interview data …

Improving Self-Management In Patients With Chronic Conditions, Jeryl Yvette Horton

Walden Dissertations and Doctoral Studies

Care Coordination Home Telehealth (CCHT) maintains a positive impact on the delivery of patient care in the primary care clinic at the Department of Veterans Administration Medical Center (VAMC). This quality improvement initiative targets patients with chronic conditions such as diabetes, hypertension, heart failure, and chronic obstructive pulmonary disease. These patient are frequently seen in the emergency room, and are often admitted to the hospital, where they saturate the outpatient clinics' waiting room with multiple walk-ins. CCHT has, to some extent, reduced walk-ins, emergency room visits, and hospitalization while minimizing the strain on access to care at the VAMC. Sustaining …

Diagnosing Fibromyalgia: Using A Diagnostic Screening Tool In Primary Care, Lilo Fink

Walden Dissertations and Doctoral Studies

Fibromyalgia (FMS) goes undiagnosed in as many as 3 out of 4 people who have the disease. Primary care providers (PCPs) are the first to evaluate patients; therefore, PCPs need to be able to recognize FMS, implement initial treatment, and refer for further consultation. The Fibromyalgia Diagnostic Screening Tool (FDST), a validated instrument to identify FMS, can improve the speed and accuracy of FMS diagnosis. The purpose of this project was to familiarize PCPS with the FDST, evaluate their receptiveness to the tool, and train them in its use. The Leventhal, Diefenbach, and Levanthal, common sense model of illness provided …

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 …

Hypertension Management Through Community Outreach Services For Inmates Released From Jail, Janet Baby Wurie

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is the most common chronic disease among jail inmates. Many inmates treated for HTN while incarcerated in the Fairfax County Jail do not continue treatment when they return to their communities. Factors that contribute to discontinuing HTN management once the inmate returns to the community include homelessness, low income, and lack of access to care. The purpose of this quality improvement project was to educate inmates with HTN about community-based outreach services for HTN management and continuity of care while in the community. The outcome measured was the number of inmates who returned to jail reporting use of …

The Role Of Illness Intrusiveness And Personal Control In Mediating The Relationship Between The Intravenous Immunoglobulin Treatment Experience And Quality Of Life In Neurological Autoimmune Patients, Pamela Jane Gennari

Walden Dissertations and Doctoral Studies

Intravenous immunoglobulin (IVIG) is a common treatment for the neurological autoimmune diseases multiple sclerosis, multifocal motor neuropathy, myasthenia gravis, and chronic inflammatory demyelinating polyneuropathy. However, there is scant literature regarding the psychological effects of this treatment on quality of life (QOL). Using illness intrusiveness theory and personal control theory, this correlational, cross-sectional study examined the relationship between the IVIG treatment experience and QOL in neurological autoimmune patients. Surveys were employed to collect data from 79 patients at a neurological infusion center in Phoenix, AZ. Quantitative analyses included correlation, multiple regression, and mediation analyses to determine whether (a) IVIG treatment experience …

Federal Health Care Fraud Statute Sentencing In Georgia And Florida, 2011-2012, Lisa Walker Johnson

Walden Dissertations and Doctoral Studies

The financial costs of U.S. federal health care fraud continue to increase, and as health care payments due to fraudulent claims increase, the portion of The Medicare Trust Fund available to pay for legitimate health care expenses decreases. Prosecution is one of several fraud management life cycle components that contributes to and can alter the course of increasing health care fraud; however, despite this recognition, there is a gap in the literature regarding the consistency of prosecution for federal health care fraud across different judicial districts. The purpose of this qualitative, exploratory multiple case study was to explore the federal …

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 …

The Utility Of Health Care Performance Indicators In Evaluating Low Back Surgery, Pradeep K. Narotam

Walden Dissertations and Doctoral Studies

Low back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was …

Improving Patient Care Delivery In A Small Alaska Native Health Care Organization, Annette Cecile Siemens

Walden Dissertations and Doctoral Studies

Chronic diseases impose heavy burdens on the United States health care system, particularly among some ethnic/racial groups such as American Indian and Alaska Natives who experience higher incidence of these diseases than non-Native population. In an effort to improve the health status of its patients, the Ukudigaunal Wellness Center (UWC) partnered with the Improving Patient Care (IPC) Collaborative to implement changes designed to improve chronic disease care for Native Alaskans through intensive monitoring of screening for chronic disease and selected chronic disease outcomes. For this program evaluation, the units of analysis were the changes in health service delivery and the …

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 …

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 …

Strategies To Retain Employees In Clinical Laboratories, Amber Rose Phipps

Walden Dissertations and Doctoral Studies

With 30 million citizens gaining access to U.S. healthcare through the Affordable Care Act by 2016, healthcare managers need preanalytic employees to ensure quality healthcare services can be provided. The purpose of this qualitative single case study explored strategies used to retain preanalytic employees. The target population consisted of 10 clinical laboratory managers in a single community-based clinical laboratory in the mid-southern United States, selected because of prior success in improved employee retention strategies. The conceptual framework grounding this study was the theory of work adjustment. Data triangulation occurred from using semistructured interviews and company documents. All interpretations from the …

Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus

Walden Dissertations and Doctoral Studies

Health care administrators in Ontario want to transform health care with a focus on improving efficiency and quality of care, yet they pay little attention to increasing revenue. The purpose of this qualitative case study was to explore strategies Ontario hospital administrators apply to generate nongovernment revenue to remain sustainable. The target study population consisted of 2 chief executive officers and 2 chief financial officers at Ontario academic research hospitals. The conceptual framework for this study included radical organizational change theory supported by complexity leadership theory, and grounded in an evidence-based approach. The researcher conducted open-ended semi-structured interviews and made …

Community And Patient-Centered Medical Home In The Care Of Chronically Ill Patients, Victor A. Carrillo

Walden Dissertations and Doctoral Studies

Large portions of the US population live in poor inner-city communities. Health needs assessment data have shown that these communities have disproportionately high rates of chronic illnesses. The patient-centered medical home (PCMH) model was developed to address the gaps that exist in the primary care system, and emphasizes a redesign of primary care that is patient centered, utilizes multiple levels of healthcare professionals, information technology, and care coordination. However, little evidence exists on the value of this model which may explain why it has not gained wide acceptance by primary care providers. Therefore, this study was designed to examine the …

Leadership Strategies For Retaining Healthcare Professionals, Kimberly Hulett

Walden Dissertations and Doctoral Studies

Obtaining information about employee engagement and retention practices is vital for organizations. Affective organizational commitment reflects the extent to which organizational members are loyal and willing to work toward organizational objectives. In particular, affective organizational commitment holds important implications at all organizational levels (e.g., turnover rates, performance, and citizenship behavior). Using general systems theory and transformational leadership theory, the purpose of this single case study was to explore strategies used to improve employee engagement and retention from 5 senior leaders with hiring responsibilities from a midsize hospital in Austin, Texas that have been successful with employee engagement and retention strategies. …

Crafting A System Of Profound Knowledge Management In Long-Term Care, Charlotte Johnston

Walden Dissertations and Doctoral Studies

The paradigm shift to a knowledge economy, predicted by Drucker, is currently reflected in a knowing-to-doing gap in healthcare, potentially threatening the lives of long-term care (LTC) residents and sustainability of LTC organizations. The purpose of this grounded theory study was to seek a substantive conceptual theory to explain how LTC uses knowledge management (KM) to improve performance by probing the a priori views and lived experiences of 11 LTC knowledge creators, managers, and users. Data were collected via semi structured interviews that were transcribed and coded. The research questions guided by the conceptual concentrated on how KM is used …

Health Care Leaders' Experiences Of Electronic Medical Record Adoption And Use, Joseph B. Weagraff

Walden Dissertations and Doctoral Studies

Adoption of electronic medical record (EMR) technology systems of meaningful use has been slow despite the mandate by the U.S. government. The purpose of this single case study was to explore strategies used by health care leaders to implement EMR technology systems of meaningful use to take advantage of federal incentive payments. Diffusion of innovation theory provided the conceptual framework for the study. Semistructured interviews were conducted with 6 health care leaders from a military installation in the Southeast United States. Data were analyzed using software, coding, and inductive analyses. The 3 prominent themes were patient, provider, and champion. Alerts …

Pharmacy Stores Profitability And Sustainability In Bulawayo, Zimbabwe, Augustine Khoza

Walden Dissertations and Doctoral Studies

Zimbabwe's catastrophic economic decline resulted in a high unemployment rate (95%), declining socioeconomic indicators, pharmacy stores' unprofitability and lower sustainability. Profitable pharmacy stores play a fundamental role in ensuring public access to medication. Lack of pharmacy profitability leads to poor healthcare delivery, resulting in increased morbidity and mortality. A healthy population is panacea to economic growth and prosperity and enhances human dignity, social cohesion, and the quality of life. In this qualitative, descriptive multicase study design, using Porter's business strategies theory and the Deming process of quality assurance as conceptual frameworks, data from 11 pharmacy stores leaders in Bulawayo, Zimbabwe …

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 …