Current Search: Healthcare (x)
View All Items
Pages
- Title
- A framework for prioritizing opportunities of improvement in the context of business excellence model in healthcare organization.
- Creator
-
Aldarmaki, Alia, Elshennawy, Ahmad, Lee, Gene, Rabelo, Luis, Darwish, Mohammed, University of Central Florida
- Abstract / Description
-
In today's world, the healthcare sector is facing challenges to improve the efficiency and effectiveness of its operations. More and more improvement projects are being adopted to enhance healthcare services, making it more patient-centric, and enabling better cost control. Healthcare organizations strive to identify and carry out such improvement initiatives to sustain their businesses and gain competitive advantage. Seeking to reach a higher operational level of excellence, healthcare...
Show moreIn today's world, the healthcare sector is facing challenges to improve the efficiency and effectiveness of its operations. More and more improvement projects are being adopted to enhance healthcare services, making it more patient-centric, and enabling better cost control. Healthcare organizations strive to identify and carry out such improvement initiatives to sustain their businesses and gain competitive advantage. Seeking to reach a higher operational level of excellence, healthcare organizations utilize business excellence criteria to conduct assessment and identify organizational strengths and weaknesses. However, while such assessments routinely identify numerous areas for potential improvement, it is not feasible to conduct all improvement projects simultaneously due to limitations in time, capital, and personnel, as well as conflict with other organization's projects or strategic objectives. An effective prioritization and selection approach is valuable in that it can assist the organization to optimize its available resources and outcomes. This study attempts to enable such an approach by developing a framework to prioritize improvement opportunities in healthcare in the context of the business excellence model through the integration of the Fuzzy Delphi Method and Fuzzy Interface System. To carry out the evaluation process, the framework consists of two phases. The first phase utilizes Fuzzy Delphi Method to identify the most significant factors that should be considered in healthcare for electing the improvement projects. The FDM is employed to handle the subjectivity of human assessment. The research identifies potential factors for evaluating projects, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of factors from experts; which includes collecting additional factors from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts' and other related stakeholders' opinions on the appropriate weight of each factor's importance. Finally, FDM analyses eliminate or retain the criteria to produce a final list of critical factors to select improvement projects. The second phase in the framework attempts to prioritize improvement initiatives using the Hierarchical Fuzzy Interface System. The Fuzzy Interface System combines the experts' ratings for each improvement opportunity with respect to the factors deemed critical to compute the priority index. In the process of calculating the priority index, the framework allows the estimation of other intermediate indices including: social, financial impact, strategical, operational feasibility, and managerial indices. These indices bring an insight into the improvement opportunities with respect to each framework's dimensions. The framework allows for a reduction of the bias in the assessment by developing a knowledge based on the perspectives of multiple experts.
Show less - Date Issued
- 2018
- Identifier
- CFE0007304, ucf:52158
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007304
- Title
- Johnson (&) Johnson's Recall Debacle.
- Creator
-
Eaddy, Lashonda, Holladay, Sherry, Neuberger, Lindsay, Coombs, Timothy, University of Central Florida
- Abstract / Description
-
Johnson (&) Johnson (J(&)J) has been viewed as a role model by many organizations for its successful handling of a 1982 crisis involving cyanide-laced Tylenol capsules that resulted in seven deaths. The public relations community applauded J(&)J for a swift response and for promptly implementing actions to prevent a similar crisis from occurring in the future. However more recently, J(&)J has become a poster child for poor crisis communications amidst a flood of recalls that started in...
Show moreJohnson (&) Johnson (J(&)J) has been viewed as a role model by many organizations for its successful handling of a 1982 crisis involving cyanide-laced Tylenol capsules that resulted in seven deaths. The public relations community applauded J(&)J for a swift response and for promptly implementing actions to prevent a similar crisis from occurring in the future. However more recently, J(&)J has become a poster child for poor crisis communications amidst a flood of recalls that started in November 2009. The present study used concepts from Coombs' (2004) Situational Crisis Communication Theory (SCCT) and media framing research to develop a coding scheme for a content analysis of newspaper coverage surrounding the 1982 Tylenol recall as well as current recalls issued by J(&)J from November 2009 through April 2012. The samples included newspaper articles from New York Times and Chicago Tribune. Results showed that most of the stories in both samples did not evaluate J(&)J's operational response or reputation overall. However, when the news coverage did evaluate J(&)J, coverage from the 1982 sample was positive and evenly balanced between favorable and unfavorable, compared to negative and unfavorable in the current sample. Additionally, when crisis type was mentioned in the coverage, the 1982 crisis was more likely described as a victim crisis while the current crises were more likely described as an accident or preventable crisis. When the 1982 sample was examined for mentions of previous recalls there were none compared to 80.5% of the current sample mentioning a previous recall. The results support the tenets of SCCT, information giving strategies and reputation management strategies. Additionally, the results provide valuable information for crisis managers regarding the media's inclusion or, lack thereof, organizations' controlled media such as news releases.
Show less - Date Issued
- 2012
- Identifier
- CFE0004372, ucf:52880
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004372
- Title
- A Framework for Quantifying Sustainability of Lean Implementation in Healthcare Organizations.
- Creator
-
Bahaitham, Haitham, Elshennawy, Ahmad, Mollaghasemi, Mansooreh, Lee, Gene, Uddin, Nizam, Furterer, Sandra, University of Central Florida
- Abstract / Description
-
Due to the remarkable positive effect of lean adoption in various firms in the manufacturing sector, it has been adopted by several organizations within the healthcare industry. Although the rate of adopting lean by hospitals in the developed countries is slower than it should be, it proved to be effective in helping healthcare organizations maintain or even improve their quality of care while containing their related costs. However, such adoption did not take place until the beginning of the...
Show moreDue to the remarkable positive effect of lean adoption in various firms in the manufacturing sector, it has been adopted by several organizations within the healthcare industry. Although the rate of adopting lean by hospitals in the developed countries is slower than it should be, it proved to be effective in helping healthcare organizations maintain or even improve their quality of care while containing their related costs. However, such adoption did not take place until the beginning of the new millennium. And with such adoption, it has been accompanied with major challenges related to proper lean implementation, sustainability of achieved levels of performance, and staff engagement in infinite cycles of continuous improvement towards perfection. Thus, the purpose of this study is to develop a framework that helps healthcare organizations quantify their experience with lean. Such quantification is obtained by measuring the agreement level of hospital staff members about the degree of adopting two sets of critical factors of successful lean implementation within their hospital. These two sets of factors are classified as process factors and organizational factors. The proposed framework has been validated by determining the sustainability level of lean implementation within one of U.S. hospitals in the State of Florida. The developed framework provides a balanced assessment of both process and organizational factors essential for achieving sustainable levels of lean implementation. In order to accommodate for the observed variation in lean adoption in hospitals, individual hospital departments are considered the (")analysis units(") of the developed framework. In order to quantify the implementation status of lean within a hospital department, a survey-based lean sustainability assessment tool has been developed based on the defined sets of factors. The sustainability level of lean implementation of a hospital can be obtained by combining various responses of its surveyed departments. The developed framework is the first that addresses both process and organizational factors of sustainable lean implementation in a balanced manner while fulfilling the assessment needs of all healthcare organizations regardless of their current level of lean adoption. In addition, utilizing the framework within a hospital enhances employee involvement and respect for employee which are essential for sustainable lean implementation. Finally, the developed framework provides healthcare supervising authorities (i.e. ministries of health or corporate offices of hospitals' groups) a macro-level benchmarking view regarding the progress of their hospitals towards implementing sustainable levels of lean.
Show less - Date Issued
- 2011
- Identifier
- CFE0004086, ucf:49140
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004086
- Title
- Patient Violence and Aggression in Non-Institutional Health Care Settings: Predictors of Reporting By Healthcare Providers.
- Creator
-
Campbell, Colleen, Burg, Mary Ann, Gammonley, Denise, Steen, Julie, Potter, Roberto, University of Central Florida
- Abstract / Description
-
This dissertation is conducted to examine the factors which contribute to the reporting of incidents of violence or aggression perpetrated by patients against health care providers in non-institutional health care settings. With a theoretical foundation grounded in community science, applying stress theory, broken windows theory and the theory of reasoned action, the following cross sectional study examines the contribution of characteristics of the healthcare provider, characteristics of the...
Show moreThis dissertation is conducted to examine the factors which contribute to the reporting of incidents of violence or aggression perpetrated by patients against health care providers in non-institutional health care settings. With a theoretical foundation grounded in community science, applying stress theory, broken windows theory and the theory of reasoned action, the following cross sectional study examines the contribution of characteristics of the healthcare provider, characteristics of the patient perpetrator and the form of violence to the providers' reporting or failing to report incidents. A self-administered survey was disseminated to a sample of non-institutional healthcare providers to test the research hypotheses about variables associated with reporting of incidents. The final sample size included 218 respondents, of which 213 met inclusion criteria for the study. 79.4% (N=169) of respondents had experienced at least one form of patient violence or aggression and were thus eligible for inclusion in the statistical analysis. The collected data was then analyzed through use of logistic regression to determine the contribution of each variable and the relative impact on the dependent variable of incident reporting. Findings indicated that there is a statistically significant contribution of the form of abuse, specifically verbal abuse in comparison to sexual abuse, to incident reporting. Specifically, the odds of reporting abuse are four times higher among individuals experiencing verbal abuse in contrast to providers subjected to patient-perpetrated sexual abuse.
Show less - Date Issued
- 2016
- Identifier
- CFE0006082, ucf:50953
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006082
- Title
- EXPERIENCES OF STIGMA DURING SEXUAL HEALTHCARE VISITS: A QUALITATIVE STUDY OF NON-MONOGAMOUS WOMEN.
- Creator
-
McCrosky, Rachael, Carter, Shannon, Grauerholz, Liz, Gay, David, University of Central Florida
- Abstract / Description
-
Access to health care services is critical to both personal health outcomes and health equity within a community. While non-monogamous behavior is widespread, stigma surrounding consensual non-monogamy can create barriers to health care access. This research outlines the experiences of non-monogamous women during sexual health care visits, how class acts to modify those experiences, the barriers to health care access that they encounter, and the adaptive strategies they employ. The sample for...
Show moreAccess to health care services is critical to both personal health outcomes and health equity within a community. While non-monogamous behavior is widespread, stigma surrounding consensual non-monogamy can create barriers to health care access. This research outlines the experiences of non-monogamous women during sexual health care visits, how class acts to modify those experiences, the barriers to health care access that they encounter, and the adaptive strategies they employ. The sample for this research was 23 consensually non-monogamous women. Participants were contacted through online support groups, message boards, and snowball sampling. In-depth interviews about their sexual health care experiences were conducted. Interviews were recorded, transcribed, and analyzed for themes related to the intersection of non-monogamy and health care experiences. The interactions between health care professionals and non-monogamous women, whether or not those women disclose their non-monogamous status, were often perceived as stigmatizing. Increased class status, both of participant and of provider, was described as increasing experiences of stigma and barriers to care. The information provided by this research may be used to better understand, and thus improve, the barriers health care access experienced by non-monogamous women. Suggestions given by the participants for improving their health care access and decreasing experiences of stigma are included.
Show less - Date Issued
- 2015
- Identifier
- CFE0005662, ucf:50183
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0005662
- Title
- MINORITY PHYSICIAN JOB SATISFACTION: A CONTENT ANALYSIS OF WRITTEN RESPONSES TO OPEN-ENDED SURVEY QUESTIONS ABOUT PROFESSIONAL AND ORGANIZATIONAL DISSATISFACTION.
- Creator
-
Daniels-Kranz, Devorah, Barfield, Rufus, University of Central Florida
- Abstract / Description
-
Few interpersonal and organizational communication studies examine the professional and organizational aspects of career satisfaction among minority physicians. Due to the underrepresenation of minority physicians, most studies resort to comparing aggregate groups of minority physicians in juxtaposition to non-minority physicians. These studies fail to uncover possible communication differences, which originate from cultural dissimilarities between disaggregate racial/ethnic groups. Even...
Show moreFew interpersonal and organizational communication studies examine the professional and organizational aspects of career satisfaction among minority physicians. Due to the underrepresenation of minority physicians, most studies resort to comparing aggregate groups of minority physicians in juxtaposition to non-minority physicians. These studies fail to uncover possible communication differences, which originate from cultural dissimilarities between disaggregate racial/ethnic groups. Even fewer studies examine physicians' written communication to open-ended survey questions about career satisfaction/dissatisfaction between disaggregate racial/ethnic minority groups and non-minorities. This study specifically examines written responses to two open-ended survey questions about professional and organizational dissatisfaction and compares responses from disaggregate minority physician and non-minority physicians. Participants were divided into five response-driven categories of race/ethnicity as follows: Asian/Pacific Islander, Black/African American, Indian/Pakistani, Hispanic, and White/Non-Hispanic. The population consists of 1849 members of the medical staff roster of a Southeastern, U.S., not-for-profit hospital group. Primary findings indicate the presence of recurrent themes among disaggregate minority physician racial/ethnic groups' responses. Significant variation exists between responses from disaggregate minority physician racial/ethnic groups and non-minority physicians. Results imply that open-ended methods of data collection are essential to gaining knowledge about ways cultural dissimilarities between disaggregate minority racial/ethnic groups affect communication and satisfaction. Understanding more about cultural dissimilarities is necessary for: improving data collection quality; recruiting and retaining minority physicians; and reducing healthcare disparities among minorities.
Show less - Date Issued
- 2006
- Identifier
- CFE0001488, ucf:47090
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0001488
- Title
- A SURVEY OF PROGRESSIVE AND AFFIRMATIVE EMPLOYEE DISCIPLINE SYSTEMS IN FLORIDA'S HOSPITALS.
- Creator
-
Johnson, Mark, Fottler, Myron, University of Central Florida
- Abstract / Description
-
Conflict between managers and employees is inevitable in any organization, whether public or private. Often, the source of the conflict is employee non-compliance. Managers are responsible for disciplining those employees whose performance or conduct is sub-standard or inappropriate. Therefore, the ability to effectively address employee non-compliance is an essential skill for all managers. Most employee discipline systems fall into one of three categories: traditional, progressive, and...
Show moreConflict between managers and employees is inevitable in any organization, whether public or private. Often, the source of the conflict is employee non-compliance. Managers are responsible for disciplining those employees whose performance or conduct is sub-standard or inappropriate. Therefore, the ability to effectively address employee non-compliance is an essential skill for all managers. Most employee discipline systems fall into one of three categories: traditional, progressive, and affirmative. Traditional systems were prevalent in the late-nineteenth and early twentieth centuries. An autocratic, demanding manager would mete out punishment to non-compliant employees both as an action against the employee and as a warning to other employees. Employees were often terminated for their first offense. With the advent of labor unionism and fair labor practices in the first half of the twentieth century, organizational leaders were required to develop more progressive employee discipline systems which protected employee "due process" and which allowed time and opportunity for improvement by the non-compliant employee. Progressive employee discipline systems are the most prevalent discipline systems in America's workforce today. These systems entail three or four steps, with each successive step usually resulting in more severe penalties for the same offense or more severe offenses. Progressive employee discipline allows the employee an opportunity to respond to non-compliance issues and to try to improve it to the extent required to maintain their position. A new employee discipline system, affirmative discipline, has gained adherents in the private sector primarily. Affirmative employee discipline systems do not use punishment to correct employee non-compliance but instead, ask managers to "coach" and "counsel" the non-compliant employee to better behavior and performance. Rehabilitating the employee's non-compliance is the primary goal of affirmative systems. The emphasis is not only upon the non-compliant employee, but on rehabilitating the "marriage" of non-compliant employee and direct supervisor. Little evidence exists to determine the extent to which progressive and affirmative employee discipline systems are being utilized in the modern organization. No evidence exists that indicates the prevalence of these systems in Florida's healthcare institutions. A survey-based analysis of the use of progressive and affirmative employee discipline systems in Florida's hospitals resulted in respondents indicating frequent utilization of formal progressive employee discipline systems. Designed in three or four steps, these progressive systems allow the employee to improve his/her behavior. Two common tools in progressive systems, the verbal warning and the performance counseling statement, are utilized frequently based upon those respondents surveyed. The use of affirmative employee discipline systems, on the other hand, is relatively rare. The use of written behavior contracts to elicit improved employee compliance is also quite rare. The vast majority of respondents appear to be unfamiliar with the use of written behavior contracts to elicit improved employee compliance.
Show less - Date Issued
- 2005
- Identifier
- CFE0000738, ucf:46580
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0000738
- Title
- SOCIAL WORK STUDENTS' ATTITUDES AND PERCEPTIONS ABOUT THE AFFORDABLE CARE ACT.
- Creator
-
Goddard, Yvichess, Burg, Mary Ann, University of Central Florida
- Abstract / Description
-
The Affordable Care Act is creating major political changes, on the state and federal levels, and is redefining American citizens' ability to access health services. Medical and mental health social workers are in high demand within the health care workforce to advocate and assist patients in navigating through a complex health care system. Little research has been conducted in understanding future social work professionals' views and knowledge about the legislation. This exploratory...
Show moreThe Affordable Care Act is creating major political changes, on the state and federal levels, and is redefining American citizens' ability to access health services. Medical and mental health social workers are in high demand within the health care workforce to advocate and assist patients in navigating through a complex health care system. Little research has been conducted in understanding future social work professionals' views and knowledge about the legislation. This exploratory-descriptive study used a convenience sample of 105 Bachelors (BSW) and Masters (MSW) level social work students to explore views on health care policy and reform based on students' personal experiences accessing health care. The study also obtained an understanding of how demographic factors affect students' support for health reform. Implications of this study show the need for greater implementation of health policy education in the social work curriculum and further research on the factors affecting students' knowledge and attitudes of health reform.
Show less - Date Issued
- 2014
- Identifier
- CFH0004649, ucf:45306
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004649
- Title
- Social Media as a Healthcare Tool: Case Study Analysis of Factors Influencing Pediatric Clinicians' Behavioral Intent to Adopt Social Media for Patient Communication and Engagement.
- Creator
-
Mustonen, Rachel, Hou, Su-I, Malvey, Donna, Gurupur, Varadraj, Wisniewski, Pamela, University of Central Florida
- Abstract / Description
-
Social media aids communication among users worldwide. However, a notable gap exist among social media users, healthcare professionals utilizing social media in the work place. While the concept of harnessing social media as a professional tool is not novel, healthcare professionals have yet to embrace the practice as standard workflow. This study identifies factors influencing clinicians' behavioral intent to adopt social media for patient engagement and communication. A new framework, the...
Show moreSocial media aids communication among users worldwide. However, a notable gap exist among social media users, healthcare professionals utilizing social media in the work place. While the concept of harnessing social media as a professional tool is not novel, healthcare professionals have yet to embrace the practice as standard workflow. This study identifies factors influencing clinicians' behavioral intent to adopt social media for patient engagement and communication. A new framework, the Healthcare Social Media Adoption Framework (HSMA), guided this mixed-method approach to assess 7 factors identified by theory and literature as adoption influencers. A custom, web-based survey collected data from 60 full-time, pediatric clinicians (47 quantitative) at the case institution (a pediatric hospital). Additionally, individual interviews of 6 participants provided their prospective on using social media for patient communications and engagement. Results: Privacy concerns were the only statically significant factor; with an inverse relationship to positive adoption intent, indicating higher privacy concerns influence lower behavioral intent to adopt social media for patient engagement and communication. The qualitative analysis revealed privacy concerns encompass two themes, personal privacy for patient and providers (boundaries), and cybersecurity. The qualitative inputs also uncovered perceived unprofessionalism as a new factor influencing clinician adoption. The implications for these findings indicate a need for both healthcare organizations and healthcare regulators to establish cyber-security defenses for security and use protocols for privacy to aid the diffusion and adoption acceptance of social media use by pediatric healthcare professionals. This research has contributed in four areas: 1) fill a knowledge gap by identifying new factors that influence the behavioral intent of pediatric clinicians to adopt social media; 2) confirm/reject behavioral intent influences found in the literature; 3) formulated a new HSMA framework that measures functional, cognitive, and social aspects of social media adoption; and 4) prioritizes policies and global standard focus.
Show less - Date Issued
- 2018
- Identifier
- CFE0007062, ucf:51998
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007062
- Title
- IS "GOOD" GOOD ENOUGH? A SMALL AREA VARIATION ANALYSIS OF DISPARITY IN EXPRESSED RATES OF ACCESS TO AND SATISFACTION WITH CHILD AND ADOLESCENT HEALTHCARE SERVICES IN EAST CENTRAL FLORIDA.
- Creator
-
Schaefer, Jay, Holmes, Stephen T., University of Central Florida
- Abstract / Description
-
The purpose of this dissertation research was to explore indications of disparities within the east Central Florida child and adolescent healthcare services market. Structured as a follow-up study to work completed in 2005 under the direction of the Health Council of East Central Florida assessing parental perceptions of community child and adolescent healthcare services, this research extended that evaluation by aggregating participant responses at the county and small area zip code group...
Show moreThe purpose of this dissertation research was to explore indications of disparities within the east Central Florida child and adolescent healthcare services market. Structured as a follow-up study to work completed in 2005 under the direction of the Health Council of East Central Florida assessing parental perceptions of community child and adolescent healthcare services, this research extended that evaluation by aggregating participant responses at the county and small area zip code group levels, contextually testing the uniformity of responses in understanding parent perceptions of access to, and satisfaction with, community healthcare service offerings available for children and adolescents. Under a variety of methodologies significance in the responses concerning access to healthcare services were demonstrated between the counties studied. Statistical modeling, however, could not demonstrate the core demographic differences among these data. Data representing perceptions of satisfaction with the services received by children and adolescents were demonstrated at the small area zip code group level within Orange county. Primary effect assessment of the demographic variables representing these respondents yielded findings generally consistent with theoretical expectations of disparity but, notably, the correlation effects between a number of key independent variables demonstrated a mediation of the primary effects on overall perception of satisfaction. Specifically, it was demonstrated that the interaction of white race with possession of private healthcare insurance, and the interaction of greater levels of educational attainment with black race, caused a proportional reduction in the predicted satisfaction score of these survey respondent cohorts. Further research specific to these phenomenon encompassing a clearer understanding of the type of care received and the individual's specific experiences with their healthcare providers was recommended, with ensuing research to better identify commonalities of interactions with specific area providers, local restrictions imposed by area insurance carriers, influences caused by language and/or cultural barriers, and the like as drivers in understanding the individual dynamics of satisfaction.
Show less - Date Issued
- 2010
- Identifier
- CFE0003505, ucf:48977
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003505
- Title
- Quality by Design Procedure for Continuous Pharmaceutical Manufacturing: An Integrated Flowsheet Model Approach.
- Creator
-
Vezina, Ashley, Elshennawy, Ahmad, Rabelo, Luis, Karwowski, Waldemar, University of Central Florida
- Abstract / Description
-
Pharmaceutical manufacturing is crucial to global healthcare and requires a higher, more consistent level of quality than any other industry. Yet, the traditional pharmaceutical batch manufacturing has remained largely unchanged in the last fifty years due to high R(&)D costs, shorter patent durations, and regulatory uncertainty. This has led regulatory bodies to promote modernization of manufacturing process to continuous pharmaceutical manufacturing (CPM) by introducing new methodologies...
Show morePharmaceutical manufacturing is crucial to global healthcare and requires a higher, more consistent level of quality than any other industry. Yet, the traditional pharmaceutical batch manufacturing has remained largely unchanged in the last fifty years due to high R(&)D costs, shorter patent durations, and regulatory uncertainty. This has led regulatory bodies to promote modernization of manufacturing process to continuous pharmaceutical manufacturing (CPM) by introducing new methodologies including quality by design, design space, and process analytical technology (PAT). This represents a shift away from the traditional pharmaceutical manufacturing way of thinking towards a risk based approach that promotes increased product and process knowledge through a data-rich environment. While both literature and regulatory bodies acknowledge the need for modernization, manufacturers have been slow to modernize due to uncertainty and lack of confidence in the applications of these methodologies. This paper aims to describe the current applications of QbD principles in literature and the current regulatory environment to identify gaps in literature through leveraging regulatory guidelines and CPM literature. To aid in closing the gap between QbD theory and QbD application, a QbD algorithm for CPM using an integrated flowsheet models is also developed and analyzed. This will help to increase manufacturing confidence in CPM by providing answers to questions about the CPM business case, applications of QbD tools, process validation and sensitivity, and process and equipment characteristics. An integrated flowsheet model will aid in the decision-making process and process optimization, breaking away from ex silico methods extensively covered in literature.
Show less - Date Issued
- 2017
- Identifier
- CFE0006923, ucf:51683
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006923
- Title
- Jail Mental Health Innovations: Factors Influencing Mental Health Services Innovations for Jails.
- Creator
-
Clayton, Orville, Wan, Thomas, Anderson, Kim, Winton, Mark, Zhang, Ning, University of Central Florida
- Abstract / Description
-
ABSTRACTThe U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding...
Show moreABSTRACTThe U.S. is recognized for uniquely high incarceration rates. Over recent decades, there has been a concurrent dramatic increase of jail detainees with mental disorders. Provision of adequate mental health services for jail inmates is constitutionally mandated, and has legal, ethical, quality of care, and fiscal implications for jails, families, communities, and detainees. Significant variation exists in the provision of mental health services across jails, and increased understanding of the factors that influence the adoption of such services may help guide jails to implement beneficial services, and ensure that such services reflect, reflect quality standards. This study used a mixed methods strategy to examine the influence of theoretically determined variables on the adoption of jail mental health services, and the quality assessment of such services. Data was gathered by survey instrumentation, secondary data review, and in-depth interviews with jail leaders. The study found that isomorphism has a significant effect on the structural adequacy of jail mental health services, innovation characteristics have a negligible relationship to structural adequacy and process integrity, structural adequacy mediates the effects of isomorphism on process integrity, and jail size has a significant effect on structural adequacy. This study advances the knowledge base in its specification of the roles of internal, external, and demographic factors in the adoption of jail mental health services, and in the testing and application of Donabedian's healthcare model to assess the quality of such services.
Show less - Date Issued
- 2017
- Identifier
- CFE0006866, ucf:51755
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006866
- Title
- HEALTHCARE COMMUNICATION NETWORKS: THE DISSEMINATION OF EMPLOYEE INFORMATION FOR HOSPITAL SECURITY.
- Creator
-
Sumner, Jennifer, Liberman, Aaron, University of Central Florida
- Abstract / Description
-
ABSTRACT: Healthcare in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. However, corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. Traditionally, hospitals have been reluctant to share information on their previous employees, even with other hospitals,...
Show moreABSTRACT: Healthcare in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. However, corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. Traditionally, hospitals have been reluctant to share information on their previous employees, even with other hospitals, for fear of issues surrounding defamation, negligent hiring, and violation of the employee's privacy. However, growth in healthcare services is expected to rise exponentially in the near future, increasing the demand for employees. The need, therefore, to exchange pertinent information regarding employees will become necessary as hospitals seek qualified employees to fill positions throughout their organizations. One way to promote this information exchange is to develop trusted information sharing networks among hospital units. This study examined the problems surrounding organizational information sharing as well as the current level of employee information sharing being conducted by hospitals nationwide. Utilizing a survey of hospital administrators, this study drew upon the theoretical foundations of the Diffusion of Innovation Theory, the Knowledge Management Theory, the Social Exchange Theory and the earlier organizational information sharing frameworks established by Dawes (1996) and Landsbergen and Wolken (1998; 2001) in order to examine the variables that contribute to propensity of hospital administrators to engage in the sharing of employee information with other organizations.
Show less - Date Issued
- 2008
- Identifier
- CFE0002010, ucf:47609
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002010
- Title
- The Effect of Registered Nurse Supply on Population Health Outcomes: A Distributed Lag Model Approach.
- Creator
-
Sampson, Carla Jackie, Unruh, Lynn, Malvey, Donna, Liu, Albert Xinliang, Neff, Donna, University of Central Florida
- Abstract / Description
-
Registered nurses (RNs) are essential to providing care in the healthcare system. To date, research on the relationship between healthcare provider supply and population health has focused on physician supply. This study explored the effect of RN supply on population health outcomes in the U.S. This is a retrospective, cross-sectional study of U.S. counties and county equivalents using national data. Seven population health outcomes (total and disease specific mortalities and low infant birth...
Show moreRegistered nurses (RNs) are essential to providing care in the healthcare system. To date, research on the relationship between healthcare provider supply and population health has focused on physician supply. This study explored the effect of RN supply on population health outcomes in the U.S. This is a retrospective, cross-sectional study of U.S. counties and county equivalents using national data. Seven population health outcomes (total and disease specific mortalities and low infant birth weight rate) were the response variables. The predictor variable, RN supply, and some control variables were anticipated to have an asynchronous effect on the seven outcome variables in the hypothesized relationship. Therefore, these variables were examined using three different models: contemporaneous; a three-year lagged; and a distributed lag (both contemporaneous and lagged variables). Quadratic terms for RN and physician supply variables were included. Because the Area Health Resource File (AHRF) outcome variables were skewed toward zero and left censored, Tobit regression analyses were used. Data were obtained from 19 states using historical RN Supply data for 1,472 counties, representing 47% of the total target population of 3,108 U.S. counties and county equivalents. Regions with rural populations(-)the Midwest and Southeast(-)were overrepresented. Higher RN supply is positively related to higher mortality rates from ischemic heart disease, other cardiovascular disease, and chronic lower respiratory disease in the distributed lag models. Higher RN supply is not significantly related to rates of low infant birth weight, infant mortality, or mortality from cerebrovascular disease in any model. Higher RN supply is positively related to total deaths in the contemporaneous and lagged model. The results suggest a counter-intuitive, but non-linear relationship between RN supply and health outcomes. More research is needed to understand these relationships and policies must be devised to reduce the current and growing future RN shortage.
Show less - Date Issued
- 2018
- Identifier
- CFE0007091, ucf:51933
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007091
- Title
- Learning Algorithms for Fat Quantification and Tumor Characterization.
- Creator
-
Hussein, Sarfaraz, Bagci, Ulas, Shah, Mubarak, Heinrich, Mark, Pensky, Marianna, University of Central Florida
- Abstract / Description
-
Obesity is one of the most prevalent health conditions. About 30% of the world's and over 70% of the United States' adult populations are either overweight or obese, causing an increased risk for cardiovascular diseases, diabetes, and certain types of cancer. Among all cancers, lung cancer is the leading cause of death, whereas pancreatic cancer has the poorest prognosis among all major cancers. Early diagnosis of these cancers can save lives. This dissertation contributes towards the...
Show moreObesity is one of the most prevalent health conditions. About 30% of the world's and over 70% of the United States' adult populations are either overweight or obese, causing an increased risk for cardiovascular diseases, diabetes, and certain types of cancer. Among all cancers, lung cancer is the leading cause of death, whereas pancreatic cancer has the poorest prognosis among all major cancers. Early diagnosis of these cancers can save lives. This dissertation contributes towards the development of computer-aided diagnosis tools in order to aid clinicians in establishing the quantitative relationship between obesity and cancers. With respect to obesity and metabolism, in the first part of the dissertation, we specifically focus on the segmentation and quantification of white and brown adipose tissue. For cancer diagnosis, we perform analysis on two important cases: lung cancer and Intraductal Papillary Mucinous Neoplasm (IPMN), a precursor to pancreatic cancer. This dissertation proposes an automatic body region detection method trained with only a single example. Then a new fat quantification approach is proposed which is based on geometric and appearance characteristics. For the segmentation of brown fat, a PET-guided CT co-segmentation method is presented. With different variants of Convolutional Neural Networks (CNN), supervised learning strategies are proposed for the automatic diagnosis of lung nodules and IPMN. In order to address the unavailability of a large number of labeled examples required for training, unsupervised learning approaches for cancer diagnosis without explicit labeling are proposed. We evaluate our proposed approaches (both supervised and unsupervised) on two different tumor diagnosis challenges: lung and pancreas with 1018 CT and 171 MRI scans respectively. The proposed segmentation, quantification and diagnosis approaches explore the important adiposity-cancer association and help pave the way towards improved diagnostic decision making in routine clinical practice.
Show less - Date Issued
- 2018
- Identifier
- CFE0007196, ucf:52288
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007196
- Title
- PERCEPTIONS OF SENIOR CITIZENS IN CENTRAL FLORIDA REGARDING QUALITY OF CARE UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA).
- Creator
-
Nieves , Rafael, Sumner, Jennifer, University of Central Florida
- Abstract / Description
-
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their...
Show moreOn March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. This reform, it is argued, is projected to increase insurance coverage of pre-existing conditions, to expand access to insurance for more than 30 million Americans, and to increase estimated National medical spending while lowering projected Medicare spending. This thesis sought to investigate and analyze the perceptions of senior citizens in Central Florida about PPACA and their perceived effects on the healthcare quality provided to them under this law. Four sections of PPACA bill, thought to specifically pertain to the elderly, were selected for this study; respondents were asked their opinions regarding PPACA's aspects of: (1) the reform on preventive healthcare services; (2) Medicare Part D [prescription drugs]; (3) Medicare; and (4) Medicaid. This thesis employed both qualitative and quantitative methodologies; data were collected and analyzed with findings presented and discussed.
Show less - Date Issued
- 2013
- Identifier
- CFH0004468, ucf:45112
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004468
- Title
- Physical-Virtual Patient Simulators: Bringing Tangible Humanity to Simulated Patients.
- Creator
-
Daher, Salam, Welch, Gregory, Gonzalez, Laura, Cendan, Juan, Proctor, Michael, University of Central Florida
- Abstract / Description
-
In lieu of real patients, healthcare educators frequently use simulated patients. Simulated patients can be realized in physical form, such as mannequins and trained human actors, or virtual form, such as via computer graphics presented on two-dimensional screens or head-mounted displays. Each of these alone has its strengths and weaknesses. I introduce a new class of physical-virtual patient (PVP) simulators that combine strengths of both forms by combining the flexibility and richness of...
Show moreIn lieu of real patients, healthcare educators frequently use simulated patients. Simulated patients can be realized in physical form, such as mannequins and trained human actors, or virtual form, such as via computer graphics presented on two-dimensional screens or head-mounted displays. Each of these alone has its strengths and weaknesses. I introduce a new class of physical-virtual patient (PVP) simulators that combine strengths of both forms by combining the flexibility and richness of virtual patients with tangible characteristics of a human-shaped physical form that can also exhibit a range of multi-sensory cues, including visual cues (e.g., capillary refill and facial expressions), auditory cues (e.g., verbal responses and heart sounds), and tactile cues (e.g., localized temperature and pulse). This novel combination of integrated capabilities can improve patient simulation outcomes. In my Ph.D. work I focus on three primary areas of related research. First, I describe the realization of the technology for PVPs and results from two user-studies to evaluate the importance of dynamic visuals and human-shaped physical form in terms of perception, behavior, cognition, emotions, and learning.Second, I present a general method to numerically evaluate the compatibility of any simulator-scenario pair in terms of importance and fidelity of cues. This method has the potential to make logistical, economic, and educational impacts on the choices of utilizing existing simulators.Finally, I describe a method for increasing human perception of simulated humans by exposing participants to the simulated human taking part in a short, engaging conversation prior to the simulation.
Show less - Date Issued
- 2018
- Identifier
- CFE0007750, ucf:52402
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007750
- Title
- The Impact of the Community Partnership Schools Model Community School on Graduation and Attendance Rates in One Florida High School.
- Creator
-
Ellis, Amy, Johnson, Jerry, Doherty, Walter, Williams-Fjeldhe, Karri, Castor Dentel, Karen, University of Central Florida
- Abstract / Description
-
The purpose of this quantitative study was to identify and describe the nature and extent of the relationships, if any, that existed between a Community Partnership Schools(TM) (CPS) model community school and the outcomes of graduation and attendance rates at one public high school in Florida. An evaluation study utilizing an interrupted time series (ITS) design addressed this problem by identifying and describing the relationship between the CPS model and the key outcome measures using...
Show moreThe purpose of this quantitative study was to identify and describe the nature and extent of the relationships, if any, that existed between a Community Partnership Schools(TM) (CPS) model community school and the outcomes of graduation and attendance rates at one public high school in Florida. An evaluation study utilizing an interrupted time series (ITS) design addressed this problem by identifying and describing the relationship between the CPS model and the key outcome measures using visual analysis and descriptive statistics. Graduation and attendance rates for seven years before the CPS model was introduced (2003-2010) and seven years after the CPS model was introduced (2010-2017) at the CPS school were compared to the graduation and attendance rates for the same time frames of five other matched comparison high schools that had not implemented a CPS model community school. Findings of this study, though mixed, suggest the Community Partnership Schools(TM) model may have provided a positive environment for improvement in key measures at the targeted CPS high school. Though no definitive conclusions were reached, this study alongside other evaluations of the Community Partnership Schools(TM) model may be helpful in informing decision makers regarding the potential positive influence of the CPS model on such measures as graduation and attendance rates.
Show less - Date Issued
- 2019
- Identifier
- CFE0007452, ucf:52698
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007452