Capstones: MBA in Healthcare: 2023

CARLEY, Jaida. (2023). The field of dermatology has been criticized for lacking diversity. A study from February 2020 found that dermatology is the second least diverse specialty in medicine, with 75% of providers being white (Omokha, 2021). It has also been reported that underrepresented minorities (URM) had lower match rates than white applicants in dermatology (Harvey, 2023). Leaders of many medical schools or residency programs must acknowledge the detrimental effects this imbalance can have on patient care. There has been increasing evidence that greater diversity among teams in the clinic and residency programs is associated with improved innovation, teamwork, communication, and risk assessment (Gomez & Bernet, 2019). Diversity in the National Resident Matching Program and leadership roles will benefit the field of dermatology, ensure the best possible care for patients from all backgrounds, and lead to increased revenue at University State Medical Center. Strategic use of marketing tactics and acquisition of additional funds to support skin of color research and provide leadership training to new dermatology faculty will strengthen efforts to recruit dermatologists from racially and ethnically diverse backgrounds. Broadening the diversity of the dermatology faculty at this institution will expand the ability to recruit and care for patients from all racial and ethnic backgrounds. Providing top-tier care and establishing strong therapeutic relationships between dermatologists and their patients will also establish a strong foundation for partnerships that will lead to cutting-edge skin of color research. These advances in research will promote innovation and advances within the field of dermatology that benefit all types of patients.

WILLIAMS, Shamaila. (2023). Compassion fatigue often presents as exhaustion. A nurse can be mentally and physically tired and lack empathy. Education is proposed for all nurses on the signs and symptoms of compassion fatigue and self-care strategies. The significant benefit of this training is that it may decreased hospital turnover rates, medication errors, and nurses job dissatisfaction. By implementing education and interventions, the amount of nurses experiencing compassion fatigue will decrease and this will in return decrease the amount of turnover and save the hospital money.

POFFENBARGER, Mary. (2023). Education is critical for the management of any chronic condition (Chatziefstratiou et al., 2021). In the absence of reliable information, many individuals will turn to the internet to sift through the information available there. For patients with hypothyroidism, effectively managing their thyroid hormone levels is the way to consistent relief (Winther et al., 2016), and education is the key to management (El Helou et al., 2019). Patients are less likely to have poor control of chronic conditions if they are well-informed, involved in their care, and engaged with their providers (McClure et al., 2020). Providing education in a shame-free environment can help to counter poor health literacy, which in turn can improve adherence to medication plans (Brown & Bussell, 2011). Midwestern Health System has four acute hospitals, two ambulatory centers, and 60 clinics, including a Diabetes and Endocrinology Specialty clinic. The Diabetes and Endocrinology Specialty clinic has the expertise to provide monthly 30-minute classes for newly diagnosed patients and their caregivers, as well as patients who have not had the benefit of the classes in the past or feel they need a refresher. The class will be open to the patients of the Diabetes and Endocrinology Specialty clinic and those who receive their care from a primary physician within the Midwestern Health System. At the minimum, the class provides an alternative for the patients who request referrals to specialists simply to gain information about the condition; this would save the patients and their payors the cost of the specialist and an additional blood test (personal communication, April 3, 2023). Additionally, the class has the potential to avoid the risk of uncompensated care for the population of hypothyroid patients. At a 15% reduction this could result in a loss avoidance of $312,000 for direct healthcare costs. A 5% reduction in the all-cause healthcare costs for hypothyroid patients would result in a loss avoidance of $550,000. This would be achieved with an annual cost of $5,981.76 to fund the project.

WILSON, Alyssa. (2023). Hospital-acquired pressure injuries (HAPIs) affect 2.5 million patients per year in the United States (Vitale & Dzioba, 2022). With the cost of treating a single instance as high as $70,000, the business need for prevention is apparent (Vitale & Dzioba, 2022). With low reimbursement from Medicare and other payers, this has the potential to cost hospitals millions of dollars annually; worse, if payers deem the hospital responsible for the development of the pressure injury, they are expected to assume full financial responsibility. The solution to this problem is the implementation of a pressure injury prevention care bundle. The pressure injury prevention care bundle will consist of five key components including risk assessment, skincare management, nutrition, documentation, and staff education. The bundle process will help to distinguish patients who arrived with a pressure injury, prevention measures for high-risk patients, and proper treatment for patients who developed pressure injuries while under the organization’s care. Implementation will take place across all units of all hospitals and will require the participation of multiple disciplines. The pressure injury prevention care bundle will be fully functioning in one year with a projected 50% decline in the incidences of pressure injuries. The cost for full implementation of the project is $6 million in the first year, which will be offset by the potential savings of $8 million per year.

WAYNE, Roxanne. (2023). Limited mental health resources are leaving youth and families with minimal options for treatment. In the absence of psychiatric availability, many may skip out on treatment, wait a long time for an appointment, or visit the ER several times (Abrams, 2023). About 20% of young people in the United States struggle with mental health issues, and 37% of high school students said they had mental health problems during the COVID-19 pandemic (Centers for Disease Control and Prevention [CDC], 2023). Since there are currently record low levels of access to psychiatrists in the United States, many of the mental health issues that young people face call for additional medical interventions. As a result, the range of work that school-based mental health providers must perform to treat young people through counseling is expected to continue to narrow (Weiner, 2022). To address the supply and demand gaps, the addition of an Advanced Practice Registered Nurse (APRN) to join the community-counseling program is proposed. The program will benefit from a 20% decrease in misdiagnosis and a reduction in psychiatric wait times from three to four months to five to 10 days when an APRN is strategically used. As more cost-effective and independent workers than doctors, APRNs can play a vital role in the mental health workforce by improving patient outcomes and facilitating prompt access to care. This project’s expansion improves patient outcomes, streamlines the delivery of care, and broadens the program. Future sustainability will be enhanced by the initial funding sources’ contributions to cover the estimated $126,000 in start-up costs.

KINNEY, Bethany. (2023). Due to the COVID-19 pandemic, the longevity of the bedside nurse has decreased, which has reduced the average experience level of charge nurses (Dols et al., 2021). This decline in experience has affected patient safety, nursing retention, and leadership skills within the hospital setting. To address this education gap, hospitals should create formalized charge nurse training for the nurses hired into the charge nurse role. The proposed program's goals are to utilize education to improve the retention rate of staff and charge nurses, enhance hospital patient experience scores, increase employee engagement scores, and decrease hospital-acquired conditions. The literature supports that increasing hospital educational programs will lead to a return on investment for the organization and decrease hospital quality indicators such as catheter associated urinary tract infections (CAUTIs). This educational program will be created with a multidisciplinary team to cover emergency management, communication and delegation skills, and handling demanding situations. For this program's success, it will be imperative to garner hospital leaders' continuing support. Risks to the program's sustainability include its ongoing cost and limited hospital unit staffing. It is projected that this program will cost approximately $31,000 to initiate. However, this innovative program will yield a positive return on investment and result in leaders trained within their own organization