Health and Medical Administration Commons^™

Electronic Health Record Incentive Program Demonstrates Adoption Association With Improved Care, Keith Rosenbaum

Applied Research Projects

This study used Meaningful Use (MU) payment information as a proxy for electronic health record (EHR) adoption linked to Centers for Medicare and Medicaid (CMS) data indicating quality to demonstrate the association of EHR adoption with improved care. The CMS quality indicators used were comprised of data from the value-based purchasing (VBP) program, readmission reduction program, and hospital compare mortality data. Results showed a positive association of EHR adoption with the VBP data, which most closely aligns the MU achievement period with the quality measure period. Readmission and mortality data showed negative and neutral associations, respectively, with a less aligned …

Anesthesia Information Management Systems: A Review Of The History, The Products, And The Adoption Of These Systems, Emily G. Hoffner

Applied Research Projects

Anesthesia Information Management Systems (AIMS) have been growing in popularity and use over the past decade, but widespread adoption of these systems by anesthesia groups and hospitals across the country is yet to occur. The promise of AIMS reaches beyond basic anesthesia recordkeeping into a realm of complex, integrated systems with enhanced billing, improved regulatory requirements, improved communication amongst caregivers, and reduced medical-legal exposure. In fact, AIMS have been shown to improve patient care and can increase the financial performance of a group. Despite the documented benefits of AIMS, adoption of these systems is low. This paper will review the …

Correctional Telemedicine And Its Benefits For Female Inmates, Chelsea Oliver

Applied Research Projects

The purpose of this study is to identify health issues that are specific to the female population of correctional institutions and how telemedicine would be beneficial in providing healthcare to same. A questionnaire was developed using information from literature on the topics obtained from a variety of places. Once the questionnaire was completed, a randomly selected group of telemedicine providers received the questionnaire, along with an introduction and information on the study that was being conducted.

The barriers of this study came from telemedicine providers either not responding to the questionnaire entirely or the providers only being able to answer …

Closing The Meaningful Use Gap Between Small And Large Practices, Crystal L. Jones

Applied Research Projects

The Lack of Meaningful Use Awareness in small practices is very prevalent. One may ask why there is such a gap in MU Awareness amongst small and large practices. The answer is quite the same across the board for small practices, “Cost”. This misfortune has resulted in many small practice physicians and staff being objective to the adoption of an electronic health record system. They are indifferent about the penalties that will be enforced soon, if they do not follow suite with the guidelines mandated by the ARRA. Essentially, this thesis will provide statistical data on the adoption rate of …

An Evaluation Of The Role Of The Originator Of Catastrophic Edits/Data Overwrites Within The Veteran Health Administration, Britney Braxton

Applied Research Projects

Objective: To determine which job function causes or creates a large number of Catastrophic Edit/ Data Overwrites within VHA.

Methods: The study is based on data extracted from the Catastrophic Edits Monthly Reports reported by the HC IdM Team staff on the CEs that have occurred on the MPI. Catastrophic Edits (CEs) reported by the HC IdM team between November 2011 through December 2012 are examined.

Result: Out of the 2736 Potential Identity Changes, 115 actually resulted in a CE. The number of CEs created by each job title ranged from 1% by Employee Health Clerk to 28% by Eligibility …

Increasing Patient Engagement In The African American Community Through Personal Health Record Use, Andrea Perkins

Applied Research Projects

Personal Health records have many potential benefits to patients, caregivers and institutions. In order to meet meaningful use standards EHR systems must allow patients to be able to access and easily download their healthcare records and images for their own use. Previous studies have shown that African Americans are less likely to enroll in a personal health record than other ethnic populations. This study was done to research and identify possible barriers the have limited the utilization of personal health record use in the African American community. A preliminary survey and focus group were convened to discuss issues affecting PHR …

Exploring The Relationship Between Adventist Hospital Board Chair Leadership Behaviors And Effectiveness, Anthony M. Stahl

Dissertations

Problem and Purpose. There is a lack of empirical research regarding the leadership behaviors that predict an effective community hospital board chair. Researchers indicate that an effective organization normally has a well-led board. However, the chair role has been largely neglected in the research of board functions and operations. With many hospitals facing reorganization or closing, it is important to understand and identify effective chair behaviors. Thus, the purpose of this study was to determine the relationship between hospital chair leadership behaviors and effectiveness, and the relationship of effective chairs to effective hospitals.

Method. This study used an ex post …

Adolescent Depression Education Program For Middle School Nurses: A Feasibility Study, Teresa Carnevale

MUSC Theses and Dissertations

While healthcare providers have increased depression screening of adolescents during preventive care, an enormous number of adolescents do not have regular contact with healthcare providers and, therefore, do not get screened. Nationwide screenings by school nurses would be an ideal way to capture students not seen by healthcare providers; however, this screening is not required and therefore does not occur. The purpose of this dissertation is to describe the three-step process by which the feasibility of using school nurses to identify and screen for adolescent depression (AD) was explored. In a pre-dissertation study, school nurses reported they lacked knowledge, time, …

Emerging Opportunities For Pharmacists To Improve Health Care For The Poor And Underserved, Lawrence M. Brown

Pharmacy Faculty Articles and Research

The changing organization, financing, and priorities of the U.S. health care system are creating new imperatives for employers, health care insurers, hospitals, and especially interprofessional health care practitioners. The Patient Protection and Affordable Care Act (ACA) of 2010 was created with the aim of decreasing overall health care cost, improving access to health care, and improving health care quality, while including provisions that support coordinated health care practitioner collaboration within the system. This coordinated collaboration among health professions has the potential to provide comprehensive, population-based, cost-effective, and high-quality patient care and a new emphasis on health promotion, wellness, and disease …

Disparity Implications Of The Medicare Medication Therapy Management Eligibility Criteria: A Literature Review, Kiraat D. Munshi, Ya-Chen Tina Shih, Lawrence M. Brown, Samuel Dagogo-Jack, Jim Y. Wan, Junling Wang

Pharmacy Faculty Articles and Research

The emphasis on eliminating racial and ethnic disparities in healthcare has received national attention, with various policy initiatives addressing this problem and proposing solutions. However, in the current economic era requiring tight monetary constraints, emphasis is increasingly being placed on economic efficiency, which often conflicts with the equality doctrine upon which many policies have been framed. The authors’ review aims to highlight the disparity implications of one such policy provision – the predominantly utilization-based eligibility criteria for medication therapy management services under Medicare Part D – by identifying studies that have documented racial and ethnic disparities in health status and …

Patients Experiences In Magnet And Non-Magnet Hospitals: Is There A Difference?, Larry Reese Kidd

MUSC Theses and Dissertations

Study Aim: To determine the relationship between hospital Magnet status designation and patient satisfaction. Data Sources: Secondary sources, the American Nurses Credentialing Center, the American Hospital Association, and Hospital Compare HCAHPS satisfaction survey data. Methods: Independent t tests were used to examine the univariate relationship between Magnet designation and 10 satisfaction survey indicators. A multivariate analysis was conducted of the 10 patient satisfaction survey indicators on Magnet designation while controlling for organization variables. It was predicted that Magnet status would be associated with 7 of the 10 measures. Results: Magnet status was found to be positively and significantly associated with …

Pharmaceutical Policy Process: Lessons From The Newly Independent States, Irina Ghazaryan

Muskie School Capstones and Dissertations

Although the pharmaceutical sector in Armenia is currently mainly established, some challenges still cause a big concern. Such facts as a lack of important policies on pharmaceuticals, an outdated legislation and a lack of regulation suggest that the pharmaceutical policy process in Armenia is not effective enough and its insufficient effectiveness is one of the most important barriers for successful implementation of pharmaceutical reforms in the country. The goal of this capstone was to analyze pharmaceutical policy process in Armenia and other Newly Independent States and to develop recommendations for Armenia. Data and information were obtained from publication searches and …

What Are The Characteristics That Explain Hospital Quality? A Longitudinal Pridit Approach, Robert D. Lieberthal, Dominique M. Comer

College of Population Health Faculty Papers

Health outcomes vary substantially between high and low quality institutions, meaning the difference between life and death in some cases. Prior literature has identified a number of variables that can be used to determine hospital quality, but methodologies for combining variables into an overall measure of hospital quality are not well developed. This analysis builds on the prior investigation of hospital quality by evaluating a method originally developed for the detection of healthcare fraud, Pridit, in the context of determining hospital quality. We developed a theoretical model to justify the application of Pridit to the hospital quality setting and then …

Simulation And Optimization Modeling For Drive-Through Mass Vaccination – A Generalized Approach, Aman Gupta, Gerald W. Evans, Sunderesh S. Heragu

Decision Science and Analytics - Worldwide

Proper planning and execution of mass vaccination at the onset of a pandemic outbreak is important for local health departments. Mass vaccination clinics are required to be setup and run for naturally occurring pandemic outbreaks or even in response to terrorist attacks, e.g., anthrax attack. Walk-in clinics have often been used to administer vaccines. When a large percentage of a population must be vaccinated to mitigate the ill-effects of an attack or pandemic, drive-through clinics appear to be more effective because a much higher throughput can be achieved when compared to walk-in clinics. There are other benefits as well. For …

Psychotropic Medication Utilization In Care Home Residents Age 65 Or Older Compared With The Equivalent General Population In Scotland, Tyler P. Stewart

MPA/MPP/MPFM Capstone Projects

Purpose: In Scotland, care homes provide assisted living and medical services. Psychotropic medications (antipsychotics, anxiolytics, and hypnotics) may be over utilized in these facilities. This study compared psychotropic medication utilization in elderly care home residents to the equivalent population of non-care home residents. It is hypothesized that patients in care homes utilize psychotropic medications more than non-care home residents.

Methods: Demographic and prescription information for all patients aged 65 years and older on January 1, 2011 who received at least one prescription for a psychotropic medication during 2011 was retrieved from the national Prescribing Information System (PIS). Patients were grouped …

Shared Leadership In Six Sigma Teams From The North Shore-Lij Health System, Brian J. Galli

Engineering Management & Systems Engineering Theses & Dissertations

The main goal of the research was to identify the relationships that the internal research team environment and external coaching variables had with the degree of shared leadership in the context of Six Sigma teams from the North Shore LIJ Health System. Furthermore, the research ascertained the relationships that these variables had with two performance metrics: a team's ability to complete project deliverables and satisfy customer's requirements. This research also sought to understand additional factors that affected the five variables.

The research found that while shared leadership did not positively change as a team progressed through the phases of the …

Decision Support For Reducing 30-Day Readmissions: General Medicine Patients In Community Hospitals, Ramez Labib Ayoub

Open Access Theses

Health expenditures in United States have experienced a gradual increase in spending with no indication of slowing down. Addressing this problem has been a major area of concern for policy makers, and as a result more consideration has been placed on decreasing health spending and increasing affordability. One major area recognized as being effective in decreasing these financial burdens has been inpatient thirty-day adult readmissions, currently costing $26 billion annually. Centers for Medicare & Medicaid Services (CMS) have determined readmissions to be an indicator of the quality and efficiency of patient care.

This research provides a prediction model for patients …

Incidence And Quality Implications Of Deep Venous Thrombosis After Peripherally Inserted Central Venous Catheter, Shawn Travis Greathouse Md, Jarom N. Gilstrap Md, Ramon Garza, Iii Md, Kimberly Reinart Rn, Holly Tavianini Rn, Bsn, Mshsa, Cnrn, Vera Deacon Rn, Crni, Robert X. Murphy Jr, Md, Ms

Department of Surgery

No abstract provided.

Information Flow And Clinical Outcomes In A Fully Functional Perinatal Continuum Of Care, Donald Levick Md, Michael Sheinberg Md, Chad D. Meyerhoefer Phd, Mary E. Deily, Shin-Yi Chou Phd, Susan A. Sherer Phd

Administration & Leadership

No abstract provided.

Evaluation Of Patient Room Furniture In An Impatient Rehabilitation Hospital, Stanley L. Healy

MUSC Theses and Dissertations

Investigating the contents of nightstands and over-the-bed tables (OBTs) located in post-acute settings is a first step towards understanding how patients use hospital furniture to allow for user-centered design. This study provides an inventory of items located on the over-the-bed table and nightstand of patients in a rehabilitation hospital. This research agenda is to improve the usability and effectiveness of patient room furniture; this study's findings have added to the current body of knowledge and have some significant implications. This study suggests that by discovering what furnishings are realistically needed or can be utilized in the patient room, hospital expenses …