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Substituting Hospitals: An Analysis of Urgent Care Centers in the Market for Healthcare

Description
The primary purpose of this paper is to analyze urgent care centers and explain their role within the U.S. healthcare system. The introduction of urgent care into the market for health care services has brought with it a new way for consumers to receive non-emergent healthcare outside of traditional hours.…

The primary purpose of this paper is to analyze urgent care centers and explain their role within the U.S. healthcare system. The introduction of urgent care into the market for health care services has brought with it a new way for consumers to receive non-emergent healthcare outside of traditional hours. Urgent care is often cited as a plausible alternative to care received at an emergency department or primary care physician's office. One of the key questions the author attempts to answer is: "To what degree are urgent care centers an economic substitute to emergency departments or physician's offices?" This paper looks at both projected demand from currently operating urgent care centers and consumer preference surveys to estimate the willingness of consumers to use urgent care. The method used to accomplish this task has been compiling scholarly research and data on urgent care centers. After a thorough examination of relevant studies and datasets, urgent care centers have been found to be just as preferred as emergency departments when considering non-emergent cases, specifically among individuals aged 18-44. The clear majority of consumers still prefer visiting a primary care physician over an urgent care center when it comes to episodic care, however. When taking into account wait times, differences in cost, and ease of access, urgent care becomes much more preferred than an emergency department and weakly preferred to a physician's office. There are still some concerns with urgent care, however. Questions of capacity to meet demand, access for underserved communities, and susceptibility to adverse selection have yet to be fully explored.
ContributorsBullington, Robert Heyburn (Author) / Foster, William (Thesis director) / Hill, John (Committee member) / Sandra Day O'Connor College of Law (Contributor) / W.P. Carey School of Business (Contributor) / Department of Economics (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
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Pressure Injury Prevention in the Inpatient Setting

Description
Background: Pressure injuries inflict a major, preventable burden onto hospital systems, healthcare providers, and patients. The purpose of this evidence based project was to evaluate the impact of a pressure injury prevention education program on nursing staff knowledge and pressure injury rates in an Arizona post-cardiac care unit.

Method: A single…

Background: Pressure injuries inflict a major, preventable burden onto hospital systems, healthcare providers, and patients. The purpose of this evidence based project was to evaluate the impact of a pressure injury prevention education program on nursing staff knowledge and pressure injury rates in an Arizona post-cardiac care unit.

Method: A single group pre-test post-test design was utilized to evaluate nursing staff knowledge before and after an education program on pressure injury prevention. Staff knowledge was evaluated using a modified version of the Pressure Ulcer Knowledge Assessment Tool 2.0. Participants completed pre- and post-education surveys. Rates of hospital acquired pressure injuries were obtained via chart review.

Results: Pre- and post-education scores were analyzed in participants who completed both surveys using a paired t-test. Post-education scores (M = 0.73, SD = 0.07) were significantly higher than pre-education scores (M = 0.59, SD = 0.09); t(7) = -5.39, p = .001. Pre- and post-education median scores of all participants were analyzed using two-tailed Mann-Whitney U test. Post-education scores (Mdn = 0.71) were significantly higher compared to pre-education scores (Mdn = 0.56); U = 102.5, z = -4.05, p = .001. Monthly incidence of pressure injuries on the unit increased following education.

Discussion: Increase in scores from pre- to post-education surveys indicate staff knowledge improved. The increased incidence of pressure injuries is thought to be secondary to staff’s increased ability to detect pressure injuries. Staff education is recommended, but more research is needed regarding the impact on pressure injury rates.
ContributorsHolloway, Jonathan (Author) / Ochieng, Judith (Thesis advisor)
Created2020-04-16
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Improving End-of-Life Care in the Primary Care Setting: Implementation of the Serious Illness Care Program

Description

Early and effective end-of-life care are associated with increased quality of life for those patients who may be nearing the end-of-life (EOL). However, evidence suggests that most non-palliative healthcare providers lack the skills and confidence to initiate EOL conversations. Consequently, about 70% of Americans would prefer to die at home…

Early and effective end-of-life care are associated with increased quality of life for those patients who may be nearing the end-of-life (EOL). However, evidence suggests that most non-palliative healthcare providers lack the skills and confidence to initiate EOL conversations. Consequently, about 70% of Americans would prefer to die at home with their families, yet only 25% die according to their wishes (State of California Department of Justice, n.d). In alignment with the Peaceful End of Life Theory, the purpose of this evidence-based project is to increase primary healthcare providers’ level of skills and confidence in end-of-life discussions.

This project utilized a pre and post study design. A total of 11 participants were recruited using convenience sampling from three primary care clinics in Phoenix, Arizona. Due to the small sample size and assumption of a non-normal distribution of the data, Wilcoxon Signed Ranks test and Pearson correlation coefficient were used for statistical analysis. There were clinical and statistical significant improvements in the EOL knowledge of the participants after the implementation of the two-and-a-half-hour Serious Illness Care Program (Z = -2.950, p = .003) with a large effect size (r = -0.62).

The project evaluation also demonstrated that most participants deemed that the intervention was effective. A brief and systematic education session, such as the SICP can be utilized to improve non-palliative healthcare providers’ skills in having more and effective end-of-life conversations.
ContributorsManalese, Rey Jericoh (Author) / Ochieng, Judith (Thesis advisor)
Created2019-05-02