<p>Federal healthcare reform has been a major driver for the widespread shift towards high-quality, value-based care at healthcare organizations in the United States. With increased emphasis on quality and value in healthcare, process and performance improvement have been identified and capitalized upon as methods by which to achieve higher quality clinical outcomes, increase patient safety and satisfaction and improve care coordination. For past several decades, lean management and related doctrines and principles have been widely adopted among healthcare organizations in the United States for process and performance improvement purposes. This business plan proposes a lean management consulting firm for healthcare organizations of all sizes and delivery models in the Greater Los Angeles area with a mission to deliver state-of-the-art lean education and training to management and staff of all backgrounds and roles. The aim of the proposed firm is to train, develop and empower its clients to ensure continuous quality improvement and eventually become one of the biggest lean consulting players in the market. </p>

<p> Mint Green is a limited liability company who provides preventative health care services to the Greater Long Beach area. Mint Green is entering the Weight Loss Services Industry which is experiencing rapid growth due to the enactment of the Patient Protection and Affordable Care Act. Mint Green has the opportunity to reach approximately 65% of firms who offer health benefits to their employees. Mint Green&rsquo;s Healthy Eating and Lifestyle Plan (HELP) is the core instruction to the weight loss programs. Mint Green has four types of weight loss programs; each developed to satisfy a wide array of budgets. Mint Green is projected to yield a profitable margin.</p>

<p> The purpose of this study was to increase the understanding of the factors that contribute to or detract from the educational preparation of graduates between associate (AD) and baccalaureate degree (BD) respiratory therapy programs through the use of graduate and employer survey ratings, Registered Respiratory Therapist (RRT) credentialing success, and document analysis of various institutional and program mission, course content, and goals.</p><p> This study employed quantitative analyses to compare the perceptions of AD graduates and their employers with the perceptions of BD graduates and their employers regarding the educational program&rsquo;s ability to prepare graduates for entry into the profession. Graduate and employer ratings of cognitive, psychomotor, and affective competencies obtained from the follow-up surveys from 16 BD and 88 AD respiratory therapy programs were analyzed to determine whether there were perceived differences in preparation of associate and baccalaureate degree graduates. Credentialing success data for graduates of 361 AD and 57 BD respiratory therapy programs were also analyzed to determine whether differences in program type had an effect on RRT credentialing success. Multivariate analyses of variance, Welch&rsquo;s F tests and Mann-Whitney two-sample test were used to analyze the data. Additional information obtained from 22 AD and 22 BD institutions were also analyzed to explore similarities and differences in mission, vision, learning outcomes and coursework.</p><p> The three most significant findings in this study were that (1) Employers rated BD graduates higher than AD graduates in the cognitive (mean ratings 4.442 and 4.256 respectively) psychomotor (mean ratings 4.508 and 4.308 respectively) and affective domain (mean ratings 4.642 and 4.496 respectively); (2) BD employer survey ratings were also higher than AD employer ratings (mean ratings 4.49 and 4.21 respectively) on the mean rating for the single item that asked graduates to rate the overall quality of their preparation for entry into the profession and (3) Findings from the document analysis revealed that BD programs required courses beyond the minimum general education, prerequisite and RT course requirements. Thus, the results of this study support the &ldquo;2015 and Beyond&rdquo; recommendation that the BD be the minimum entry-level education required for entry into the profession.</p>

<p> Type 1 diabetes is an autoimmune condition which has seen numbers increase in recent years. Being a diabetic is neither easy for the diabetic themselves nor the parents raising the diabetic child. In looking over the literature, very little research was found on the lived experiences of fathers raising a child with type 1 diabetes. Therefore, a qualitative design with a phenomenological approach was used in order to discover and describe the phenomenon. This study was based on 12 male respondents (fathers) who shared their experiences on parenting a child with type 1 diabetes. The responses of the 12 participants revealed four major themes discovered via the hermeneutic method of textual description, and sought to present the essence of their lived experience. The four major themes were diabetes is forever, dealing with it, increased pressure, and the &ldquo;new normal.&rdquo; The lived experiences of fathers who participated in this study disclosed a sense of resiliency, while learning a lot of information, quickly to better understand type 1 diabetes. The interviewees wanted to share their stories and help others, interested in this topic, gain a better understanding of what life is like parenting and raising a child with type 1 diabetes.</p>

Ethnographic interviews with pregnant Mexican-American and Native-American adolescents and young adults from low-income households explored their knowledge about conception and contraception as well as their contraceptive and sexual behavior. The findings suggest that their unwanted pregnancies are not due to a lack of knowledge but rather are due to their heteronomous sexual behavior which results in infrequent contraceptive usage and thereby a risk of unwanted pregnancy.

No description available.

<p> Monitoring bodies in the District of Columbia articulated that people diagnosed with an intellectual and developmental disability (IDD) who reside in community-based group home settings are vulnerable to safety issues, poor quality of care from registered nursing services, and poor oversight. Those monitors have identified the lack of knowledge of roles and responsibilities among registered nurses (RNs) in these settings as a significant risk factor. The District of Columbia Developmental Disabilities Administration (DDA) has no formal orientation or training for RNs that encompasses the multifaceted needs of people diagnosed with IDD. This capstone project aimed to identify the effectiveness of an educational intervention and the effect of continuing education on RNs' perception of their practice in the field of IDD. After review of current literature, an educational presentation addressing all facets of entry-level registered nursing was developed. The presentation focused on the fundamentals of IDD nursing. A group of RNs working in the District of Columbia IDD community participated in an all-day educational program and completed a pre- and posttest evaluation to measure their knowledge prior to the intervention and their knowledge gain immediately after the intervention. A standard five-point Likert scale survey was delivered on the third and sixth months after educational intervention (EI). The survey asked the participants to rate the impact of the EI at three and six months post intervention to measure their perceived confidence level and actual practice changes. Eighty-seven percent of the RNs that participated in the EI and responded to the questionnaire reported that their role as an IDD nurse had changed because of participating in this training, and 93.8% reported that they would recommend this training to other RNs entering or working in this subspecialty.</p>

<p>Peer assessment is used by health care professionals as a way to share knowledge and evaluate the performance of colleagues. Peer assessment is used widely in medical education as a preparatory tool for students, but peer assessment research in athletic training education is lacking. Athletic trainers are healthcare providers with a similar skill-set to physicians, thus, athletic training education can benefit from the use of peer assessment. Athletic training educators need to research the use of peer assessment as an evaluation tool in order to better prepare students to practice as healthcare professionals. This study investigated the accuracy and reliability of undergraduate athletic training students in their ability to assess their peers. This quasi-experimental study used between-group and within-group designs to answer the research questions. Junior-level students, senior-level students, and their instructors were enrolled as participants. Each student group&rsquo;s ratings of clinical skills and professional behaviors were compared to instructor ratings to measure accuracy, and each student group&rsquo;s ratings were compared for reliability. Cohen&rsquo;s kappa coefficient measured inter-rater agreement for all statistical analyses. Both groups of students were accurate raters (<i>p</i> &lt; .05) of their peers on clinical skills, but only the senior-level students were accurate in rating professional behaviors. Both groups of students were reliable in rating their peers on about half of the clinical skills. The senior-level students were also reliable in evaluating professional behaviors, but the junior-level students were not. The data for this study showed high levels of observed agreement for most clinical skills, subscales and the professional behaviors, but some items had low Cohen&rsquo;s kappa values, most likely due to a known paradox that occurs with the kappa statistic. As the first study in athletic training education to use undergraduate students, live data collection, and rating of professional behaviors, the findings were promising for future research. Future research needs to include training in peer assessment, use of repeated measures, and comparison of instructor scores in order to better understand peer assessment in this population. Additionally, there is a need to establish consistent, quality measures in peer assessment research, including those used in athletic training education. </p>

<p> The study was designed to examine the predictive relationship between the variables of seat preference, learning style, and past profession, and student achievement. A convenience sample of N = 248 traditional manual osteopathic students of two Canadian and one Swiss accredited English speaking part-time colleges was recruited for the quasi experimental predictive study. The participants were adult learners ranging in age from 20 &ndash; 69 years with 71% of the sample being female in accordance to the population demographic. The data collection included grade score, learning style as measured by the Learning Style Inventory (LSI 3.1), and a researcher designed survey, Demographic and Seat Preference Survey (DSPS), which gathered information on age, past profession, education, sensory deficits, and seat preferences of three seat diagrams. A multiple regression analysis was used to create the predictive equation. The variables seat preference, learning style, and past profession statistically predicted student achievement <i>R</i>² = .10, <i> F</i>(10, 217) = 2.33, <i>p</i> = .01, power .92. The specific variables action seat in the 10 X 5 seating plan <i>b</i>₁ _10X5AS = 2.91, <i>t</i>(217) = 2.51, <i> p</i> = .01, 95%CI[0.63, 5.20]; the professions of athletic therapy <i> b</i>₂ _AT = 4.60, <i>t</i>(217) = 2.77, <i> p</i> = .01, 95%CI[1.33, 7.86], Nurse/kinesiologist/occupational therapist <i> b</i>₂ _NR/KIN/OT = 4.10, <i>t</i>(217) = 2.54, <i>p</i> = .01, 95%CI[0.92, 7.27], and Other profession <i> b</i>₂ _OTHER = 3.48, <i>t</i>(217) = 2.26, <i>p</i> = .03, 95%CI[0.45, 6.52]; and the diverging learning style <i>b</i>₅_diverging = -3.03, <i> t</i>(217) = -2.13, <i>p</i> = .03, [-5.83, -0.23] contributed significantly to the prediction. In pair-wise comparisons there were significant (<i>p</i> &lt; .05) differences in mean achievement scores between the professions of athletic therapists, nurse/kinesiologists/occupational therapists, and other professions, and medical doctor/osteopathic physician/dentist, and massage therapists; between students preferring the assimilating learning style and students preferring the diverging learning style; and between the 10 X 5 action seats and non-action seats. The findings of the study support the predictive nature of past professions, learning style, and action seat preference in an English-speaking accredited part-time traditional manual osteopathic program. Recommendations for continued data collection and investigating the variables of first language and campus location are made.</p>

<p> Simulation based learning (SBL) is pedagogical method poised to innovate nursing educational approaches. Yet, despite a growing body of research into SBL, limited investigation exists regarding assumptions and beliefs that underpin SBL pedagogy. Even though key simulation design characteristics exist, the particular methods nurse educators use to operationalize simulation design characteristics and how these choices are viewed from the perspective of nursing students is unknown. Without understanding what motivates educators to design simulations as they do, it is difficult to interpret the evidence that exists to support chosen methods. Through the exploration of perspectives (points-of-view), underlying beliefs can be uncovered. Educators readily share their points-of-view on simulation design both formally (in literature) and informally (ordinary conversations). These conversations portray the subjectivity surrounding simulation design and become a vehicle for exploration. The purpose of this study was to describe and compare nurse educators' and nursing students' perspectives about operationalizing design characteristics within educational simulations. The National League for Nursing-Jeffries Simulation Framework guided this study by identifying the interaction of teacher, student, and educational practices on the five design characteristics (objectives, student support, problem solving, fidelity, and debriefing). It was from this interaction that perspectives were investigated. A Q-methodological approach was employed to investigate the subjectivity inherent in perspectives. Derived from 392 opinions on simulation design, a 60-statement Q-sample was rank-ordered into a quasi-normal distribution grid by 44 nurse educators and 45 nursing students recruited from two national organizations. Factor analysis and participants' explanations for statement placement contributed to factor interpretation. Factor analysis revealed nurse educators share a common, overriding <i>Facilitate the Discovery</i> perspective about operationalizing simulation design. Two secondary bipolar factors revealed that even though educators share a common perspective, there exist aspects of simulation design held in opposition regarding student role assignment and how far to let students struggle including when and if to stop a simulation. Factor analysis revealed nursing students hold five distinct and uniquely personal perspectives labeled <i>Let Me Show You, Stand By Me, The Agony of Defeat, Let Me Think it Through,</i> and <i> I'm Engaging and So Should You.</i> Second-order factor analysis revealed nurse educators share similar aspects of thinking with four of the five nursing students' perspectives. Results suggest ongoing and sustained educational development along with time for nurse educators to reflect on and clarify their perspective about simulation design is essential. Educators need to emotionally prepare and support nursing students prior to and during simulation activities. Further educational research is needed on how operationalizing simulation design characteristics differ based on a SBL activity with either a formative or a summative purpose.</p>