Matching Items (19)
Description
As the complexity of healthcare continues to rise, the need for change in healthcare delivery is more prominent than ever. One strategy identified by the World Health Organization (WHO) for responding to these increasing complexities is the use of interprofessional practice and education to improve patient outcomes, reduce costs, and enhance the patient experience of care (Triple Aim). Interprofessional collaboration among diverse disciplines is evident on the Phoenix Biomedical Campus, integrating a wide variety of institutions and multiple health profession programs; and at the Student Health Outreach for Wellness (SHOW) free clinic, -- a successful tri-university, student-led, faculty mentored, and community-based model of interprofessional learning and care -- based in downtown Phoenix. This project conducted a comparative analysis of interprofessional components of 6 different clinical models in order to provide recommendations for best practice implementation. These models were chosen based on availability of research on interprofessionalism with their clinics. As a result, three recommendations were offered to the SHOW clinic for consideration in their efforts to improve both patient and educational outcomes. Each recommendation was intentionally formulated for its capacity to increase: interprofessionalism and collaboration between multiple disciplines pertaining to healthcare, among healthcare professionals to promote positive patient and educational outcomes. These recommendations include implementing an interprofessional education (IPE) course as a core component in an academic program's curriculum, offering faculty and professional development opportunities for faculty and mentors immersed in the interprofessional clinics, and utilization of simulation centers. Further studies will be needed to evaluate the impact these specific interventions, if adopted, on patient and educational outcomes.
ContributorsMousa, Mohammad (Co-author) / Mousa, Bakir (Co-author) / Johnson, Ross (Co-author) / Harrell, Liz (Thesis director) / Saewert, Karen (Committee member) / Harrington Bioengineering Program (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05
Description
This paper details the development of a six-week health education class for pregnant and parenting women recovering from substance abuse. The class was developed in collaboration with Student Health Outreach for Wellness (SHOW) Community Initiative, a student-run organization providing free healthcare to underserved populations, and with Crossroads, Inc., a licensed treatment provider serving men, women, and veterans recovering from addiction and substance use disorders. A needs assessment via personal interview was conducted to identify the demographics of the female residents at the Crossroads for Women treatment facility, the existing medical health promotional services, and the needed medical and health promotional services. The needs assessment identified the need for health education for pregnant and parenting women recovering from addiction. The SHOW Program Development Guide was utilized to develop the content for the classes based on the Health Belief Model theory. The Health Belief Model focuses on the beliefs and attitudes of individuals and altering them to make achieving good health more feasible (Hochbaum, Rosenstock, and Kegels, 1952). The program curriculum identifies potential perceived barriers to health and utilizes strategies to decrease the perceived barriers and increase perceived benefits. The six-week course was divided to address six different topics: 1. Introduction, 2. Physical Health, 3. Stress Management, 4. Nutrition, 5. Exercise, and 6. Conclusion and Discharge Planning. The class will be taught by a variety of health professional disciplines in accordance with the interprofessional practice theory, which utilizes two or more health professions to improve health outcomes. This project outlines all presentation materials, handouts, activities, and implementation recommendations required to produce a program that helps pregnant and parenting women on their road to recovery.
ContributorsPhillips, Megan Anne (Author) / Harrell, Liz (Thesis director) / Reifsnider, Elizabeth (Committee member) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2016-12
Description
Introduction. Evidence shows that the United States' healthcare system is inefficient and lacks the quality and cost-effectiveness of other systems. The Institute for Healthcare Improvement outlined the Triple Aim to improve the healthcare system through 1) improvement of population health for a defined population, 2) enhance the patient care experience, and 3) reduce per capita cost of care. The World Health Organization has identified interprofessional practice (IPP) and interprofessional education (IPE) as a possible approach to achieve the Triple Aim. The Student Health Outreach for Wellness (SHOW) initiative is an interprofessional free clinic and outreach initiative for individuals experiencing homelessness. The goal of the current study was to evaluate whether interprofessional care delivery through SHOW moved SHOW's practice towards the Triple Aim for SHOW's defined population. Methods and Results. Data assessing adherence to Triple Aim goals of population health and costs of care were collected from voluntary post-visit patient satisfaction surveys, while data assessing patient experience were collected from shift rosters of SHOW versus a similar non-interprofessional clinic. SHOW, on average, provided access to more disciplines than a similar non-interprofessional clinic. Access to care cost savings was assessed by surveying patients on where they would have sought care elsewhere SHOW had not been available ; of the 53 patients surveyed, 14 indicated they would have gone to the emergency department (ED); in all, SHOW diverted a little over $30,000 in patient ED visits. Improved health outcomes were measured by each patient's self-perception of his/her health. 91% of patients agreed or strongly agreed that their health had been improved by coming to the clinic. Conclusion. Preliminary data suggest that SHOW's IPP care delivery results in high patient satisfaction rates and positive self-perception of health outcomes, thus may improve the patient experience and minimize costs of care by deterring ED visits within the population. Further studies are needed to determine how specific aspects of interprofessional care can further move towards Triple Aim objectives.
ContributorsSingh, Sukhdeep (Co-author) / Paode, Pooja (Co-author) / Harrell, Liz (Thesis director) / Wermers, Rita (Committee member) / Department of Finance (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
Background: Current standard of care practices for substance use disorder is inadequate in reducing relapse, with rates persistently 40-60% within one year of treatment. Unconventional approaches must be explored to reduce the risk of relapse, climbing rate of overdoses, and healthcare expenditures exceeding $740 billion annually. The purpose of this quality improvement project demonstrates how an evidence-based group exercise intervention, used as adjunctive support to standard addiction treatment, can reduce relapse and promote long-term recovery during a global pandemic. Methods: Aims of this project sought to enhance quality of life scores. Participants were recruited upon admission to a residential treatment center. Pre-posttest design utilized the World Health Organization Quality of Life Abbreviated scale to assess program impact on quality of life. Pre-program descriptive questions and a survey assessing prior addiction treatment were collected. Group exercise and wellness education sessions were delivered twice weekly in a live, interactive, virtual format with on-site participants. Upon completion, a post-program survey was utilized to capture the qualitative experiences of participants and impact of project to instill confidence to execute long-term sobriety. Results: Pre and post scores, as well as domain scores were clinically and statistically significant. Additionally, 80% of participants reported feeling more prepared to achieve long-term sobriety secondary to their participation in this project. Discussion and Conclusion: Results from this project demonstrate the positive impact that group-based exercise and lifestyle interventions can have on quality of life and long-term recovery. Peer support exercise programs may offer means to enhance addiction treatment and reduce overall healthcare expenditures globally by defying the odds of relapse.
ContributorsAvino, M. Hayley (Author) / Nunez, Diane (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-05-01
Description
Background: This quality improvement project examined the effect an educational intervention focused on the psychosocial needs of cancer patients had on knowledge, attitudes, and behaviors (KAB) of a group of nurses. While nurses understand the physical toll of cancer, they may forget the impact cancer has on mental health. The project was guided by the Health Belief Model.
Methods: Consent was obtained from 15 participants working as nurse advocates for a large insurance company. Nurse advocates are tasked with improving the health of patients and connecting them to additional resources. A twenty-minute educational intervention focused on the impact cancer has on mental health and the benefit of multiple psychosocial supportive resources was delivered to the participants. Education included a comprehensive review of the resources available for cancer patients at the project site. Participants were then given 10 minutes to complete a retrospective post-then-pre survey, based on a Likert Scale.
Results: Statistically significant improvements in survey scores were observed in each of the three KAB domains. Statistical analysis confirmed improvements in survey scores were significant and not likely due to random variation. Participants also referred more patients into a cancer support program following the intervention.
Conclusion: A brief educational intervention was able to improve KAB scores among nurses. There was also an increase in the number of patients these nurses referred into a psychosocial supportive program. Nurses that better understand the mental health needs of cancer patients are more likely to connect them with psychosocial resources. This intervention will become part of standard training for new nurse advocates at the project site.
ContributorsLeyba, S. Edward (Author) / Harrell, Liz (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-05-02
Description
Sedation exists along a continuum; and, it is impossible to predict a patient’s exact response to a medication administered to induce any level sedation. Under the direction of a licensed independent practitioner (LIP), registered nurses (RN) in the Emergency Department (ED) have been permitted to administer propofol for time-sensitive, moderate sedation procedures (e.g. orthopedic reductions). In 2019, this changed when a Board of Nursing (BON) in the Southwestern United States posted an Advisory Opinion (AO) limiting the circumstances under which acute care RNs could administer propofol. The purpose of this doctoral project was to revise the 2019 AO to remove specific medication names and to generate recommendations for aligning hospital-based adult sedation policies and procedures (P&P) with the revised AO. In May 2020, the BON enacted the revised AO. Enactment endorses RNs practicing at the top of their scope and justifies amending existing hospital-based sedation P&Ps. Not restricting nurses’ scope of practice according to medication name supports medication selection based on patient condition and clinical situation and safeguards provision of timely, personalized healthcare to communities statewide.
ContributorsBonefield, Brittany A. (Author) / Tharalson, Erin (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-18
Description
Solo private physician-owned clinics report lower rates of electronic health record (EHR) use. Lack of use of an EHR results in billing penalties, revenue losses, and may affect quality of care. An EHR provides a concise recollection of a patient’s complete medical history, and any pertinent exam information clearly and succinctly. The aim of this pilot project was to support a small solo private physician-owned clinic transition from paper-based charting to an EHR. The pilot assessed through a validated survey EHR readiness and confidence of the employees at the beginning of the change process (pre-intervention) and at 16 weeks (post-intervention). During the 16-weeks, interventions in the form of transition assistance included vetting an EHR modality for the practice, virtual training via EHR modules, weekly check-ins with stakeholders, and organizational planning and scheduling with staff. EMR-based goal setting with EHR rollout deadlines was also provided. Results noted confidence decreased pertaining to EHR transitioning over the 16 weeks. Unforeseen barriers and challenges likely led to reduced confidence and provided information on future transition supports needed for the practice. The findings of this pilot are beneficial in gaining insight on how to enhance readiness in an outpatient clinic for EHR readiness. This information is utilized as a guide for small privately-owned outpatient clinics in their organizational transition from paper-charting to EHR. The results of this pilot project provide evidence-based data on the demands of system-wide organizational change.
ContributorsLong, Dana (Author) / Tharalson, Erin (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-22
Description
Due to complexities surrounding healthcare for the homeless, continuity of care is virtually nonexistent. Continuity of care refers to individualized, comprehensive health care services that are timely, accessible, and coordinated. Health care continuity has been demonstrated to reduce mortality and improve health outcomes. A literature review determined access to mobile phones could improve health care continuity among homeless individuals. LifeLine is a state and federal program providing free phones and phone service to impoverished Americans. Enrollment into LifeLine can be challenging for the homeless, who lack access to even the most basic necessities. A project was developed to assist homeless individuals with enrollment into LifeLine in order to increase mobile phone access and improve care continuity. For four weeks, LifeLine enrollment assistance was offered to homeless clients of a mobile health outreach organization in San Francisco, California. Original, anonymous pre- and post-intervention surveys were administered to collect data regarding phone access and healthcare utilization patterns among this population. All 13 participants endorsed mobile phone access; only one participant completed enrollment into LifeLine. Seventy percent of participants reported health care continuity was directly improved by phone access, endorsing consistent healthcare visits and low hospitalization rates. Ninety-two percent of participants reported preexisting awareness of LifeLine, which likely contributed to low program enrollment. This project yielded clinically significant results indicating access to mobile phones can improve health care continuity for the homeless. Improving health care continuity for this population has both ethical and economic implications and remains a public health priority.
ContributorsHaug, Hailey (Author) / Harrell, Liz (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
Description
Purpose: Understanding the factors impacting communication between residents and peer staff in peer-run residential substance abuse treatment programs. The purpose of this paper is to explore male survival behaviors and cultural norms such as no snitching that impede communication to prevent relapse. Methods: The sample was male residents accepted into a residential treatment facility in the southwestern United States. Stories of peer-staff’s personal struggles with the no snitching code videotaped and shown in group followed with a guided discussion of relapse triggers, communication, and behavior norms that impede treatment. An online confidential pre-post retrospective survey designed using the Drug Abstinence Self-Efficacy Scale. Results: Descriptive statistics run show Cronbach's alpha of 0.96. A two-tailed paired samples t-test was conducted to examine the Overall Confidence Pre-test and Post-test mean difference. The overall confidence post-test was not statistically significant, but it was clinically significant. Clinical significance evidenced by residents 3-point lower confidence post-intervention. Conclusions: How-to elicit behavior change is unique to every individual. The goal is behavior change to sustain recovery and better communication between clients and peer staff to prevent relapse.
ContributorsKoreny, Danielle M. (Author) / Harrell, Liz (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-26
Description
A federally qualified health center in the southwest United States serves low-income, uninsured communities. By provider reports, unprescribed antibiotic use is common in this clinic’s population, promoting development of antibiotic resistant bacteria. Antibiotics are widely available in Mexico and may be sold illegally in the United States without a prescription. This project’s purpose is to identify social risks and opportunities for antibiotic education. A telephone survey was administered to patients at least 18 years of age. The 32-item survey included a demographic questionnaire created for this project, the PRAPARE social determinants of health questionnaire, and the Eurobarometer antimicrobial resistance questionnaire. Any social risks identified were forwarded to clinic staff for referral. The survey was completed in English or Spanish, per the participant’s preference. A total of 20 surveys were completed. Low education level and unemployment were the most common social risks identified. Spanish language, housing and food insecurity, and difficulty meeting basic needs were associated with overall higher social risks. An antibiotic knowledge gap was identified, and self-medication with antibiotics was confirmed as a behavior within the population. Although no determinants for antibiotic misuse were identified, all participants indicated preference for provider-based education. This FQHC has an opportunity to develop a provider-based educational intervention. The length of the survey and the telephone format, required due to COVID-19 restrictions, were significant limitations, impacting recruitment. Further research is needed to determine the most effective way of delivering education. The clinic is continuing to administer the PRAPARE survey, expanding data on social risks.
ContributorsMiranda, Sarah (Author) / Tharalson, Erin (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-28