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Title: AFRICAN AMERICAN MOTHERS' NARRATIVES OF BREASTFEEDING SUPPORT FROM HEALTHCARE PROVIDERS.
Creator: Treadwell, Tessa, Carter, Shannon Dr., University of Central Florida
Abstract / Description: Research indicates that African American women breastfeed at the lowest rates of any racial/ethnic group in the U.S. Breastfeeding has shown to have numerous health benefits for both mother and baby, making the lower rates of breastfeeding among African Americans a public health concern. Racial disparities in healthcare may contribute to these discrepancies. This research will analyze the perceptions of information and social support for breastfeeding provided by healthcare providers among a...
Show moreResearch indicates that African American women breastfeed at the lowest rates of any racial/ethnic group in the U.S. Breastfeeding has shown to have numerous health benefits for both mother and baby, making the lower rates of breastfeeding among African Americans a public health concern. Racial disparities in healthcare may contribute to these discrepancies. This research will analyze the perceptions of information and social support for breastfeeding provided by healthcare providers among a sample of African American mothers who breastfed their babies. The study asks: Do participants regard their healthcare providers as supportive of breastfeeding? Data were collected through in-depth qualitative interviews with 22 African American mothers. Participants interpreted their providers' opinions on breastfeeding and formula and discussed whether they felt supported to breastfeed. Findings reveal which healthcare providers were perceived to be the most supportive of breastfeeding and themes within the time-frame codes: pregnancy, labor and birth, immediately after birth, and postpartum. The majority of participants felt supported during the first three stages. However, during the postpartum period, there was a lack of assistance from healthcare providers, resulting in limited breastfeeding support. Participants that did receive postpartum support typically received verbal affirmation, rather than given useful information.
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Date Issued: 2017
Identifier: CFH2000260, ucf:45924
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000260

Title: WHAT DO PHYSICIANS WANT? INFORMATION TECHNOLOGY ACCEPTANCE AND USAGE BY HEALTHCARE PROFESSIONALS.
Creator: ILIE, Virginia, Courtney, Jim, University of Central Florida
Abstract / Description: This study builds on the theory of planned behavior, institutional and innovation diffusion theories to investigate physicians' responses to introduction of electronic medical records (EMR) in large healthcare organizations. Using a case study methodology, we show that physicians' attitudes towards using EMR are influenced by their perceptions of EMR complexity, relative advantage, compatibility with professional beliefs and individual predisposition to change. Specifically, we found that EMR...
Show moreThis study builds on the theory of planned behavior, institutional and innovation diffusion theories to investigate physicians' responses to introduction of electronic medical records (EMR) in large healthcare organizations. Using a case study methodology, we show that physicians' attitudes towards using EMR are influenced by their perceptions of EMR complexity, relative advantage, compatibility with professional beliefs and individual predisposition to change. Specifically, we found that EMR usability characteristics such as system interface, "navigation," "search" and "speed" are major dimensions underlying physicians' perceptions of EMR complexity. To the extent that navigating and searching for clinical results are seen as difficult, physicians' perceptions of the complexity of using EMR are enhanced, with the result of physicians forming more negative attitudes towards EMR and using EMR less. Accessibility to EMR (i.e. logging in) and availability of hardware are two emergent constructs. These factors are immediate barriers for physicians not using EMR or using EMR minimally. At the same time, these barriers contribute to impacting physicians' perceptions that EMR is difficult to use and disadvantageous (i.e. time inefficient) compared to the paper chart. Results also show that most EMR usage at Alpha is rather "shallow." Physicians tend to use data-retrieval EMR minimally, mainly to supplement the paper chart. The availability of this "competing artifact," that is much easier to use and conveniently located near a patient's room limits the extent to which physicians use EMR at Alpha. Use of an imaging EMR system (EMR3) is more committed. EMR3 is used to replace the "old way" of accessing films. Lack of accessibility and hardware barriers, the relative advantage of EMR3 and other system usability considerations contribute to physicians using this system more faithfully. As regards the question "what do physicians want?" it seems that physicians want a system that that is easy to access and simple to use but most importantly, a system that they can directly identify with, an EMR that is personally relevant. In order to promote a "deeper" level of EMR usage, the benefits of EMR need to be emphasized to physicians while any potential costs or barriers reduced or eliminated.
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Date Issued: 2005
Identifier: CFE0000880, ucf:46635
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0000880

Title: EXPERIENCES OF YOUNG LESBIAN, GAY, AND BISEXUAL LATINX PEOPLE IN HEALTHCARE.
Creator: Hernandez, Caleb, Mishtal, Joanna, University of Central Florida
Abstract / Description: Latinx lesbian, gay, and bisexual (LGB) queer community members have unique health needs compared to non-Latinx heterosexual patients, including sexual and mental health issues, and challenges in ability to access healthcare. But research is unclear whether LGB Latinx patients may also face double stigma related to their sexual orientation and race. This study examined this issue in experiences of queer and Latinx adults with healthcare providers. I conducted semistructured in-depth...
Show moreLatinx lesbian, gay, and bisexual (LGB) queer community members have unique health needs compared to non-Latinx heterosexual patients, including sexual and mental health issues, and challenges in ability to access healthcare. But research is unclear whether LGB Latinx patients may also face double stigma related to their sexual orientation and race. This study examined this issue in experiences of queer and Latinx adults with healthcare providers. I conducted semistructured in-depth interviews with 13 LGB Latinx adults between November 2018 and February 2019. Interviews were audio-recorded, and transcribed. Transcripts were coded, and data analyzed for themes using the Grounded Theory approach. My findings indicate that the quality of individual experience depends on key factors of the provider, in particular the provider's sexuality, gender, age, race, and ability to empathize. When LGB Latinx patients interact with like-identified providers, their experience is significantly more satisfactory, however, differently-identified providers who create open and non-judgmental communication with patients have the ability to provide this level of satisfactory service. More diverse staff in clinics also contributes to a better experience for LGB Latinx patients. This study calls attention to the need for greater diversity of healthcare providers as well as new non-judgmental approaches in care delivery to address LGB Latinx patients' needs.
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Date Issued: 2019
Identifier: CFH2000472, ucf:45889
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000472

Title: UNDERSTANDING THE HEALTHCARE EXPERIENCES OF DEFERRED ACTION FOR CHILDHOOD ARRIVALS (DACA) RECIPIENTS.
Creator: Kluesener, Jacob A, Gonzalez, Laura, University of Central Florida
Abstract / Description: Background: There is limited research on the healthcare experience of Deferred Action for Childhood Arrivals (DACA) recipients both before and after enrollment in the program. DACA is a program designed to defer deportation to children and young adults in the United States for up to 2 years. The goal of this qualitative study is to explore the lived experiences of DACA students with regards to access to healthcare and perceptions of treatment. Method: This study is qualitative and uses a...
Show moreBackground: There is limited research on the healthcare experience of Deferred Action for Childhood Arrivals (DACA) recipients both before and after enrollment in the program. DACA is a program designed to defer deportation to children and young adults in the United States for up to 2 years. The goal of this qualitative study is to explore the lived experiences of DACA students with regards to access to healthcare and perceptions of treatment. Method: This study is qualitative and uses a phenomenological approach. DACA Recipients (N = 5) were recruited from the UCF student population and 1:1 interviews were conducted. Interviews were transcribed and manually coded. Results: Thematic analysis revealed the following three themes (1) Meeting Needs (2) It Takes a Village and (3) Documentation�� Over Insurance Conclusion: The fundamental structure of the findings shows the struggles of receiving healthcare as an undocumented immigrant, and the limitations of DACA as a solution. Health insurance is a more prominent and impactful factor than documentation status in the quality and quantity of healthcare access. The healthcare experience ranges from volunteer clinics to local pharmacies. Although, if DACA recipients have insurance, their healthcare experience is more consistent, regardless of documentation. Their day to day lives is composed of meeting basic needs, receiving only necessary doctor's visits as a child, and being prepared for all circumstances in terms of future citizenship.
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Date Issued: 2019
Identifier: CFH2000515, ucf:45641
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000515

Title: Risk in Privacy Breach Determination: The Application of Prospect Theory to Healthcare Privacy Officers.
Creator: Walden, Amanda, Cortelyou-Ward, Kendall, Noblin, Alice, Gabriel, Meghan, Knox, Claire, University of Central Florida
Abstract / Description: A significant concern in healthcare is that of patient privacy and how organizations protect against unauthorized access to protected health information. The federal government has responded by instituting policies and guidelines on requirements for protection. However, the policy language leaves areas open to interpretation by those following the guidelines. Reporting to the Office for Civil Rights and/or the patient can open an organization to risk of financial and possible criminal...
Show moreA significant concern in healthcare is that of patient privacy and how organizations protect against unauthorized access to protected health information. The federal government has responded by instituting policies and guidelines on requirements for protection. However, the policy language leaves areas open to interpretation by those following the guidelines. Reporting to the Office for Civil Rights and/or the patient can open an organization to risk of financial and possible criminal penalties. There is a risk of harm to their reputation which could impact patient visits and market share. Therefore, Privacy Officers might view risk in different ways and therefore handle breach reporting differently. Privacy Officers are responsible for determining an individual organization's breach reportability status. Their processes may vary dependent on their knowledge of the policy, the status of previous reported breaches, and their framing of an incident. This research aims to explore the following factors: (1) personal and organizational knowledge, (2) prior breach status, (3) and scenario framing, to explore if Prospect Theory is applicable to the choices a Privacy Officer makes regarding breach determination. The study uses primary data collection through a survey that includes loss and gain scenarios in accordance with Prospect Theory. Individuals listed as Privacy Officers within the American Health Information Management Association (AHIMA) were the target audience for the survey. Univariate, Bivariate, Multivariate, and Post Regression techniques were used to analyze the data collected. The findings of the study supported the theoretical framework and provided industry and public affairs implications. These findings show that there is a gap where Privacy Officers have to make their own decisions and there is a difference in the types of decisions they are making on a day to day basis. Future guidance and policies need to address these gaps and can use the insight provided by this study.
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Date Issued: 2018
Identifier: CFE0007382, ucf:52076
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0007382

Title: A CONFIGURAL APPROACH TO PATIENT SAFETY CLIMATE: THE RELATIONSHIP BETWEEN CLIMATE PROFILE CHARACTERISTICS AND PATIENT OUTCOMES.
Creator: Weaver, Sallie, Salas, Eduardo, University of Central Florida
Abstract / Description: Patient safety climate is defined as a holistic snapshot of enacted work environment practices and procedures related to patient safety, derived from shared perceptions of social and environmental work characteristics. While patient safety climate has been touted as a critical factor underlying safe patient care, our understanding of input factors influencing shared climate perceptions and, in turn, the effects of climate as a collective, group-level construct on important outcomes remains...
Show morePatient safety climate is defined as a holistic snapshot of enacted work environment practices and procedures related to patient safety, derived from shared perceptions of social and environmental work characteristics. While patient safety climate has been touted as a critical factor underlying safe patient care, our understanding of input factors influencing shared climate perceptions and, in turn, the effects of climate as a collective, group-level construct on important outcomes remains underdeveloped, both theoretically and empirically. Therefore, the current study examines (1) the antecedents that impact individual patient safety climate perceptions and (2) the relationships between hospital unit patient safety climate and two important unit level outcomes: patient willingness to recommend a facility to others and patient safety. This study also examines climate strength-the degree to which climate perceptions are shared-as a moderator of these relationships. While climate is conceptualized as a holistic description of the working environment, existing evidence has focused on relationships between the independent dimensions of patient safety climate and patient safety. No study to date has examined the configurations (i.e. patterns or profiles) among the multiple dimensions of patient safety climate or how these configurations are related to important employee and patient outcomes. This gap is redressed in the current study by examining patient safety climate in terms of three profile characteristics: (1) climate elevation (i.e., mean positive or negative valence across all dimensions), (2) climate variability (i.e., variance among dimensions), and (3) climate shape (i.e., the pattern of peaks and valleys among climate dimensions). Evidence from studies of general organizational climate suggests that the shape of the pattern among climate dimensions, the overall mean score across dimensions, and the degree to which dimension scores vary are predictive of employee attitudes, customer satisfaction, and organizational financial performance (Dickson et al., 2006; Joyce & Slocum, 1984; Jackofsky & Slocum, 1988; Gonzalez-Roma, Peiro, & Zornoza, 1999; Litwin & Stringer, 1968; Schulte et al., 2009). The current study, then, tests a theoretical model of patient safety climate examining the configural nature of the construct. An archival dataset collected from seven hospitals located in a metropolitan area of the southeastern United States was utilized to test study hypotheses. Data was collected from 3,149 individuals nested within 84 hospital units using the Hospital Survey on Patient Safety Culture (Sorra & Nieva, 2004). Unit level patient safety and patient willingness to recommend was collected by the hospital risk management and nursing administration departments. Hierarchical linear modeling (HLM7; Raudenbush, Bryk, Cheong, Congdon, & du Toit, 2011) was utilized to test hypotheses regarding antecedents of individual level perceptions of patient safety climate to account for the fact that individuals were nested within hospital units. Traditional multiple regression analyses were utilized to test unit level hypotheses examining the relationships between unit level patient safety climate and patient outcomes. Results indicated that unit membership was significantly related to individual climate perceptions-specifically, individual-level climate profile elevation. In turn, individual climate profile elevation and profile variability were related to employee willingness to recommend their organization to family and friends in need of care. At the unit level of analysis, climate profile variability was significantly related to patient willingness to recommend the organization to others, and climate shape was found to be related to patient safety. Furthermore, these results were not dependent on climate strength. The current study meaningfully contributes to the conceptual understanding of the patient safety climate construct by examining the degree to which configural aspects of the construct are predictive of important outcomes across multiple levels of analysis. In this way, it extends beyond existing studies of climate configurations to examine relationships at multiple levels of analysis and to also examine the moderating effects of climate strength. Practically, results provide insight into how the construct of patient safety climate can be used diagnostically and prescriptively to improve patient care and the working environment for providers. In addition to contributing to the theoretical understanding of the patient safety climate construct, this study also augments the evidence-base available to administrators, front-line providers, and regulators regarding how patient safety climate can be used to guide and align quality improvement efforts for greatest impact.
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Date Issued: 2011
Identifier: CFE0003992, ucf:48668
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0003992

Title: Examining the impact of a fatigue intervention on job performance: A longitudinal study across United States hospitals.
Creator: Gregory, Megan, Salas, Eduardo, Wang, Wei, Fritzsche, Barbara, Burke, Shawn, University of Central Florida
Abstract / Description: Fatigue in healthcare providers has been linked to dangerous outcomes for patients, including medical errors, surgical complications, and accidents. Resident physicians, who traditionally work long hours on minimal sleep, are among the most fatigued. In attempt to mitigate the impact of fatigue on resident physician performance and improve patient safety, the Accreditation Council for Graduate Medical Education (ACGME) implemented a fatigue intervention program in 2011 for medical residency...
Show moreFatigue in healthcare providers has been linked to dangerous outcomes for patients, including medical errors, surgical complications, and accidents. Resident physicians, who traditionally work long hours on minimal sleep, are among the most fatigued. In attempt to mitigate the impact of fatigue on resident physician performance and improve patient safety, the Accreditation Council for Graduate Medical Education (ACGME) implemented a fatigue intervention program in 2011 for medical residency programs in the United States. This caused a significant decrease in the number of hours that first-year residents were permitted to work, compared with hours worked by first-year residents in prior years. While studies investigating the impact of the 2011 ACGME fatigue intervention on outcomes are limited thus far, some initial evidence seems to be promising. For instance, Pepper, Schweinfurth, and Herrin (2014) found that the rate of transfers to the intensive care unit after a code blue significantly decreased from pre- to post-intervention. However, it is not currently understood what variables may drive positive changes in patient outcomes, nor how long it may take for these changes to occur. Thus, the purpose of this study was to examine the effect that the 2011 ACGME fatigue intervention has had on job performance in healthcare providers in U.S. hospitals. The current study attempted to address this question by taking both a micro perspective, by drawing upon cognitive theories (Kahneman, 1973, 2011) and skill acquisition theory (Fitts, 1964; Fitts (&) Posner, 1967), as well as a macro perspective, by drawing upon organizational change theories (DiMaggio (&) Powell, 1983).This study combined public-use databases provided by the Center for Medicare and Medicaid Services (CMS). Specifically, 1,277 hospitals in the United States were examined over a five year period on job performance behaviors to determine if there was significant change from pre-intervention to post-intervention. Hospitals were categorized as control hospitals (n = 594) and intervention hospitals (n = 683). More specifically, intervention hospitals were analyzed according to their resident-to-patient bed ratio, using guidelines provided by Patel et al. (2014), including very low resident-to-bed ratio hospitals (n = 174), low resident-to-bed ratio hospitals (n = 287), high resident-to-bed ratio hospitals (n = 143), and very high resident-to-bed ratio hospitals (n = 79). Further, organizational size was examined as a moderator. The current study used discontinuous growth modeling (Bliese, 2008; Ployhart, 2014; J. D. Singer (&) Willett, 2003) to analyze the data, which allowed for investigation into the magnitude and rate of change from pre- to post-intervention. Results show that there was a significant improvement in employee job performance over time across both intervention and control hospitals. In particular, job performance significantly improved abruptly at the transition period (i.e., when the intervention was introduced) and continued to improve gradually throughout the post-intervention period; yet, these results held for both intervention and control hospitals. However, exploratory analyses comparing control hospitals to very high resident-to-bed ratio hospitals found that the latter group improved significantly more at the transition period in comparison to control hospitals. I therefore conclude that there may be some effect of the fatigue intervention on job performance, but this effect may be visible only in very high resident-to-bed ratio hospitals. Further, organizational size was not a significant moderator of the relationship. Future research is needed to confirm these findings.
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Date Issued: 2015
Identifier: CFE0005952, ucf:50807
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005952

Title: HEALTHCARE INFORMATION SYSTEMS:DESIGN THEORY, PRINCIPLES AND APPLICATION.
Creator: Richardson, Sandra, Courtney, James, University of Central Florida
Abstract / Description: Healthcare information systems (HISs), as a class of systems, are not currently addressed in the MIS literature. This is in spite of a sharp increase in use over the past few years, and the uniquely qualified role that MIS has in the development of, impact and general understanding of HISs. In this project the design science paradigm frames the development of a set of design principles derived from the synthesis of the design literature, ethics literature, and professional guidelines, from...
Show moreHealthcare information systems (HISs), as a class of systems, are not currently addressed in the MIS literature. This is in spite of a sharp increase in use over the past few years, and the uniquely qualified role that MIS has in the development of, impact and general understanding of HISs. In this project the design science paradigm frames the development of a set of design principles derived from the synthesis of the design literature, ethics literature, and professional guidelines, from both the medical and computing professions. The resulting principles are offered to address the design of healthcare information systems. Action research, a widely accepted methodology for testing design principles derived from the design science paradigm, is employed to test the HIS principles and to implement change in a healthcare organization through the use of an HIS. The action research project was a collaborative effort between a Central Florida hospice and the researcher, the result of which was an advanced directives decision support system. The system was design to meet a number of organizational goals that ranged from tracking compliance with federal regulations to increasing the autonomy of the patients that used the system. The result is a set of tested design principles and lessons learned from both anticipated and unanticipated consequences of the action research project.
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Date Issued: 2006
Identifier: CFE0001339, ucf:46960
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001339

Title: HEALTH TRANSITIONS AND THE AGING POPULATION: A FRAMEWORK TO MEASURE THE VALUE OF RAPID REHABILITATION.
Creator: Ross, Dianne, Liberman, Aaron, University of Central Florida
Abstract / Description: Healthcare services for the aging population in the United States are a complex configuration of acute healthcare organizations, and post acute nursing facilities, home healthcare, and community based services. The system encompasses all services that imply the need for clinical, medical, or professional judgment (Baldrige National Quality Program, 2006). Most Americans believe the system exists to provide preventive services, management for chronic conditions, and health care services to...
Show moreHealthcare services for the aging population in the United States are a complex configuration of acute healthcare organizations, and post acute nursing facilities, home healthcare, and community based services. The system encompasses all services that imply the need for clinical, medical, or professional judgment (Baldrige National Quality Program, 2006). Most Americans believe the system exists to provide preventive services, management for chronic conditions, and health care services to meet the needs of the people (National Committee for Quality Assurance (NCQA), 2004). However, the healthcare delivery system is fragmented across a broad array of settings (Coleman, Smith, Frank, Min, Parry, & Kramer, 2004), plagued by gaps in quality of care, and does not provide optimal care to the majority of American citizens (NCQA, 2004). As a result, national efforts are focused on the identification of quality indicators, performance measures, and the driving need for consensus standards across a multiplicity of providers, payers, and stakeholders. The overarching focus of this effort is to bridge the gaps in health care quality, and reduce documented disparities for vulnerable populations (National Quality Forum (2004). Healthcare transitions occur as patients receive a broad range of services across a multiplicity of providers, payers, and settings. Aging patients > 65 are most vulnerable during these transitions. A poorly executed transition can result in complications for the patient, duplication of tests and services, discharge delays, increased lengths of stay, early readmissions to the acute care setting, frustration for families and care givers, and dissatisfaction with overall services. Management of care and accountability across settings is limited and patients are falling through the cracks in the foundation of the healthcare system (Covinsky, 2003). The intent of this research was to examine healthcare transitions for patients > 65 admitted to a large acute healthcare system, and to identify measurable quality indicators for an innovative delivery model designed to optimize early discharge from the hospital through rapid rehabilitation. This was a quasi-experimental, cross-sectional design measured at the patient level. The research included a total sample of 250 patients representing both the intervention and the control group. The intervention group consisted of 100 patients who were rapidly discharged to a transitional care facility in the community, and 150 patients randomly selected to a control group that did not transition to rapid rehabilitation. The groups were matched as closely as possible by age, gender, race, primary diagnoses, and the complexity of case. Inefficiency was measured by 3 indicators (1) length of stay, (2) total expenses before contractual allowances, and (3) discharge delays from the hospital. Ineffectiveness was measured by 3 indicators: (1) readmission within 30 days, (2) patient safety with falls serving as the proxy, and (3) overall patient satisfaction. Descriptive analysis was performed utilizing SPSS 15.0. Path analysis was method of choice for data analysis and AMOS 7.0 was utilized for the measurement model. Descriptive analysis found a broad range of diagnosis related groups across 183 women and 67 men with a mean age of 80 for both groups. Initial analysis found the intervention group had a mean length of stay of 9.17 days, and experienced 20 readmissions. The control group had a mean length of stay of 6.77 days, and 30 readmissions. The statistical analysis suggested length of stay and cost of healthcare services are statistically significant indicators at the 0.05 or lower level and that patient safety has the potential to be developed as an indicator for effective outcomes. The identification of quality indicators, measurement of efficiency and effectiveness, and establishing predictors for successful healthcare transitions is dependent on the quality and integrity of data abstracted from hospital information systems, accuracy of information in patient records, and the consensus of standards and definitions across a multiplicity of stakeholders. Further research and collaboration is necessary to ensure that patient transition to innovative care programs such as rapid rehabilitation is based on well-defined patient selection criteria. The intent of the methodologies and quality indicators explored in this research supports the increasing need to ensure that inferences and quality measurements drawn from healthcare information is based on valid, reliable, and well defined data sources (Pan, Fergusson, Schweitzer, & Hebert, 2005). This research suggests hospitals are making steady progress to overcome challenges to safe, quality health services as outlined by the Institute of Medicine (2001) for system redesign, but finds specific implications for hospital leadership. There is a need to thread evidence based practice initiatives into hospital and clinical structures to accommodate new delivery models, processes, and case management. Health services information needs to be housed in a central repository or data warehouse to increase transparency of reportable information across systems and to ensure that valid and reliable information is utilized to draw inferences about performance of hospital systems (Selden & Sowa, 2004) and that quality measurements are established to ensure a scientific foundation for the management of healthcare services (Wan, 2002).
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Date Issued: 2008
Identifier: CFE0002130, ucf:47543
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002130

Title: MY CHILD HAS WHAT? THE MOST EFFECTIVE MEANS OF COMMUNICATION WHEN DELIVERING A DIFFICULT DIAGNOSIS TO THE PARENTS OF A PEDIATRIC PATIENT.
Creator: Sethi , Nidhi, Gibson-Young , Linda, University of Central Florida
Abstract / Description: For the healthcare provider, disclosing a pediatric patient's difficult diagnosis in the form of an acute or chronic condition to the parents is a challenging task. Healthcare providers often feel unprepared when relaying the news of such diagnosis, and the parents feel equally unprepared upon receiving it (Pririe, 2012). This systematic literature review examined the various communication techniques used in the past, and the techniques' effectiveness in increasing parental satisfaction when...
Show moreFor the healthcare provider, disclosing a pediatric patient's difficult diagnosis in the form of an acute or chronic condition to the parents is a challenging task. Healthcare providers often feel unprepared when relaying the news of such diagnosis, and the parents feel equally unprepared upon receiving it (Pririe, 2012). This systematic literature review examined the various communication techniques used in the past, and the techniques' effectiveness in increasing parental satisfaction when first learning of the child's diagnosis. A scarce number of studies related to the most effective techniques were found in the literature, and even fewer were found that evaluated the techniques presented. Overall, three of the most commonly occurring communication themes identified from the studies were: 1) Parents desired privacy during the disclosure and wanted a support system present (mostly a spouse); 2) The diagnosis must be given as soon as the healthcare provider suspected it, and; 3) The healthcare provider must emphasize the positive characteristics of the pediatric patient, as well as the patient's future with the diagnosis. Both parents and providers agreed that further research is needed to identify effective communication techniques used during disclosure. The aim of the research should be to identify the most effective means of communication to increase parental satisfaction. Furthermore, all healthcare providers need collaborative and interdisciplinary training in delivering a difficult diagnosis to increase parental satisfaction.
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Date Issued: 2014
Identifier: CFH0004655, ucf:45273
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH0004655

Title: EXPLORING WHAT IT IS LIKE TO BE AN UNDOCUMENTED ALIEN IN SEEK OF HEALTHCARE.
Creator: Torrez Pon, Eliany C, Loerzel, Victoria, Chase, Susan, University of Central Florida
Abstract / Description: Currently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased...
Show moreCurrently, there are about 11.8 million undocumented aliens in the United States who are not eligible for public insurance or any type of private coverage obtained through the American Health Care Act of 2017. This creates barriers to healthcare for this large population and has negative implications for the healthcare system. Despite the availability of clinics and low-cost healthcare, this group tends to underuse resources or seek healthcare for emergencies only which leads to increased cost totaling approximately $1.1 billion a year. The goal of this qualitative study is to better understand what it is like to be an undocumented alien seeking healthcare. Eight semi-structured interviews with Latino undocumented aliens were conducted. Interviews were transcribed into WORD documents and reviewed for accuracy. Data was analyzed using content analysis to code and identify prominent themes. Analysis of data from participants indicate the following themes embody the experience of being an undocumented alien in seek of healthcare: living in the unsure, high costs, system barriers, language and communication incongruences, perceived discrimination, exploitation and deportation, and relief in finally getting care. Undocumented aliens put off getting healthcare as long as possible due to these factors, despite having many needs. Healthcare practitioners must become familiar with these experiences to address and correct these barriers. Advocacy and healthcare changes take on increasing urgency to ensure the well-being of these individuals.
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Date Issued: 2018
Identifier: CFH2000316, ucf:45886
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000316

Title: LESBIAN, GAY, BISEXUAL, AND TRANSGENDER (LGBT) HEALTHCARE IN RURAL SETTINGS: AN INTEGRATIVE REVIEW OF THE LITERATURE.
Creator: Cox, Caitlin, Bushy, Angeline, University of Central Florida
Abstract / Description: The lesbian, gay, bisexual, and transgender (LGBT) community is a unique population that has specific health issues and health care needs associated with lifestyle behaviors that increase risk for certain diseases. Health concerns include mental and behavioral health, issues associated with gender identity and relationships (i.e. intimate partner violence), sexually transmitted infections, and chronic illnesses. The research suggests poorer health outcomes for the LGBT population compared to...
Show moreThe lesbian, gay, bisexual, and transgender (LGBT) community is a unique population that has specific health issues and health care needs associated with lifestyle behaviors that increase risk for certain diseases. Health concerns include mental and behavioral health, issues associated with gender identity and relationships (i.e. intimate partner violence), sexually transmitted infections, and chronic illnesses. The research suggests poorer health outcomes for the LGBT population compared to heterosexual and/or cisgender counterparts. Most research conducted with LGBT populations occurred in more populated urban settings with very few studies focusing on this population in the rural context. Consequently, there is a paucity of information on the health care concerns of the rural LGBT population. Considering the information gap, this integrative review of 14 research articles focused on health-related issues of the LGBT population in rural regions. The findings revealed rural LGBT persons experience disparities in accessing health care and support services; coupled with health care providers who often were not culturally competent; and, sometimes, unfamiliar with evidence-based health care protocols when caring for the LGBT patient. Implications for nursing research, education, practice, and policy and study limitations are highlighted.
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Date Issued: 2019
Identifier: CFH2000503, ucf:45685
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000503

Title: Using Case-Based Reasoning for Simulation Modeling in Healthcare.
Creator: Alshareef, Khaled, Rabelo, Luis, Elshennawy, Ahmad, Lee, Gene, Rahal, Ahmad, University of Central Florida
Abstract / Description: The healthcare system is always defined as a complex system. At its core, it is a system composed of people and processes and requires performance of different tasks and duties. This complexity means that the healthcare system has many stakeholders with different interests, resulting in the emergence of many problems such as increasing healthcare costs, limited resources and low utilization, limited facilities and workforce, and poor quality of services.The use of simulation techniques to aid...
Show moreThe healthcare system is always defined as a complex system. At its core, it is a system composed of people and processes and requires performance of different tasks and duties. This complexity means that the healthcare system has many stakeholders with different interests, resulting in the emergence of many problems such as increasing healthcare costs, limited resources and low utilization, limited facilities and workforce, and poor quality of services.The use of simulation techniques to aid in solving healthcare problems is not new, but it has increased in recent years. This application faces many challenges, including a lack of real data, complicated healthcare decision making processes, low stakeholder involvement, and the working environment in the healthcare field.The objective of this research is to study the utilization of case-based reasoning in simulation modeling in the healthcare sector. This utilization would increase the involvement of stakeholders in the analysis process of the simulation modeling. This involvement would help in reducing the time needed to build the simulation model and facilitate the implementation of results and recommendations. The use of case-based reasoning will minimize the required efforts by automating the process of finding solutions. This automation uses the knowledge in the previously solved problems to develop new solutions. Thus, people could utilize the simulation modeling with little knowledge about simulation and the working environment in the healthcare field.In this study, a number of simulation cases from the healthcare field have been collected to develop the case-base. After that, an indexing system was created to store these cases in the case-base. This system defined a set of attributes for each simulation case. After that, two retrieval approaches were used as retrieval engines. These approaches are K nearest neighbors and induction tree. The validation procedure started by selecting a case study from the healthcare literature and implementing the proposed method in this study. Finally, healthcare experts were consulted to validate the results of this study.
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Date Issued: 2016
Identifier: CFE0006831, ucf:51769
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006831

Title: A Framework for Quantifying and Managing Overcrowding in Healthcare Facilities.
Creator: Albar, Abdulrahman, Elshennawy, Ahmad, Rabelo, Luis, Lee, Gene, Rahal, Ahmad, University of Central Florida
Abstract / Description: Emergency Departments (EDs) represent a crucial component of any healthcare infrastructure. In today's world, healthcare systems face growing challenges in delivering efficient and time-sensitive emergency care services to communities. Overcrowding within EDs represents one of the most significant challenges for healthcare quality that adversely impacts clinical outcomes, patient safety, and overall satisfaction. Research in this area has resulted in creating several ED crowding indices, such...
Show moreEmergency Departments (EDs) represent a crucial component of any healthcare infrastructure. In today's world, healthcare systems face growing challenges in delivering efficient and time-sensitive emergency care services to communities. Overcrowding within EDs represents one of the most significant challenges for healthcare quality that adversely impacts clinical outcomes, patient safety, and overall satisfaction. Research in this area has resulted in creating several ED crowding indices, such as National Emergency Department Overcrowding Scale (NEDOCS) and Emergency Department Work Index (EDWIN) that have been developed to provide measures aimed at mitigating overcrowding. Recently, efforts made by researchers to examine the validity and reproducibility of these indices have shown that they are not reliable in accurately assessing overcrowding in regions beyond their original design settings. The shortcomings of such indices stem from their reliance upon the perspective and feedback of only clinical staff and the exclusion of other stakeholders. These limited perspectives introduce bias in the results of ED overcrowding indices. This study starts with confirming the inaccuracy of such crowding indices through examining their validity within a new healthcare system. To overcome the shortcomings of previous indices, the study presents a novel framework for quantifying and managing overcrowding based on emulating human reasoning in overcrowding perception. The framework of the proposed study takes into consideration emergency operational and clinical factors such as patient demand, patient complexity, staffing level, clinician workload, and boarding status when defining the crowding level. The hierarchical fuzzy logic approach is utilized to accomplish the goals of this framework by combining a diverse pool of healthcare expert perspectives while addressing the complexity of the overcrowding issue. The innovative design of the developed framework reduces bias in the assessment of ED crowding by developing a knowledge-base from the perspectives of multiple experts, and allows for its implementation in a variety of healthcare settings. Statistical analysis of results indicate that the developed index outperform previous indices in reflecting expert subjective assessments of overcrowding.
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Date Issued: 2016
Identifier: CFE0006521, ucf:51378
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0006521

Title: How many are out there? A novel approach for open and closed systems.
Creator: Rehman, Zia, Kincaid, John, Wiegand, Rudolf, Finch, Craig, Uddin, Nizam, University of Central Florida
Abstract / Description: We propose a ratio estimator to determine population estimates using capture-recapture sampling. It's different than traditional approaches in the following ways:(1)Ordering of recaptures: Currently data sets do not take into account the "ordering" of the recaptures, although this crucial information is available to them at no cost. (2)Dependence of trials and cluster sampling: Our model explicitly considers trials to be dependent and improves existing literature which assumes independence. ...
Show moreWe propose a ratio estimator to determine population estimates using capture-recapture sampling. It's different than traditional approaches in the following ways:(1)Ordering of recaptures: Currently data sets do not take into account the "ordering" of the recaptures, although this crucial information is available to them at no cost. (2)Dependence of trials and cluster sampling: Our model explicitly considers trials to be dependent and improves existing literature which assumes independence. (3)Rate of convergence: The percentage sampled has an inverse relationship with population size, for a chosen degree of accuracy. (4)Asymptotic Attainment of Minimum Variance (Open Systems: (=population variance).(5)Full use of data and model applicability (6)Non-parametric (7)Heterogeneity: When units being sampled are hard to identify. (8)Open and closed systems: Simpler results are presented separately for closed systems.(9)Robustness to assumptions in open systems
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Date Issued: 2014
Identifier: CFE0005403, ucf:50411
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0005403

Title: THE EFFECTS OF EMERGING TECHNOLOGY ON HEALTHCARE AND THE DIFFICULTIES OF INTEGRATION.
Creator: Pavlish-Carpenter, Skyler J, D'Amato-Kubiet, Leslee, University of Central Florida
Abstract / Description: Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements...
Show moreBackground: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all. Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare. Methods: Peer reviewed articles were gathered from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Elton B. Stephens Co. Host (Ebsco Host), Medical Literature On-line (Medline), and Psychological Information Database (PsychINFO). Articles were included if written in English and focusing on technology that was or is difficult to implement. Results: Research suggests that the primary reason disruptive technology is not implemented sooner is the cost versus benefit ratio. Those technologies with extremely high benefits that greatly improve efficiency, safety, or expense are integrated relatively quickly, especially if their cost is reasonable. Secondary reasons for difficulty with integration include ethical dilemmas, extreme complexity, technical limitations, maintenance, security, and fallibility. Conclusion: Research indicates that a decrease in production cost and selling price along with removing any issues that may depreciate the technology will provide better incentives for healthcare systems to integrate disruptive technologies on a wider scale.
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Date Issued: 2018
Identifier: CFH2000374, ucf:45799
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000374

Title: A MICROECONOMIC MODEL OF HEALTHCARE SYSTEMS: FROM THEORETICAL TO PRACTICAL.
Creator: Helligso, Jesse, Hamann, Kerstin, University of Central Florida
Abstract / Description: This thesis is a microeconomic market analysis of healthcare systems. Different countries use various forms for financing and providing healthcare, and the effects of market forces on the quality, access and economic efficiency of these divergent healthcare markets is the primary subject. The purpose of this thesis is to describe the forces working in the healthcare market. Free-market healthcare systems allow medical providers to become price-setters. Price-setting by medical providers...
Show moreThis thesis is a microeconomic market analysis of healthcare systems. Different countries use various forms for financing and providing healthcare, and the effects of market forces on the quality, access and economic efficiency of these divergent healthcare markets is the primary subject. The purpose of this thesis is to describe the forces working in the healthcare market. Free-market healthcare systems allow medical providers to become price-setters. Price-setting by medical providers creates an economically inefficient system which decreases public access to healthcare but creates a high quality system. Single-payer systems make government the price-setter which creates a system in which medical providers are price-takers. Government price-setting guarantees access but quality and economic efficiency vary drastically between countries. Universal single-payer systems tend to set prices higher than the theoretically necessary price which creates a high quality, economically inefficient system. Socialized single-payer systems tend to set prices lower than the theoretically necessary price which creates government savings, wait-lists and poorer quality. The quality, economic efficiency, and equity of the healthcare system are determined by the form of the market used in the country. Ultimately, this market determines price. In a free-market system price is determined by providers of healthcare, in a socialized market price is determined by government, and in a universal healthcare system price is negotiated by both healthcare providers and government. Price negotiation in a universal system creates the greatest access to healthcare, and quality of healthcare. Socialized systems can be more economically efficient than a universal system, but quality and access can be limited. Price negotiation in a universal healthcare system fixes the problems of price negotiation inherent in the healthcare market.
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Date Issued: 2007
Identifier: CFE0001821, ucf:47355
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001821

Title: DOES SAFETY CULTURE PREDICT CLINICAL OUTCOMES?.
Creator: Wilson, Katherine, Salas, Eduardo, University of Central Florida
Abstract / Description: Patient safety in healthcare has become a national objective. Healthcare organizations are striving to improve patient safety and have turned to high reliability organizations as those in which to model. One initiative taken on by healthcare is improving patient safety culture--shifting from one of a 'no harm, no foul' to a culture of learning that encourages the reporting of errors, even those in which patient harm does not occur. Lacking from the literature, however, is an...
Show morePatient safety in healthcare has become a national objective. Healthcare organizations are striving to improve patient safety and have turned to high reliability organizations as those in which to model. One initiative taken on by healthcare is improving patient safety culture--shifting from one of a 'no harm, no foul' to a culture of learning that encourages the reporting of errors, even those in which patient harm does not occur. Lacking from the literature, however, is an understanding of how safety culture impacts outcomes. While there has been some research done in this area, and safety culture is argued to have an impact, the findings are not very diagnostic. In other words, safety culture has been studied such that an overall safety culture rating is provided and it is shown that a positive safety culture improves outcomes. However, this method does little to tell an organization what aspects of safety culture impact outcomes. Therefore, this dissertation sought to answer that question but analyzing safety culture from multiple dimensions. The results found as a part of this effort support previous work in other domains suggesting that hospital management and supervisor support does lead to improved perceptions of safety. The link between this support and outcomes, such as incidents and incident reporting, is more difficult to determine. The data suggests that employees are willing to report errors when they occur, but the low occurrence of such reportable events in healthcare precludes them from doing so. When a closer look was taken at the type of incidents that were reported, a positive relationship was found between support for patient safety and medication incidents. These results initially seem counterintuitive. To suggest a positive relationship between safety culture and medication incidents on the surface detracts from the research in other domains suggesting the opposite. It could be the case that an increase in incidents leads an organization to implement additional patient safety efforts, and therefore employees perceive a more positive safety culture. Clearly more research is needed in this area. Suggestions for future research and practical implications of this study are provided.
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Date Issued: 2007
Identifier: CFE0001924, ucf:47472
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0001924

Title: PROFIT-BEARING ADMINISTRATORS: EXPLORING THE APPLICATION OF ECONOMICS AND FINANCIAL CONCEPTS IN HEALTHCARE MANAGEMENT.
Creator: Riddick, Brandon K, Wessel, Philip K., University of Central Florida
Abstract / Description: Healthcare managers face an incredible challenge today; understanding and implementing financially and economically sound decisions in the complex healthcare environment of the United States. The pressure to be profitable managers is greater than ever. Considering current research, past studies, and articles focused on the demands of healthcare managers will illuminate the state of health care administration, and the importance of real world application of accounting and economics in...
Show moreHealthcare managers face an incredible challenge today; understanding and implementing financially and economically sound decisions in the complex healthcare environment of the United States. The pressure to be profitable managers is greater than ever. Considering current research, past studies, and articles focused on the demands of healthcare managers will illuminate the state of health care administration, and the importance of real world application of accounting and economics in healthcare. This thesis will explore and examine research about industry standards, and the need for preparedness in healthcare finance management. It will also examine the important and complex role of accounting and economics in healthcare administration by answering the three following questions: What do administrators, according to studies and literature available, believe is essential to becoming and remaining effective managers? What financial and economic concepts are understood and implemented by healthcare managers? What changes, if any, are necessary to adequately train and educate future healthcare administrators for successful financial management? The answers to these questions will highlight the impact of the economic, political, and social changes on administrators, as well as the best ways to succeed despite the difficulties often faced by those in this field.
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Date Issued: 2017
Identifier: CFH2000212, ucf:45922
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFH2000212

Title: TOP MANAGEMENT'S PERCEPTIONS OF SERVICE EXCELLENCE AND HOSPITALITY: THE CASE OF DR. P. PHILLIPS HOSPITAL.
Creator: Aiello, Taryn, Severt, Denver, University of Central Florida
Abstract / Description: This study investigated service excellence and hospitality in a healthcare setting. It is unique from other hospitality research in that it considers hospitality and service excellence as separate concepts, applicable across industries. Part of the premise of this study explores how hospitality extends past service excellence to create a comfortable and welcoming environment to combat patient anxiety and stress. Furthermore, this is one of the first qualitative studies on the importance of...
Show moreThis study investigated service excellence and hospitality in a healthcare setting. It is unique from other hospitality research in that it considers hospitality and service excellence as separate concepts, applicable across industries. Part of the premise of this study explores how hospitality extends past service excellence to create a comfortable and welcoming environment to combat patient anxiety and stress. Furthermore, this is one of the first qualitative studies on the importance of service excellence and hospitality in the healthcare industry. This case study measured top management's perceptions of service excellence and hospitality within one community-based hospital located in Orlando, Florida. The researcher conducted one-hour interviews with twelve leading managers to gain their opinions of service excellence and hospitality within their organization. Consistent with a thorough review of literature, three conclusions were revealed: 1) there is a strong, but mixed, top management commitment to service excellence and hospitality throughout organization; 2) the terms "service excellence" and "hospitality", when used, were discussed interchangeably as if the two theories were equivalent; and 3) External barriers to the patient experience that were identified included improvement of technology, increased consumerism, quality regulations, and workforce deficits. Internal barriers to the patient experience include communication and inconsistency. The research provided implications to healthcare organizations that are looking to implement practices of hospitality and service management to improve service delivery. Additionally, the study of hospitality outside the industry offers ideas of improvement for hospitality management and organizational researchers. It can also be used as a foundation to formulate additional studies in the area of service excellence and hospitality within the healthcare field, as this research is limited to only top management's views.
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Date Issued: 2008
Identifier: CFE0002311, ucf:47837
Format: Document (PDF)
PURL: http://purl.flvc.org/ucf/fd/CFE0002311

Healthcare (12)	+ -
healthcare (9)	+ -
Central Florida (2)	+ -
disparity (2)	+ -
satisfaction (2)	+ -

3D Printing (1)	+ -
ACA (1)	+ -
Action Research (1)	+ -
African Americans (1)	+ -
Agreement Measure (1)	+ -
Bisexual (1)	+ -
Breach (1)	+ -
Breastfeeding (1)	+ -
Business Excellence (1)	+ -
Cancer (1)	+ -
Cancer Diagnosis (1)	+ -
Capture Recapture (1)	+ -
Case-Based Reasoning (1)	+ -
Communication (1)	+ -
Community Partnership Schools (1)	+ -
Community schools (1)	+ -
Computer Vision (1)	+ -
Criminalization and mental illness (1)	+ -
DACA (1)	+ -
Deep Learning (1)	+ -
Disruptive (1)	+ -
Dissension Measure. (1)	+ -
Donabedian’s healthcare model (1)	+ -
Dreamer (1)	+ -
EMR (1)	+ -

ETD Collection (28)	+ -
Honors Collection (10)	+ -

University of Central Florida (38)	+ -
Elshennawy, Ahmad (5)	+ -
Lee, Gene (4)	+ -
Rabelo, Luis (4)	+ -
Salas, Eduardo (3)	+ -

Burg, Mary Ann (2)	+ -
Gonzalez, Laura (2)	+ -
Liberman, Aaron (2)	+ -
Malvey, Donna (2)	+ -
Rahal, Ahmad (2)	+ -
Sumner, Jennifer (2)	+ -
Uddin, Nizam (2)	+ -
Aiello, Taryn (1)	+ -
Albar, Abdulrahman (1)	+ -
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Alshareef, Khaled (1)	+ -
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