Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
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Description
The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Through a qualitative case study analysis of innovation implementation, a new framework of leadership was uncovered. This framework presented new characteristics of leaders that led to the successful implementation of an innovation. Characteristics uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence information flow, relationships, connections, and organizational context to implement innovation.
ContributorsWeberg, Daniel Robert (Author) / Fluery, Julie (Thesis advisor) / Malloch, Kathy (Thesis advisor) / Porter-O'Grady, Timothy (Committee member) / Hagler, Debra (Committee member) / Arizona State University (Publisher)
Created2013
Description
Preoperative team briefings have been suggested to be important for improving team performance in the operating room. Many high risk environments have accepted team briefings; however healthcare has been slower to follow. While applying briefings in the operating room has shown positive benefits including improved communication and perceptions of teamwork, most research has only focused on feasibility of implementation and not on understanding how the quality of briefings can impact subsequent surgical procedures. Thus, there are no formal protocols or methodologies that have been developed.
The goal of this study was to relate specific characteristics of team briefings back to objective measures of team performance. The study employed cognitive interviews, prospective observations, and principle component regression to characterize and model the relationship between team briefing characteristics and non-routine events (NREs) in gynecological surgery. Interviews were conducted with 13 team members representing each role on the surgical team and data were collected for 24 pre-operative team briefings and 45 subsequent surgical cases. The findings revealed that variations within the team briefing are associated with differences in team-related outcomes, namely NREs, during the subsequent surgical procedures. Synthesis of the data highlighted three important trends which include the need to promote team communication during the briefing, the importance of attendance by all surgical team members, and the value of holding a briefing prior to each surgical procedure. These findings have implications for development of formal briefing protocols.
Pre-operative team briefings are beneficial for team performance in the operating room. Future research will be needed to continue understanding this relationship between how briefings are conducted and team performance to establish more consistent approaches and as well as for the continuing assessment of team briefings and other similar team-related events in the operating room.
The goal of this study was to relate specific characteristics of team briefings back to objective measures of team performance. The study employed cognitive interviews, prospective observations, and principle component regression to characterize and model the relationship between team briefing characteristics and non-routine events (NREs) in gynecological surgery. Interviews were conducted with 13 team members representing each role on the surgical team and data were collected for 24 pre-operative team briefings and 45 subsequent surgical cases. The findings revealed that variations within the team briefing are associated with differences in team-related outcomes, namely NREs, during the subsequent surgical procedures. Synthesis of the data highlighted three important trends which include the need to promote team communication during the briefing, the importance of attendance by all surgical team members, and the value of holding a briefing prior to each surgical procedure. These findings have implications for development of formal briefing protocols.
Pre-operative team briefings are beneficial for team performance in the operating room. Future research will be needed to continue understanding this relationship between how briefings are conducted and team performance to establish more consistent approaches and as well as for the continuing assessment of team briefings and other similar team-related events in the operating room.
ContributorsHildebrand, Emily A (Author) / Branaghan, Russell J (Thesis advisor) / Cooke, Nancy J. (Committee member) / Hallbeck, M. Susan (Committee member) / Bekki, Jennifer M (Committee member) / Blocker, Renaldo C (Committee member) / Arizona State University (Publisher)
Created2014
Description
HIV/AIDS is the sixth leading cause of death worldwide and the leading cause of death among women of reproductive age living in low-income countries. Clinicians in industrialized nations monitor the efficacy of antiretroviral drugs and HIV disease progression with the HIV-1 viral load assay, which measures the copy number of HIV-1 RNA in blood. However, viral load assays are not widely available in sub-Saharan Africa and cost between 50-$139 USD per test on average where available. To address this problem, a mixed-methods approach was undertaken to design a novel and inexpensive viral load diagnostic for HIV-1 and to evaluate barriers to its adoption in a developing country. The assay was produced based on loop-mediated isothermal amplification (LAMP). Blood samples from twenty-one individuals were spiked with varying concentrations of HIV-1 RNA to evaluate the sensitivity and specificity of LAMP. Under isothermal conditions, LAMP was performed with an initial reverse-transcription step (RT-LAMP) and primers designed for HIV-1 subtype C. Each reaction generated up to a few billion copies of target DNA within an hour. Presence of target was detected through naked-eye observation of a fluorescent indicator and verified by DNA gel electrophoresis and real-time fluorescence. The assay successfully detected the presence of HIV in samples with a broad range of HIV RNA concentration, from over 120,000 copies/reaction to 120 copies/reaction. In order to better understand barriers to adoption of LAMP in developing countries, a feasibility study was undertaken in Tanzania, a low-income country facing significant problems in healthcare. Medical professionals in Northern Tanzania were surveyed for feedback regarding perspectives of current HIV assays, patient treatment strategies, availability of treatment, treatment priorities, HIV transmission, and barriers to adoption of the HIV-1 LAMP assay. The majority of medical providers surveyed indicated that the proposed LAMP assay is too expensive for their patient populations. Significant gender differences were observed in response to some survey questions. Female medical providers were more likely to cite stigma as a source problem of the HIV epidemic than male medical providers while males were more likely to cite lack of education as a source problem than female medical providers.
ContributorsSalamone, Damien Thomas (Author) / Jacobs, Bertram L (Thesis advisor) / Marsiglia, Flavio (Committee member) / Stout, Valerie (Committee member) / Johnson, Crista (Committee member) / Arizona State University (Publisher)
Created2011
Description
Sports communication is a vibrant, blossoming research area within the communication discipline. One of the more fruitful directions in sports communication research pertains to social media. Social media has embedded itself in the sports world in a very short period of time. As a result, there is a need for instructional resources that prepare students to understand the nuances and power that social media possess. This research provides the foundation for a case study textbook centered on social media and sports communication. Specifically, four cases dealing with: (a) athletes using social media to encourage input from fans; (b) sports organizations using social media as an agenda-setting tool; (c) negative parasocial interaction expressed to athletes via social media; and (d) athletes using social media to enact image repair are presented. These cases demonstrate that social media is a valuable conduit between athletes and fans that enables athletes and sports organizations to cultivate fan identity and maintain control over public information. The cases also demonstrate that fan behavior via social media can quickly turn problematic, requiring that athletes and sports organizations respond appropriately, yet strategically. The research concludes by offering implications for future social media and sports communication research.
ContributorsSanderson, Jimmy (Author) / Kassing, Jeffrey W. (Thesis advisor) / Ramirez Jr, Artemio (Committee member) / Meân, Lindsey J. (Committee member) / Arizona State University (Publisher)
Created2012
Description
The objective of this project was to evaluate human factors based cognitive aids on endoscope reprocessing. The project stems from recent failures in reprocessing (cleaning) endoscopes, contributing to the spread of harmful bacterial and viral agents between patients. Three themes were found to represent a majority of problems: 1) lack of visibility (parts and tools were difficult to identify), 2) high memory demands, and 3) insufficient user feedback. In an effort to improve completion rate and eliminate error, cognitive aids were designed utilizing human factors principles that would replace existing manufacturer visual aids. Then, a usability test was conducted, which compared the endoscope reprocessing performance of novices using the standard manufacturer-provided visual aids and the new cognitive aids. Participants successfully completed 87.1% of the reprocessing procedure in the experimental condition with the use of the cognitive aids, compared to 46.3% in the control condition using only existing support materials. Twenty-five of sixty subtasks showed significant improvement in completion rates. When given a cognitive aid designed with human factors principles, participants were able to more successfully complete the reprocessing task. This resulted in an endoscope that was more likely to be safe for patient use.
ContributorsJolly, Jonathan D (Author) / Branaghan, Russell J (Thesis advisor) / Cooke, Nancy J. (Committee member) / Sanchez, Christopher (Committee member) / Arizona State University (Publisher)
Created2011
Description
ABSTRACT Nursing physical fatigue is a critical issue that may lead to degradation of care delivery and ultimately result in medical errors. This issue is equally relevant due to the looming shortage of nurses, which has been linked to the physical demands and potential occupational hazards intrinsic to the profession; as well as to the graying of the nursing workforce who experiences gradual loss of strength and agility that accompanies aging as time in the career advances. In a hospital Emergency Department, the level of nursing physical fatigue can potentially reach its threshold in light of challenging workloads, scope of job assignments and demanding schedules. While in other safety-sensitive industries such as aviation and nuclear plants, similar concerns have been the object of systematic research and addressed with consequent regulations, just recently, the healthcare sector has been engaged in further investigations. This study proposed to explore the linkage between Emergency Department design-layout and nursing physical fatigue. It was expected that further understanding on this relationship would support evidence-based design propositions linking nursing wellness, job satisfaction, and performance to a higher quality of care and improved patient safety levels. To this end, data collection was performed during four weeks in a community-based hospital. A convenience sample of twenty-four eligible nurses was invited to participate in this two-part study. The first section consisted of the completion of a self-administered questionnaire, which assessed nurses' perception of the impact of working conditions on nursing physical fatigue. The second section included the monitoring, through the use of accelerometers, of nurses' actual activity intensity levels during three consecutive shifts. Among other findings, data demonstrated that nurses perceive several attributes or components of the built environment as potential contributors to physical fatigue. In addition, various operational practices and organizational protocols were linked to physical fatigue. Contrary to nurses' perception of physical fatigue, their actual physical activity levels fell mostly between sedentary or light intensity ranges. This paradox offers the opportunity for design interventions that, in alignment with operational practices and organizational protocols will enhance nurses' performance and improve nurses' retention.
ContributorsShakman, Karen (Author) / Bender, Diane (Thesis advisor) / Stein, Morris (Committee member) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2011
Description
In modern healthcare environments, there is a strong need to create an infrastructure that reduces time-consuming efforts and costly operations to obtain a patient's complete medical record and uniformly integrates this heterogeneous collection of medical data to deliver it to the healthcare professionals. As a result, healthcare providers are more willing to shift their electronic medical record (EMR) systems to clouds that can remove the geographical distance barriers among providers and patient. Even though cloud-based EMRs have received considerable attention since it would help achieve lower operational cost and better interoperability with other healthcare providers, the adoption of security-aware cloud systems has become an extremely important prerequisite for bringing interoperability and efficient management to the healthcare industry. Since a shared electronic health record (EHR) essentially represents a virtualized aggregation of distributed clinical records from multiple healthcare providers, sharing of such integrated EHRs may comply with various authorization policies from these data providers. In this work, we focus on the authorized and selective sharing of EHRs among several parties with different duties and objectives that satisfies access control and compliance issues in healthcare cloud computing environments. We present a secure medical data sharing framework to support selective sharing of composite EHRs aggregated from various healthcare providers and compliance of HIPAA regulations. Our approach also ensures that privacy concerns need to be accommodated for processing access requests to patients' healthcare information. To realize our proposed approach, we design and implement a cloud-based EHRs sharing system. In addition, we describe case studies and evaluation results to demonstrate the effectiveness and efficiency of our approach.
ContributorsWu, Ruoyu (Author) / Ahn, Gail-Joon (Thesis advisor) / Yau, Stephen S. (Committee member) / Huang, Dijiang (Committee member) / Arizona State University (Publisher)
Created2012
Description
The field of authorship determination, previously largely falling under the umbrella of literary analysis but recently becoming a large subfield of forensic linguistics, has grown substantially over the last two decades. As its body of research and its record of successful forensic application continue to grow, this growth is paralleled by the demand for its application. However, methods which have undergone rigorous testing to show their reliability and replicability, allowing them to meet the strict Daubert criteria put forth by the US court system, have not truly been established.
In this study, I set out to investigate how a list of parameters, many commonly used in the methodologies of previous researchers, would perform when used to test documents of bloggers from a sports blog, Winging It in Motown. Three prolific bloggers were chosen from the site, and a corpus of posts was created for each blogger which was then examined for each of the chosen parameters. One test document for each of the three bloggers which was not included in that blogger’s corpus was then chosen from the blog page, and these documents were examined for each of the parameters via the same methodologies as were used to examine the corpora. Once data for the corpora and all three test documents was obtained, the results were compared for similarity, and an author determination was made for each test document along each parameter.
The findings indicated that overall the parameters were quite unsuccessful in determining authorship for these test documents based on the author corpora developed for the study. Only two parameters successfully identified the authors of the test documents at a rate higher than chance, and the possibility exists that other factors may be driving these successful identifications, demanding further research to confirm their validity as parameters for the purpose of authorship work.
In this study, I set out to investigate how a list of parameters, many commonly used in the methodologies of previous researchers, would perform when used to test documents of bloggers from a sports blog, Winging It in Motown. Three prolific bloggers were chosen from the site, and a corpus of posts was created for each blogger which was then examined for each of the chosen parameters. One test document for each of the three bloggers which was not included in that blogger’s corpus was then chosen from the blog page, and these documents were examined for each of the parameters via the same methodologies as were used to examine the corpora. Once data for the corpora and all three test documents was obtained, the results were compared for similarity, and an author determination was made for each test document along each parameter.
The findings indicated that overall the parameters were quite unsuccessful in determining authorship for these test documents based on the author corpora developed for the study. Only two parameters successfully identified the authors of the test documents at a rate higher than chance, and the possibility exists that other factors may be driving these successful identifications, demanding further research to confirm their validity as parameters for the purpose of authorship work.
ContributorsCox, Taylor (Author) / Gelderen, Elly van (Thesis advisor) / Gillon, Carrie (Committee member) / Gee, Elisabeth (Committee member) / Arizona State University (Publisher)
Created2017
Description
Previous research has shown that perceptual illusions can enhance golf putting performance, and the effect has been explained as being due to enhanced expectancies. The present study was designed to further understand this effect by measuring putting in 3 additional variations to the Ebbinghaus illusion and by measuring putting kinematics. Nineteen ASU students with minimal golf experience putted to the following illusion conditions: a target, a target surrounded by small circles, a target surrounded by large circles, a target surrounded by both large and small circles, no target surrounded by small circles and no target surrounded by large circles. Neither perceived target size nor putting error was significantly affected by the illusion conditions. Time to peak speed was found to be significantly greater for the two conditions with no target, and lowest for the condition with the target by itself. Suggestions for future research include having split groups with and without perceived performance feedback as well as general performance feedback. The size conditions utilized within this study should continue to be explored as more consistent data could be collected within groups.
ContributorsCoon, Victoria (Author) / Gray, Rob (Thesis advisor) / Roscoe, Rod (Committee member) / Branaghan, Russ (Committee member) / Arizona State University (Publisher)
Created2019
Description
Medical policies, practices, and definitions do not exist solely in the clinical realm; they show up in the lived experiences of patients. This research examines how people with the chronic illness called myalgic encephalomyelitis (ME) define their own illness experiences. They have situated knowledge about their illness onset, search for care, and clinical encounters. Their knowledge complicates and challenges the existing norms in clinical practice and medical discourse, as the experience of searching for care with ME reveals weaknesses in a system that is focused on acute care. Patient narratives reveal institutional patterns that obstruct access to medical care, such as disbelief from clinicians and lack of training in chronic illness protocols. They also reveal patterns in physician behavior that indicate the likelihood of receiving effective care. These patient narratives serve as a basis for continued examination of ME as well as further reconstruction of medical practice and procedure.
ContributorsCutler, Carmen (Author) / Oliverio, Annamaria (Thesis advisor) / Mann, Annika (Thesis advisor) / Behl, Natasha (Committee member) / Arizona State University (Publisher)
Created2019