Thèse (M.Sc.)--Université de Sherbrooke (Canada), 2008. / Titre de l'écran-titre (visionné le 1 février 2007). In ProQuest dissertations and theses. Publié aussi en version papier.

Thesis (Educat.D.)--Fairleigh Dickinson University, 1983. / Source: Dissertation Abstracts International, Volume: 43-11, Section: B, page: 3529.

<p> The purpose of this qualitative exploratory case study was to explore the perceptions held by physicians, nurses, and other allied clinicians regarding hand-hygiene practices in order to understand what causes non-compliance with those practices. The conceptual framework guiding the research study was based on the social behavioral theories Rosenstocks Health Belief Model, The theory of reasoned action (TRA), introduced by Ajzen and Fishbein (1975) and The social cognitive theory which suggests that an individual&rsquo;s behavior is determined by his or her own personal intention and that this intention is a function that also determines the individual&rsquo;s attitude toward the subjective norm or behavior. This research study employed a telephone interview with open-ended questions to explore physician, nurse, and allied clinician perceptions about the hand washing and the factors for non-compliance. The content of the transcribed interviews were analyzed using NVivo 10 software to explore the hand hygiene perspective of a purposeful sample of 3 nurse, 3 physicians and 4 allied clinicians with at least two years of direct patient care experience. Interview data collected from the study resulted in 5 major themes encompassing the need for healthcare institutions to consider when developing hand hygiene initiatives. The descriptive patterns that emerged were: (a) lack of reoccurring formal education/training, (b) staff shortages, (c) sink placement, (d) skin breakdown and sensitivity to hand hygiene products, (e) educational differences among the three groups (physician, nurse, and allied clinician staff). Specifically the results of the case study showed demographic and generational variability with participants of different ages, educational backgrounds, and patient care experience. Results from the study led to recommendations for healthcare leaders that may strengthen hand hygiene compliance enforcement. Study results were also used to make suggestions for future research.</p>

<p>Between 2004 and 2014, healthcare jobs were among the fastest growing occupations in the U.S, adding 4.3 million positions and expected job growth of 30.3%. The majority of the healthcare workforce is overwhelmingly dominated by women. However, when it comes to leadership positions, especially executive and board levels, females are considerably underrepresented. Interestingly, though, women, more than men, are reported to demonstrate traits such as transparency, compassion, and support for teamwork, which would benefit organizations as they venture into the future of healthcare delivery. In recent years, women have made minimal entry into the highest ranks of managerial positions of healthcare in American corporations. The purpose of this phenomenological qualitative study was to identify experiences, barriers, and obstacles that women in healthcare organizations have overcome in their efforts to obtain successful leadership positions. Ten women in varying capacities of healthcare leadership positions from across the United States engaged in open-ended interviews to discuss what obstacles and adversities they have faced and conquered to advance to their levels of leadership. The data focused on career paths, obstacles, leadership qualities, demographics, and experiences. The participants identified their perceived leadership styles to be centered around the importance of communication and what they deemed soft skills, suggesting a different style from their male counterparts. The results of this study confirmed that even in the 21st century, career barriers such as family responsibilities, gender, lack of self-confidence, and current career challenges continue to exist for women seeking executive leadership positions in the healthcare field. Keywords: women?s leadership, healthcare, leadership barriers, obstacles

<p> Studies have revealed that bilingual individuals opt their native language as the first choice for consultation with health professionals. Moreover, a concordant cooperation between patient and pharmacist is significantly impaired where one party is applying a language with which both sides are not comfortable or confident. Accordingly, a multilingual pharmacy has the potential to remove language barriers for non-compliance among customers who need pharmacy services. On the other hand, in today&rsquo;s competitive market, a pharmacy may guarantee its survival, and also high revenue, if it fills a sizable amount of Medicare patients&rsquo; prescriptions since a majority of these physician orders include at least three types of chronic-disease medications. However, there are still communication barriers with some of Medicare beneficiaries because of their limited proficiency in English.</p><p> DANA, a private community pharmacy, intends to remove aforementioned obstacles in the heart of Laguna Woods and its neighboring cities where they place prescriptions for a large number of Persian and Hispanic immigrants and serve a community with the highest density of elderly people in Southern California.</p><p> DANA&rsquo;s mission is to deliver highly valued health care in a manner that ensures optimal medication therapy outcomes for the whole community by performing its trilingual Farsi-Spanish-English pharmacy service and being more attentive to elderly patients.</p><p>

<p> This dissertation explores patient trust in their physician and its impact on telemedicine. Telemedicine is using any technology to remotely communicate with a healthcare professional. The first study explores patient trust in their physician by validating the Wake Forest Trust in Physician scale for use in telemedicine research. The original (TIP) scale consists of 10 items and measures four of the five dimensions of trust: Fidelity, Competence, Honesty, and Global Trust. The final validated scale for telemedicine use (T-TIP) consisted of 12 items measuring three subscales: trustworthiness, interpersonal skills, and confidentiality. Study two explores the relationship between patient trust and delivery mode (telemedicine versus traditional interactions). The results from Study 2 indicate that patients trust their physician more in the telemedicine interaction than in the traditional interaction. There was also an effect of location, ethnicity, and frequency of doctor visits on patient trust. Study three delves further into the relationship between patient trust and telemedicine by examining the impact of communication mode on patient trust. Additionally, study three explores the relationship between usability and trust. There was no difference in patient trust scores between text and verbal communication. However, study three did find that as perceived usability of the interface increases, patient trust in their physician also increases. Also, this study found that the text interface had a higher fixation rate and shorter fixation duration than the video interface, indicating that the text interface had less cognitive load. These studies not only provide a tool for measuring patient trust in their telemedicine physician but also demonstrate that there is an impact of patient trust on telemedicine. The fact that patient trust in their physician is higher in telemedicine means that telemedicine could be used to increase patient participation in their own healthcare. Additionally, the relationship between usability and patient trust could be used to increase telemedicine use.</p><p>

<p>Functional Status in Hospitalized Senior Patients: Measurement, Prediction Models, and Cost-Saving Opportunities By Margaret A. Kornuszko-Story Abstract Seniors have declining functional ability which is made worse from immobility during hospitalization. Accountable providers have underestimated how addressing patient function can reduce costs and improve quality by reducing length of stay, readmissions, and discharges to skilled nursing facilities (SNF). This study conducted a budget impact analysis to determine potential cost savings associated with an early patient function assessment and mobility intervention. Binary logistic regression was employed to explore whether prediction models for discharge disposition and 30-day all-cause hospital readmissions can be improved with the addition of Ambulatory Measure Post-Acute Care (AM-PAC) predictors. Semi-structured interviews were conducted with process stakeholders to understand how function measurement and patient mobility can be supported in acute care facilities. Results indicated that acute care facilities in this Network would save a net of $6.4 million; and the Accountable Care Organization by reducing discharges to SNFs and readmissions would generate $4.6 million and $4.5 million respectively. AM-PAC Mobility and Self-Care scores are good predictors of discharge destination (C = 0.890), and while not significant predictors of readmission, improved the C-statistic from 0.792 to 0.811. All interviewees (n=13) stated that a culture of mobility is an important aspect for an early patient assessment and mobility intervention.

<p> The United States health care system has evolved over the years, to be a massive system with many steps required to obtain medical care. With the current shortage of primary care providers, patients are often waiting for an available appointment to receive basic medical treatments, screenings, immunizations, etc. A trip to the physician&rsquo;s office, urgent care, or emergency department can be an entire day ordeal. The emergence of retail clinics since the year 2000, has been tackling this issue to provide convenient medical care in the community. The cost of health care has also risen, leading to many individuals, even those that are newly insured, to avoid seeking treatment. Wellness Check is a new convenient care clinic seeking to fill the gap in the market for patients that wish to be seen quickly and conveniently. This new retail health clinic chain will be in central hubs throughout multiple communities, with the goal of bridging the gap in primary care. The following proposed business plan outlines an analysis of the market, business feasibility, legal and regulatory factors, and finances. Wellness Check will succeed in providing expedient convenient care with tremendous growth potential looking towards the future.</p><p>

<p> Many individuals or couples have a strong desire to have their own biological children. When experiencing difficulty conceiving many struggle with high levels of anxiety, stress, and depression. Infertility is caused by a variety of factors affecting both women and men. Treatment can be medically invasive and expensive. The purpose of this project is to offer a well-rounded perspective on infertility to help clients cope and start a family. WeCare Fertility Support Center will be a comprehensive counseling center improving the lives of many individuals and couples by providing educational guidance on infertility treatments, communication skills, psychological support and direction with adoption. Patient&rsquo;s will have someone to rely on every step of the way offering support and guidance. WeCare Fertility Support Center will provide physical, emotional and psychological well-being for patients in Long Beach CA and its surrounding neighborhoods.</p><p>

<p> The U.S. healthcare industry seeks to improve patient satisfaction as the national trend of increasing diversity and ethnic representation continues. The provision of culturally sensitive health care will not only increase patient satisfaction and outcome metrics but also allow healthcare organizations to thrive financially by meeting patient needs and payer requirements. Just Culture Consulting, LLC. is a start-up, for-profit healthcare consulting firm that will provide cultural competency and language training services for healthcare professionals. Just Culture Consulting, LLC. aims to build a regionally and potentially a nationally recognized brand in specialty healthcare consulting by capitalizing on the growing need for culturally competent providers in healthcare. The Firm will retain a large client base through aggressive marketing and by leveraging the skills of its multicultural staff who possess significant career and native exposure to language, cultural sensitivity, healthcare delivery, and administration.</p><p>