<p> User acceptance and usage of technology is an established field of academic inquiry with distinct applications to health information technology adoption. Healthcare systems lag behind in technological advancements related to information systems. The recent push toward health information exchange (HIE) systems to enable the sharing of electronic medical records (EMR) between healthcare organizations has many working to upgrade to the latest EMR system technology. Healthcare organizations strive to lower costs, improve patient care, streamline processes, and meet regulatory requirements. Leading EMR systems promise the realization of attaining these goals. User acceptance and usage of technology is a challenge when implementing new technology. In more recent years, a growing need appeared to study user acceptance and usage behavior in healthcare organizations. The central question of this study is: What deeper understanding can be developed when evaluating the similarities and differences of healthcare and business users&rsquo; experiences and behaviors through the lens of the unified theory of acceptance and usage of technology (UTAUT)? A subset of related research questions focuses on factors influencing users&rsquo; acceptance and usage, similarities and differences among healthcare users, and similarities and differences between healthcare and non-healthcare users. This study explores participants&rsquo; experiences using a comparative cross-case approach applying the theoretical framework of the UTUAT by Venkatesh, Morris, Davis, and Davis (2003). Twenty-one participants were interviewed to ascertain their lived experiences of learning and using computer systems. Areas of inquiry included new system implementations; the importance of factors in the UTAUT model such as effort expectancy, facilitating conditions, performance expectancy, and social influence; and the impact of these on users&rsquo; experiences. The majority indicated sub-elements of facilitating conditions and effort expectancy as critical factors. Training is dominant among the majority of cases, while ease to learn and use, process alignment, and time are interwoven with training and usage experiences. Social influence and voluntariness of use were seldom observed, with shared experiences being circumstantial and situational. The success of EMR systems hinges on how the foundational system is built, which involves understanding detailed clinical and business processes, and ensuring the new system is built on forward-thinking practices. </p>

<p> Alternative healthcare programs have been steadily flooding the health care market, with the most notable being mobile health. Mobile health, more popularly known as mHealth, is expected to generate upward of $59 billion dollars. This is astonishing, considering the mHealth market is still in its infancy as an alternative healthcare model. Still, there are over 100,000 mHealth smartphone applications and platforms on the market. The concept of offering affordable medical services that are accessible to anyone, at any time and in any place appeals to the mission and purpose of healthcare organizations. However, a large number of the studies and publications on mHealth are associated with the technologies behind mHealth and provide very little information on the practices and challenges associated with implementing mHealth, especially within a medical facility. For this reason, it was important to learn from executive health IT professionals who have successfully implemented mHealth services within the US healthcare system. Accordingly, the purpose of this study was to identify the practices used and challenges faced by CIOs in implementing mHealth technologies. The study also obtained recommendations CIOs believe are associated with successful mHealth services.</p><p> This was a qualitative study that used a phenomenology lens focused on the viewpoint of CIOs and the growing phenomenon of mHealth as a part of the U.S. healthcare system. This approach allowed the research to obtain data on the lived experiences of seven CIOs through semi-structured interviews who were identified as top experts by <i>Becker Hospital Review</i> publications. The analysis of their experiences revealed 13 best practices for mobile health implementation. The findings in this study aimed to identify how mHealth services could expand access to medical services by outlining key considerations and resources required for successful implementation.</p>

<p> A significant amount of evidence existed in support of the positive effect on the quality of healthcare that resulted from transitioning to electronic health information systems, equally compelling evidence suggests that the development process for electronic health information systems falls short of achieving its potential. The objective of this research was to assess the existing HIT standards and health information management (HIM) principles to determine if they are robust enough to inform the development of national and international interoperability standards. The research question asked; How do HIT standards and HIM principles and practices influence the quality of EHR performance? This study&rsquo;s goal was to maintain focus on the collaborative challenges revealed by the lack of understanding and shared vision that commonly exists between HIM professionals, HIT developers, and HIT vendors that obstruct synergy and enfolding of health information standards-based capabilities and HIM practice (business) standards. The complex electronic health record (EHR) universe proved well suited for testing by a combination of complexity science and the unified theory of acceptance and use of technology (UTAUT) information management theories. Through analysis of research literature and qualitative interviews, the research identified nine factors defined into drivers and barriers that influenced the actions of healthcare organizations; leadership, patient focus, planning, communication, alignment with lifecycle models people, processes, dynamics, training and user input, change management standard adoption, and recognition of the power of technology. Analysis of the data obtained from exploratory qualitative interviews of health information technology professionals selected from a professional healthcare management organization supported conclusions that leadership, collaboration, planning, and training limiters, have a direct impact on EHR system success or failure.</p><p>

<p> The purpose of this quantitative correlational study using archived data was to determine if there is a relationship between patient satisfaction and indicators of medical harm in the state of Florida. The study reviewed the archived data for patient satisfaction for the 328 hospitals located in Florida along with archived data of six hospital-acquired infections for the hospitals in the study. The metric used for patient-centered care is patient satisfaction. Although the literature supports a patient-centered model supplanting non patient-centered models, patients continue to suffer medical harm and even die while no one has evaluated the difference between the models. A linear regression and Spearman&rsquo;s rho analysis was performed for each of the six research questions in the study. The results demonstrated a rejection of the null hypothesis for two of the research questions. This outcome indicates a relationship between patient satisfaction and two indicators of medical harm; SSI Colon, and MRSA. Although the results did not support all six of the research questions, leadership of hospitals supportive of a patient-centered environment should continue to investigate the positive relationships demonstrated in this study to duplicate efforts in increasing the quality of care. Additionally, leaders of hospitals who have low patient satisfaction scores may consider implementing a patient-centered model of care to reduce indicators of medical harm.</p>

<p>Employee turnover affects retail organizations in the form of lower productivity, decreased profitability, and reduced sustainability. In 2014, organizations lost over $11 billion in tangible and intangible assets as the result of employee turnover. High employee turnover rates have an adverse effect on productivity, which lead to unsustainable business practices. The number of retail employees who quit their jobs each month increased from 432,000 in December 2016 to 464,000 in January 2017, which indicates that some managers lack strategies to reduce employee turnover. Using the transformational leadership theory, the purpose of this single case study was to explore effective strategies used by retail store managers from El Paso, Texas to decrease employee turnover. Participants were purposefully selected because of their experience implementing effective employee turnover reduction strategies; they reduced employee turnover from 24% in 2012 to 15% in 2016. Data were collected via face-to-face semistructured interviews with 10 managers and the review of organizational documents on employee turnover. Data were analyzed using inductive coding of phrases, word frequency searches, and theme interpretation. Three themes emerged: supportive leadership reduced employee turnover, managing personnel scheduling decreased employee turnover, and competitive compensation reduced employee turnover. Reducing employee turnover contributes to social change by providing retail store managers with valuable insight that can lead to enhanced sustainability, improved organizational growth, and increased profitability, which might promote prosperity for local families and the community.

<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.