Health Services Research Commons^™

Relationships Between Activation Level, Knowledge, Self-Efficacy, And Self-Management Behavior In Heart Failure Patients Discharged From Rural Hospitals., Van Do, Lufei Young, Sue Barnason, Hoang Tran

Journal Articles: Health Services Research & Administration

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate …

Bundled Payments For Care Improvement Initiative – Insights From The Test Pilots Of Payment Reform, Jason M. Sutherland, William B. Borden

Medicine Faculty Publications

Background: The Medicare Bundled Payments for Care Improvement (BPCI) pilot program aims to reward high-value providers by setting a global payment target for particular episodes of care. The representativeness of BPCI participants will influence the ability of this pilot to inform policy decisions. Methods: We linked the Medicare lists of participants in the risk-bearing portion of BPCI Model 2, encompassing acute and post-acute care, to the American Hospital Association resource file and the 2013 Hospital Value-Based Purchasing quality performance data. We classified episode-initiating hospitals by the number of bundles in which they were participating into “narrow”, “medium” and “comprehensive”. The …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

A Neural Network Analysis Of Treatment Quality And Efficiency Of Hospitals, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Objectives: Due to the escalating healthcare expenditure and the number of hospitalizations, it is becoming increasingly important for healthcare organizations to evaluate the cost and improve the quality and efficiency of treatment.

Method: We deploy neural networks to examine the strategic association between hospitalization experience and treatment results. The healthcare data for the years 2009-2012 are downloaded from the Statewide Planning and Research Cooperative System (SPARCS) of the New York State Department of Health (NYSDOH). We operationalize the hospitalization experience using the indicators facility ID, procedure description, type of admission, patient disposition upon discharge, APR severity of illness, source of …

Evaluation Of An Assertive Continuing Care Program For Hispanic Adolescents, Eric Strunz, Joanna Jungerman, Juliet Kinyua, Paula M. Frew

Environmental & Global Health Faculty Research

PURPOSE: This study evaluated an Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC) program targeting Hispanic adolescents at risk for substance abuse.

La Paradoja Hispana Epidemiológica: Investigando Las Preconcepciones Y Generalizaciones, Maya H. Sandalow

CMC Senior Theses

En los Estados Unidos, los latinos suelen tener menos acceso a la educación, el trabajo, y el seguro médico en comparación con los blancos no-latinos, pero aun así el grupo parece superar ciertos obstáculos de la salud. Las estadísticas de la población latina muestran mayor longevidad y otras tasas favorables en comparación con los blancos no-latinos. Los expertos han titulado esta contradicción “La Paradoja Hispana Epidemiológica”.

Desafortunadamente, la investigación de la paradoja está llena de generalizaciones y presuposiciones erróneas sobre la población latina diversa. Esta tesis investiga los participantes que producen generalizaciones sobre la supuesta paradoja para mostrar que estas …

Ems Use By The Young Adult Population In The Region Of Waterloo, Karen J. Totzke

Theses and Dissertations (Comprehensive)

Anecdotal evidence suggests that university students are accessing local Emergency Medical Services (EMS) more frequently, usually as a result of alcohol consumption. In doing so, they endanger their personal health and create challenges for EMS and local hospitals. This study examined EMS use by young adults (ages 16-24 years) to identify differences between university students and youth in the Region of Waterloo, and to determine predictors of transport to hospital. This cross-sectional study used retrospective data collected during a six-year period (2006-2011) from a large, mixed urban and rural municipal ambulance service located in southwestern Ontario. Data were extracted from …

Unicondylar Knee Arthroplasty In The Inpatient Vs Outpatient Setting: Impact On Process Time, Quality Outcomes, And Patient Satisfaction, Ibrahim Zeini

Electronic Theses and Dissertations

The implications of rising healthcare expenditures are of great concern nationally and internationally. Performing procedures in the outpatient setting can be one solution to this crisis. However, there is a lack of research on systematic approaches for transitioning procedures to the outpatient setting. Unicondylar knee arthroplasty (UKA) presents an opportunity, as it is already in the early stages of transitioning to the outpatient setting. The key step in facilitating an effective transition to the outpatient setting is comparing outpatient UKAs with inpatient UKAs with a focus on process time, quality outcomes, and patient satisfaction. This study retrospectively compares 400 UKA …

Rural Health Clinic Readiness For Patient-Centered Medical Home Recognition: Preparing For The Evolving Healthcare Marketplace [Working Paper], John A. Gale Ms, Zachariah T. Croll Mph, David Hartley Phd, Mha

Rural Health Clinics

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). The authors present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for …

Evidence-Based Hospitals, David R. Bardach

Theses and Dissertations--Epidemiology and Biostatistics

In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of …

Integration Of Rural Community Pharmacies Into A Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis, Nicholas E. Hagemeier, Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, Kelly Ferris

ETSU Faculty Works

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits …

Respectful Maternity Care Resource Package, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

The Respectful Maternity Care Resource Package is a set of manuals, tools, and resources to ensure high-quality, respectful maternal and newborn health services. The resources help program managers, health workers, and technical advisors set up workshops and trainings for facility-based providers and community health workers. The workshops provide practical, low-cost, and easily adaptable strategies to improve respectful care.

The Respectful Maternity Care Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project.

Training facility-based health providers

• Facilitator’s guide
• Orientation slide deck
• Participant’s guide

Training community health workers

• Facilitator’s guide
• Orientation slide …

Provider Recommendations For Human Papillomavirus Vaccine (Hpv) Among Adolescent Males In Southwest Georgia Counties And The Associated Hpv Prevalence In This Population, Benjamin K. Poku

College of Graduate Studies: Theses & Dissertations

Objective: The purpose of this research study was to examine the variation in healthcare providers’ behavior in recommending the Human Papillomavirus (HPV) vaccine to young male adolescents (aged 11-12), middle male adolescents (aged 13-17) and late male adolescents (aged 18-26) in rural Southwest Georgia counties. This research also aimed to identify factors associated with providers’ behaviors concerning HPV vaccination recommendation to youth in various age groups.

Methods: Upon IRB approval, secondary data were obtained from Albany Area Primary Care for a paper-based survey that was conducted in 2014 using a representative random sample of family physicians (n=12), pediatricians (n=6), and …

Assessment Of Organizational Readiness: Parent Advisory Councils In A Children's Hospital Within A Hospital, Suzanne R. Springate

DNP Projects

Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles.

Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH.

Methods: A cross-sectional survey design was …

Is Conflict A Factor In A Population's Quality Of Life? A Comparative Study Of University Students In The Palestinian Territories And Jordan, Yara Asi

Electronic Theses and Dissertations

As nearly one third of the world's population lives in an area that is in some way touched by war, researchers have long been interested in the varied impacts of conflict on civilians. Many indicators, measuring both physical and mental constructs, have been assessed in war-torn populations from around the world, one of which is health-related quality of life (HRQoL). The occupied Palestinian Territories (oPt) are one region in which copious research on health indicators has been undertaken in an effort to understand how long-term conflict manifests itself in noncombatant populations. However, existing studies focus primarily on indicators within the …

‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney

Department of Sociology: Faculty Publications

This paper explores Native American perceptions on DNA biobanking. A qualitative study was conducted among self-declared Native Americans living off reservation in two Midwest cities. Findings demonstrate a paradox: Informants maintain strong hopes for the transformative power of gene-based research while voicing very particular social anxieties. Emerging genomic technologies elicit concerns over the potential for genetic stigmatization or discrimination based on race, preventing access to health insurance or employment. Frequently, social anxieties adopt the narrative form of conspiracy theories which portray powerful agents exploiting or abusing a disenfranchised population. We argue that while Native Americans do not have a monopoly …

A Tale Of Two Diseases: Mental Illness And Hiv/Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

There have been dramatic advances in the treatment of HIV/AIDS. Whereas HIV was once a dire diagnosis, today it is treatable, and individuals who receive early and consistent treatment can expect to live a normal lifespan. Why has the scientific community made the same strides with mental illness? When I was the Legal Director of the National Association of Mental Health in the United Kingdom in the 1980s, major mental illnesses were primarily treated with powerful antipsychotics, such as haloperidol, that carried the debilitating side effects of tardive dyskinesia—involuntary movements of the tongue, lips, face, trunk, and extremities. When I …

Applying The Pharmacists’ Patient Care Process To Immunization Services: A Resource Guide For Pharmacists, Albert Bach, Jeff Goad, Mitchel Rothholz, Brian Wall, Anne Burns, Liza Chapman, Jean-Venable “Kelly” R. Goode, Sheila Seed, Rebecca Snead

Pharmacy Faculty Articles and Research

"This guidance document has been written and formatted to align comprehensive components of a pharmacy-based immunization patient encounter Collect Assess Plan Implement Follow-Up 6 American Pharmacists Association and recommendations from the National Vaccine Advisory Committee (NVAC) the Standards for Adult Immunization Practice with the original framework of the PPCP.5 The colored columns to the right throughout this document are the PPCP steps as they have been published by JCPP, and the main document text describes how to integrate each PPCP step into immunization services."

The Impact Of Patient Portals On Release Of Information Requests, April Insco

Applied Research Projects

Patient portals are no longer a thing of the past. The government has issued a mandate that all covered entities who are reimbursed under Medicare payments must implement patient portals as a part of the Meaningful Use initiative or suffer penalties. The objective of this study is to review the data to see if there is a decrease in the number of release of information (ROI) requests at facilities that have implemented patient portals. A survey was conducted to determine if there was any change in the number of ROI requests that facilities received prior to implementation of patient portal …

Managing Copy And Paste Functionality In The Electronic Health Record, Tricia Urquhart-Jones

Applied Research Projects

The increased adoption of Electronic Health Records (EHR) has identified a significant need to develop tools to help providers maximize time spent documenting in the EHR. Copy and paste functionality, also known as carrying forward, cut and paste, and cloning, is one of many tools that can help providers save time and has been around longer than computers. A survey of thirteen Health Information Management (HIM) professionals responsible for HIMS functions within an acute care hospital in North Carolina was conducted. The survey response rate was 53%. The data gathered in this research study will add to HIM body of …