Thesis (Ph. D.)--University of Washington, 1993. / Vita. Includes bibliographical references (leaves [132]-140).

<p> The purpose of this case study was to explore the perceptions and experiences of hospital emergency preparedness coordinators of preparing for and responding to incidents. Stakeholder and protection motivation theories provided the theoretical framework for the study. The nonprobability sampling technique of purposive sample was used to identify 10 hospital preparedness coordinators employed at acute care hospitals with emergency departments located in Connecticut and Massachusetts. A field-tested researcher developed 20-question interview questionnaire guided data collection. This qualitative case study answers the questions: What are hospital emergency preparedness coordinators perspectives of hospital preparedness? How do hospital emergency preparedness coordinators prepare for a hospital incident? How do hospital emergency preparedness coordinators respond to a hospital incident? What factors do hospital emergency preparedness coordinators believe best prepares a hospital for incidents? Ranked in order of replication, the researcher identified three themes using first and second cycle coding techniques with pattern coding: (a) planning, (b) training, and (c) communication. Control and motivation emerged as subthemes. Results of the study provide detail rich data for hospital emergency preparedness coordinators, and provide insight and information for stakeholders from all types of private and public organizations to improve hospital emergency preparedness programs. </p>

<p> The purpose of this study was to examine the utilization of emergency department services by homeless adults in Pomona, California achieved through quantitative cross-sectional research. The results revealed that many homeless adults frequent the emergency department for mental health reasons and those homeless adults with physical ailments required longer lengths of stay and extensive discharge planning. Most participants had insurance coverage, but many appeared to lack social or primary care resources in the community, leading to frequent emergency department usage. This study may be beneficial to individuals, communities, and professionals to better understand the healthcare experiences of homeless individuals. The tangible and nontangible barriers to healthcare, as well as outside social resources affect the general public health through risks of contagious diseases and the rise in emergency department overcrowding. </p><p>

<p> Mental health-related cases in the United States today are largely attributed to employment. Healthcare professionals in particular are at increased risk for mental health adversities due to stress, burnout, and chronic fatigue. As a result, healthcare workers become an occupational hazard and a hindrance to an organization&rsquo;s service delivery. The lack of adequate job resources and positive work climate and conditions have been found to contribute to employee stress and burnout. Organizations can then increase the health and wellness of their employees with the adoption of green and environmentally conscious workplace setting designs and expect a significant economic return annually. Having an all-inclusive green business plan such as that of GreenSpace, LLC&rsquo;s consulting company will supplement and fill in the gaps of existing research regarding the benefits of exposure to greenery and mental health in the healthcare workplace. GreenSpace, LLC, adopts the concept of green building by designing sustainable and health-conscious work spaces within the healthcare sector that seek to improve employee wellness, fuel environmental sustainability, and thus increase its clients&rsquo; profit. The company intends to distribute its services within the Orange County area; where over 10% of its working population belongs to healthcare, to the largest healthcare industries and employers. GreenSpace, LLC is poised for success and promises to target this industry. In what follows is GreenSpace, LLC&rsquo;s business plan which includes an analysis of the market, feasibility, SWOT, legal and regulatory issues, and assumptions for expenses under which the company will distribute its services.</p><p>

<p> The purpose for this qualitative research was to provide comparative data to determine if there was areas in need of improvement when it pertained to medical errors. Researchers have validated that initiating measures for continuous improvement would minimize error rates and benefit the clinicians and their patients. Patient safety was important and cause major concerns, therefore this research explored categories that influenced decision-making processes or conditions that causes deficit in reasoning, which could have an impact on cognitive abilities. Therefore, medical errors are a research worthy problem; since they cause phenomenon, conflict within managerial processes, and was a contributing factor for malpractice payouts, per a report from 2015 Institute of Medicine. As a result, researchers validated that initiating measures for continuous improvement would benefit the clinicians and their patients by minimizing errors or keeping them at a minimum. Utilizing the qualitative approach provided the best framework to narrow down cause and effects to validate the importance of support that relates to memory and relational network through retrieval-mediated learning. This research provides evidence that medical errors occurred during decision-making processes with (90%) cognitive errors, anchoring (75.7%), and (78.6%) premature closure. As a result, this qualitative research concentrated on constructs, such as, data collection from observation of prior research from scholarly, empirical, peered reviewed articles; <i>Medical Journals</i>, and education materials to provide pertinent information on diagnostic medical errors for the material within this investigation. The results from this study indicated, although, there was suggestions to improve patient-safety no significant decrease in medical harm occurred, therefore additional investigations will provide a valuable contribution to the body of knowledge and conditions for continuous improvement.</p><p>

<p> The purpose of this study was to collaborate with one of the New England VA Healthcare Systems to conduct research to evaluate the current leadership competencies at the Department of Veterans Affairs (VA) to identified competencies essential for leadership by the VA. The researcher also assessed how VA front-line staff, first-line supervisors, mid-level managers, and senior/executive leadership rate their performance and that of their supervisors. Lastly, the researcher evaluated how these leaders are trained to assume their important roles at the VA and how much of a role are executive coaching and mentoring play in this training process. The research is a quantitative research study, and the competencies and specific behavior indicators were assessed using a web-based survey via a self-administered competency instrument designated to determine employee&rsquo;s perceptions. The data collected comprised data from four different surveys/questionnaires for each position level within the organization including the demographic data. A total of 143 VA employees participated in the research study and completed surveys to measure the frequency of behaviors on a 10-point scale to answer the research questions. The results answered the key research questions asked in this study to measure leaders and emerging leader competence.</p><p>

<p> The disconnect between what evidence-based research indicates is best care for the seriously ill patient and what is delivered is significant. Local communities are charged with addressing the impact of this breakdown in care for their residents. In a system initially designed to cure, medical care is focused now on slowing the progression of complex, chronic illnesses in an aging population. The opportunities for a breakdown in care are significant. This participant action research study explored factors contributing to the breakdown of care for the seriously ill in an isolated, medically under-served County in Northwestern U.S. The combined action research and appreciative inquiry approach in this study focused on what were the actionable interventions community stakeholders considered taking in supporting improvement in the care of the County&rsquo;s population. Purposeful sampling of community providers identified 14 physicians, registered nurses and clinical social workers, who participated in semi-structured interviews. Data was analyzed through the theoretical lenses of general systems, complexity, and working whole systems theories. Issues related to trust, turf, and respect emerged as stakeholders minimized the role and effectiveness of others, and overemphasized both the capacity and burden of their agency or profession&rsquo;s ability and responsibility to address the problem. Professional training and position in the medical hierarchy were linked to the perceptions of stakeholders across all work settings and need to be acknowledged in future collaborations across disciplines. County specific recommendations are included along with recommendations for additional research.</p><p>

<p><b>Introduction</b>: Cancer registries collect tumor-related data to monitor incident rates and support population-based research. A common concern with using population-based registry data for research is reporting timeliness. Data timeliness have been recognized as an important data characteristic by both the Centers for Disease Control and Prevention (CDC) and the Institute of Medicine (IOM). Yet, few recent studies in the United States (U.S.) have systemically measured timeliness. </p><p> The goal of this research is to evaluate the quality of cancer data and examine methods by which the reporting process can be improved. The study aims are: 1- evaluate the timeliness of cancer cases at the Indiana State Department of Health (ISDH) Cancer Registry, 2- identify the perceived barriers and facilitators to timely reporting, and 3-reengineer the current reporting process to improve turnaround time. </p><p> <b>Method</b>: For Aim 1: Using the ISDH dataset from 2000 to 2009, we evaluated the reporting timeliness and subtask within the process cycle. For Aim 2: Certified cancer registrars reporting for ISDH were invited to a semi-structured interview. The interviews were recorded and qualitatively analyzed. For Aim 3: We designed a reengineered workflow to minimize the reporting timeliness and tested it using simulation. </p><p> <b>Result</b>: The results show variation in the mean reporting time, which ranged from 426 days in 2003 to 252 days in 2009. The barriers identified were categorized into six themes and the most common barrier was accessing medical records at external facilities. </p><p> We also found that cases reside for a few months in the local hospital database while waiting for treatment data to become available. The recommended workflow focused on leveraging a health information exchange for data access and adding a notification system to inform registrars when new treatments are available. </p>

This study was conducted with the focus on medical and nursing education programs in the U.S. in order to learn if they include training for their students on dealing with victims of human trafficking. In order to address this goal, the survey among professors and instructors of 650 randomly selected medical and nursing education programs was conducted, where they were asked if their programs' curricula include training on recognizing victims of trafficking, as well as providing them with health care services and assistance to escape from their traffickers. The analysis of 116 received responses revealed that the majority of medical and nursing education programs do not train their students on recognizing victims of trafficking, and providing them with relevant assistance. / McAnulty College and Graduate School of Liberal Arts / Graduate Center for Social and Public Policy / MA / Dissertation

In view of the difficulty of recruiting staff to care profession and in terms of the increasing need to find ways of ensuring a good language level in the profession, have an interest in language tests been revealed. The purpose of this paper is therefore to highlight the use of language tests for admission to the care courses for adults in Värmland. What provided This is a survey of the prevalence and an examination of the validity of the test. The issue that this study assumed is: How is language test in connection with admission to the certified health and social care courses for adults in Värmland? How well correlates intent of the use of the language test with the test's validity and reliability? The methods used to seek answers to these questions has been a combination of questionnaires and experiments. The questionnaire was used to map the use of the language test whereas the experiment was to investigate the validity and reliability of the used language test. The result shows that there are municipalities that use or plan to use language test for admission to nursing and care programs. Of a total of six answered the survey responses, showed three an affirmative answer to the question of the existence of language tests. As the intention of this use was to define "Mapping the student's language skills," "In order to determine whether the student can assimilate the content of education", and "as a basis for any linguistic support to be given". The individuals included in this testing are in a municipality only Swedish as a second language students in two municipalities all students. When asked about how well språktestets validity and reliability correlates with the intent specification, illustrate this study that there are some difficulties. The language test which formed the basis of this experiment showed deficiencies in, among other things, data content, question design and pragmatic application.