<p> Shared leadership paradigms are becoming more popular in organizations because of the increased responsibilities placed on leaders within health care organizations. Researchers have conducted little research on how individuals on leadership teams perceive their role in engaging with others in their team. The qualitative phenomenological hermeneutic study involved examining how radiology administrators in Northern California describe their lived experiences on shared leadership teams, with an emphasis on their perceptions of team productivity and trust. The conceptual framework for the study included shared leadership theory, which scholars have noted is still a new field of study. Seven research participants representing from three to 18 years of experience as radiology managers with experience serving on shared leadership teams. From the five initial questions and sub questions, the analysis involved breaking down the responses into 175 separate areas of exploration. In addition to the demographics of the groups and types of teams served on, four themes emerged from this data: lived experience on shared leadership teams, knowledge and skills learned from shared leadership teams, key factors affecting team performance on shared leadership teams, and the effect of diversity on shared leadership teams. The implications of the research to leadership are that radiology managers may gain a better understanding of when to use shared leadership and how to best staff the teams to support organizational work, and how to improve shared leadership team dynamics.</p>

<p> The LASIK market in Orange County, CA is extremely saturated, with the exception of the city of Laguna Niguel. This business plan proposes the creation of The LASIK Experts in Laguna Niguel to fulfill the need for such a LASIK center within the city. Based on the detailed financial projections prepared by the company&rsquo;s management, it is estimated that a bank loan is necessary to begin the company&rsquo;s operations successfully. The funds will be used to provide the initial working capital for the first three fiscal years. </p>

<p>Recent innovations in bio-medical technologies had made it possible to have a livelier and healthy skin. The field of dermatology has seen a tremendous development from the era of Botox to the current one of skin peeling. This business plan proposes the establishment of a Los Angeles area dermatology clinic that specializes in dermatology and provides cosmetic services under the hands of experienced providers. This clinic would provide the latest and most researched treatment options to the patients. The patients would be given the privilege to choose from a variety of treatment options. This plan recognizes the challenges in providing these specialized cosmetic services to the patient population of Los-Angeles and the neighboring Orange County. </p>

<p>Oceanside Durable Medical Equipment (DME) is an accredited start-up company that will offer a comprehensive line of the latest medical supplies and equipment to patients in Long Beach, California. This company will focus on the distribution of leading medical equipment brands to patients who are in need of support for short-term and chronic health conditions. Durable medical equipment can offer help outside of the hospital environment and aid in a better quality of life. </p><p> With more than 2.4 million individuals over 60 years old in Southern California, there appears to be a large market and opportunity for this company. Oceanside DME will contract with leading medical equipment manufacturers and healthcare providers to deliver patients with quality products. A rapidly growing market for medical equipment will allow Oceanside DME to create a presence in this healthcare industry. </p>

<p> Traditional nursing homes are based on a model that can limit a resident&rsquo;s ability to make basic choices, minimize opportunities to direct their own lives, and ultimately destroy the human spirit. As an alternative to the traditional model, the household model is an arrangement in which small groups of residents direct their daily lives in a shared home setting (a household), supported by a decentralized self-led service team of frontline professionals empowered to be responsive to the residents&rsquo; needs. While many frontline nursing staff members are advocates of the need for change, it is also common for them to react negatively toward the process of household model implementation. The purpose of this qualitative study was to examine nurse aides&rsquo; and licensed nurses&rsquo; reactions to household model implementation. Sixteen semi-structured interviews were transcribed verbatim, divided into 524 units of meaning, and coded using concepts of Oreg, Vakola, and Armenakis&rsquo; (2011) theoretical model, derived from 60 years of qualitative studies on change recipients&rsquo; reactions to organizational change. In this model, employee reactions are a function of antecedents, categorized as pre-change (individual characteristics and internal context) and change antecedents (change process, perceived benefit/harm, and change content). Antecedents influence affective, cognitive, and behavioral reactions to change and, subsequently, lead to change consequences, including work-related and personal consequences. Two trained independent coders reviewed transcripts and achieved 70% agreement. Explicit reactions accounted for 48% of comments, followed by antecedents (27%) and change consequences (25%). Most common antecedents were related to change process (71%), perceived benefit/harm (24%), and change recipient characteristics (4%). Study participants reported difficulties with cross training, initial experiences of hardship and fear, confusion over the new model, and perceptions that it would be harmful to staff members and residents. Although experiences improved over time, some staff members, who self-identified as positive individuals, still reported perceived harm and engaged in resistant behaviors. Explicit reactions to change were behavioral (41%), cognitive (33%), and affective (26%). Most staff members supported household model implementation through their actions. They communicated with each other to learn and to cope with change. While three staff members actively resisted changes, they still supported at least some aspects of the household model. Cognitive and affective reactions were mixed, ranging from excitement and happiness to fear, nervousness, and frustration. Core household model components were received as positive, especially for residents. Concerns regarding work accounted for 94% of all reported organizational change consequences and included insufficient household staffing, harder working conditions, insufficient time to get everything done (or to do it well), and widespread feelings of isolation. The theoretical model for analyzing organizational change proved to be useful in understanding nursing staff members&rsquo; reactions to household model implementation and for identifying proactive steps to manage this change. Ongoing education is recommended to ensure staff members follow through with changes over time and to reduce confusion and perceptions of harm. The household model may need to be staffed at a higher level, at least initially, to maintain the same quality of care as in the traditional care delivery model. Ongoing team training within each household can serve to improve operations and balance responsibilities of blended roles. Due to the decentralized environments, potential feelings of isolation among residents and staff members are anticipated, which can be alleviated through regular multi-household gatherings.</p>

<p> Given the ever increasing population of elderly in U.S, home healthcare agencies (HHA) serve as a model of continuous quality and affordable care. HHA hold a promise to boost economy and reduce healthcare expenditures to a significant level. This business plan examines the business potential of a home healthcare startup in downtown LA. Chapter 1 deals with market analysis, providing detailed information on the company, its organization, services, market definition, customer analysis, target population, and service demand. Chapter 2 deals with feasibility analysis and strategic planning, including SWOT, to sell our services. In chapter 3, we have discussed the legal issues and regulations, and defined policies to abide by state and federal rules and regulations. Finally, chapter 4 is about financial analysis, providing detailed pricing structure, other expenditures and revenues and the overall potential of the business to strive profitability and survive market competition. In conclusion, the Health Elixir Home Healthcare business has shown potential for success in the market.</p>

<p> The healthcare industry is undergoing a shift due to changes in revenue cycles and therefore delivery models. This shift is causing horizontal integration among providers and a subsequent assumption of risk that behooves them to operate similar to a payer. Analytics, while used predominately by healthcare payers in the past, will now be applicable to providers of care. This opens the door to a niche consulting firm that can provide these services effectively and affordably. Provider Precision Labs is an idea for a company that can render payer-like services on the scale of regional provider groups but at a manageable cost to the owner and operator.</p>

<p> Time-Drive Activity-Based Costing (TDABC) is a bottom-up costing approach that involves calculating a unit cost of supplying capacity (Capacity Cost Rate) and estimating time spent performing an activity. TDABC has been implemented in healthcare; however, most of the studies have been conducted at a project or departmental level. A pilot study based on the TDABC principles was performed for proof of concept at UT MD Anderson Cancer Center. In the pilot study, the TDABC cost was first calculated manually and later by software. The goal of this research study was to evaluate the feasibility of devising and implementing an effective / reliable / robust system of cost measuring to provide the true costs of patient care delivery institution-wide in an academic medical center. Chapter one provides a literature review of costing methods and costing in healthcare, a brief introduction of TDABC, and the significance of this study. Chapter two describes and analyzes the pilot study. Chapter three includes the review of conceptual models in the literature and the development of a conceptual model of implementing TDABC institution-wide in healthcare. Chapter four describes the methodology of generating practical and validated recommendations for an institution-wide implementation of TDABC and the final recommendations. Chapter five provides a brief summary of the current study, research and operational implications, as well as limitations and the future research. </p><p> The five recommendations generated are listed below: &bull; Gain top management support and horizontal and vertical collaboration, &bull; Educate and motivate staff to have an accurate concept of costing and an awareness of costing at all times, &bull; Understand existing information systems and develop a strategy to collect process, activity, resources and time information effectively and efficiently, &bull; Assess the current condition of the institution and determine the right timing of implementation by top management, &bull; Consider future enhancements with new technology such as a real-time location system</p>

<p> Express Aid is an Urgent Care Center (UCC) that will be providing non-emergency care for the community of Riverside, California. With the expansion of Medicaid due to the Affordable Care Act (ACA) there has been a surge in Emergency Department (ED) usage which resulted in crowding, increased treatment time, and decreased patient satisfaction. Express Aid offers care ranging from primary care services to non-acute chest pain and functions as a walk-in basis. As a Limited Liability Company, Express Aid will function as a hybrid type of legal structure, which has the limited liabilities of a corporation as well as having the tax advantages and operational flexibility of a partnership. Express Aid will be the first center to open in an area where the population is increasing. Therefore, expenses and revenue will be forecasted based on competitors UCC needs, but will also take into account the future needs of the surrounding community. All forecasted finances are performed accurately by using conservative estimates, which will assist in properly developing an operational strategy.</p>

<p> The prevalence of overweight and obese individuals has been a critical issue which has caused a worldwide concerns for the health threats, since it is burdened due to several linked diseases. This business plan proposes the establishment of a for-profit health clinic named NutriMed that provides a quality care and is mainly patient centered. This clinic provide the care to decrease the prevalence of overweight and obesity among the children of the ages 5 to 19 years. The functioning of this clinic is based on Barlow et al approach for prevention and treatment of obesity using the multidisciplinary team effort, which consist of physician, dietitian, exercise expert, nurse and behavioral therapist. The goal of this health clinic is to improve the health in the Los Angles community especially for children. This is done by identifying the priorities and striving for a patient-centered and evidence based approach to care. While this plan acknowledges the challenges in serving indigent populations, the clinic will contract with Medi-Cal and commit to continuous fundraising efforts to remain financially sustainable in order to improve the health of vulnerable Angelino&rsquo;s children.</p>