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Alexander, Betty Acey. "The department headship in college and university allied health departments." Diss., Virginia Polytechnic Institute and State University, 1989. http://hdl.handle.net/10919/54479.
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Programs to prepare allied health professionals are the latest in a progression of health-related programs to be assimilated into college and university life. Like their predecessors, preparation programs for physicians and nurses, allied health programs developed almost willy-nilly in the past 50 years, and only within the past decade have begun to be taken seriously by the nation's leading colleges and universities.
In this study, new departments of allied health that have been established in 133 senior colleges and universities with two or more programs accredited by the Committee on Allied Health Education and Accreditation were surveyed. From a sample of 36 institutions, fully useable responses were received from 114 heads of allied health departments and 90 heads of other academic departments, such as education, English, psychology, chemistry, and biology.
The study revealed that there are significant differences in responses from allied health department heads and other academic area department heads in terms of personal characteristics (age, academic rank, and gender), departmental activities (allied health department heads place more emphasis on administrative tasks), and departmental goals. The most powerful variables differentiating responses between the two classes of department heads were percent of faculty with doctoral degrees, size of departments, percent of students in departmental courses who are departmental majors, emphasis given to teaching service courses, and emphasis on administrative activities. In summary, allied health departments (in contrast to other departments) are small (about six FTE), under credentialed, insular, engaged principally with their own majors, and committed primarily to the professional preparation of their students for future careers. Allied health department heads typically are experienced professionals who were brought to the institution from the outside to serve an indefinite term, and who appear to be overly concerned with the nuts and bolts of departmental administration. The researcher concluded that extant departments of allied health are still predominantly professional rather than academic in outlook and standard practice.<br>Ed. D.
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Johnson, S., M. Belcher, M. Moody, and Megan Quinn. "Collaboration Between Local Health Department and College of Public Health." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6794.
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Griffiths, Ieuan Wynn. "Managing change in the Department of Health." Thesis, University of South Wales, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397884.
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Williams, Christian L. "Assessing Health Department Readiness for Public Health Accreditation through Quality Improvement." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etd/2417.
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Engaging in quality improvement (QI) activities can help local and state health departments improve current processes, develop more effective new processes, increase leadership capacity, and prepare for public health accreditation. Public health organizations that have implemented QI processes have seen improvements in health outcome indicators, delivery of the 10 essential services, patient satisfaction, and performance management.
Quality improvement is the foundation of the Public Health Accreditation Board‟s (PHAB) program and further pushes health departments, at both the local and state level, to adopt QI activities within their organizations. There are numerous potential benefits associated with accreditation in public health, one of the most important being that accreditation sets a benchmark for public health agencies. It also helps create a platform of continuous quality improvement that should increase efficiency, decrease waste, and improve health outcomes.
The purpose of this study was to determine the current status of QI processes in a sample of regional and metro health departments across the state of Tennessee and to assess whether those health departments with a formal QI process demonstrate an increased readiness for public health accreditation compared to those without a formal QI process in place. A survey tool aimed at assessing QI processes and efforts within health departments including the organization‟s: 1) QI culture, 2) QI capacity and competency, 3) QI alignment and spread, and 4) readiness for public health accreditation was used. In addition to the survey tool, respondents were also asked about types of QI processes used within their health department and their associated outcomes.
Initial results revealed that the majority of respondents reported high levels of QI maturity in their respective health department sites. However, further analysis of qualitative data indicated that most sites were engaged in quality assurance (QA) practices rather than true QI processes and activities.
Overall, study results indicate that further training in QI practices is needed in order to enhance performance and align with PHAB standards. The results from this study could be used to help gauge QI processes and accreditation readiness at appropriate intervals following training and education.
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Bruce, Rebecca. "Barren River District Health Department Health Education/Risk Reduction Demonstration Projects." TopSCHOLAR®, 1989. https://digitalcommons.wku.edu/theses/2172.
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In July 1980, the Barren River District Health Department (BRDHD), serving eight counties (combined population approximately 204,000) in Southcentral Kentucky, was selected as a demonstration site under the auspices of the federal Health Education Risk Reduction (HERR) Program. With continued HERR funding for eight years, the BRDHD developed several successful health promotion projects. Major components of these projects include: 1) community health promotion, which serves to identify high -risk groups in the community and provide them with health education-health promotion services, 2) school health education which included the development of a preschool health education curriculum, 3) teacher education workshop, which instructs primary and secondary public school teachers in health education methods, 4) smoking cessation. and 5) a large industrial wellness program. This study reports on an eight year program evaluation of the HERR demonstration. Overall, the program evaluation suggests an increase in health knowledge and some attitude and behavior change for many of the participants ii BRDHD programs.
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Brooks, Billy, David Blackley, Paula Masters, Robert P. Pack, and Stephen May. "Developing an Academic Health Department in Northeast Tennessee." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/3190.
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Ortiz, Alicia. "Using Health Literacy to Improve Emergency Department Discharge." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3716.
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Patients with limited health literacy often fail to understand verbal and written discharge instructions, and they frequently return to the emergency department (ED) for care. Patients returning to the ED and 30-day readmission rate are core quality performance measures. The purpose of this project was to decrease repeat visits and readmissions to the ED by implementing components of health literacy programs within the ED on patient education and written discharge instructions. Change implementation consisted of (a) use of teach back method (b) modifying medical terminology to language that patient could understand (c) limiting use of words with more than three syllables and (d) discouraging nursing practice of copying and pasting other completed clinician notes in discharge notes. Following the tenets of the logic model and Watson's caring theory, ED nurses (n=45) at a veteran's healthcare facility participated in the modification of the ED discharge note design. A retrospective quantitative design was used to obtain data from 5,474 records related to each patient's language preference, educational level, and the readability index of the discharge note pre-and post-modification of the note. The comparative analysis of the descriptive statistics before and after modification of the discharge note indicated a decrease of 1.75% in the readability index of the discharge note, a 24% decrease in return visits within 30 days and a 40% decrease in readmission rate within 30 days. Healthcare costs and health disparities associated with health literacy decrease if patients comprehend discharge instructions. Understanding verbal and written discharge instructions correlates with healthy communities. Health literacy policies and technological innovation can promote health literacy and research on health literacy.
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Beatty, Kate, Jeffrey Mayer, Michael Elliott, Ross C. Brownson, Safina Abdulloeva, and Kathleen Wojciehowski. "Barriers and Incentives to Rural Health Department Accreditation." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6826.
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Context: Accreditation of local health departments has been identified as a crucial strategy for strengthening the public health infrastructure. Rural local health departments (RLHDs) face many challenges including lower levels of staffing and funding than local health departments serving metropolitan or urban areas; simultaneously their populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural local health departments can become better equipped to meet the needs of their communities.
Objective: To better understand the needs of communities by assessing barriers and incentives to state-level accreditation in Missouri from the RLHD perspective.
Design: Qualitative analysis of semistructured key informant interviews with Missouri local health departments serving rural communities.
Participants: Eleven administrators of RLHDs, 7 from accredited and 4 from unaccredited departments, were interviewed. Population size served ranged from 6400 to 52 000 for accredited RLHDs and from 7200 to 73 000 for unaccredited RLHDs.
Results: Unaccredited RLHDs identified more barriers to accreditation than accredited RLHDs. Time was a major barrier to seeking accreditation. Unaccredited RLHDs overall did not see accreditation as a priority for their agency and failed to the see value of accreditation. Accredited RLHDs listed more incentives than their unaccredited counterparts. Unaccredited RLHDs identified accountability, becoming more effective and efficient, staff development, and eventual funding as incentives to accreditation.
Conclusions: There is a need for better documentation of measurable benefits in order for an RLHD to pursue voluntary accreditation. Those who pursue accreditation are likely to see benefits after the fact, but those who do not pursue do not see the immediate and direct benefits of voluntary accreditation. The finding from this study of state-level accreditation in Missouri provides insight that can be translated to national accreditation.
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Beatty, Kate, Michael Meit, O. Luzzi, et al. "The Journey to Accreditation: Clinton County Health Department." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6828.
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Book Summary: JPHMP's 21 Public Health Case Studies on Policy & Administration , compiled by the founding editor and current editor-in-chief of the Journal of Public Health Management and Practice, provides you with real-life examples of how to strategize and execute policies and practices when confronted with issues such as disease containment, emergency preparedness, and organizational, management, and administrative problems.Feautures: Each case is co-written by a professional writer and tells a “story,” using characters, conflicts, and plot twists designed to compel you to keep reading. Case elements include the core problem, stakeholders, steps taken, challenges, results, conclusions, and discussion questions for analysis. More than 60 contributors—experts in public policy, clinical medicine, pediatrics, social work, pharmacy, bioethics, and healthcare management. Ideal for public health practitioners as well as students in graduate and undergraduate public health and medical education programs. Tracks 2016 CEPH (Council on Education for Public Health) accreditation criteria. These cases can be used as tools to develop competencies designated in the new CEPH (Council on Education for Public Health) accreditation criteria.
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Luk, Che-chung. "An analysis of the planning system of the Medical and Health Department / Hospital Services Department." [Hong Kong : University of Hong Kong], 1993. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13636868.
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Richards, Anika Tahirah. "Health Equity Education, Awareness, and Advocacy through the Virginia Department of Health Health Equity Campaign." Diss., Virginia Tech, 2011. http://hdl.handle.net/10919/77312.
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This study showed that health equity must be achieved through education, awareness, and advocacy. A structured program must be put in place to provide accountability towards achieving health equity within organizations, communities, cites, and states. In Virginia, the Health Equity Campaign was a program put in place to provide such accountability to the citizens of Virginia. This study attempted to evaluate the Health Equity Campaign implemented by the Virginia Department of Health Office of Minority Health and Public Health Policy Division of Health Equity in order to get all Virginians to become advocates for health equity in their organizations, communities, neighborhoods. Organizational/group leaders were interviewed in addition to surveying various staff members. This study provides a detailed description of the strength of the Health Equity Campaign's ability to promote education and awareness about health equity and why many participants found it difficult to transition from motivation to advocacy.<br>Ph. D.
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Dover, Saunya. "Emergency Department use: Why do patients choose the Emergency Department for medical care and how much does it really cost?" Thesis, University of Ottawa (Canada), 2010. http://hdl.handle.net/10393/28805.
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Background: It is important to understand Canadians' expectations of health care services and the costs of delivering care in the Emergency Department (ED) in order to continue to provide health care in a sustainable manner.
Objectives: To examine the reasons patients present to the ED, and to conduct a cost analysis to compare the costs of seeking care in the ED versus a primary care setting.
Methodology: We surveyed patients (n=606) triaged to the cubicles of the ED of The Ottawa Hospital, Civic Campus. The survey asked about their perceived urgency level and their patterns of health service use. Patient surveys were accompanied by physician surveys to assess each patient's level of urgency from a medical perspective. We performed bivariate analysis and logistic regression on survey variables of interest. We also conducted a cost analysis to determine the costs of providing non-urgent care in the ED.
Results: Both a presenting symptom of a musculoskeletal injury (OR=2.93, CI 1.42-6.04) and having heard of TeleHealth Ontario (OR=2.08, CI1.08-4.03) were significantly associated with non-urgent ED use from the patient perspective. We also found that non-urgent ED visits cost an average of $248.75, which is significantly more costly than a primary care visit.
Implications: Our results provide insights regarding patient factors influencing ED use and relative costs of non-urgent ED visits versus outpatient family doctor visits. However, additional work may be required to identify non-medical factors influencing patient motivations for seeking care in the ED.
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Luk, Che-chung, and 陸志聰. "An analysis of the planning system of the Medical and Health Department / Hospital Services Department." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1993. http://hub.hku.hk/bib/B3196462X.
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Maas, Christine C. "Emergency department utilization patterns in patients with diabetes." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1526926.
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<p> Diabetes is one of the most prevalent diseases in America, and the associated costs place a heavy burden on our health care system. This study was undertaken to provide information on emergency service utilization and hospitalization among people with diabetes in the United States. The hypotheses were that adults with diabetes visit the emergency department (ED) more than those without diabetes, that persons with diabetes who present in the ED are hospitalized more than those without diabetes and that more patients with diabetes present in the ED within 1 week of hospital discharge than those without diabetes. To test these hypotheses, secondary data from the 2010 National Hospital Ambulatory Medical Care Survey was analyzed. The results indicate that adults with diabetes did utilize the ED more than those without diabetes, and that patients with diabetes were admitted to the hospital through the ED more than those without diabetes. Furthermore, persons with diabetes presented within 1 week of hospital discharge more than those without diabetes.</p>
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Shah, Jalpa. "Factors associated with higher emergency department utilization." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1586168.
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<p> The purpose of this study was to analyze the factors associated with higher Emergency Department (ED) visits in the United States. Higher ED utilization contributes in a major way to costs in the healthcare industry. Unnecessary utilization of emergency department causes medication errors, poor patient satisfaction, lower quality and higher cost. This study analyzed the data from National Hospital Ambulatory Medical Care Survey (NHAMCS) collected in 2010, which involved a sample size of 34,936 ED visits nationwide. The variables in this study included age, ethnicity, type of coverage and gender differences. The result showed that Medicaid population has a higher number of ED visits than other types of insurance coverage; white population shows maximum ED visits than other race types; males visits ED more than females and infants has higher ED rate than other age groups. More research is needed to develop health policies to limit the non-urgent ED visits.</p>
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Capwell, Ellen M. "Local health department use of Ohio Department of Health Assistance to plan and implement community programs directed toward smoking control among women /." The Ohio State University, 1991. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487687115924146.
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Banker, Karen Lee. "Morale and the mental health worker: Burnout in the Department of Behavioral Health." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1885.
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Knott, Jonathan Charles. "Management of mental health patients in the emergency department /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002656.
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Noe-Norman, Resa Jane. "Evaluating Behavioral Health Homes to Decrease Emergency Department Use." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3361.
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The Affordable Care Act of 2010 proposed a new integrated care model for individuals with chronic mental illness and multiple medical comorbidities by using Behavioral Health Homes (BHH). The purpose of this doctoral project was to evaluate the effectiveness of the BHH in reducing emergency department (ED) use in the community mental health outpatient setting. Guided by the American Association for Critical Care Nurses synergy model for patient care a cross-sectional, post-test only with comparison group quasi-experimental research design was used. A de-identified data set of 68 patient records in the BHH group and 73 patient records in non-BHH as a control group were analyzed using logistic regression. The analysis revealed that participants in the BHH were statistically less likely to visit the ED. Sensitivity was 16.2%, specificity was 95.2%, positive predictive value was 54.5%, and negative predictive value was 76.2%. The Homer-Lemeshow and omnibus test of model coefficients showed the model was a good fit (p=.726, p=.007). Participants in BHH were .225 less likely to visit the ED. For every year of reduction in age, the odds of visiting the ED increased by a factor of 1.0. Females had a 1.8 higher odds of visiting the ED than males. This study provides evidence for the effectiveness of the BHH in reducing visits to the ED. Standard measures to track ED use in BHH are essential to understanding reasons for ED use and reducing nonurgent use. The BHH has the potential to transform health care delivery toward an all-inclusive model of care. Providers can utilize the findings of this project to promote social change by targeting patients with serious mental illness and reducing health disparities by emphasizing preventive care and eliminating barriers to care.
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Rouse, Eno J. "Care Intervention in Reducing Emergency Department Utilization in Medicaid Populations." Thesis, Walden University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13425519.
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<p> Expansion of Medicaid and private health insurance coverage through passage of the Affordable Care Act of 2010 was expected to increase primary care access and reduce emergency department (ED) use by reducing financial burden and improving affordability of care. The aim of this study was to examine the differences in utilization patterns that exist among the Medicaid population that participated in an optimal level of care (OLC) intervention inclusive of appointments scheduled to primary care providers. Using the integrated behavior model as a theoretical framework, the key research question focused on determining if there was a difference in ED use among Medicaid individuals who scheduled follow-up appointments compared to those that did not schedule follow-up appointments. The sample population consisted of 176 Medicaid enrollees who presented to the ED for treatment of nonurgent conditions and participated in an OLC intervention from June 2016 to July 2017. The results showed that there were no differences in ED utilization between the population that had scheduled appointments compared to the population that did not have scheduled appointments. A bivariate analysis on demographic variables also showed no differences in ED utilization among the variables. The social change implications of this study are that the practice of scheduling appointments with primary care providers does not reduce or affect ED utilization in the Medicaid population. This study contributes to positive social change through the findings that reducing ED utilization requires more than follow-up appointment scheduling with primary care providers. Further studies are warranted to understand the potential barriers and factors that affect ED utilization.</p><p>
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Beatty, Kate E., Jeffrey Mayer, Michael Elliott, Ross C. Brownson, Safina Abdulloeva, and Kathleen Wojciehowski. "Patterns and Predictors of Local Health Department Accreditation in Missouri." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6866.
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Background: The Healthy People 2020 goal for the public health system is “to ensure that Federal, State, Tribal, and local health agencies have the necessary infrastructure to effectively provide essential public health services.” To address this goal, Missouri established the first statewide, voluntary accreditation program of local health departments (LHDs) and began accrediting the LHDs in 2003. The purpose of this study was to identify organizational, structural, and workforce factors related to accreditation status of LHDs in Missouri.
Methods: Using data from the National Association of County & City Health Officials (2010) and the Missouri Department of Health & Senior Services (2012), binary logistic regression analysis was performed to predict accreditation status of LHDs. Likelihood ratio tests were used to examine whether the addition of each predictor added significantly to the model compared with a model including total revenues alone. Adjusted odds ratios (aORs), 95% confidence intervals, the significance level of the likelihood ratio test, and the overall Nagelkerke pseudo-R2 for each model are reported.
Results: Having a community health improvement plan (aOR = 6.2), a strategic plan (aOR = 7.9), evaluating programs (aOR = 3.6), being in a region with a high proportion of accredited LHDs (aOR = 5.5), and participating in multijurisdictional collaborations (aOR = 6.4) all increased the likelihood of accreditation. Barriers of time (aOR = 0.1) and cost (aOR = 0.3) were negatively associated with accreditation.
Conclusions: Accredited LHDs were more likely to have completed the prerequisites for accreditation and collaborate with other LHDs. These activities help LHDs meet the accreditation standards. In addition, with shrinking budgets, LHDs will need additional financial and technical support to achieve accreditation. Assisting LHDs to find ways to increase the staff is important. Through collaborations with other LHDs, regional or multicounty positions can be created. Also collaborations with universities, specifically colleges or schools of public health, can provide opportunities for internships at LHDs giving practical experience while providing important assistance to LHDs.
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Yuwanich, Nuttapol. "Occupational stress among Thai emergency department nurses : Development and validation of an instrument for measuring stressors in emergency departments." Doctoral thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-36691.
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Working at an emergency department has some characteristics, which may generate stress. In this thesis, the stressors for emergency nurses were evaluated and an instrument was developed for measuring their impact. In order to gain a deeper understanding regarding the occupational stress among emergency nurses, a descriptive qualitative design with semi-structured interviews were used in two studies (I, II), one at a private and the other at a public hospital in Thailand. Three main categories of stressors were identified, related to the activity at the emergency departments, to human factors and to perceived consequences of these factors. Nurses in both private and public hospitals frequently experienced occupational stress, which influenced their psychophysiological health, and resulted in incomplete nursing care. Since no validated instrument had been published for measuring stressors in emergency nurses’ workplace, a scoping literature review was performed and a questionnaire for this purpose was developed, based on the review and the results from the interviews (I and II). The questionnaire was validated (III) and the influence of socio-economic factors were evaluated (IV). Four-hundred and five emergency nurses in Thailand completed a questionnaire containing 59 items. The responses were analyzed using 1) item generation, 2) content and face validity and test-retest reliability and 3) evaluation of the internal consistency and construct validity of the instrument. An exploratory factor analysis was performed on 200 of these responses and a confirmatory factor analysis on the remaining 205. The analysis provided a final four-factor solution with 25 items distributed among the factors Life and death situations, Patients’ and families’ actions and reactions, Technical and formal support, and Conflicts. The statistical evaluation (Cronbach’s alpha and intra-class correlation coefficient) indicated good homogeneity and stability. The type of organization, educational level and average income were associated with stressor related to Life and Death situations. Stressor related to Patients’ and families’ actions and reactions was predicted by educational level. While sociodemographic variables had no influence on stressor related to Technical and formal support and Conflicts. Future research regarding patient safety should focus on both emergency nurses’ and patients’ perspectives regarding consequences of occupational stress related to patient safety. Different perspectives may create a knowledge-base which can be used to develop guidelines or protocols aiming at reducing nurses’ stress and prevent its consequence, such as poor patient safety.
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Capps, Patricia A. "Assessing Lyme disease knowledge of Indiana local health department nurses." Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1048370.
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Lyme disease is a multisystemic, infectious disease caused by the tick-borne spirochete Borrelia burgdorferi. The CDC designated LD as a reportable disease in 1990 and evidence suggests underreporting of the disease in Indiana. Local health department nurses have a major role in the areas of disease recognition, reporting, and education about LD. The present study assessed local health department nurses' knowledge of LD to determine their competence as LD educators.The study consisted of 428 nurses in 92 counties and three cities with independent health departments who were mailed a questionnaire containing 30 multiple-choice and/or true/false questions. Twenty-four nurses participated in a pilot study to establish the reliability of the instrument.The results were: (1) nurses did not differ in knowledge regardless of their duties, (2) urban and rural counties did not differ in knowledge, (3) experience did not make a difference in knowledge, and (4) less educated nurses were more knowledgeable. The nurses were least knowledgeable about LD reporting criteria, late stage symptoms, and and description of EM and most knowledgeable about prevention. The following are some of the recommendations suggested: more research with nurses on vector- borne diseases, better dissemination of information from CDC and ISDH, inservice programs for nursing personnel, and educational materials to distribute to the public.<br>School of Nursing
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Pickering, Kristina Marie. "Pediatric Behavioral Health Best Practices in the Children's Emergency Department." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7057.
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Emergency department (ED) use for behavioral-health-associated diagnoses has steadily increased in adult and pediatric populations, accounting for 1 out of every 8 ED visits. The increase in pediatric behavioral health ED visits, combined with limited resources for treatment, has created a challenge for EDs faced with extended boarding and constant observation of this population. The generalized behavioral health guidelines used at the practice site have not been adapted for the pediatric population. This project focused on providing age- and developmentally appropriate best practice guidelines for children under constant observation in the children's emergency department (CED) using Havelock's theory of planned change as the framework. Practice in the CED was compared to best practice recommendations identified in the literature and community standards including workflow, defined roles and responsibilities, addressing the needs of the parent/guardians, and defined outcomes. These best practices were incorporated in a guideline developed to provide age- and developmentally appropriate recommendations. An expert panel comprising the behavioral health nurse manager and children's emergency department nurse manager reviewed the guideline using the AGREE II tool, and the guideline was revised based on the composite results from the 6 domains in the AGREE II tool. Based on these composite results and panel feedback, domain 5 was revised to include an auditing and monitoring plan. In addition to improving the safety and care for the CED patient population, this project also serves to increase awareness of the topic while emphasizing on the need for additional research and evidence-based practice focused on pediatric behavioral health patients.
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Johnson, Himes Becky Sue. "Blood Lead Testing Guideline Development for a Public Health Department." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6443.
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A lack of consistent, evidence-based practices for blood lead testing of children existed in a local public health department (LHD). No known blood lead level is safe, and toxicity can result in behavioral and cognitive impairments. The purpose of this project was to develop and analyze a clinical practice guideline to establish blood lead testing procedures in the LHD to improve testing procedures and enhance future testing within the jurisdiction. The RE-AIM framework was used to address the reach, effectiveness, adoption, implementation, and maintenance of the clinical practice guideline. Five experts evaluated the guideline using the Appraisal of Guidelines for Research and Evaluation instrument. The assessment results indicated 96.4% agreement across all domains. The experts agreed unanimously to recommend adoption of the clinical practice guideline. Implementation of the guideline might advance nursing practice and patient care in the LHD through incorporation of evidence-based practices. Implementation might also lead to early identification of lead-burdened children and may provide the opportunity for treatment to mitigate cognitive and behavioral deficits related to lead toxicity, thereby improving child health and decreasing related health care costs. Engagement of the clinical practice guideline will support positive social change through the empowerment of public health nurses to provide optimal care to a population of children at risk of deleterious and long-term side effects of lead exposure.
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Ozanich, Matthew S. "Socioeconomic and Job-Related Determinants of Emergency Department Use." Youngstown State University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1403184917.
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Stang, Antonia. "Emergency department conditions associated with the number of patients who leave a pediatric emergency department prior to physician assessment." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=86630.
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As emergency department (ED) waiting times and volumes increase, substantial numbers of patients LWBS (leave after registration but prior to physician assessment). The objective of this study was to identify ED conditions reflecting patient input, throughput and output associated with the number of patients who LWBS in a pediatric setting. Multivariate analysis was used to examine the impact of variables describing the timing of patient arrival and ED conditions including patient acuity, volume and waiting times on the number of patients who LWBS. During the study period there were 138,361 patient visits; 11,055 (7.99%) of patients LWBS. The throughput variables, time from triage to physician assessment (rate ratio 2.11 (95% CI 2.01-2.21)) and time from registration to triage (rate ratio 1.55 (95% CI 1.25 - 1.90)) had the largest impact on the number of patients who LWBS. Interventions designed to decrease the number of patients who LWBS should focus on improving ED throughput.<br>Avec l'augmentation du débit et du temps d'attente dans les services des urgences, un nombre élevé de patients ayant rempli les formulaires d'accueil quittent avant d'avoir été vus par un médecin. Cette étude avait pour but de déterminer les conditions du service des urgences reflétant l'inscription, le temps de prise en charge ainsi que le débit de patients, et ayant un lien avec le nombre de personnes qui, dans un milieu pédiatrique, quittent avant d'avoir vu un médecin. Une analyse multivariée a été utilisée afin d'examiner l'effet de variables décrivant le moment de l'arrivée du patient et les conditions qui prévalent au service des urgences (y compris l'acuité des patients, le volume de patients et le délai d'attente), sur le nombre de personnes qui quittent sans avoir été examinés. Un total de 138,361 patients se sont présentés à l'urgence au cours de l'étude et 11,055 (7,99%) ont quitté avant d'avoir vu un médecin. Les résultats de l'étude révèlent que les variables liées au temps de prise en charge, soit le délai entre le moment du triage et l'examen du médecin (ratio des taux = 2,11; intervalle de confiance [IC] de 95% : 2,01 - 2,21) et le délai entre l'inscription et le triage (ratio des taux = 1,55; IC de 95% : 1,25 - 1,90) exercent la plus grande influence sur le nombre de patients quittant avant d'avoir été vus par un médecin. Les interventions visant à réduire le nombre de départs prématurés devraient être orientées en vue d'améliorer le temps de prise en charge dans les services d'urgence.
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Victor, Elise C. "Pediatric asthma care in the emergency department| An examination of racial disparities." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1524129.
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<p> This study is an examination of the prevalence of asthma in adolescents, and it seeks to identify associations that may exist among individuals from different racial and socioeconomic backgrounds. The primary areas of focus were defined by the two research questions posed; these explored the differences among individuals in the study population who had a primary diagnosis of asthma and those who did not. The population consisted of children from birth to 17 years old treated in an emergency department during 2009. The National Hospital Ambulatory Medical Care Survey dataset from 2009 was used as the secondary data source for this retrospective study. After conducting a statistical analysis using a Chi-Squared test, it was determined that race has a statistically significant relationship to pediatric asthma. The factors for this correlation can be attributed to a number of theories that are discussed in detail throughout this research.</p>
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Holleran, Reneé Semonin. "Caring from the patient's perspective in the emergency department /." The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu148768424546834.
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Goss-Bottorff, Barbara. "Hand hygiene compliance in the emergency department| A project report." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527943.
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<p> The purpose of this project was to demonstrate whether a multifaceted quality improvement intervention program would improve hand hygiene compliance of healthcare providers (HCPs) in the Emergency Department (ED). A descriptive design with an observational approach was used with a convenience sample of ED healthcare personnel at a large, 500 bed community hospital. Seven hundred and fifty-eight hand hygiene compliance direct observations were collected during 3 time periods (baseline, pre-intervention and post-intervention observation periods). Descriptive and inferential statistics were used to analyze differences in hand hygiene compliance across the observation periods and by HCP job category. </p><p> The results indicated a statistically significant increase in hand hygiene compliance among all groups combined after a multifaceted intervention program was implemented. Efforts to change behavior, lifestyle and the environment must be varied and the target audience must be involved to be effective. This model can be applied to HCPs in other healthcare settings to improve compliance with hand hygiene, a fundamental infection prevention practice to prevent healthcare acquired infections.</p>
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Lassiter-Edwards, Cheryl Anne. "Emergency Department Use for Nontraumatic Dental Conditions and Adult Oral Health." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4972.
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Nontraumatic dental-related emergency department visits has resulted in a financial burden to hospitals across the United States. This study investigated whether there is a relationship between adult preventive dental care and emergency department visits for nontraumatic dental conditions by comparing specific states. Guided by Andersen's behavioral model of health services utilization, this retrospective quantitative study also investigated associations between state-specific community water fluoridation and dental-related emergency department visits. The population of interest was adult Medicaid enrollees who visited the emergency department for non-trauma-related dental conditions in the top 5 most populous states as identified in the 2012 NHAMCS survey. These top 5 states represented 52% of emergency department visits. Among these visits, 2.4% were for adults with nontraumatic dental conditions. Two binary regression models were constructed, and statistically significant relationships were found between emergency department visits and age, gender, race/ethnicity, and Medicaid as a payment source (n=18,112). State-specific community water fluoridation did not emerge as a statistically significant predictor of emergency department visits. Social change implication may allow taxpayers and public health policy leaders to identify new strategies in promoting oral health. New approaches include reeducating the public on policies in support of community water fluoridation as a preventive strategy and understanding how to encourage adult Medicaid enrollees to use preventive dental care in their community and avoid the emergency department for dental care.
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Sefcik, Angela M. "Emergency Department Health Care Provider Perceptions of the Drug-seeking Patient." University of Cincinnati / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1406809531.
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Reid, Tracey. "The impact of physician communication skills on continuity of care and emergency department use by regular emergency department users /." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=21629.
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Regular use of the emergency department is associated with a patient's inability to identify a regular primary care physician. Continuity of the physician-patient relationship is largely determined by patient satisfaction, which in turn is influenced by the physician's communication and interpersonal skills. The objective of this study was to estimate the relationship between the communication competency of newly licensed family physicians and the ambulatory health care utilization behaviour of their regular emergency department users. It was hypothesized that physicians with higher levels of competency in patient communication would be the providers of a greater proportion of their patients' ambulatory care than physicians with poorer communication abilities. Consequently, these patients would rely on the emergency department for a smaller proportion of their ambulatory care than patients of physicians with lower levels of communication competency.<br>In total, 474 newly licensed family physicians and 42 113 regular ED user patients were included in the study population. Analysis was conducted at the level of the physician and patients were attributed to the practice populations of the first study physician they saw. (Abstract shortened by UMI.)
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Gillespie, Gordon Lee II. "Violence Against Healthcare Workers in a Pediatric Emergency Department." University of Cincinnati / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1212109392.
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Mathusa, Amy Walrath. "Emergency Department Use in Accidental Childhood Poisonings Involving a Grandparent." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1248909612.
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Kubiel, Theresa J. "Transforming Care of the Behavioral Health Patient in an Emergency Department Setting." Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10010886.
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<p>Abstract
Behavioral and mental health issues contribute to the needs of many patients presenting to emergency departments, and yet these needs often go unrecognized. Patient processing procedures in emergency departments may not include mechanisms to consistently identify and triage patients whose care is complicated by behavioral illness. The purpose of this project was to plan a program to improve early identification and management of behavioral health patients presenting to the emergency department. The objective of this project was to develop a rapid mental health screening tool and policies guiding use of the tool in the emergency department. A multi-disciplinary team of emergency department providers cooperated in the selection and evaluation of available screening tools. A literature search was done with the inclusion criterion of behavioral screening tools to be used at time of triage, and results were brought to the team for further consideration. The HEADS-ED pediatric screening tool was chosen through the expert opinions of the team members. The team evaluated and approved adaptations to the tool for its use in adults. Policies were developed to guide the future implementation of the screening tool in the emergency department. A plan for process and outcome evaluation was included in the developed program. Process will be evaluated by monitoring provider use of the screening tool, and patient length of stay in the emergency department will serve as the outcome measure. The program may contribute to social change through improved emergency department care of patients with behavioral illnesses.
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Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2004. http://escholarship.umassmed.edu/gsbs_diss/710.
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Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population.
In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands.
We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable.
We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models.
In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group.
In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).
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Lines, Lisa M. "Outpatient Emergency Department Utilization: Measurement and Prediction: A Dissertation." eScholarship@UMMS, 2014. https://escholarship.umassmed.edu/gsbs_diss/710.
Full textAbstract:
Approximately half of all emergency department (ED) visits are primary-care sensitive (PCS) – meaning that they could potentially be avoided with timely, effective primary care. Reducing undesirable types of healthcare utilization (including PCS ED use) requires the ability to define, measure, and predict such use in a population.
In this retrospective, observational study, we quantified ED use in 2 privately insured populations and developed ED risk prediction models. One dataset, obtained from a Massachusetts managed-care network (MCN), included data from 2009-11. The second was the MarketScan database, with data from 2007-08. The MCN study included 64,623 individuals enrolled for at least 1 base-year month and 1 prediction-year month in Massachusetts whose primary care provider (PCP) participated in the MCN. The MarketScan study included 15,136,261 individuals enrolled for at least 1 base-year month and 1 prediction-year month in the 50 US states plus DC, Puerto Rico, and the US Virgin Islands.
We used medical claims to identify principal diagnosis codes for ED visits, and scored each according to the New York University Emergency Department algorithm. We defined primary-care sensitive (PCS) ED visits as those in 3 subcategories: nonemergent, emergent but primary-care treatable, and emergent but preventable/avoidable.
We then: 1) defined and described the distributions of 3 ED outcomes: any ED use; number of ED visits; and a new outcome, based on the NYU algorithm, that we call PCS ED use; 2) built and validated predictive models for these outcomes using administrative claims data; 3) compared the performance of models predicting any ED use, number of ED visits, and PCS ED use; 4) enhanced these models by adding enrollee characteristics from electronic medical records, neighborhood characteristics, and payor/provider characteristics, and explored differences in performance between the original and enhanced models.
In the MarketScan sample, 10.6% of enrollees had at least 1 ED visit, with about half of utilization scored as PCS. For the top risk group (those in the 99.5th percentile), the model’s sensitivity was 3.1%, specificity was 99.7%, and positive predictive value (PPV) was 49.7%. The model predicting PCS visits yielded sensitivity of 3.8%, specificity of 99.7%, and PPV of 40.5% for the top risk group.
In the MCN sample, 14.6% (±0.1%) had at least 1 ED visit during the prediction period, with an overall rate of 18.8 (±0.2) visits per 100 persons and 7.6 (±0.1) PCS ED visits per 100 persons. Measuring PCS ED use with a threshold-based approach resulted in many fewer visits counted as PCS, discarding information unnecessarily. Out of 45 practices, 5 to 11 (11-24%) had observed values that were statistically significantly different from their expected values. Models predicting ED utilization using age, sex, race, morbidity, and prior use only (claims-based models) had lower R2 (ranging from 2.9% to 3.7%) and poorer predictive ability than the enhanced models that also included payor, PCP type and quality, problem list conditions, and covariates from the EMR, Census tract, and MCN provider data (enhanced model R2 ranged from 4.17% to 5.14%). In adjusted analyses, age, claims-based morbidity score, any ED visit in the base year, asthma, congestive heart failure, depression, tobacco use, and neighborhood poverty were strongly associated with increased risk for all 3 measures (all P<.001).
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Ray, Brandan. "America Supports Love: The History of Goodridge v. Department of Public Health." Thesis, Boston College, 2015. http://hdl.handle.net/2345/bc-ir:104224.
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Thesis advisor: Alan Rogers<br>Until the late 20th century marriage in the United States meant "the legal union of a man and a woman as husband and wife." In 2003, this was forever changed when the Massachusetts Supreme Judicial Court found a state law barring marriage between two individuals of the same sex unconstitutional in Goodridge v. Dept. of Public Health (2003). The case triggered a legal and social transformation for LGBT civil rights. Same-sex marriage has become one of the most widely discussed legal topics in the past ten years. This thesis examines the content, context, and significance of this particular case and the effect it has had on the American legal and cultural landscape<br>Thesis (BA) — Boston College, 2015<br>Submitted to: Boston College. College of Arts and Sciences<br>Discipline: Departmental Honors<br>Discipline: History
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Sartore, Melanie L. "An exploration of the lesbian label among health and kinesiology department academicians." [College Station, Tex. : Texas A&M University, 2007. http://hdl.handle.net/1969.1/ETD-TAMU-1546.
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Nelson, Kristin Marie B. S. RHIA. "Determining Perceived Workplace Stress and Resilience among Health Information Management Department Employees." The Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1363089131.
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Seitshiro, Tshidiso. "A study to determine the motivational climate in the Department of Health." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1021090.
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The Department of Health, being a public entity, has a responsibility to provide quality health services to the community. The Department has experienced repeated negative feedback from the press with respect to job dissatisfaction and the quality of service. This could be the result of low employee motivation. The researcher was concerned and interested in investigating possible causes of these allegations by the press. The main purpose of this study was to analyse the motivational climate of employees in the Department of Health. The study included a literature study of employee motivation and organisational climate. The purpose of the literature was to determine how the Department of Health measures up to what the literature reveals. A questionnaire was used as an instrument to collect data. The questionnaire was formulated from the literature discussed in the research study. The major findings indicated that the level of motivation in the Department of Health was low. Findings also indicated the majority of employees were not trained in the Batho Pele principle. The researcher argued that if employees were trained in the Batho Pele principle and also practised, the negative press feedback would be minimal. The researcher suggested certain recommendations for those areas where findings indicated shortcomings in an attempt to increase the overall levels of employee motivation within the Department of Health.
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Simon, Nobuzwe. "Assessing the effect of absenteeism in the Eastern Cape Department of Health." Thesis, University of Fort Hare, 2016. http://hdl.handle.net/10353/2271.
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The Department of Health is experiencing repeated negative press releases with the respect to the quality of service delivery in the Eastern Cape. The public sector is an entity that provides a unique service. This is made evident by the services provided such as provision of free health services for primary health care as well as free health services to children under six, disabled and senior citizens. The Eastern Cape Department of Health has developed service standards adopted in 2007 by the Eastern Cape Department of Health. This study aims to determine the casual effect of absenteeism and their relationship to poor service delivery. According to Makhubu (2006) many vacancies in the Eastern Cape Department of Health exist which result in service delivery problems. In terms of the second principle in the Batho Pele Principles the norms and standards which are service standards serves as a baseline where the Department of Public Service and Administration (2007) issued directive that the vacancy rate of any government department should range between ten and fifteen percent Makhubu (2006) further refers to the doctors/patient ratio as one is to three hundred patients (1:300), which is unhealthy and abnormal as the doctor/patient ration in terms of the Health Professional is one is to thirty (1:30). Such cases pose an opportunity to those employees who are within the service to absent themselves from such unhealthy situations and this behavior later result in the exodus (professional drainage) of employee. Schultz, Nel, Gerber, Hassbroek, Van Dyk and Werner (2001:582) define absenteeism as withdrawal of levels of productivity and collegial interaction for a given time to escape a perceived undesirable working environment. This behavior is disruptive to continuous organizational efficiency. Absenteeism is found in two forms that are avoidable and unavoidable. In the unavoidable forms of absenteeism, the situation in unplanned and is governed by external factors, thus it is beyond one’s control and has to be managed differently. Control of absenteeism can exercise by the immediate manager through the human resource section regarding the duration and terms of absence pertaining salary and terms of services.
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Flaming, Susan L. "The effect of implementing a flow coordinator on emergency department throughput." Thesis, California State University, Long Beach, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1586503.
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<p> Emergency department (ED) overcrowding is a widespread and multifaceted problem caused by many factors including overutilization of the ED by non-emergency patients and a decreasing number of available ED beds nationwide. The flow of patients through the ED is known as throughput process, and many interventions to improve the efficiency have been described in the literature including sorting patients by acuity or condition, placing providers in the triage area, using a flow expeditor role and various technology applications.</p><p> This retrospective, comparative study assessed the implementation of an experienced registered nurse in the role of flow coordinator, with the focus solely on moving patients efficiently through their ED course. Three throughput metrics were used to measure ED efficiency before and after the role implementation: discharge length of stay (DCLOS), left without being seen (LWBS) and elopements. While no difference was seen in any of the three throughput metrics with regard to the sample as a whole, there were statistically significant differences between each of the throughput metrics when the sample was partitioned by age and gender. Additionally, though not statistically significant at the <i>p < .05</i> level, patient satisfaction improved after the flow coordinator was implemented. These findings add to what is known about the science of ED throughput processes as they suggest a flow coordinator may improve patient satisfaction and interventions to improve flow should be individualized to patients based on their age and gender.</p>
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Gunnarsdóttir, Oddný. "Users of a hospital emergency department : Diagnoses and mortality of those discharged home from the emergency department." Thesis, Nordic School of Public Health NHV, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3323.
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Objectives – To ascertain the annual number of users who were discharged home after visits to the emergency department, grouped by age, gender and number of visits during the calendar year, and to assess whether an increasing number of visits to the department predicted a higher mortality. Methods – This is a retrospective cohort study, at the emergency department of Landspitali University Hospital, Reykjavik capital city area, Iceland. During the years of 1995 to 2001 19259 users visited the emergency department, and were discharged home and they were follow-up for cause specific mortality through a national registry. Standardised mortality ratio, with expected number based on national mortality rates was calculated and hazard ratios according to number of visits per calendar year using time dependent multivariate regression analysis were computed. Results – The annual increase of visits to the emergency department among the patients discharged home was seven to 14 per cent per age group during the period 1995 to 2001, with a highest increase among older men. The most common discharge diagnosis was the category Symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified. When emergency department users were compared with the general population, the standardised mortality ratio was 1.81 for men and 1.93 for women. Among those attending the emergency department two times, and three or more times in a calendar year, the mortality rate was higher than among those coming only once in a year. The causes of death which led to the highest mortality among frequent users of the emergency department were neoplasm, ischemic heart diseases, and the category external causes, particularly drug intoxication, suicides and probable suicides. Conclusions – The mortality of users of the emergency department who had been discharged home turned out to be higher than that of the general population. Frequent users of the emergency department had a higher mortality than those visiting the department no more than once in a year. Since the emergency department serves general medicine and surgery patients, not injuries, the high mortality due to drug intoxication, suicide and probable suicide is notable. Further studies are needed into the diagnosis at discharge of those frequently using emergency departments, in an attempt to understand and possibly prevent this mortality<br><p>ISBN 91-7997-128-8</p>
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Brim, Carla B. "A descriptive analysis of non-urgent emergency department utilization." Online access for everyone, 2006. http://www.dissertations.wsu.edu/Thesis/Spring2006/c%5Fbrim%5F040606.pdf.
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Desir, Samara. "Strategies Department Store Managers Use to Increase Employee Engagement." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6416.
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Business leaders are challenged with sustaining an engaged workforce to achieve economic prosperity in their organizations. The implementation of effective strategies to increase employee engagement can mitigate the challenges of employee disengagement. The purpose of this qualitative, single case study was to explore the strategies that department store managers used to increase employee engagement. The conceptual frameworks selected for the research were Vroom's expectancy theory of motivation and Kahn's engagement theory. The research participants consisted of 5 department store managers, from the northeastern United States, who successfully used strategies to increase employee engagement. Data were collected from the participants in semistructured interviews and from company archival documents about the strategic efforts that department store managers used to increase employee engagement. Data analysis consisted of compiling the data, coding for emergent themes, disassembling the data into common codes, reassembling the data into themes, interpreting the meaning, and reporting the themes. The 9 themes that emerged from the data were manager and employee relationship, employee motivation, rewards and incentives, expressing appreciation, ensuring employee wellbeing, health and safety, employee empowerment, employee feedback, and establishing employee expectations. The study results could contribute to positive social change by providing department store managers with strategies to increase employee engagement, which may reduce employee turnover and create community-wide employment opportunities for community members.
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Kapur, Atul Kumar. "Emergency department treatment of clinically stable paroxysmal atrial fibrillation." Thesis, University of Ottawa (Canada), 2002. http://hdl.handle.net/10393/6228.
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Introduction. Optimal management of paroxysmal atrial fibrillation (PAF), a common presenting complaint in emergency departments (EDs), remains undetermined. Methods. Six month prospective observational study at three EDs. Patients had clinically stable PAF for less than 48 hours. Conservative (rate control) and aggressive (pharmacologic and/or electrical cardioversion) treatment were analyzed. Results. 169 patients were analyzed, 32 treated conservatively and 137 aggressively. 83.9% of aggressively treated patients converted in the ED, 8.0% were admitted, and 52.3% stayed in sinus rhythm for four weeks. The corresponding proportions for conservative treatment were 34.4%, 37.5%, and 30.0%. There were 15 ED complications (2 rate control, 4 pharmacologic, and 9 electrical), two required admission (one pharmacologic and one electrical). No thromboembolism occurred by four-week follow-up. Conclusions. The results of this study---the first prospective study of ED treatment of PAF---will be used to plan a randomized controlled trial which will compare the two treatments.
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Mrara, Msibulele Theophilus. "An investigation of turnover and retention factors of health professional staff within the Eastern Cape Department of Health." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1003875.
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Health Professionals are critical in the provision of health services, more especially when it comes to nurses who are next to the patient most of the time. It is critically important for the Eastern Cape Department of Health to ensure that skilled health professionals such as doctors, pharmacists, nurses and the like are retained and the staff turnover regarding this category of staff is appropriately managed. The difficulty to attract and retain health professionals is negatively affecting service delivery in the Eastern Cape department of Health and leaves the department with an unacceptably high vacancy rate. This often put more of a burden on to the health professionals who remain within the organization. Some of them will end up leaving the organization. There is a great shortage of health professionals in South Africa and it becomes easier for the health professionals to get employment elsewhere, particularly in the private sector which appears to have a competitive advantage as compared to the public sector. In this study, both quantitative and qualitative methods were used to gather information through the utilization of a questionnaire and interviews were conducted mainly to confirm the results obtained. The results of the study have assisted to reflect factors that could be influencing the health professionals to leave health facilities of the Eastern Cape Department of Health. The respondents were drawn from the two areas within the Health Department, and these are, Mthatha and Port Elizabeth areas. One hundred (100) questionnaires were issued to the health professionals and sixty three responded. Documents that were received from the department were helpful in determining the turnover rate. The study has revealed that the Eastern Cape Department of Health may succeed in retaining the health professionals if they can be made to feel that their job is important. It appears that health professionals would like to be given enough opportunity to perform their functions and participate in the decision making processes of the department. Some factors may be contributing to the staff turnover and these are, lack of career opportunities to develop, challenges in the workplace, conflict with the management and colleagues. It is always important for the organizations to recognize its employees by giving them space to practice their profession and create a comfortable workplace that could have an impact in influencing the employee to remain within the organization. Employee turnover can be minimized, if employees can be exposed to a healthy workplace environment that will assist if fostering happiness, and in the process, enhance their motivation. It is imperative for the Eastern Cape Department of Health to focus on the training and development of its employees in order to increase the efficiency and competitiveness. As the employees gain the necessary skills to perform their job, productivity may improve. The performance of the employees should be properly managed, and the resultant incentives and rewards must be fairly distributed. This could promote harmony in the workplace and that could help in building relationships among employees. If employees are satisfied, there is an increased chance that they will stay within the organization and it becomes difficult for other competitors to attract them. Employees must be given adequate space to participate in the decision making processes of the organization, and by doing so, their loyalty to the organization could be increased.
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Frye, Elaine C. "Nontraditional Bed Utilization to Support Decompression of Emergency Department Crowding." Thesis, Saint Francis Medical Center College of Nursing, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10842813.
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<p> Mitigating ED crowding will not be solved by working harder and faster, and is not a one-solution problem. There are tactics the ED can implement, tactics the inpatient units can implement, and tactics that should be implemented to support the transitioning of patients from the ED to the inpatient units. This DNP project focuses on implementing a pilot to evaluate the use of hall beds in the inpatient units for ED patients awaiting placement. This will be a significant change for the inpatient caregivers, and time and attention must be committed to the initial phase to promote cultural readiness in order to achieve success. Crowding in the ED is a facility problem, not an ED problem. A multipronged approach when mitigating ED crowding must emphasize safe, efficient patient care that leads to the best possible outcomes without delays in treatment, while still maintaining standards of care, respect for privacy, and clear communication with the patient. This project focuses on both providing care to adult general medical-surgical patients admitted to a Midwestern level-1 trauma center through the ED and reducing the volume of patients who leave before treatment complete or without being seen. In the end, this practice change will benefit patients seeking care in addition to capturing the lost patients and reimbursement that accompanies the care. </p><p>