Health and Medical Administration Commons^™

Implementing Preoperative Anxiety Screening To Enhance Patient-Centered Care: A Quality Improvement Initiative, Adam Chaban, Abigail Limary, Amir Ghafarian, Joyce Li, George Mckelvey, Wael Saasouh

Medical Student Research Symposium

Background: Preoperative anxiety affects 40–80% of surgical patients and is associated with poorer perioperative experiences. Despite evidence linking preoperative anxiety to increase postoperative pain, sleep disturbances, morbidity and delayed recovery, structured anxiety assessment is not routinely integrated into outpatient pre-anesthesia workflows. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a validated tool that quantifies patient anxiety and information needs. This quality improvement (QI) project aims to implement APAIS screening in a Pre-Anesthesia Testing (PAT) clinic and evaluate its feasibility, workflow integration, and acceptability.

Methods: This QI initiative will be conducted in adult elective surgery patients at the Detroit Medical …

Evaluating Normothermic Machine Perfusion For Dcd Liver Transplants: Outcomes, Costs, And Value Implications, Meet S. Patel, Alisha Williams, Kyrillos Ayoub, Noor Kamaladin, Charles S. Day

Medical Student Research Symposium

Background: As liver transplantation expands to include marginal donor organs, technologies such as the TransMedics Organ Care System (OCS) offer the potential to improve graft viability and clinical outcomes. However, limited institution-level evidence exists evaluating the cost-outcomes balance of OCS use in Donation-After-Circulatory-Death (DCD) liver transplantation. This study assesses the clinical, operational, and economic value of OCS implementation within a high-volume transplant center.

Methods: A retrospective cohort analysis was conducted of all DCD liver transplants performed at Henry Ford Hospital from January 2021 to April 2024. Outcomes were compared between traditional cold storage (2021; n=23) and OCS perfusion (2023–2024; n=82). …

Healthcare Supply Chain Optimization Techniques: Case Studies Of Pittsburgh-Area Healthcare Centers, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Beyond The Ban: Chhaupadi Abolition And The Governance Of Menstrual Autonomy In Western Nepal, Nikita Paudel

Master in Public Policy Theses

This thesis examines how two decades of efforts to abolish chhaupadi have shaped the everyday conditions under which women and girls experience menstruation in western Nepal. Chhaupadi, commonly understood as menstrual seclusion, has been addressed through Supreme Court directives, national policy, criminal law, municipal implementation instruments, hut demolition campaigns, public health programming, and rights-based advocacy. Yet the practice has persisted, adapted, and in some cases moved into less visible spaces. Rather than treating this as a simple gap between law and practice, this thesis asks how abolition efforts themselves have become part of the regulatory regime through which menstruation is …

Comparison Of Selected Supply Chain Management Practices Of Three Major Regional/Metropolitan Hospitals, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Exploring Health Insurance’S Role In Chronic Disease Management Among Hispanics, Romelyn Dones

Seton Hall University Dissertations and Theses (ETDs)

This qualitative study examined how insured non-English- and English-speaking Hispanic adults perceive the role of health insurance in the management of chronic disease. Chronic conditions remain a leading cause of morbidity in the United States, and although prior research suggests that insurance coverage improves access to care, it does not always enhance how individuals understand or utilize support for chronic disease management. Limited research has explored how individuals with chronic conditions interpret the role of insurance in their daily self-management practices, particularly among Hispanic populations. Guided by Andersen’s Behavioral Model of Health Services Use, this study explored how contextual, enabling, …

Quality Improvement (Qi) Project Aimed At Reducing Unnecessary Antibiotic Usage Among Older Adult Patients By Addressing Inappropriate Antibiotic Prescribing In Primary And Long-Term Care Settings, Pamela M. Thomas

Seton Hall University Dissertations and Theses (ETDs)

Antibiotic overuse among older adults remains a significant patient safety and public health concern. Recent national data indicate that approximately 30%–50% of outpatient antibiotic prescriptions may be unnecessary, particularly for viral or self-limiting conditions (Chua et al., 2021). Antimicrobial resistance has been associated with more than 1.27 million deaths globally (Murray et al., 2022). This quality improvement project evaluated a multifaceted antimicrobial stewardship intervention in primary and long-term care settings. Baseline review of 167 antibiotic cases revealed 37.1% were inappropriate or questionable, and 28.7% lacked adequate diagnostic documentation. The intervention incorporated provider education, electronic health record decision-support tools, audit and …

Exploring Practicing Registered Eeg Technologies' Opinions And Preferences Regarding Electroencephalographic Scope Of Practice Standard Forms Of Occupational Regulations, Richard A. Steer

Seton Hall University Dissertations and Theses (ETDs)

Abstract Background: Neurodiagnostic (NDT) is the study and recording of electrical activity in the central and peripheral nervous systems, it is essential for providing critical information that can aid in the diagnosis and treatment of neurological disorders. EEGs are the most frequently performed NDT procedures. The proportion of hospitalizations involving EEG use increased by 122.7% from 2003 to 2014, an average increase of 11.2% annually and continues to grow. The rate of rEEG use increased by 49.4% over 11 years (4.5% annually), while cEEG use increased by 302.3% (27.5% annually) (Bernheimer et al., 2018). Under existing law, the EEG profession …

Exploring Direct Support Professionals' (Dsps) Attitudes Regarding Trauma Informed Care And Its Impact On Turnover Intention, Lorraine D'Sylva-Lee

Seton Hall University Dissertations and Theses (ETDs)

The relationship between Direct Support Professionals’ (DSPs’) attitudes toward trauma-informed care (TIC) and their turnover intention has remained empirically untested, despite DSPs’ exposure to primary and secondary trauma. An estimated 8.38 million Americans with intellectual and developmental disabilities (IDD) depend on this workforce, yet 2024 turnover rates reach 53.7%. This convergent mixed methods study examined TIC attitudes, turnover intention, and their relationship among 109 DSPs in IDD provider agencies in New Jersey. Grounded in the Theory of Planned Behavior (TPB), the cross-sectional design used the ARTIC-10, TIS-6, and two open-ended items. DSPs with more favorable TIC attitudes were significantly less …

Addressing Sexual Health For Older Veterans By Healthcare Providers: A Mixed Method Study, Andrew James White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Older adults remain sexually active, yet sexual health is frequently under-discussed in healthcare settings, particularly within veteran populations. Sexual health is essential to overall quality of life, and prior studies have shown that older patients value these conversations. However, veterans often face unique factors such as military-related trauma, including military combat exposure and post-traumatic stress disorder, in addition to compounded stigma from these topics in regards to open discussions about sensitive health issues to their healthcare providers. This study is significant in its potential to uncover systemic, cultural, and interpersonal influences that shape these dynamics, with a particular emphasis …

The Use Of Electronic Notifications To Improve Guideline Adherence In Amiodarone Adverse Reaction Monitoring, Naruepat Sangpornsuk, Teetouch Ananwattanasuk

Chulalongkorn Medical Journal

Background: Amiodarone is an antiarrhythmic drug that can cause side effects on the thyroid, liver, lungs, vision, and nervous system. Guidelines for monitoring and surveillance of these side effects have been established since 2000, but adherence to them is low in many countries including Thailand. An electronic alert system was implemented to remind physicians of the monitoring guideline at Vajira Hospital, Navamindradhiraj University, Thailand since 23 August 2023.

Objective: This study aimed to compare adherence with the amiodarone guideline before and after implementing an electronic notification system (primary outcome) and to assess the incidence of amiodarone-related adverse reactions (secondary outcome). …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.

Trauma-Informed Care (Tic) In Dental Settings, Kristi M. Soileau, Angeline Lee

New Orleans Dental Association News

Trauma-Informed Care (TIC) is an approach that recognizes the impact of trauma on patients, considering trauma to better utilize methods for more effective patient care. This approach contains the following ten implementation domains that serve as a guide in organizational change:

1. Governance and Leadership
2. Policy
3. Physical Environment
4. Engagement and Involvement
5. Cross-sector Collaboration
6. Screening, Assessment, and Treatment Services
7. Training and Workforce Development
8. Progress Monitoring and Quality Assurance
9. Financing
10. Evaluation

Implementing TIC will ensure that patients feel safe and autonomous in dental clinics, which results in increased trust between patient and provider, reduced patient anxiety during office visits, and therefore better oral …

Implementation Of A Planned Extubation Nurse-Led Safety Bundle In A Pediatric Cardiac Intensive Care Unit, Broderick Sutton

Doctor of Nursing Practice Final Project Abstract

Purpose: To implement and evaluate a nurse-led planned extubation safety bundle designed to improve nurse preparedness, interdisciplinary communication, workflow consistency, and confidence during planned extubation events in a pediatric Cardiac Intensive Care Unit (CICU).

Background: Planned extubation in critically ill pediatric cardiac patients requires effective interdisciplinary coordination. Variability in nurse preparation, communication, and knowledge of sedation pharmacokinetics contributed to workflow inefficiencies and patient safety concerns. Evidence supports standardized nurse-led protocols to improve extubation readiness and reduce practice variability.

Methodology: A prospective pre-post quality improvement project was conducted over eight weeks in a pediatric CICU. The intervention included a nurse-led planned …

Improving Postoperative Handoff For Placenta Accreta: Implementing A Structured Handoff Communication Tool, Isabelle L. Gerrard

Doctor of Nursing Practice Final Project Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology …

Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.

Rowan-Virtua Research Day

The legal and ethical evolution of involuntary psychiatric medication in New Jersey has been shaped through the landmark legal cases Rennie v. Klein and Brandt v. Monte. To this effect, this poster explores how each case shaped state hospital policy and the balance between patient autonomy and clinical judgment. Rennie v. Klein (1978) established a constitutional right for involuntarily committed patients to refuse psychotropic medication, except in emergencies or with due process safeguards. Decades later, Brandt v. Monte (2006) exposed flaws in New Jersey’s administrative procedures—particularly Administrative Bulletin 78-3—which permitted coercive practices under the guise of emergency treatment and lacked …

Evaluating Referral Coordination And Scheduling In Primary Care: A Qualitative Study Of Workflow Gaps, Aprupa Alahari, Philycia Foote, S. Vincent Grasso

Rowan-Virtua Research Day

Background

Healthcare referral workflows remain fragmented despite widespread adoption of electronic health records. Primary care to specialty referrals frequently rely on fax, phone calls, manual scheduling, and disconnected communication systems, creating delays, incomplete referrals, and administrative burden.1,2 Prior literature has identified a lack of referral tracking, referral leakage, and lack of closed-loop communication as major barriers to coordinated care. Altogether, efforts are required to keep cases from falling into the “referral black hole” that plagues health systems.2-4

Hypothesis

We hypothesized that:

1. there is substantial patient burden

2. there is substantial operational fragmentation

3. current referral systems contain limited visibility or verification

Methods …

Evaluating The Efficacy Of The Confusion Assessment Method For The Icu (Cam-Icu) In Reducing Length Of Stay Among Critically Ill Patients: A Scoping Review, John Simmons, Fay Nelson, Keith Hunt, Lindsey Waller, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a prevalent complication among critically ill patients in intensive care units (ICUs), associated with increased mortality, prolonged hospital stays, and higher healthcare costs. The Confusion Assessment Method for the ICU (CAM-ICU) is a validated tool designed to aid in the early identification of delirium; however, systematic screening remains low among healthcare professionals. This scoping review aims to evaluate the efficacy of the CAM-ICU in identifying delirium and its potential impact on reducing ICU length of stay.

Method

            This scoping review began by establishing inclusion criteria to ensure the results were applicable to the researchers’ patient population, including …