Health and Medical Administration Commons^™

Mentorship: A Powerful Tool For Ipg Success, Andrea Nelson

The Organizational Improvement Plan at Western University

Because Canada espouses principles of diversity and multiculturalism, many international pharmacy graduates (IPGs) immigrate to Canada expecting to find employment using skills for which they trained in their home country. Upon arrival, they often face challenges in credential recognition and licensure. Barriers include systemic discrimination, socio-psychological isolation, the precipitous decline in social status, and financial challenges of navigating the steps that bridge the training received in their home countries to the scopes of practice in Canada. The problem of practice (PoP) explored in this organizational improvement plan (OIP) focuses on the lack of opportunity that IPGs have to access clinical …

Intervention To Increase Home Preparation For Colonoscopies, Joshua Victor Stone

Master's Projects and Capstones

Abstract

Problem: Inpatient colonoscopies are costly to healthcare systems and inconvenient for eligible patients. The cost for a two-night inpatient bed is currently $4800.00 currently. The department manager led a five-month quality improvement project that was initiated in one 180-bed community medical center in Northern California to increase outpatient options, reduce the census and decrease the admission rate.

Context: Overburdened medical facilities often miss the opportunity to utilize ambulatory procedures due to competing operational priorities. In this setting, the Care Without Delay (CWD) department microsystem addresses barriers that impact operational throughput, efficiency, and unnecessary admissions.

Intervention: A …

The Effects Of Bundle Adherence On Ventilator-Associated Pneumonia: A Quality Improvement Project, Sara Borges, Tracy L. Brewer, Donita Beard

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Ventilator-associated pneumonia (VAP) is a hospital-acquired infection that affects intubated patients on a ventilator. The risk of acquiring the infection increases the longer a patient stays on the ventilator. Complications from ventilator-associated pneumonia can impact the patient physically, financially, or emotionally. Evidence-based recommendations collectively implemented to prevent VAP are referred to as a care bundle. Despite rising VAP cases in a local hospital, adherence to all elements of the VAP prevention bundle remained low. Our quality improvement project aimed to provide training to staff to increase awareness and adherence to the VAP bundle and decrease the number of VAP …

Understanding Intelligent Non-Adherence By Measuring The Differences In Knowledge, Attitudes, Beliefs, And Behaviors Of Self-Care In Heart Failure Patients, Marco Mimbela

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Research shows that six in ten U.S. adults have a chronic disease and four in ten have two or more (CDC, 2018). Of all chronic diseases, heart failure is the leading cause of hospitalization and mortality in the U.S. (Kilgore, Patel, Kielhorn, Maya, & Sharma, 2017). Luckily, this condition can be managed through various self-care practices. Although healthcare providers are educating their patients on these self-care practices, patients are making a conscious decision to non-adhere. This phenomenon is known as intelligent non-adherence and is mostly affected by an individual’s level of knowledge, attitudes, beliefs, …

Needs-Assessment Questionnaire Development Through The Interviews Of Mothers Post Neonatal Intensive Care Unit (Nicu) Discharge: A Qualitative Study, Cierra Robinson

Department of Occupational Therapy Entry-Level Capstone Projects

Current literature shows a gap in documenting the experiences and needs of mothers after being discharged home from the neonatal intensive care unit (NICU) (Lakshmanan et al., 2019). However, the literature that does exist suggests, following discharge from the NICU, parents and caregivers of infants' report feelings of stress and anxiety and lower levels of competence in caring for their infants (Lakshmana et al., 2019; Lee et al., 2019). There are discharge programs in existence that focus on providing services and resources for mothers, however, there is a lack of exposure, resources, introduction of programs to healthcare practitioners, and a …

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% …

Teamwork That Affects Outcomes: A Method To Enhance Team Ownership, Brian Carlson, Richelle Graham, Brad Stinson, Jordan Larocca

Patient Experience Journal

Healthcare is the ultimate team sport, and this case study explores how to build teamwork across teams. The ability for nursing, environmental services and food and nutrition services to work collaboratively to benefit patients is paramount to a patients experience and outcomes. The case study describes how the work was done to build teams and then improved outcomes in both patient and employee experiences. The learnings are applicable to any team setting not just those described in this case study.

Experience Framework

This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework ( …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

Understanding Modern Drivers Of The Employee Experience In Healthcare, Antonio Pangallo, Tim Atwell, Kristi Roe, Adrienne Boissy

Patient Experience Journal

Employee engagement has been considered the guiding metric to convey the health, loyalty, and performance of the healthcare workforce. However, the pandemic created new challenges and stimulated deeper conversations around remote work, systemic racism, inclusivity, trust, well-being, and mental illness, which calls into question whether engagement alone is enough. Using an employee experience model deployed in other industries, we identified key drivers of six employee experience (EX) outcomes. We conducted a panel study with close to 5,000 nurses and physicians to identify and prioritize current key drivers specific to the healthcare employee experience. Relative weights analyses suggest that being treated …

Rules Of Engagement: The Role Of Mistreatment From Patients In The Nurse, Physician And Advanced Practice Provider Experience, Katherine A. Meese, Alejandra Colón-López, Aoyjai P. Montgomery, Laurence M. Boitet, David A. Rogers, Patricia A. Patrician

Patient Experience Journal

The objective of this study is to examine the incidence of reported stress due to mistreatment by patients toward clinicians and the role of mistreatment from patients along with organizational factors in clinician distress. A survey of clinicians was conducted at a large academic medical center, resulting in a final analytic sample of 1,682 physicians, nurses, advanced practice providers and clinical support staff. Nurses reported the greatest incidence of mistreatment by patients as a major stressor (18.69%), followed by Advanced Practice Providers (11.26%), Clinical Support Staff (10.36%), and Physicians (7.69%). Logistic regression analysis was conducted to determine the relationship of …

Improving Workforce Experiences At United States Federally Qualified Health Centers: Exploring The Perceived Impact Of Generational Diversity On Employee Engagement, Verneda Bachus, Lihua Dishman, John W. Fick

Patient Experience Journal

This qualitative study aimed to explore a multigenerational workforce’s impact on employee engagement as perceived by Federally Qualified Health Centers’ (FQHCs) C-suite executives. It sought to answer one research question: What is the perceived impact of generational diversity on employee engagement of Federally Qualified Health Centers (FQHCs) in the United States? This cross-sectional study was national. Primary data were collected using a self-developed, two-part survey instrument: (1) eight demographic questions and (2) two open-ended, short-answer questions. Cognitive interviews, reviews by five subject matter experts, and a pilot study were completed to ensure the instrument’s validity and reliability. Demographic data were …

Comparison Of Routine Health Screening Rates Between Two Emr Systems, Lauren M. Cancio, Caleb J. Berta

Longitudinal Scholar's Project

An EMR, electronic medical record, system refers to the software widely adopted by medical practitioners to reduce the use of hard-copy files, and improve the documentation, storage, and retrieval of patient information. Some EMR systems can generate automatic alerts reminding providers when patients are due for certain preventive services or meet the criteria for various screening measures. Epic, one of the leading EMR systems in use today, contains this additional feature. The screening recommendations built into Epic are derived from a committee of USPSTF, U.S. Preventive Services Task Force, medical experts whose focus is to improve patient health across the …

Improving Residents’ Well-Being Through Mindful Interventions And Character Strength Amplification, Hasan Mabry

Master of Applied Positive Psychology (MAPP) Capstone Projects

Abstract

This paper offers a new approach that aims to improve the well-being of nursing home residents through implementing positive psychology. Developing care plans that include mindful practices as positive interventions may help improve cognition, mood stabilization, and amplification of character strengths. Specifically, residents engaging in the positive interventions may help improve their ability to live in the moment, while also learning to amplify certain character strengths as needed. Through improving mindfulness and learning to rely on their strengths, nursing home residents may become more self-sufficient during times of change. These care plans also inspire a sense of mattering within …

Nursing Perspectives And Opinions On Early Or Delayed Sepsis Treatment: A Mixed Methods Approach, Pamela L. Harris

Theses and Dissertations (ETD)

Purpose. Each year at least 1.7 million adults in America develop sepsis. Sepsis can lead to life threatening organ dysfunction, severe hypotension, and death when severe sepsis or septic shock is involved. Sepsis is responsible for 50% of acute kidney injury (AKI), which is the most common form of organ dysfunction seen in critical care. Sepsis associated AKI results in loss of, or decreased renal function, is associated with adverse long-term outcomes, and carries a higher mortality rate than non-septic AKI, sepsis without AKI, or septic shock without AKI. Surviving sepsis guidelines suggests a 1-hour window from the time of …

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity among health …

Navigating Care Transitions For Older Adults In The Emergency Department When A Social Worker Is Unavailable, Rebecca Weeks, Kathy Sawasky, Adam Perry, Michael Malone

Journal of Geriatric Emergency Medicine

Some Emergency Departments do not have social worker staffing to assess high- risk older adults who have been identified. This is of particular concern in during care transitions for older patients who are at risk for poor health outcomes. We describe triggers for the emergency provider to recognize older patients at high risk and bundles of appropriate services and community supports to mitigate risk.

Geriatric Emergency Medicine Fellowship Journal Club: Operational Changes For Recognizing Prevalent Delirium And Preventing Incident Delirium, Natalie M. Elder

Journal of Geriatric Emergency Medicine

N/A

Predictor Of Hospital Closure In The United States, Haniyeh Shariatmadari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hospital closures have recently been more common and a crucial concern in the United States since they can influence many aspects of patients' health conditions. This situation has led many scholars to investigate the adverse effect of hospitals closure. Previous research has well documented the effects of a hospital closure. However, there is a lack of studies on the predictor of a hospital closure. To fill this gap, the objective of this longitudinal study is to explore organizational and market factors associated with hospital closure. We used Data from the American Hospital Association (AHA), the Centers for Medicare and Medicaid …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

Emergency Department Policies To Improve Care Experiences For Older Adults During The Covid-19 Pandemic, Anita Chary, Shan Lliu, Lauren Southerland, Lauren Cameron Comasco, Kei Ouchi, Christopher R. Carpenter Md, Msc, Edward W Boyer, Aanand D. Naik, Maura Kennedy

Journal of Geriatric Emergency Medicine

n/a