Health Services Administration Commons^™

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

Symptom Management Care Pathway Adaptation Process And Specific Adaptation Decisions, Emily Vettese, Farha Sherani, Allison A. King, Lolie Yu, Catherine Aftandilian, Christina Baggott, Vibhuti Agarwal, Ramamoorthy Nagasubramanian, Kara M. Kelly, David R. Freyer, Etan Orgel, Scott M. Bradfield, Wade Kyono, Michael Roth, Lisa M. Klesges, Melissa Beauchemin, Allison Grimes, George Tomlinson, L. Lee Dupuis, Lillian Sung

School of Medicine Faculty Publications

BACKGROUND: There is substantial heterogeneity in symptom management provided to pediatric patients with cancer. The primary objective was to describe the adaptation process and specific adaptation decisions related to symptom management care pathways based on clinical practice guidelines. The secondary objective evaluated if institutional factors were associated with adaptation decisions. METHODS: Fourteen previously developed symptom management care pathway templates were reviewed by an institutional adaptation team composed of two clinicians at each of 10 institutions. They worked through each statement for all care pathway templates sequentially. The institutional adaptation team made the decision to adopt, adapt or reject each statement, …

Telehealth Family Navigation For Early Autism Services Access: The Autism Alert Project, Mohadeseh Solgi, Avneet Sidhu, Annie Hoang, Alicia Feryn, Joseline Raja-Vora, Patricia Cavanaugh, Michelle Tae, Eric Fombonne, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown.

Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program.

Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with >30% Medicaid, located in 5 …

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Revealing Geographic Transmission Pattern Of Covid-19 Using Neighborhood-Level Simulation With Human Mobility Data And Seir Model: A Case Study Of South Carolina, Huan Ning, Zhenlong Li, Shan Qiao, Chengbo Zeng, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Direct human physical contact accelerates COVID-19 transmission. Smartphone mobility data has emerged as a valuable data source for revealing fine-grained human mobility, which can be used to estimate the intensity of physical contact surrounding different locations. Our study applied smartphone mobility data to simulate the second wave spreading of COVID-19 in January 2021 in three major metropolitan statistical areas (Columbia, Greenville, and Charleston) in South Carolina, United States. Based on the simulation, the number of historical county-level COVID-19 cases was allocated to neighborhoods (Census block groups) and points of interest (POIs), and the transmission rate of each allocated place was …

Female Infertility And Maternal And Infant Outcomes In South Carolina – The Role Of Insurance Type, Chelsea Mencio Norregaard

Theses and Dissertations

The overall objective of this research study was to examine the association between fertility treatments and maternal and infant birth outcomes, and to understand what role insurance type plays in these associations.

This retrospective statewide cohort study utilized population-based birth certificate data from January 2018 – December 2021in South Carolina, linked to all-payer claims data for outpatient services, inpatient admissions/discharges, and emergency department visits. Key exposure variables included insurance type and fertility treatment, depending on Aim. Key outcomes of interest included fertility treatment (Aim 1); maternal outcomes (Aim 2) including severe maternal morbidity, cesarean delivery without medical indication, elective labor …

Increased Physician Literacy As An Intervention To Improve Value-Based Care And Reduce Cost In The Surgical Setting, Melissa Boyles

MUSC Theses and Dissertations

The primary goal of this scoping review was to identify studies where an intervention of education and awareness of surgical supply costs with surgeons was employed as a possible stimulus for healthcare organization cost reduction in the surgical/procedural service space.

Surgical procedures are performed on approximately 25 percent of all inpatient hospital admissions. In 2018 that equated to 14.4 million surgical procedures and $210.3 billion dollars in health system costs. Surgical Procedures are a substantial portion of healthcare system expenditure and are one of the highest revenue producing services provided to patients. Additionally, there exists high variability in costs based …

Sources Of Stress, Burnout, And Career Decisions Of Male Health And Nursing Professionals: A Qualitative Inquiry Of The Challenges During The Covid-19 Pandemic, Luis Miguel Dos Santos

The Qualitative Report

The human resources and workforce shortage of registered health and nursing professionals has been a long-term problem in health systems internationally, particularly during the COVID-19 pandemic. Many health and nursing professionals face stress and burnout, which may influence their career decisions and long-term human resources development. The purpose of this study is to investigate and understand the relationship(s) between sources of stress and the reasons why male health and nursing professionals decide to leave the profession within the next six months. With the employment of the social cognitive career and motivation theory and general inductive approach with 40 male health …

Telemedicine, Not The Panacea We Thought It Would Be. A Tale Of Caution, Ahmed Elkhapery, Syed Faiz Abbas, Basil George Verghese

Advances in Clinical Medical Research and Healthcare Delivery

In the last few decades, the growing use of telemedicine has allowed access to healthcare at reduced costs and increased monitoring of chronic conditions, especially in underserved and rural areas. It is a tool of great value in low-income countries where there is a paucity of specialists. In the height of the COVID-19 pandemic, telemedicine was used to screen patients with COVID-19 like symptoms and send them to test sites directly. This helped minimize unnecessary healthcare staff and patient exposure to the infection and helped decompress ERs. Due to a lack of testing resources, many mildly symptomatic patients were presumed …

Logic Model And Data System Recommendations, Claire Devine, Natalie Royal Kenton, Kristen Lacijan, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

Mortality And Major Adverse Cardiovascular Events In Hospitalized Patients With Atrial Fibrillation With Covid-19, Lucas Wang, Lawrence Hoang, Kristopher Aten, Mujahed Abualfoul, Victor Canela, Sri Prathivada, Michael Vu, Yi Zhao, Manavjot Sidhu

Faculty, Staff and Student Publications

COVID-19 results in increased incidence of cardiac arrhythmias, including atrial fibrillation (AF). However, little is known about the combined effect of AF and COVID-19 on patient outcomes. This study aimed to determine if AF, specifically new-onset AF (NOAF), is associated with increased risk of mortality and major adverse cardiovascular events (MACEs) in hospitalized patients with COVID-19. This multicenter retrospective analysis identified 2,732 patients with COVID-19 admitted between March and December 2020. Data points were manually reviewed in the patients' electronic health records. Multivariate logistic regression was used to assess if AF was associated with death or MACE. Patients with AF …

Health Care Provider’S Perceptions Of The Transition Between Pediatric To Adolescent And Adulthood: A Qualitative Inquiry, Antoinette W. Coward, Andrea E. Mcdonald

The Journal of the Research Association of Minority Professors

This study examines the current practices provided from pediatric to adult health care for children with special health care needs at FQHCs using the Six Core Elements of Health Care. Methods: A phenomenological approach was used to recruit and interview ten (10) health leaders from FQHCs. The participants were recruited through this letter sent to the Mid-Atlantic Association of Community Health Center. The researchers-initiated contact with the key informant to introduce them to the study. After consent was obtained, demographic information collected, and interviews were scheduled. During the semi-structured interview session, the key informant was asked questions related to their …

From In-Person To Virtual: A Case Study Of An Animal-Assisted Visiting Program In A Pediatric Setting, Whitney Romine

People and Animals: The International Journal of Research and Practice

This article focuses on the practical aspects of converting a successful in-person AAA program to a virtual program in a health care setting including human, canine, and physical resources; animal welfare considerations; training, infection control, and safety guidelines; and visit delivery procedures. In 1992, an interdisciplinary team at Akron Children’s Hospital founded the Doggie Brigade, an animal-assisted activities (AAA) program where volunteer therapy dogs and their handlers visit pediatric patients. The program has become a cornerstone of the hospital’s culture over its now 30-year tenure. In March 2020, the announcement of the COVID-19 pandemic forced health care organizations to suspend …

Time Is Brain: How A Descriptive Analysis Of Telestroke Metrics Can Improve Program Performance, Christopher Cordero

MUSC Theses and Dissertations

In the event of an acute ischemic stroke, 1.9 million neurons are lost in the brain per minute. Since the inception of thrombolytic therapy and mechanical thrombectomy as effective tools in the treatment of acute ischemic stroke, the focal point of quality improvement in this field has become the time to treatment delivery. As rural and more interspersed environments exhibit high disability and mortality rates associated with these acute neurological conditions, inequities in timely care delivered to these patient populations persist. Limitations in access are now abated by the extension of neurologist expertise into these areas via Telestroke. This study …

Southern Oregon Peer Workforce Project Presentation, Lizzie Fussell, Roxanne Marsillo

Articles, Abstracts, and Reports

No abstract provided.

Additional Priorities For Peer Services Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Peer Training And Certification Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.

Southern Oregon Peer Workforce Project Report, Lizzie Fussell, Roxanne Marsillo, Natalie Royal Kenton, Maggie Weller

Articles, Abstracts, and Reports

No abstract provided.

Peer Supervision And Support Brief, Lizzie Fussell

Articles, Abstracts, and Reports

No abstract provided.