Matching Items (2)
Description
This dissertation explores findings from a year-long investigation of the context-driven practices, strategies and beliefs of five multilingual Cultural Health Navigators (CHNs) working in a local pediatrics clinic serving large numbers of refugee families from a variety of cultural backgrounds who are experiencing a range of healthcare challenges. Grounded in a methodology of engagement (Grabill, 2010), this inquiry systematically documents and analyzes the range of ways in which the CHNs assist refugee families and their healthcare providers, their rationale for the decisions made and actions taken, and their concerns about the challenges they encounter. I show that while much of what the CHNs do to assist refugee families and their healthcare providers is routine and can be expected, CHNs also tend to manage complex work involved in mediating refugee families’ interactions with healthcare providers and the healthcare system in ways that cannot always be anticipated in advance. Through a close analysis of their practices and reflections, I show how their various interactions, actions and decisions are responsive to specifics of the situation at hand, informed by their lived experiences as CHNs and immigrants/refugees, and influenced by a dynamic, emergent and embodied notion of context. The findings of this study demonstrate how the CHNs’ collective and distributed knowledge production work shapes experiences with acquiring health literacy, and the material consequences of such efforts and practices.
Drawing on ethnographic research methods and critical-incident methodologies that involved the CHNs in the inquiry process, this study provides a nuanced analysis of the different kinds of work they do, the constraints they encounter, and how they creatively respond to such constraints in real time. The findings demonstrate that a collaborative engagement with critical incidents as a method of intercultural inquiry facilitates a more robust and dynamic understanding of the distributed nature of decision-making practices and ways of knowing. Embodying sensitivity to situated ways of knowing and dynamic practices in institutional settings, this study demonstrates the value of combining social science methodologies with rhetorical inquiry methods to conduct interdisciplinary and cross-institutional research to address pressing social problems in ways that benefit historically marginalized groups.
Drawing on ethnographic research methods and critical-incident methodologies that involved the CHNs in the inquiry process, this study provides a nuanced analysis of the different kinds of work they do, the constraints they encounter, and how they creatively respond to such constraints in real time. The findings demonstrate that a collaborative engagement with critical incidents as a method of intercultural inquiry facilitates a more robust and dynamic understanding of the distributed nature of decision-making practices and ways of knowing. Embodying sensitivity to situated ways of knowing and dynamic practices in institutional settings, this study demonstrates the value of combining social science methodologies with rhetorical inquiry methods to conduct interdisciplinary and cross-institutional research to address pressing social problems in ways that benefit historically marginalized groups.
ContributorsMorelli, Katherine Elizabeth (Author) / Warriner, Doris (Thesis advisor) / Long, Elenore (Committee member) / Goggin, Peter (Committee member) / Arizona State University (Publisher)
Created2018
Description
Hospital Emergency Departments (EDs) are frequently crowded. The Center for
Medicare and Medicaid Services (CMS) collects performance measurements from EDs
such as that of the door to clinician time. The door to clinician time is the time at which a
patient is first seen by a clinician. Current methods for documenting the door to clinician
time are in written form and may contain inaccuracies. The goal of this thesis is to
provide a method for automatic and accurate retrieval and documentation of the door to
clinician time. To automatically collect door to clinician times, single board computers
were installed in patient rooms that logged the time whenever they saw a specific
Bluetooth emission from a device that the clinician carried. The Bluetooth signal is used
to calculate the distance of the clinician from the single board computer. The logged time
and distance calculation is then sent to the server where it is determined if the clinician
was in the room seeing the patient at the time logged. The times automatically collected
were compared with the handwritten times recorded by clinicians and have shown that
they are justifiably accurate to the minute.
Medicare and Medicaid Services (CMS) collects performance measurements from EDs
such as that of the door to clinician time. The door to clinician time is the time at which a
patient is first seen by a clinician. Current methods for documenting the door to clinician
time are in written form and may contain inaccuracies. The goal of this thesis is to
provide a method for automatic and accurate retrieval and documentation of the door to
clinician time. To automatically collect door to clinician times, single board computers
were installed in patient rooms that logged the time whenever they saw a specific
Bluetooth emission from a device that the clinician carried. The Bluetooth signal is used
to calculate the distance of the clinician from the single board computer. The logged time
and distance calculation is then sent to the server where it is determined if the clinician
was in the room seeing the patient at the time logged. The times automatically collected
were compared with the handwritten times recorded by clinicians and have shown that
they are justifiably accurate to the minute.
ContributorsFrisby, Joshua (Author) / Nelson, Brian C (Thesis advisor) / Patel, Vimla L. (Thesis advisor) / Smith, Vernon (Committee member) / Kaufman, David R. (Committee member) / Arizona State University (Publisher)
Created2015