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Healthcare Leadership Strategies during the COVID-19 Pandemic

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COVID-19 has been challenging for nearly everyone in different ways. Healthcare organizations have had to quickly change policy, modify operations, reorganize facilities, hire, and train staff to overcome COVID-19 related challenges to be able to still provide care for patients,

COVID-19 has been challenging for nearly everyone in different ways. Healthcare organizations have had to quickly change policy, modify operations, reorganize facilities, hire, and train staff to overcome COVID-19 related challenges to be able to still provide care for patients, all while being mindful of the protection of their staff. Some healthcare organizations have responded particularly well, perhaps due to preparedness, planning, or exceptional leadership in times of crisis. To explore this, we invited seven healthcare system leaders from three different organizations in Arizona to talk about how they overcame challenges at the beginning of this pandemic with effective strategies and any leadership tips they had for the future. After the interviews were conducted, the interviews were transcribed, coded qualitatively, and separated into themes and categories to analyze their answers to the questions asked. The results and conclusions included strategies such as having open and honest communication, teamwork, rapidly developing communicating policies, and widely adopting new work practices like Telemedicine, Zoom, and working at home as crucial. This report is designed to assist in aiding and inspiring future or other leaders to be better prepared for solving various challenges with other emergencies that arise in the future.

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2021-05

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Uncovering Organizational Positive Deviant Practices Influencing Low Opioid Prescribing Rates

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Over-prescription of opioid medications for chronic pain has been a major driver of the opioid abuse epidemic. Arizona has an opioid prescription rate of 50.7/100 persons annually, which is about the average US rate of 51.4/100 persons. Novel approaches to

Over-prescription of opioid medications for chronic pain has been a major driver of the opioid abuse epidemic. Arizona has an opioid prescription rate of 50.7/100 persons annually, which is about the average US rate of 51.4/100 persons. Novel approaches to treat chronic pain and reduce opioid overuse are promptly needed. Using analysis of Medicaid prescribing data from across Arizona, Mountain Park Health Center was identified to have the lowest opioid prescribing rates among all Community Health Centers (CHC) in Arizona (14.2/100 persons) using analysis of Medicaid prescribing data from across Arizona. A healthy work culture of patient engagement, behavioral health integration into primary care (BHI), and active case management of SDoH issues were critical to successful opioid prescribing and management. In order to account for the complex systemic contributors towards opioid over-prescription, the underlying theoretical framework, positive deviance (PD), was used to uncover effective practices for notably low opioid prescribing. Focus groups of interdisciplinary provider teams (physicians, nurses, pharmacists, and behavioral health) were structured around the PD inquiry approach. Participants were asked about practice and culture factors that might foster or enable low-prescribing practices. Focus group interviews were audio-recorded and transcribed. Six critical themes were identified after extensive qualitative analysis of focus group transcripts: medication management; non-opioid pain management; service integration; preventive strategies; patient and family engagement; underlying factors (including medical/behavior comorbidity and socioeconomic factors). These findings illustrate that this CHC system has a culture which values a high level of care integration, internal systems, and community partnerships to address patient social determinants of health, and patient engagement and provider norms to provide alternatives to opioid prescription. Behavioral health integration into the care team is another key aspect of the culture. Our findings, if confirmed in other settings, could be useful in planning organizational interventions and training. We anticipate that efforts to implement and spread these approaches may be effective in decreasing opioid overuse, promoting health equity by targeting CHCs with room for improvement, and informing the larger research goals: to inform practice change and opioid prescribing across Arizona CHCs.

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2020-05

The Need for Contextual Design when Creating Electronic Health Records

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Electronic Health Records (EHRs) began to be introduced in the 1960s. Government-run hospitals were the primary adopters of technology. The rate of adoption continually rose from there, doubling from 2007 to 2012 from 34.8% to about 71%. Most of the

Electronic Health Records (EHRs) began to be introduced in the 1960s. Government-run hospitals were the primary adopters of technology. The rate of adoption continually rose from there, doubling from 2007 to 2012 from 34.8% to about 71%. Most of the growth seen from 2007 to 2012 is a result of the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the American Reinvestment and Recovery (ARRA) Act. $19 billion dollars were made available as part of these two acts to increase the rate of Health Information Technology (HIT), of which EHRs are a large part. A national health information network is envisioned for the end stages of HITECH which will enable health information to be exchanged immediately from one health network to another. While the ability to exchange data quickly appears to be an achievable goal, it might come with the cost of loss of usability and functionality for providers who interact with the EHRs and often enter health data into an EHR. The loss of usability can be attributed to how the EHR was designed.

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2020-05

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Family-Centered Perspectives to Improving Care Coordination for Children with Special Health Care Needs

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It is well known that the lack of care coordination in the healthcare system causes numerous problems including cost inefficiency and inconsistent care, specifically for complex pediatric and adult patients. Many pediatric patients have complex medical and social service needs

It is well known that the lack of care coordination in the healthcare system causes numerous problems including cost inefficiency and inconsistent care, specifically for complex pediatric and adult patients. Many pediatric patients have complex medical and social service needs which can be expensive for both the patient’s parents and the general healthcare system. Therefore, it is difficult for the healthcare system to deliver the highest quality care possible, due to the number of appointments that have to be scheduled (with some being out of state), the large volume of physical health records, and overall lack of time parents have to coordinate this care while also caring for themselves and other family members. It is integral to find a more efficient way to coordinate care for these patients, in order to improve overall care, cost efficiency, and outcomes. <br/>A number of stakeholders in Arizona came together to work on this problem over several years. They were funded through a PCORI Eugene Washington Engagement grant to investigators at ASU. This project, Take Action for Arizona's Children through Care Coordination: A Bridge to Action was developed in order to further develop a research agenda and build the network (PCOR). Regional conferences were conducted in Flagstaff, Yuma, Phoenix, and Tucson, as well as a final capstone conference held in Phoenix. At these conferences, frustrations, suggestions, and opinions regarding Children with Special Health Care Needs (CSHCN) and navigating the healthcare system were shared and testimonials were transcribed.<br/>This study focused on the capstone conference. The study design was a strategic design workshop; results of the design analysis were analyzed qualitatively using descriptive content analysis. Themes described parent’s common experiences navigating the system, impacts resulting from such experiences, and desires for the care coordination system. Quotes were then grouped into major themes and subthemes for the capstone conference. After these themes were determined, the overarching goals of stakeholders could be assessed, and implementation projects could be described.

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2021-05

Social Isolation and Loneliness in Older Adults During COVID-19

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The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis

The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis used two primary data sets to draw conclusions about individuals’ subjective feelings of loneliness and isolation and to further understand what strategies were used to overcome these feelings. The results from this thesis demonstrated that individuals who successfully avoided feelings of social isolation and loneliness during the COVID-19 pandemic took up new activities, used strategies to facilitate communication, participated in community engagement, completed acts of service, practiced mindfulness and reflection, and made new connections.

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2021-12

Social Isolation and Loneliness in Older Adults During COVID-19

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For our thesis, we analyzed a set of data from the on-going longitudinal study, “Aging In the Time of COVID-19” (Guest et al., ongoing) from the Center for Innovation in Healthy and Resilient Aging at Arizona State University. This study

For our thesis, we analyzed a set of data from the on-going longitudinal study, “Aging In the Time of COVID-19” (Guest et al., ongoing) from the Center for Innovation in Healthy and Resilient Aging at Arizona State University. This study researched how COVID-19 and the resulting physical/social distancing impacted aging individuals' health, wellbeing, and quality-of-life. The survey collected data regarding over 1400 participants’ social connections, health, and experiences during COVID-19. This study gathered information about participants’ comorbid conditions, age, sex, location, etc. We presented this work in the form of a website including the traditional elements of an Honors Thesis as well as a visual essay with the data analysis portion coded with the JavaScript library D3 and a list of resources for our target audience, older adults who are experiencing social isolation and/or loneliness.

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2021-12

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pishko_fall_2021.pdf

Description

The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis

The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis used two primary data sets to draw conclusions about individuals’ subjective feelings of loneliness and isolation and to further understand what strategies were used to overcome these feelings. The results from this thesis demonstrated that individuals who successfully avoided feelings of social isolation and loneliness during the COVID-19 pandemic took up new activities, used strategies to facilitate communication, participated in community engagement, completed acts of service, practiced mindfulness and reflection, and made new connections.

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Date Created
2021-12

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honors-thesis-visualizations-presentation.pdf

Description

The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis

The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis used two primary data sets to draw conclusions about individuals’ subjective feelings of loneliness and isolation and to further understand what strategies were used to overcome these feelings. The results from this thesis demonstrated that individuals who successfully avoided feelings of social isolation and loneliness during the COVID-19 pandemic took up new activities, used strategies to facilitate communication, participated in community engagement, completed acts of service, practiced mindfulness and reflection, and made new connections.

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Agent

Created

Date Created
2021-12