<p> Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow&rsquo;s hierarchy of needs theory, and the opposing theory, Vroom&rsquo;s expectancy theory. Semistructured interviews occurred with 5 leaders. The review of hospital human resource documents, website pages, and training program information combined with interview data for methodological triangulation using the Yin 5-step process, leading to 5 themes. Participants emphasized selective recruitment and hiring with a focus on hiring employees for a good organizational fit. Participants discussed different ways of engaging, supporting, and motivating hospital employees. Strategies included valuing employees, effective communication, recognition, and respect. Participants identified a fair, flexible, collaborative, and safe organizational culture as ideal for the retention of hospital employees who fit with the hospital environment. Reducing employee turnover may improve customer relations and quality of care in hospitals, leading to lower health care costs, representing positive social change for hospital employees and the patients served.</p>

<p> Medication administration is an important task performed daily by nurses and is one of the key aspects of safe patient care. The multiple and varied roles of nurses, complexity of workplace, chaotic and technical nature of the work environment may result in cognitive overload that may overwhelm nurses, which may possibly lead to medication errors. All medication errors committed are considered serious events but some may consequently be harmful to patients. Research indicates that when medication errors occur the concern is usually for the patients involved in the incident. However, making a medication administration error has a lasting effect on the nurse as well as the patient (Schelbred &amp; Nord, 2007; Treiber &amp; Jones, 2010).</p><p> This study examined what it was like to make a medication error for eight registered nurses through in-depth and focused face to face interview using the descriptive phenomenological approach rooted in the philosophical tradition of Husserl. Two interviews were carried out with each participant and the research data were generated from a total of sixteen interviews and field notes. The transcripts were analyzed using the seven-step methodological guidelines developed by Colaizzi for data interpretation to understand the meaning of the nurses lived experiences of making medication errors.</p><p> Five theme categories emerged: Immediate <i>Impact: Psychological and Physical Reactions; Multiple Causes within Chaos: Cognitive Dimensions; Embedded Challenges: Healthcare Setting; Organizational Culture: Within the Place/Within the Person; Dynamics of Reflection: Looking Forward</i>. The essential structure of the phenomenon of making a medication administration error included the realization that a profound experience had happened to them. This resulted in physical and emotional upheavals, a threatened professional status, with low self-esteem and confidence. An overwhelming workload, a stressful work environment and ill-treatment by peers were descriptions of the cause of the errors. Nurses did offer ways to improve the system but felt their concerns were often not valued. Implications for nursing practice to improve patient outcomes, and for nursing education, to radically change the teaching of medication administration were formulated.</p>

<p> This study examined the relationship between health care leadership competencies as measured by the American College of Healthcare Executives Healthcare Executives Competencies Assessment Tool 2014 and leadership behaviors measured by the Path-Goal Theory Leadership Questionnaire among health care administrators and executives. The purpose of the study was to identify relationships between the 4 leadership behaviors (Directive, Supportive, Achievement-Oriented, and Participative) of the path-goal leadership theory with the 4 leadership competencies (Leadership Skills and Behavior, Organizational Climate and Culture, Communicating Vision, and Managing Change) from the health care sector as identified by the Leadership Domain of the American College of Healthcare Executives Healthcare Executive Competencies Assessment Tool 2014. Leadership competencies have been linked to increased performance and building professional development in individuals. For this study, quantitative methodology using survey administration was distributed to health care administrators and executives across the United States. Multiple linear regression design addressed the relationship among the Path-Goal Theory Leadership Questionnaire leadership behaviors variables and the health care leadership competencies identified by the Leadership Domain of the American College of Healthcare Executives Healthcare Executives Healthcare Executive Competencies Assessment Tool 2014. One hundred and fifty-three health care administrators and executives from across the United States were surveyed. The Path-Goal Theory Leadership Questionnaire was used to examine the impact of leadership behaviors on leadership competencies. The results of this study verified Directive and Supportive leadership behaviors were statistically significant predictors of health care leadership competencies in male subjects. Achievement-Oriented and Participative leadership behaviors were positive predictors of health care leadership competencies in female subjects. However, there was no statistical significance found between the organizational climate and culture health care leadership competencies in women.</p>

<p>The following non-experimental quantitative study was conducted in the context of an acute care hospital, surveying almost 4,000 registered nurses across 14 hospitals. The study had two primary objectives: the first utilized a two-sample t-test to determine if there was a statistically significant difference in job satisfaction and years of professional experience for those identified as informal leaders and those not identified as informal leaders. In both cases the study found a statistically significant relationship. Second, the study performed regression analysis to assess the relationship between registered nurses that were as informal leaders and patient satisfaction. Additionally, the study further assessed the impact of leadership style of the informal leader, specifically studying the impact of transactional, transformational, and passive-avoidant leadership tendencies on patient satisfaction. In this case, the study was unable to identify a statistically significant relationship between informal leadership and patient satisfaction. Similarly, the study was unable to identify a statistically significant relationship between transactional, transformational, and passive-avoidant leadership tendencies of the informal leaders and patient satisfaction. The study found that informal leaders tend to have more experience and a higher job satisfaction than their peers who were not identified as informal leaders. While failing to demonstrate a relationship between informal leadership and patient satisfaction, the study opens the door for future studies that can further assess the impact of the informal leader as a means of accomplishing important organizational outcomes. </p><p> <i>Key words</i>: informal, emergent, leadership, transformational, transactional, passive-avoidant, nursing, patient satisfaction, outcome </p>

<p>Turnaround time is a metric most often used to determine a laboratory?s performance. This business project discusses the proposal of a mobile laboratory company called the Mobile Laboratory Unit. The focus of this project is the implementation of a mobile laboratory company that can reduce turnaround time on laboratory results and deliver services at a competitive rate while keeping the integrity and reliability of laboratory results that health care providers are accustomed to receiving. North Orange County businesses are the demographic target and currently does not have an organization such as this, therefore, a company that offers a service such as the Mobile Laboratory Unit would fill a void that is present within this market. Organizations outside of health care companies would be able to use the services of the Mobile Laboratory as well to conduct onsite health screenings and drug tests for students and employees.

<p> This business plan proposes a health promotion center to help educate low-income families in Compton suffering from obesity on how to begin and maintain weight loss. Obesity is one of the leading causes of preventable deaths in adults and children. By creating a family and community-based center that provides individualized and group nutrition and fitness services, the rate of obesity can be significantly reduced. </p><p> The center which will be located in east Compton will operate as a non-profit organization. It will offer nutrition and fitness services through certified nutritionist and fitness specialist with emphasis placed on gradual weight loss. Meal planning, label reading and training, and grocery store tours are some of the nutrition services that will be offered, while aerobic training and weight training will be part of the fitness service. There will be a life coach and an on-site daycare at the center. The life coach will help potential families establish their weight loss needs, while the on-site day care will provide care for children while families exercise. Services will be offered at reduced prices, and payment will only be made out-of pocket.</p>

<p> In recent years, the financial barrier to access for prescription contraceptives has been lifted due to the Affordable Care Act. However, there is still a barrier to access because those who want it still need to get a prescription from a provider. This business plan proposes the establishment of Azura Digital Health, a scheduling tool that obstetricians and gynecologists can use to schedule their appointments, while also offering patients convenience for birth control prescriptions and assistance with finding the women&rsquo;s health provider that is right for them. Allowing patients to choose their provider can increase quality for their health, since they can choose the doctor they feel is best for them. Additionally, the convenience of getting their birth control prescription helps patients get a simple prescription for what they need in a timely manner. The scheduling tool allows providers to market themselves and broaden their patient base, as Azura Digital Health would do that work for them. Azura Digital Health hopes to improve women&rsquo;s healthcare quality, breaking the barrier to prescriber access.</p>

<p> Over one-third (78.6 millions) of U.S. adults are obese. Weight management in the typical health care practice is inadequate with fewer than half of primary care physicians consistently providing guidance on diet, physical activity, or weight control. Because 60 percent of Americans get their health insurance through their jobs, employers often bear the bulk of the obesity costs, but are also well-positioned to implement effective lifestyle interventions. The Patient Protection and Affordable Care Act (PPACA) of 2010 included provisions for the incentives and penalties employers and health plans can impose on employees&rsquo; health insurance premiums based on the participation and goal completion in wellness programs giving a major boost to a now rapidly-growing multi-billion dollar workplace wellness industry. Fit4Life, LLC intends to offer on-site wellness, fitness, and nutritional services to medium- to large-size employers with fitness facilities in the Los Angeles Metropolitan area. The company&rsquo;s unique combination of fitness, nutritional, and medical expertise rarely offered by other providers in the Los Angeles area and the convenience of the on-site service model, paired with low start-up and overhead costs are the major strengths likely to contribute to Fit4Life, LLC&rsquo;s success. </p>

<p> <i>Purpose:</i> Implement and evaluate a formal evidence-based risk screening protocol in a rural clinic setting to optimize early identification of prediabetes and T2DM in asymptomatic, non-pregnant adults age 18&ndash;44. </p><p> <i>Significance:</i> Absence of an evidence-based risk screening protocol contributed to under/overutilization in laboratory test referral and inconsistency in prescribed treatments among clinic providers. Early identification of prediabetes and initiation of appropriate treatment plans may assist in preventing T2DM and its associated complications. </p><p> <i>Methodology:</i> Quality improvement project utilizing a retrospective, randomized representative sample of charts, <i>n</i> = 30 and a convenience sample of participants, <i>n</i> = 40. The American Diabetes Association Diabetes Risk Test (ADA DRT) served as a prediabetes risk screening tool. Provider adherence to ADA DRT risk screening and laboratory test referral, type of laboratory test ordered, the relationship between demographic characteristics and the ADA DRT score, participant follow-up, and treatment ordered based on risk screening and laboratory results were analyzed using group data. </p><p> <i>Results:</i> Thirteen (35.7%) participants had laboratory values in the prediabetes or T2DM range and 100% of treatment ordered are substantiated by ADA guidelines. Using the ADA DRT tool, risk screening was completed in 100% of eligible participants; accordingly, appropriate utilization of laboratory test referral improved by 33.33%. </p><p> <i>Recommendation:</i> Incorporation of best-practices for risk screening and laboratory test referral for early identification of prediabetes is needed. APRNs are instrumental in promoting efficacious screening strategies and preventative treatment aimed at improving health outcomes. The benefits of using the ADA DRT as a prediabetes risk screening protocol in primary care should be elucidated in a prospective study.</p><p>

This study investigated the phenomenon of hospital leadership in a free-standing psychiatric hospital attached to a private, non-profit medical center. This phenomenon was studied primarily because little is known about leadership in hospitals. Therefore, the question: What is hospital leadership? was addressed. Secondary issues pertaining to external, internal, and personal aspects of hospital leadership were also addressed. They included developing understanding of: (a) How environmental constraints might affect the practice of hospital leadership; (b) how the practice of hospital leadership might vary internally; and (c) how the values and beliefs of hospital leaders might affect the practice of hospital leadership. / Hospital leadership was considered to be a form of cultural expression; therefore, ethnography was chosen as the method of research. Moreover, ethnography was chosen because it encourages development of grounded concepts and theory; outcomes expected to inform the practice of hospital leadership. / Research proceeded in three stages--entry and orientation, data gathering, and ethnography preparation--and used observation, interviewing, and secondary sources of information to generate data. Data were recorded as fieldnotes, and were analyzed continuously according to Spradley's (1980) Developmental Research Sequence Method. Data were presented as follows: Narrative descriptions of key domains, critical events, and emergent themes; ranked frequency tables for guided interview responses; taxonomies for other domains; and topological and schematic diagrams to summarize the cultural scene and concluding thesis. / This thesis suggests leadership is essentially a process of implementing a mission through the attainment of goals. It involves two major components: Values and power. Values are necessary to establish the mission; power is necessary to overcome goal constraints. Outcomes provide measures of goal attainment and quality of leadership. Feedback provides information on constraints, clarifying where power should be directed. Goals may be modified in the process. / Implications include: Successful leadership requires (a) there be a clear mission, implicitly shared by members of an organization; (b) that a leader have sufficient power to overcome constraints; and (c) that a leader be able to benefit from feedback. Future research possibilities suggested by these implications were discussed. / Source: Dissertation Abstracts International, Volume: 48-12, Section: B, page: 3526. / Thesis (Ph.D.)--The Florida State University, 1987.