<p> Healthcare spending in the United States has reached an all-time high in recent years, with an estimated $3.2 trillion spent, without any significant impact on patient outcomes because of this excessive spending. Whether the excess be attributed to over-utilization, fee-for-service payment methodology or medical errors, there is an immediate need to mitigate these issues and greatly reduce healthcare costs. </p><p> Epic Systems Corporation has developed a widely-adopted health management software that provides functionality to accomplish such goals. It applies a fully-integrated methodology to all of its different applications that support different healthcare business and clinical functions. Epic is a leader in the health management software industry. </p><p> ALLTAP Solutions, LLC provides high quality, efficient custom solutions to its clients, by applying healthcare industry expertise and Epic technical knowledge to increase efficiency and reduce costs. The market analysis that is to be presented will provide an overview of the target market, key players, the demand for these services and growth potential.</p><p>

<p> The Gulf Coast Cooperation region has seen rapid growth over the past 30 years. The State of Qatar is one such country that has been building their infrastructure and has required the use of migrant laborers to build physical structures within Qatar. Through a Sequential Explanatory Mixed-Method analysis of 1 year of Patient Care Reports (PCR) from the Hamad Medical Corporation Ambulance Service (HMCAS) in Qatar, the study looked at provisional diagnoses and factors considered for specific ambulance transport triggers amongst the unskilled/low-level migrant workers. Potential causal factors for the rising use of emergency services for non-emergency medical issues was the focus of this exploration. The study identified common themes, as well as conditions that prompt the migrant worker to utilize pre-hospital emergency services. The process was accomplished through a review of PCRs from the Ambulance Service, and thematic analysis using triangulation. Recommendations toward improving service and cost effectiveness- for the health care system in Qatar were derived.</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> Posttraumatic stress disorder (PTSD) is a serious issue for post-deployment United States Marine Corps (USMC) veterans, especially because PTSD can increase the risk of suicide. Marines are screened post-deployment, yet little is known about Marine veterans&rsquo; perceptions of the PTSD screening process. The purpose of this phenomenological study was to explore USMC male veterans&rsquo; perceptions of the Post- Deployment Health Reassessment (PDHRA). The social cognitive theory constructs of a triadic relationship among person, environment, and behavior were the framework for understanding this population&rsquo;s perceptions of the PDHRA and potential stigma. Two research questions focused on how people, culture, and behavior affect Marines perception of the PDHRA and PTSD attached stigma. Interviews were conducted with 10 Marine veterans&rsquo; participants and transcribed interview responses were input into NVivo 11 software to retain a reliable database and Colaizzi&rsquo;s strategy to identify emerging themes. Key findings revealed potential positive social change to military chaplains and veterans&rsquo; health service providers. This knowledge might inform about the perceptions of Marines through informed understanding and may help develop an updated evaluation tool. Future researchers might focus on the forthcoming answers and treatment of PTSD and the attached stigma among Marines by alleviating repercussions for Marines&rsquo; answers on the PDHRA. An understanding of the study&rsquo;s findings may elicit strategies for health care administrators to expound on the PDHRA and provide educational programs to assist in future screening environments and processes through Marines perspectives.</p><p>

<p> Patients and families play an important role at the bedside, and that is making sure the transition of care among providers is safe and effective. Bedside shift report (BSR), a type of patient and family engagement, is a process where patients, families, and health care providers work together as partners to improve the quality and safety of hospital care. In 2010, TJC developed and revised the standards for patient-centered care, which were designed to improve the safety and quality of care for patient and family involvement. The purpose of this quantitative descriptive study with a causal-comparative design was to compare two dependent variables of patient and nurse satisfaction from the pre-and post-implementation of BSR as a patient and family engagement strategy and determine if BSR resulted in a positive return on investment for a health care organization. This quantitative descriptive study employed Donabedian&rsquo;s structure-process-outcome (SPO) approach model. This model is a foundation for modern health care quality measurement, studying the structures of process and outcome, and the means to an end of a relationship. The data analysis utilized both descriptive and inferential statistics. The mean and standard deviation were calculated on two dependent variables, nurse satisfaction and patient satisfaction. Both research questions were measured using Chi-square to compare the difference in the yearly data for patient satisfaction and nurse satisfaction pre-and post-implementation of BSR as a patient and family engagement strategy on a surgical unit. The dependent variable patient satisfaction is statistically significant and the dependent variable nurse satisfaction is not statistically significant. Each year, post-implementation BSR for both dependent variables had a positive trend.</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> In today&rsquo;s healthcare environment, change is plentiful. Hospitals and healthcare providers are expected to provide excellent quality outcomes, exceed patient expectations, and transform the healthcare delivery system. All of these imperatives are required within a highly regulated environment that is also experiencing restrictive payment models and shrinking patient benefits/coverage. Effective leadership in healthcare is therefore more important now than ever before. To achieve these goals, the voice of the physician must become a growing part of an organization&rsquo;s leadership ranks. </p><p> Although physicians need to participate as equal members of the transformational leadership team, are they prepared for this new and expanding role? Effective leadership requires the capacity to work collaboratively, display empathy, and obtain buy-in from various stakeholders. Physicians are expected to succeed in an environment where they not only lead themselves but help to develop the clinical and leadership skills of others; something that is in opposition to the development of their clinical competencies. This paper explored the relationship between the early professional socialization physicians receive within their medical school and residency program education and the leadership skills, in particular emotional intelligence, they demonstrate post training. This mixed methods study explored the perceptions of 36 physician administrative leaders at Northwell Health and the experiences they had during medical school and residency education. The interviews focused on this early professional socialization period and whether it prepares physicians in a way that fosters the development of essential interpersonal and leadership competencies. The primary method of data collection used in this study was in-depth one-to-one interviews. Deductive thematic analysis of the data utilized the competencies from the Emotional and Social Competency Inventory (ESCI) model to code the data. The interviews were strengthened by quantitative data obtained through the Emotional and Social Competency Inventory (ESCI), an online 360&deg; assessment measuring emotional intelligence. Three key findings emerged from this study: 1) 100% of the physician leaders displayed leadership qualities and participated in leadership roles prior to beginning their formal medical careers, 2) physician behavior is learned through mentorship, and 3) the physician leaders feel emotional intelligence is a differentiating factor in effective leadership.</p><p>

<p> African American women have the highest obesity rate of all groups in the United States. An increase in physical activity is recommended to decrease the risk of obesity associated diseases and premature death. To combat these risks, workplace wellness programs are increasingly being used to increase the physical activity levels of employees. HealthyLife Gym, LLC is a workplace wellness program that collaborates with local small businesses in Inglewood, CA to provide their employees with discounted gym memberships. This women-only gym strives to increase the physical activity levels of African American obese employees between the ages of 35&ndash;64. Religion plays an important part in the lives of African American women so the unique collaboration between the gym and faith-based organizations provides an additional source of social support and motivation for the women to sustain increased levels of physical activity.</p><p>

<p> Eliciting and evaluating new ideas to improve the quality of health care are important processes for health care organizations. Creativity, which refers to the generation of novel and useful ideas, is required for innovation and is valued by many organizations. Health care staff (e.g., primary care providers, nurses and medical assistants) can be an important source of creative ideas. In my dissertation, I conducted a longitudinal, mixed methods study of 220 improvement ideas generated over 18 months by improvement team members from 12 federally qualified community health centers. I also analyzed the experiences of 2,201 patients cared for by these individuals. I used data from patient surveys, quality improvement team meeting transcripts, staff surveys and wearable sociometric sensors.</p><p> Part one of this research draws on organizational theory to develop hypotheses and tests empirically the impact of creative idea implementation on patient care experiences, the relationship between idea creativity and implementation, and moderators of this relationship. Results suggest that the implementation of creative ideas is positively associated with better patient care experiences, but such ideas are less likely to be implemented. Three staff-level characteristics - more collaborative relationships, longer organizational tenure, and higher network centrality (a more central position in the organization's social network) &ndash; increase the likelihood that staff's creative ideas will be implemented. Part two of this research assesses the health care staff characteristics associated with idea creativity. The results show that staff with a peripheral perspective on care delivery (behavioral health provider and medical assistant), and staff with lower satisfaction and who have a shorter organizational tenure, are significant correlates of idea creativity. Part three of this dissertation focuses on the tactics that quality improvement leaders use to foster idea creativity, evolution, and implementation in their groups. The results suggest that the leader tactic of brainstorming is associated with groups having more creative, rapidly implemented, low-engagement ideas, which might be an effective tactic for leaders seeking disruptive change. The tactic of group reflection on process is associated with slower implemented, high-engagement ideas, which might help leaders elicit well-considered and deliberated solutions. I develop a conceptual framework for understanding creativity in health care organizations based on these findings, which may help scholars and health care professionals improve their understanding of health care innovation and how better to facilitate the expression and implementation of creative ideas.</p><p> This dissertation contributes to health services and organizational research by elucidating how creativity in health care organizations is fostered and facilitated, and how it affects outcomes. Understanding how creative ideas may improve the organization and delivery of quality care could facilitate efforts to discover and evaluate new ideas regarding the quality of health care delivery. </p><p>

<p> Both compassion and employee engagement are determined to have positive impacts in a healthcare setting. Previous research indicates that patients who receive compassionate care from healthcare providers may recover more quickly from illnesses and better manage long-term health issues. Additionally, high employee engagement has been shown to have a positive relationship with quality of patient care, patient safety, and patient-centered care. Due to the far-reaching impact of both variables, an association between compassion and employee engagement would enable healthcare providers to leverage the relationship for improved patient outcomes. </p><p> This study explored the relationship between compassion and employee engagement. Qualitative data was collected from 118 nurses through the International Nurses Society on Addictions. All participants completed a 9-item Utrecht Work Engagement Scale (UWES). Participants were then distributed by engagement category and volunteers were contacted to complete a semi-structured interview to discuss their experiences with compassion in the workplace. This qualitative data was obtained from nine interviewees. </p><p> A review of the research data and previous academic research led to four findings. First, previous academic research findings were confirmed. Second, the participant&rsquo;s connection to compassion in their work indicated the importance of this emotionally charged topic. Third, a trend between the average frequency of daily acts of compassion and engagement level indicated a potential relationship or confounding variable. Fourth, the research data indicated an inconclusive relationship between compassion and employee engagement.</p><p>