Browsing by Subject "Healthcare"
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Item Borderlands curanderismo : folk healing in the Rio Grande Valley(2016-05) Azua, Anneleise Victoria; Guidotti-Hernández, Nicole Marie; Cordova, CaryThis study examines the ways the Rio Grande Valley of South Texas has been a unique haven for the Mexican and Mexican American folk healing system of curanderismo, as well as other informal approaches to healthcare. I argue that this trend in inherently connected to the emergence of Tejano identity in the Rio Grande Valley, which has deep connections to notions of sovereignty and self-sufficiency in the borderlands. My research provides a brief history of the South Texas region and the formation of Tejano identity. This identity formation is considered in relation to the multiple modes of traditional and informal healthcare practices continuously practiced in the region, despite the region’s recent surge in medical development. Further, it suggests contemporary models for community engagement and graduate medical education that, if implemented, could serve the Rio Grande Valley’s population (which is currently over 90% Latino) in innovative ways. Most importantly, this M.A. report exposes aspects of the region’s historically insufficient healthcare systems based upon one local woman’s oral history.Item Comparison Test for Infection Control Barriers for Construction in Healthcare(2013-05-06) Bassett, AimeeUnderstanding the extent of infection control measures to be taken to protect immunosuppressed and other types of patients from airborne infection agents during construction is crucial knowledge for both healthcare and construction professionals. The number of aspergillosis-related fatalities due to dust transmission during construction activity has decreased with the improvement of antifungal therapy, however the illness is particularly debilitating and the treatment is not always successful. This experimental work is the first stage in a research program to develop better dust controls for construction at existing medical facilities to reduce the incidence of dust borne fungi, such as Aspergillus spp. To better protect at-risk patients from exposure to Aspergillus spp. and other airborne fungal infections, an experiment was conducted to determine what materials can be used to create a barrier for infection control to moderate particle transmission from the construction area to the treatment area. This study investigated the relationship between construction barriers and particle transmission. A new experimental procedure and equipment simulates the transmission of disturbed dust from construction activity across a barrier. The effective of the barrier is determined from measured particle count on filter. The results show that an effective barrier manufactured from simple and readily available building supplies stops the transmission of 12-micron dust particles under a standard set of conditions. The test provides a simple and cost effective method to compare transmission rates for dust.Item Corporate responsibility as a strategic goal : open source healthcare appliances in developing countries(2010-12) Rosales, Antonio A., 1981-; Ambler, Tony; Duvic, Robert Conrad, 1947-Despite the trillions of dollars spent over the past decades on foreign aid 80% of humanity still lives on less than $10 dollars a day. There is an alarming need to deliver quality healthcare services and products to developing countries. The healthcare industry for developing countries is estimated to be $202 million and growing exponentially. However, intrinsic obstacles have prevented companies from fully deploying solutions in these countries. With the emergence of Citizen-Sector Organizations companies now have an alley to create High Value Chains enabling companies to deliver solutions to developing countries. Thereby, increasing shareholder value and increasing the living conditions of global citizens. As citizens of developing countries have better health care they are better equipped to succeed economically and consume other services and products the company has to offer. This paper discusses how an engineering manager can increase shareholder value by aligning corporate responsibility with the company’s strategic goals by leveraging High Value Chains. Specifically this paper discusses how open source methodologies can be utilized to improve healthcare in developing countries while increasing shareholder value.Item Critical processes and performance measures for patient safety systems in healthcare institutions: a Delphi study(Texas A&M University, 2004-11-15) Akins, Ralitsa B.This dissertation study presents a conceptual framework for implementing and assessing patient safety systems in healthcare institutions. The conceptual framework consists of critical processes and performance measures identified in the context of the 2003 Malcolm Baldrige National Quality Award (MBNQA) Health Care Criteria for Performance Excellence. Methodology: The Delphi technique for gaining consensus from a group of experts and forecasting significant issues in the field of the Delphi panel expertise was used. Data collection included a series of questionnaires where the first round questionnaire was based on literature review and the MBNQA criteria for excellence in healthcare, and tested by an instrument review panel of experts. Twenty-three experts (MBNQA healthcare reviewers and senior healthcare administrators from quality award winning institutions) representing 18 states participated in the survey rounds. The study answered three research questions: (1) What are the critical processes that should be included in healthcare patient safety systems? (2) What are the performance measures that can serve as indicators of quality for the processes critical for ensuring patient safety? (3) What processes will be critical for patient safety in the future? The identified patient safety framework was further transformed into a patient safety tool with three levels: basic, intermediate, and advanced. Additionally, the panel of experts identified the major barriers to the implementation of patient safety systems in healthcare institutions. The identified "top seven" barriers were directly related to critical processes and performance measures identified as "important" or "very important" for patient safety systems in the present and in the future. This dissertation study is significant because the results are expected to assist healthcare institutions seeking to develop high quality patient safety programs, processes and services. The identified critical processes and performance measures can serve as a means of evaluating existing patient safety initiatives and guiding the strategic planning of new safety processes. The framework for patient safety systems utilizes a systems approach and will support healthcare senior administrators in achieving and sustaining improvement results. The identified patient safety framework will also assist healthcare institutions in using the MBNQA Health Care Criteria for Performance Excellence for self-assessment and quality improvement.Item Designing for lived experience : a suite of tools for people with Type 1 diabetes(2014-05) Kinbarovsky, Jesse Israel; Catterall, Kate; Gorman, Carma; Stuckey, HeatherDiabetes is a chronic, patient-managed illness. Type 1 diabetics must maintain near-constant awareness of their blood sugar levels and perform frequent medical interventions in order to remain alive and healthy. Research has shown that symptoms of poor treatment adherence manifest both physically and emotionally. While a great deal has been written about, and many products designed for, treatment of physiological symptoms and outcomes, far less has been written about, and even fewer products designed to address, the emotional experience of the type 1 diabetic. Yet the emotional effects of chronic illness have been well documented, including the effects of blood glucose variation on mood (Penckofer, 2012) and increased comorbid depression among diabetics (Anderson, 2001). For my thesis project, I have created a connected system of physical and digital tools called the t1D Suite that addresses the unique emotional needs of people with diabetes, thereby bridging the gap between life-giving treatment and life-enriching experience.Item Doctor without borders : he's a physician who covers huge stretches of rural Texas -- and whose work provides key lessons about the fate and future of rural health care in America(2011-12) Garcia-Ditta, Alexa Nicole 1986-; Dahlby, Tracy; Minutaglio, BillDr. Jim Luecke, a rural family physician in Alpine, Texas, is one of six doctors responsible for thousands of patients across a sprawling 25,000 square foot remote region of the state. He is a community doctor that travels between three towns to treat patients with various illnesses, injuries and income levels. But his type of general medicine is a dying practice in Texas, especially in rural areas. Texas, with a primary care and family physician shortage likely to get worse over the next several years, faces continued obstacles in providing access to quality healthcare in some of its most isolated areas. Luecke, while he embodies some of the challenges that come with practicing rural medicine, is in some ways an exception to those challenges.Item Effectiveness of Infection Control Barriers for Construction in Healthcare(2014-08-12) Huo, JinyunAspergillosis spores enter buildings during renovation or construction. Recent research shows a causal link between new construction in existing healthcare facilities and increased infection rates in at risk patients. Aspergillosis is a dangerous pathogen that can lead to death, especially in immune suppressed patients, who are most at risk. Not all patients have the same risk level of infection, but infection control is an important step in the construction process, as the Aspergillosis spores are transmitted on dust particles, to reduce the risk of fatal infections. Infection control barriers have been largely adopted for new hospital construction at an existing facility to reduce the incidence of infections caused by construction dust borne pathogens. Previous research on construction barriers at TAMU showed that a properly placed plastic sheet barrier stopped all particle movement for a pressure differential of 105 kiloPascals measured over twenty-four hours. It is not possible to maintain a sealed barrier during all construction, although this is the most effective means of stopping dust transmission intra-building, doors are often needed to access the construction site safely. This study extends the work on the sealed barrier to introduce a small door into the sealed barrier. The door area is five percent of the wall area. The purpose of the experiment is to study the rate of particle movement, size range of one to ten microns, through the barrier with a door present under a defined set of standard air flow conditions. The door will be opened and closed at different times during the experimental period. No dust could be observed to have moved through the doorway under the present study conditions. The results show that it is not a sufficient condition to assume that measuring air exchange rates is sufficient to determine the rate of dust movement; it appears to have an air surface velocity dependence that was not studied in this research. Future research is recommended to include the air velocity movement as a variable in the study.Item Environmental color for pediatric patient room design(2009-05-15) Park, Jin GyuColor has a large impact on our psychological and physiological responses. This study examines the value of color as a component in a healing environment for pediatric patient rooms by measuring color preferences among healthy children, pediatric patients, and design professionals. Environmental satisfaction is a significant mediator between the physical environment and children?s health. Previous color preference studies have typically been done with small color chips or papers, which are very different from seeing a color applied on wall surfaces. A simulation method allowed for investigating the value of color in real contexts and controlling confounding variables. The findings of this study demonstrated that blue and green are the most preferred, and white the least preferred color, by both children and design professionals. Children?s gender differences were found in that boys prefer red and purple less than girls. Pediatric patients reported lower preference scores for yellow than did healthy children. These findings lead to color application guidelines for designers to understand color more and eventually to create better environments for children and their families.Item Health care and corporate finance(2015-12) Towner, Mitch Scott; Starks, Laura T.; Cohn, Jonathan B.; Fracassi, Cesare; Alti, Aydogan; McInnis, JohnThis dissertation examines issues in U.S. healthcare and capital structure. In the first chapter I give a brief summary of the institutional details of the U.S. healthcare sector with a special emphasis on healthcare finance. In addition to its large size, U.S. healthcare has four unique features that can be used to help answer corporate finance questions: segmented markets, variation in corporate type, extensive data requirements and recent consolidation. I explain how changes over the last 100 years have led to each of these features. Next, I delve deeper into bargaining between insurance companies and hospitals, Medicare pricing, and hospital capital structure decisions during my sample period, 2008-2012. Finally, I conclude with a brief discussion on how the Affordable Care Act has contributed to these factors. In the second chapter I use the health care industry as a novel laboratory in which to study a firm's strategic use of debt to enhance their bargaining power during negotiations with non-financial stakeholders. I show that reimbursement rates negotiated between a hospital and insurers for a specific procedure are higher when the hospital has more debt. I also show that this effect is stronger when hospitals have less bargaining power relative to insurers ex ante, and that hospitals take on more debt when they have less bargaining power using six proxies including differences in state Medicare laws to further strengthen identification. This is the first paper to provide direct evidence that debt improves a firm's bargaining outcomes.Item How organizational communication strategies and training influence healthcare employees' perception of crisis readiness(2009-05) Buck, Emily L.; Callison, Coy; Seltzer, TrentTo better understand perception of crisis readiness, 731 hospital employees were surveyed online. Employees who participated in crisis training, attended a meeting, etc., perceived themselves and their hospital to be more crisis ready. Results showed awareness of the crisis communication plan leads to higher levels of perceived crisis readiness. This research showed training, two-way communication, and face-to-face communication all lead to greater perceived crisis readiness. Unlike previous research indicated, occupation (medical personal v. administration) and time employed did not lead to differences in perceptions of crisis readiness. Participants also reported that hospitals presented crisis plans through oral presentation more frequently than any other method. This type of face-to-face meeting is also the most preferred method of communication selected by participants. The top crisis concern of hospital employees is the threat of a nurse shortage followed by a natural disaster. Finally, previous crises experience leads to higher level of perceived awareness. Findings of this study can assist hospitals and other organizations when training and preparing employees to deal with crises.Item Ill communication : designing media, preventing risks, and defining responsibility(2016-05) Gansky, Paul Alton; Kumar, Shanti; Lewis, Randolph, 1966-; Caraway, Brett; Frick, Caroline; Strover, SharonThis dissertation investigates how health risks have historically affected the design of communications media in the United States. Concentrating upon the telephone from 1888 through 1913, and the cell phone from 1970 through 2003, I explore how these media intersected with three epidemic risks: tuberculosis in the early 1900s, coronary heart disease in the 1970s, and electrosensitivity from the 1990s through 2003. At these junctures, I examine three social groups – physicians, industrial designers, and everyday users – who attempted to influence the design of phones and determine if institutions or individual citizens would primarily prevent these health risks. This dissertation suggests that due to their socioeconomic status and professional expertise, physicians and designers were most effective in altering telephones and cell phones. They subsequently framed the prevention of health risks as the responsibility of individual users. This dissertation argues that such design decisions were shaped by strong social prejudices, specifically a desire to limit communications media use among poor and ethnic minorities in the U.S., a desire to reinforce the health of wealthy white users, and a desire to centralize authority over the identification and treatment of disease, as well as the process of design. However, the individualization of responsibility pursued by physicians and industrial designers may have produced an unintended effect, helping to generate considerable fragmentation at the intersections where communications media, design, and health risks meet. This dissertation plumbs the ramifications of physicians’ and designers’ work by surveying a community of everyday media users who challenge medico-technological authority, articulating undiagnosed health risks and designing unsanctioned forms of prevention.Item Improving access to care by determining key elements of culturally and linguistically appropriate healthcare interventions for Hispanic populations in Texas using a Delphi technique(Texas A&M University, 2007-04-25) Ponder, Linda MilamCultural competence, mandated by Federal law since 1964, has not been appropriately addressed due to its lack of specifics and the lack of specifics within subsequent mandates. This study was designed to determine specific key elements of cultural and linguistic appropriateness which would "operationalize" cultural competence in the provision of healthcare services. Knowing the elements of cultural and linguistic appropriateness will assist non-Hispanic healthcare providers to remove personal barriers of cultural and linguistic differences for Texas' Hispanic population. The problem of cultural competence gained national focus during the Civil Rights movement of the '60s. Current research revealed that Hispanics continue to have the worst healthcare outcomes of any minority population. Census data reflecting that Hispanics are the fastest growing segment of the population, with Texas having the nation's second largest Hispanic population, make it imperative for healthcare providers to determine methods to improve healthcare for Texas' Hispanic population. A Delphi Technique was used to extract expert opinions from 26 highly qualified, Texas Hispanic healthcare providers regarding the key elements of cultural and linguistic appropriateness for Texas' Hispanic population. The ultimate goal of the research was to determine essential information which would assist non-Hispanic healthcare providers in removing personal barriers of cultural and linguistic appropriateness to the delivery of healthcare services for Texas' Hispanics. Through the approximately 16-month process of the Delphi Technique, the Panel produced 249 distinct elements in 11 groups of cultural appropriateness and 8 groups of linguistic appropriateness. Members of the Panel ranked the groups for importance, indicated the level of agreement/disagreement with each element, and rated each element for its individual importance. This study is important because it is the first time an expert panel of solely Hispanic healthcare providers has spoken collectively about what constitutes cultural and linguistic appropriateness. This research can provide a framework for professional practices, grant providing organizations, or evaluation teams to assess professionals and programs to determine their degree of cultural and linguistic appropriateness. The work can also form the basis for curricula to be used in Texas' healthcare professions preparatory schools or continuing education for practicing healthcare professionals.Item In the Middle: Experiencing Medicaid as a Texas Healthcare Provider(2011-08-08) Spaulding, CadeIn this study I investigate how healthcare workers, involved in the Texas Medicaid program as healthcare providers, cope with four workplace constraints. Healthcare workers are constrained by: 1) the policies and practices of the Medicaid program, 2) their own individual and professional values towards indigent care, 3) the rules and policies of their own organization and business type, and 4) the Medicaid patients with whom they interact. I use structuration theory and sensemaking to better understand how these professionals cope with these challenging constraints.Using in depth interviews of 36 private and public healthcare professionals from four unique fields of service (i.e., dental, optical, pediatric, mental health) I applied a modified grounded theory approach to understand: 1) how professionals make sense of the four Medicaid constraints described above, 2) how sensemaking strategies help or hinder professional performance, and 3) how sensemaking communication shapes professional identity and work perceptions. Healthcare workers viewed Medicaid support staff as "flippant", "rude", incompetent, unhelpful, and unreliable. However, providers believed Medicaid was equal to or better than other insurance companies for speed and reliability of payment. While they unanimously identified with providing indigent healthcare, they also clashed with the Medicaid program as a vehicle for those services. Private practices framed Medicaid as a liability while public non-profit organizations relied on Medicaid as a primary source of revenue. Providers agreed that Medicaid patients had poor follow-through, a high no-show rate, were undisciplined, and crowded provider offices with unscheduled family members. Healthcare workers enacted self-reliance as individuals, by networking with other Medicaid providers, and by relying on in-house experts. They also engaged in discursive strategies by minimizing, blaming, and detaching. They viewed themselves as disciplinarians, problem-solvers, advocates, and benefactors. Theoretically, this study develops the concept of identity regions and reframes workplace constraints as necessary identity structures. It also suggests that how Medicaid patients behave may have a more damaging impact on whether providers are willing to work with Medicaid than low reimbursement rates.Item Information technology and corporate acquisitions(2013-08) Du, Kui, active 2013; Tanriverdi, HüseyinThis dissertation examines how information technology can help acquirers to improve the performance of their acquisition targets. An acquisition creates value when the acquirer can generate more returns from the acquired business than its former owner can, a condition we call the acquirer's parenting advantage. Then, we introduce two IT-related sources of parenting advantage. Acquirers with more extensive process digitization can provide richer digitized resource to serve their newly acquired businesses, and acquirers with more related process digitization can unlock more synergies between the newly acquired and existing business units. So, as we argue, digitization extensiveness enables a digitization-revitalization mechanism for acquisition value creation, and digitization relatedness enables an integration-synergy-creation mechanism. Both mechanisms can be carried out through digital accommodation activities after acquisitions. Furthermore, the digitization gap between acquirers and targets is a major contingency for digital accommodation, with the second mechanism functioning mostly when the target has already had advanced digitization achievements. We empirically validated these hypothesized relationships by tracking the IT and performance changes in 109 U.S. hospitals before and after they were acquired, using a 7 year study timeframe.Item Motivation in Medicaid programs for promoting preventive care compliance(2012-12) Quebe, Dennis Fredrick; Lewis, Kyle, 1961-; Crawford, RichardTraditionally, the compliance rates with preventive care services for members in the Medicaid Program are significantly lower than their peers enrolled in a commercial health insurance plan even when there are no financial costs for those services to Medicaid members. Start of life services which include prenatal care for pregnant mothers and well-child visits for newborns and infants are used to focus the research. Non-compliance, defined as not receiving recommended preventive services within the timeframe expected, has large financial and societal costs. Women who receive only the minimal prenatal care are at high risk for developing pregnancy complications and having negative birth outcomes while those that failed to receive prenatal care were three times more likely to have a low-birth weight infant. Within the first 6 months of life, children with incomplete visits are 60 percent more likely to visit the emergency room. They may have untreated development delays and disabilities, which occur in approximately 13 percent of children and are estimated to cost $417,000 in direct medical costs and indirect lost productivity per child. This thesis looks at motivational theories and economic incentives in practice in the health care industry to address the lack of compliance of services. It will analyze the problem from the perspective of how does a business, the State Medicaid Program or Medicaid Managed Care Organization (MCO), get a customer, the Medicaid population, to perform a specific behavior, receive preventive care services using motivational theories.Item Patient flow optimization at Seton healthcare(2011-08) Wang, Lei, master of science in operations research and industrial engineering; Morton, David P.; Hasenbein, JohnWe analyze the patient flow of three community health clinics from the Seton group in Austin, Texas, using simulation tools. Our goal is to help the clinics find solutions to cope with increasing patient demand. Several scenarios for increasing efficiency are explored using an ARENA-based patient flow model. Multiple bottlenecks are identified and solutions are found to help the clinics minimize overall patient cycle time and to distribute the workload more evenly across the staff. This study demonstrates that healthcare service facilities may benefit from quantitative analysis, especially simulation tools, to improve their efficiency.Item Personalizing the experience : the emergence of yoga therapy(2014-05) Bertoldi, Jeana Christine; Coleman, RenitaYoga has recently been a subject of some media attention, both positive and negative. Some people advocate it for its mental and physical benefits, but others are also concerned that it might cause or lead to injury, particularly in the Western world where it's commonly seen primarily as a form of exercise. Yoga therapy emerged in part because of such concerns. Though people have used yoga to aid in health and wellness for as long as the practice has existed, the idea of yoga therapy being its own specialized field is relatively new. Yoga therapists hope to personalize the experience of yoga by working with people with various mental and physical conditions and giving them customized programs. Using quotes from professionals and people with personal yoga experience, this article explores the roots of yoga therapy, yoga itself: its praises, criticisms, science and a small sample of its plentiful history. It also addresses the definition of yoga therapy, specialties in the field, its professional organization and possibilities for the future. The question of whether yoga therapy can gain credibility and become a reliable healthcare resource has not yet been answered, though there are those who say their own personal experiences are enough to convince them one way or the other. In any case, yoga and all its various forms of practice likely won't disappear anytime soon.Item Preventing cervical cancer in rural Tanzania : a program model for health worker trainings(2015-12) Morrison, Peter Barclay; Weaver, Catherine, 1971-; Harrell, Melissa BlytheWith a focus on Northern Tanzania, this report seeks to demonstrate the need for increased resource allocation to cervical cancer interventions, examine best practices for cervical cancer screening promotion, and develop an intervention and program evaluation framework. The intervention is a training program designed for dispensary-level healthcare providers in the Northern Zone of Tanzania and aims to increase provider awareness and knowledge of cervical cancer, and build skills among providers to educate patients on cervical cancer prevention and screening and treatment resources. This report is purely a program design and planning tool; no new data was collected, nor interventions implemented in the development of report. The first objective of the report is to develop an intervention to be presented to Foundation for Cancer Care in Tanzania (FCCT) and the second is to develop an evaluation framework to be presented to FCCT. FCCT is a non-profit agency working to bring comprehensive cancer services to the region. The program will complement existing and planned services related to cervical cancer prevention and treatment in the Northern Zone of Tanzania, and will be considered for implementation by the Foundation for Cancer Care in Tanzania (FCCT). Part I of the report reviews published literature and data to demonstrate the need for increased resource allocation to cervical cancer interventions and the appropriateness of Northern Tanzania as a case selection. Part I also examines best practices for cervical cancer screening promotion in Northern Tanzania, providing evidence from the published literature to inform Part II, the intervention design and program evaluation framework. Included in the intervention design is a logic model for change, detailed training plans and curriculum, and guidelines for selecting trainers. The report recommends appointments to a local planning team and estimates a timeline and budget for the program. Additionally, the report designs a thorough program evaluation, the objective of which is to measure the effect of training and health education materials on dispensary-level healthcare providers’ awareness, knowledge, and skills regarding cervical cancer prevention.Item Privacy-aware publication and utilization of healthcare data(2014-08) Park, Yubin; Ghosh, JoydeepOpen access to health data can bring enormous social and economical benefits. However, such access can also lead to privacy breaches, which may result in discrimination in insurance and employment markets. Privacy is a subjective and contextual concept, thus it should be interpreted from both systemic and information perspectives to clearly understand potential breaches and consequences. This dissertation investigates three popular use cases of healthcare data: specifically, 1) synthetic data publication, 2) aggregate data utilization, and 3) privacy-aware API implementation. For each case, we develop statistical models that improve the privacy-utility Pareto frontier by leveraging a variety of machine learning techniques such as information theoretic privacy measures, Bayesian graphical models, non-parametric modeling, and low-rank factorization techniques. It shows that much utility can be extracted from health records while maintaining strong privacy guarantees and protection of sensitive health information.Item Social media usage in campus health communication(2012-12) Maresh, Shayla Nicole; Mackert, Michael; Love, BradThis paper seeks to understand how college health organizations use social media to communicate alcohol-related issues with its audiences, specifically universities that are recognized as “party schools” and “sober schools”. Existing literature, social networking trends, and a content analysis are applied to two communication models – the Theory of Planned Behavior and the Uses and Gratification Model – to identify how organizations can leverage social media to influence students’ behavior. The qualitative data collection will be used to provide social media communication recommendations for the University of Texas’ health service organization – Healthy Horns. These recommendations will be applied to the general healthcare field as well as the advertising industry.