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Theses & Dissertations: Health Services Research, Administration, and Policy

Theses/dissertations from 2023 2023.

Factors Associated with the Difficulty of Computerized Tasks Among Office-Based Physicians in the United States , Khalid Alshehri

Reducing Oral Health Disparities: Effectiveness of Preventive Dental Care on Treatment Use, Expenditures and Determinants of Service Utilization , Rashmi Lamsal

'The Very Structure of Opportunities Has Collapsed': How Taxation Policies Enhance, Decay, and Otherwise Affect the Distribution of Health & Health Services in the United States , Valerie Pacino

An Exploration of Policies, Equity, and Emerging Threats to the Traffic Safety Environment in the U.S. , Sachi Verma

Theses/Dissertations from 2022 2022

The State of Oral Health in People with Disabilities and the Impact of Family-Centered Care on the Oral Health of Children with Special Health Care Needs , Bedant Chakraborty

Theses/Dissertations from 2021 2021

The Ecology of Mental Health and the Impact of Barriers on Mental Health Service Utilization , Alisha Aggarwal

Health Service Utilization and Expenditure in Cardio-Metabolic Conditions in the United States Adults , Kavita Mosalpuria

Impact of Prescription Drug Monitoring Program on Drug Misuse and Drug-related Fatal Vehicle Crashes , Moosa Tatar

Theses/Dissertations from 2020 2020

Essays on rehospitalization under the Hospital Readmission Reduction Program , Yangyuna Yang

Theses/Dissertations from 2019 2019

Impact of Healthcare Delivery and Policies on Children's Outcomes after the Affordable Care Act of 2010 , Shreya Roy

Examining the Effects of Approaches on Reducing Hospital Utilization: The Patient-Centered Medical Home, Continuity of Care, and the Inpatient Palliative Consultation at the End-of-Life , Xiaoting Sun

Theses/Dissertations from 2018 2018

Essays on the Patient-Centered Medical Home in the United States Military Health System , Glen N. Gilson

A Multi-Level Assessment of Healthcare Facilities Readiness, Willingness, and Ability to Adopt and Sustain Telehealth Services , Jamie Larson

Healthcare Utilization for Behavioral Health Disorders: Policy Implications on Nationwide Readmissions, and Outcomes in the States of Nebraska and New York , Rajvi J. Wani

Theses/Dissertations from 2017 2017

Structural violence and gender-based violence in the United States , Sarbinaz Z. Bekmuratova

Community Benefits Spending by Private Tax-Exempt Hospitals in the U.S. , Wael ElRayes

Patient-Centered Medical Home Adoption in School-Based Health Centers , Abbey Gregg

Meaningful Use of Electronic Health Records for Population Health Management in U.S. Acute Care Hospitals , Niodita Gupta

Hospital Based Emergency Department Visits With Dental Conditions: Outcomes and Policy Implications in the States of California, Nebraska and New York , Sankeerth Rampa

Theses/Dissertations from 2016 2016

Adoption of Medication Management Technologies by U.S. Acute Care Hospitals after the HITECH Act , Aastha Chandak

The Impact of Electronic Health Records on Healthcare Service Delivery, Patient Safety, and Quality , Kate Elizabeth Trout

Essays on Immigration-Related Disparities in Health Behavior and Health Care Utilization , Yang Wang

Theses/Dissertations from 2015 2015

The Impact of Gasoline Prices on Medical Care and Costs of Motor Vehicle Injuries , He Zhu

Theses/Dissertations from 2014 2014

Provision, cost, and quality of robot-assisted radical prostatectomies in the United States , Soumitra Sudip Bhuyan

Organizational factors associated with the implementation of evidence-based public health interventions in local health department settings , Janelle J. Jacobson

Hospital cost shifting in the United States , Tao Li

Patient-centered medical home readiness in the veterans health administration: an organizational perspective , Anh T. Nguyen

Organizational and environmental correlates of electronic health records implementation and performance in acute care hospitals in the United States , Diptee Ojha

Assessing geographic variation and migration behaviors of foreign-born medical graduates in the United States , Samuel Tawiah Yaw Opoku

Theses/Dissertations from 2013 2013

Organizational and environmental correlates of strategic behavior and financial performance in the US hospice industry , Bettye Appiah Apenteng

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Health systems management and health sector reform

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• The Use of Clinical Practice Guidelines to Improve Provider Performance of Well-Child Care in Armenia
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• The Perception of Quality Among Users of Commune Health Centers and Users of Private Providers in Northern Vietnam

Health financing

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• Evaluating the Effectiveness of User Fee Increase in Improving The Quality of Care: Government Primary Health Care Services in Indonesia
• The Impact of Community-Based Health Insurance on Health Care Utilization and Financial Sustainability: The Example of Rwanda
• Impact of Health Insurance on Health Care Utilization in Vietnam
• Stimulating Demand:  An Assessment of the Conditional Cash Transfer Project in Afghanistan

Health policy and resource allocation

• Exploring Attitudes and Perceptions of Policymakers and Health Researchers Towards Evidence-Based Health Policymaking in Argentina: A Mixed Methods Approach
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Maternal, neonatal and child health

• Antenatal and Delivery Care in Afghanistan Knowledge and Perceptions of Services, Decision Making for Service Use, and Determinants of Utilization
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• An Assessment of Maternal Health Service Needs of Immigrant Women Living in East Calgary, Canada
• Health Seeking Behavior of Women and Their Families During Pregnancy, Delivery and Postpartum Period in Nepal

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Equity and fairness in distribution of health services

• Gender and Access to DOTS Program (Directly Observed Treatment, Short-Course) in a Poor, Rural and Minority Area of Gansu Province, China
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• Gender, Empowerment, and Women's Health in India: Perceived Morbidity and Treatment-Seeking Behaviors for Symptoms of Reproductive Tract Infections among Women of Rural Gujarat
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• The Effect of Contracting for Health Services on the Equity of Utilization and Out-of-Pocket Health Expenditure in Rural Afghanistan

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• Economic Evaluation of the Costs and Cost-Effectiveness of the Diarrhea Alleviation through Zinc and Oral Rehydration Therapy Program at Scale in Gujarat, India
• The Economics of Non-Communicable Diseases in Rural Bangladesh: Understanding Education Gradients in Mortality and Household Wealth Impacts from an Adult Death

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• Measuring the Burden of Disease: Introducing Healthy Life Years
• Measuring the Burden of Injuries in Pakistan Epidemiological and Policy Analysis
• Strengths and Limitations of Population-Based Health Surveys in Developing Countries: A Case Study of National Health Survey of Pakistan: 1990-94
• Approaches to Measuring Non-Fatal Health Outcomes: Disability at the Iganga-Mayuge Demographic Surveillance System in Uganda
• A National Burden of Disease Study for The United Arab Emirates (UAE): Quantifying Health Differentials Between Nationals and Migrants

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• The Effect of Private Managed Care on Medicaid Spending and Fiscal Predictability
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• The Demand for Preventive Activities and its Association with Medicare Expenditures
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• Generic Pharmaceutical Entry via Paragraph IV Certification
• Precautionary Savings to Manage Common Health Risks Among the Poor
• The Impact of Medical Spending Growth on Guaranteed Renewable Health Insurance
• The Effect of Publicized Hospital Charges on Hospital Choice
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• The Effect of Specialty Tier Placement on Enrollment and Utilization in Medicare Part D.
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• Changing Activity and Behavior of Primary Care Physicians Following Practice by Academic Medical Centers
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• Economic Determinants and Consequences of Physical Activity
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• Organizational Form and Niche Overlap: The Dynamics of Surgery Center Entry and Exit
• Is More Necessarily Better? The Impact of Prescription Drug Coverage on Clinical Outcomes in the Medicare Population
• The Impact of Physical Activity on Short-Run Healthcare Utilization and Costs in US Adults
• Perception, Selection and Performance: Hospitals’ Adaption Strategies
• Creative Value in Pharmaceutical and Biotechnology Research: The Role of Resource Allocation and Capabilities Development
• Patent Policy and Entry: Evidence form Pharmaceutical Patent Challenges
• The Formation of Surgeon Peer Reputation and its Effect on Technology Adoption
• Understanding the Role of Genetic Factors and Risky Health Behavior on Adolescent Student Outcomes
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• Analysis of Acquisitions by Medical Device Manufacturers
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• Medicare and Prescription Drug Coverage: Impacts on Non-Drug Medical Spending and Disability
• The Impact and Response of Physicians to Malpractice Liability Claims
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• The Adoption and Diffusion of Hospital Information Systems
• Firm Ownership Form and Quality: An Examination of the Impact of the Balanced Budget Act of 1997 on Hospitals
• Responses to Mortality Report Cards for Cardiac Surgery
• Educational Programs As Incentives to Students for Selecting Dental Schools of Their Choice
• The Value of Choice in Health Insurance Purchasing
• Price Regulation, Capital Market Imperfections, and Strategic R&D Investment Behavior in the Pharmaceutical Industry: Consequences for Innovation
• The Impact of CABG Report Cards on Racial Disparities

1999 – 2002

• Community Rating and Regulatory Reform in Health Insurance Markets
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1996 – 1998

• Do Relative Fees Affect Utilization of Surgical Procedures Under Medicare? A Study of Geographic Variations
• Technology Diffusion of Marketed and Unmarketed Products: Addressing the Social Welfare of Promotional Restriction and Positive Reimbursement Policy for Off-Label Anti-Cancer Drugs
• The Impact of Internal Structural Changes on Hospital Costs
• Environmental Turbulence, Organizational Capabilities and Strategic Response: Hospital Strategy in an Era of Managed Care
• Role of Functional Status in Predicting Inpatient Mortality with AIDS
• How Parent’s Schooling Affects Child Health: The Importance of Quality Time

1992 – 1995

• A Theory of Congestion in General Hospitals
• An Analysis of the Effect of Changes in Coinsurance Rates on Health Care Use and Cost
• The Effects of Alternative Third Party Reimbursement Systems on the Adoption and Diffusion of New Medical Technologies
• Hospital Pricing and Organizational Control: The Effect of Government Payment Changes on Hospital Prices
• A Theory of Incentives for Providers: Payment Systems, Quality of Services, and Consumer Information in Health Care Markets
• Productive Efficiency and Cost-Effectiveness of Public-Funded Drug Treatment Programs in New Jersey

1987 – 1991

• A Theoretical and Empirical Study of Physician Compensation Arrangements
• The Effects of Liability on the Practice Patterns of Obstetricians and Gynecologists
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• Consumer Discount Rates for Health and Money in Health Care Cost Effectiveness Analysis
• The Extent and the Determinants of Variations in Nursing Home Staffing and Practice

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Exploring the thesis experience of Master of Health professions education graduates: a qualitative study

Leslie skeith.

1 Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Canada

Heather Ridinger

2 Department of Medicine, Vanderbilt University Medical Center, USA

Sushant Srinivasan

3 Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, USA

4 Department of Otolaryngology, Head and Neck Surgery, New York University School of Medicine, USA

Nazih Youssef

5 Department of Surgery-Urology, Lebanese American University, Lebanon

Ilene Harris

6 Department of Medical Education, University of Illinois College of Medicine, USA

To explore the thesis experience of recent Master of Health Professions Education (MHPE) graduates in the University of Illinois at Chicago (UIC) program.

This is a qualitative case study exploring the experience of MHPE graduates between 2014 and 2016 (n=31). Using convenience sampling, all graduates with an email address (n=30) were invited to participate in an online survey and semi-structured interviews. Interviews were completed in-person or via telephone or video conference; interviewers collected detailed notes and audio recordings.  Two authors independently analyzed the data iteratively using thematic analysis and discrepancies were discussed and resolved.

Survey results (n=20, 67%) revealed an average graduation of 5.1 years; 10 graduates (33%) were interviewed. Three themes related to the thesis experience were identified: success factors, challenges, and outcomes. Success factors, when present, promoted completion of a thesis; these included: a supportive program environment, time management, available resources, MHPE foundational coursework, aligning theses with career goals, and identifying a project with limited scope. Challenges made thesis completion more difficult for graduates; these included: institutional factors, personal or professional responsibilities, burnout, externally-imposed deadlines, and barriers in the research process. Despite these challenges, completing the thesis resulted in many professional or personal benefits (outcomes).

Conclusions

Multiple success factors and challenges were identified in the master’s thesis process among MHPE graduates at UIC. These findings can help students conducting education-based scholarship through the master’s thesis process. This study also informs program evaluation and improvements and outlines personal and professional outcomes of completing a master’s thesis.

Introduction

There is a growing expectation and need for health care professionals interested in medical education to obtain advanced qualifications and pursue education-based research scholarship. 1 - 4 While there are known barriers to training clinician scientists, 5 little is known about the challenges that Master of Health Professions Education (MHPE) students face when planning and conducting education-based research. By better understanding the MHPE students’ experience when completing education-based research, programs can target interventions to better support the development of future medical educators and scholars.

Training for an academic career in medicine can be challenging. Barriers to clinical research training include how best to integrate clinical training and research, lack of protected time, insufficient infrastructural support for trainees in the research environment, and lack of mentorship. 5 - 9 Practicing medical educators involved in scholarship describe additional challenges such as balancing multiple educator roles, having less well-defined career paths, limited funding for education research, and the emphasis placed on research productivity in academia over other educator roles such as teaching. 1 , 2 , 4 , 10

Little is known about the barriers that health care professionals face in education-based scholarship as they complete advanced degrees. Students enrolled in advanced MHPE training programs are unique, and often come from a variety of clinical backgrounds with a varying amount of experience in medical education and research training. Learning to conduct education-based research and balancing the ‘day job’ of being a current educator poses unique challenges.

A thesis or research component of an MHPE program is often one of the first exposures that MHPE students have to conducting rigorous education-based research and thus presents an opportunity to observe the successes and challenges that may arise. A master’s thesis project can provide students with the opportunity to synthesize, extend, and apply the knowledge and competencies they have developed during the program, with faculty guidance and mentorship. 3

The purpose of this qualitative case study was to explore the master’s thesis experience of recent graduates of the University of Illinois at Chicago (UIC) MHPE program. The UIC MHPE Program is one of the most established master’s and doctoral programs in health professions education. The UIC MHPE program offers both online and in-person core and elective MHPE courses and includes a master’s thesis research project that is required to complete the program. The master’s thesis is designed for experiential learning opportunities with education-based research and scholarship. Unfortunately, not all students who are accepted into the MHPE program can successfully complete the thesis and thus time to graduation is significantly prolonged or progress halted.  Not all MHPE programs require a master’s thesis and therefore, a deeper understanding of benefits and barriers to master’s thesis completion among working health professions education students within the UIC MHPE program will not only benefit the UIC MHPE program. However, they can evaluate the characteristics and skills that result in successful completion of a master’s thesis among working health professions education students. Therefore, the primary purpose of this qualitative case study is to explore the thesis experience of recent Master of Health Professions Education (MHPE) graduates in the University of Illinois at Chicago (UIC) program. The results of this study can inform similar programs about the benefits and challenges of incorporating a master’s thesis graduation requirement to support, train and graduate future medical educators and scholars.

Study design and participants

An intrinsic case study inquiry design was chosen to evaluate the unique situation among graduates of the MHPE program. This study format using semi-structured interviews focuses on understanding details of a case to allow for an in-depth exploration of complex issues. 5 A convenience sample of all UIC MHPE graduates who defended their thesis project between 2014 and 2016 was included (n=31). All graduates with an available email address (n=30) were emailed with a request to participate in an online survey and semi-structured interviews. The UIC MHPE thesis process involves developing a pre-proposal outlining a proposed research project, selecting a thesis committee (2-4 UIC and/or local faculty members to advise on the research process), refining the thesis proposal with the thesis committee, conducting the research, and presenting the thesis in an oral defense followed by written submission in the form of a journal manuscript. The online survey collected demographic information including MHPE enrollment and completion dates, thesis committee members, and publication information. Thesis publication information was supplemented by a literature review.

Graduates who agreed to participate in the online survey (n=20, 67%) were informed that all data would be collected and stored anonymously, and that data would be used in aggregate form by graduating cohort. Graduates who agreed to a semi-structured interview (n=10, 33%) were notified of the study objectives and practices and agreed to audio recording prior to participation. The study was deemed to be minimal risk since participants were former students and the study was being conducted by current MHPE students rather than faculty who could have had undue influence or whose involvement may have elicited social desirability bias. The study was approved by the University of Illinois Chicago Institutional Review Board (IRB).

Data collection method

The 7-item online survey was designed to collect demographic information about graduates, including the time to graduation, whether the thesis project was published, the number and composition of thesis committee members. It was an anonymous online survey open to any graduate whether or not they agreed to an interview. The semi-structured interviews were conducted in person or via telephone or video conference and were on average 30-60 minutes in length. All interviews were audio recorded. Interview questions (23 items) were developed based on a methodological conceptual framework of the components of thesis completion: 1) selecting a mentor, 2) developing a research question and scope, 3) selecting a research design, 4) navigating the ethics approval process, 5) collecting and analyzing data, 6) writing the manuscript, and 7) defending the thesis. The five interviewers were enrolled MHPE students at the time of the study. As such, interview questions reflected the investigators’ collective inquiries regarding the thesis process. Investigators took detailed notes on a standard interview form during the interview, supplemented the notes, and checked for accuracy by listening to the audio-recordings immediately following the interview to ensure that all ideas were recorded, at which time direct quotations were transcribed verbatim.

Data analysis

Notes from the interviews were independently analyzed by two investigators (LS, HR) with qualitative analysis experience using a thematic analysis methodology based on an iterative inductive analysis design. 11 The dataset was comprised of interview notes and audio recordings from each interview. Two investigators independently read the interview notes to generate a list of initial themes. These themes were discussed, and a coding scheme and common definitions were developed. The investigators then re-read and coded the interview records independently, returning to discuss any discrepancies, add subthemes and revise the coding scheme based on a process of constant comparative analysis. 12 Comparative analysis was performed, and discrepancies were resolved through discussion and reference to relevant quotations and audio-recordings when necessary. All data were collected and stored online in a shared folder to allow all investigators or auditors to examine for dependability. This process continued until thematic saturation was obtained and the dataset had been thoroughly discussed and coded. Themes and subthemes were reviewed and discussed with the remaining investigators, which served as a means of member checking to ensure that the final themes were representative of the interviews that each investigator had conducted.

Results from the online demographic survey (n= 20, 67% response rate) are presented in Table 1 . The mean time from MHPE enrollment to graduation was 5.1 years (range of 2-10). Students’ thesis committees were comprised of a mean of 3.25 members (range of 3-5), and 77% of students' committees included a supervisor from the students’ home institution. Over a quarter of recent graduates had already published their thesis work in a medical education journal.

* Data was based on program information or a literature search for published manuscripts (n=31)

‡ Data based on survey respondent information (n=20)

Three major themes were identified from the thematic analysis, each with multiple subthemes: (1) Success Factors – factors that, when present, facilitated the thesis process and when absent seemed to hinder the thesis process; (2) Challenges - difficulties with the thesis process; and (3) Outcomes - professional or personal benefits gained from thesis completion. Each theme was mentioned by all the interviewed graduates although the subthemes varied in prevalence.

Success factors

All interviewed graduates commented on one or more of the success factors that helped them succeed in completing their master’s thesis and results with representative quotes are presented in Table 2 . Several success factors were identified that supported student progress toward successful thesis completion when present and, when absent, hindered student progress. Subthemes include a supportive program environment; time management strategies; use of available resources; MHPE coursework as a foundation; aligning their thesis topic with career goals and developing a specific research question with limited scope.

Supportive program environment

Mentorship was the most critical success factor described by all graduates in providing guidance and enriching the experience. Two (10%) graduates described a failed mentorship experience before they were able to succeed with another mentor(s). When selecting thesis committee members, the majority of graduates (90%) considered personal qualities in addition to content expertise. Half of the graduates communicated with a central advisor before deciding on a thesis topic and committee members; one member of the MHPE faculty who was endearingly described as the “faculty mom” provided support and guidance to MHPE students throughout the thesis process. Graduates described feeling a sense of family and collegiality with the mentors, peers and administrative staff who had helped them succeed. The thesis defense was viewed as a "celebration" of their accomplishments, rather than a cause for concern.

Time management

Seven graduates (70%) mentioned time management as an important aspect of their success. Six graduates (60%) described external accountability, either to committee members or through peer support, as a success factor. Graduates commented that deadlines imposed during coursework were helpful; however once it came to the thesis, “the lack of external deadlines was a huge problem” (No.6, male, 2016 graduate). Students described wanting some form of accountability. As one student commented, “I wish I had set up either a mentor or committee to have more accountability. I think they needed to be more “in your face” and set aside time in my calendar for scholarship” (No.6, male, 2016 graduate).  Students also described techniques for managing their own time. One student used a series of Gantt charts to manage time gradually throughout the year and another set aside vacation time to write the manuscript. Other students sought accountability to each other by having a “thesis buddy” who helped them stay on track.

Use of available resources

The resources that students used to aid in their thesis completion tended to be simple, widely-available resources such as Microsoft Excel and Word, and Google. One student commented about keeping data analysis simple:

“Sometimes a big kitchen table and a bunch of sticky notes can be just as effective [as coding software]”. (No.10, female, 2016 graduate).

Interestingly, 40% of graduates secured a grant, often a small sum of money from their home institution, to buy supplies or recruit participants. Obtaining a grant is not required. However most (90%) graduates used some hired or volunteer help. Half of the graduates mentioned seeking out a prototype to understand the process and aid in their thesis completion, whether attending a thesis defense or using a competed thesis as a “worked example.”

The importance of MHPE coursework as a foundation

The majority (90%) of graduates felt that their coursework

positively contributed to thesis preparation. One student commented:

“One of the biggest things that I learned from MHPE was the idea of the conceptual frameworks and how to not just describe what you did but also how to elevate it and to contribute it to the literature”. (No.2, female, 2014 graduate)

The importance of idea generation during the MHPE coursework and using “every course to build your thesis” (No.4, female, 2016 graduate) was described.

Aligning thesis topic and research question with career goals

Half of the graduates (5, 50%) perceived that the thesis experience would help them to achieve their educational goals and were motivated to make the thesis meaningful in their personal or professional development. A smaller percentage of graduates (4, 40%) used the thesis experience to jumpstart research careers by becoming a content expert; fewer (2, 20%) felt that the thesis was practical (or required) for their job responsibilities. Interestingly, when deciding on a research question, the majority of graduates (6, 60%) chose research topics based on the practicality and applicability to their work, to make the thesis “count twice.”  Others chose their research question based on project feasibility (2, 20%) or as a challenge to learn new methodologies (3, 30%).

Developing a specific research question with limited scope

Limiting the scope of the thesis research project was an outstanding success factor described by the majority of MHPE graduates. Although they often didn’t realize it until the project was underway, five of the graduates (50%) admitted to starting with a research design scope that was too broad. With the help of mentors, all of these graduates narrowed the scope in some way to successfully complete the thesis. As one student commented,

“I wish I’d have known it could have been smaller. I didn’t have to do everything in one fell swoop. [Georges] Bordage always says, ‘small is beautiful.’ Try to take the first bite of the donut, not shove the whole thing in. I think that would have been liberating. I agonized a lot about coming up with something that was huge and ambitious”. (No.9, female, 2015 graduate)

Several challenges that MHPE graduates experienced that stalled the thesis process included: institutional factors, personal or professional responsibilities, burnout, externally imposed timelines and frustrations with the overall research process.

Institutional factors

Institutional factors, such as institutional policies at either home institutions or UIC led to frustrations in 70% of graduates. Interestingly, 5 (50%) found the IRB process easy, 3 (30%) found it difficult and 2 (20%) had a mixed experience with the UIC and home institution IRB. One common frustration was the UIC thesis formatting policies, as one student described,

“Crossing your T’s and dotting all your I’s… that was annoying! That felt like busywork. [The thesis manual] has not been updated in years, so it has instructions for using a typewriter. I had PDFs and trying to put them in there was frustrating. That had NEGATIVE educational value”. (No.6, male, 2016 graduate)

Still, other graduates describe lack of local faculty support (3, 30%) or lack of funding (1, 10%) as challenging.

Professional or personal responsibilities

Work responsibilities were the most common reason (4, 40%), outside of the research itself, that led to taking longer for thesis completion. As one student commented,

“The minute they got word I was interested in [medical education], suddenly I was on every committee and being asked to participate. That’s what drowned me, [and] why I couldn’t get the thesis done. There is a lot of hunger for people with expertise in medical education in medicine right now... so be careful about what you say yes to”. (No.8, male, 2016 graduate)

Other graduates (3, 30%) described personal or family responsibilities as obstacles for completing the thesis in the timeline that they had originally intended. One student describes thesis completion after maternity leave:

“The biggest barrier is once you are back in your normal life it’s not on top of your priority list”. (No.2, female, 2014 graduate)

Two graduates (20%) felt a sense of burnout after completing the coursework, which stalled their thesis progress for lack of motivation. Still others (3, 30%) commented that they had short external deadlines to meet that required them to complete the degree quickly, such as starting fellowship or a new job. While graduates viewed these situations as challenging due to burnout, they typically did not struggle with time management compared to graduates who had no such external deadline.

Research process

Many (7, 70%) graduates described at least one frustration or challenge with the research process, including recruitment, data collection and analysis and project feasibility. The most frequently expressed challenge within research was data collection and recruitment of participants (4, 40%). Skills learned through coursework mitigated some of these challenges.  One student commented that her data analysis was so difficult that she “could have taken [the] stats course for the time it took [her] to figure out Excel” (No.9, female, 2015 graduate). Thirty percent (3, 30%) of graduates found manuscript writing difficult; some were graduates whose first language was not English. Others found that manuscript writing was the easiest component (6, 60%) of the thesis process, in part due to the preparatory work of the pre-proposal and proposal documents. 

Graduates reported several important outcomes as result of successfully completing their MHPE thesis. Forty percent of graduates were promoted or took on new responsibilities during the program that they directly attributed to the MHPE program or thesis component. Of the 31 graduates, 26% (8/31) have successfully published their theses in peer-reviewed journals. While none of the ten graduates had published their thesis, the majority (8, 80%) were in the process of revising for submission to a journal or had intentions to publish. As one student commented,

“I will consider it a personal failure if I don’t publish it!” (No.6, male, 2016 graduate)

Other positive aspects of the thesis process included receiving respect and recognition (4, 40%), networking opportunities (5, 50%), self-confidence (7, 70%) and a sense of completion (5, 50%).  The majority of graduates (8, 80%) describe being able to apply their knowledge or skills to new problems and to create scholarship opportunities as a result of their thesis and MHPE experience. As one student commented,

“I think it really forced me to apply what we learned in the coursework. It’s easy when you do the projects in the coursework, and you have to theoretically create a curriculum or theoretically create a research project. It’s really different to actually go out and do it. It was much harder, but I could do it. I really did have the tools to do this successfully from the coursework and with the right support. It was really successful. It’s amazing to me how much I’ve learned and how much I can contribute to the people I’m working with now and how they view what I’ve done as this amazing thing that gives me all sorts of expertise and credibility. I didn’t realize the influence that would have and how important it would be for my career advancement. That’s definitely the most rewarding part”. (No.2, female, 2014 graduate)

Graduates reflecting on their MHPE thesis experience identified several important success factors, challenges, and outcomes to thesis completion. Graduates felt that thesis completion, and thus their MHPE degree, influenced their promotion, led to significant networking opportunities and helped them apply principles learned within the coursework to contribute to the body of literature in health professions education, all of which earned them respect and resulted in improved self-confidence. Several success factors and challenges were also identified to prepare future MHPE graduates and foster MHPE program improvement better.

Strong mentorship, a supportive environment, and external accountability were common factors identified for successful thesis completion. When choosing a research supervisor, matching mentors' relationship styles or personal qualities may be of equal importance to matching content expertise. 13 More than one mentor is often required to assist early-career investigators. 14 Having a diverse faculty base promotes the importance of a mentorship model that can best match faculty to MHPE students’ needs. One challenge in distributive learning (distance) master’s program may be the initial thesis supervisor selection and fostering a mentorship relationship from afar. 15 A central thesis advisor may mitigate this challenge because he or she is familiar with the faculty and can facilitate pairings from a distance. One success factor for thesis completion was faculty and student camaraderie, with benefits including idea generation, sharing resources and external accountability. Giddings and colleagues report the success and positive experiences of a peer-support working group to aid in thesis completion among nursing and midwifery students. 16 Developing more formal online peer networks may improve accountability and information sharing for thesis completion.

The majority of graduates had to recalibrate their project scope and expectations with mentor assistance once they realized the scope of their initial research question. Most acknowledged that by limiting the project to one, focused research question they were able to finish the project and learn significantly during the process. Targeting mentorship during the planning stage may improve the thesis experience and outcomes.

Challenges to thesis completion included institutional factors, personal or professional responsibilities, burnout, externally imposed timelines, and frustrations with the overall research process. By using the MHPE thesis project as a case example for completing education-based research, we identified barriers that have previously been reported by practicing medical educators. Lack of institutional support for education-based research, balancing different roles and responsibilities of an educator, and lack of funding were identified challenges that are not unique to MHPE students. 1 , 2 Navigating the research process itself was daunting for some students, which has been reported among junior doctors interested in pursuing medical education, as well as among practicing medical educators. 2 , 17 While many challenges may be difficult to modify; others are potential targets for programmatic intervention. Most participants completed their project using widely-available familiar software; however, a majority required some help and/or funding to cover incurred costs. Programs could consider promoting and advertising small funding opportunities to help assist students with thesis-related expenses.

A critical aspect of the graduate thesis experience is the complex social-cultural interactions, which promote identity formation as a medical educator. 17 , 18 Completing an MHPE thesis and program is also an introduction and “transformation that comes through immersion in the medical education environment and association with mentors, teachers, and students with similar interests can be life-changing.” 3 MHPE graduates did talk about the importance of mentorship, a supportive program environment with the thesis viewed as a celebration, and the importance of building a future network of educators, which does relate to a larger community of practice that may affect their identity formation as educators. 19

Limitations

Our sample was restricted to graduates from a single MHPE program, limiting generalizability to other programs. Direct comparison to graduates from a program without a thesis component was not possible. Interviews were limited to a convenience sampling and were not selected randomly, creating the potential for selection bias. Interviewing MHPE students who have not completed the thesis could provide valuable insight into additional barriers or challenges. Potential researcher bias is also another limitation since the authors were (at the time of the study) enrolled MHPE students in various stages of thesis completion. Including data from faculty and administrators may enhance knowledge about the experience and outcomes of thesis completion. Interviewing recent graduates provides the most relevant and timely feedback; however, their experience with publishing thesis projects is limited. Future studies could elicit objective data regarding graduates’ promotion status and a number of peer-reviewed publications compared to graduates from similar programs without a thesis component.

In summary, we present a qualitative study of the thesis experience of recent MHPE graduates from an established master’s program. We found that although completing a thesis project was challenging; graduates found it instrumental in their career development as medical educators. We identified both success factors and challenges to the thesis process that may assist current and future MHPE students. Some of the challenges faced have been previously described by practicing medical educators and may play a role in future identify formation as medical educators. Medical educators or health professions education programs should consider the benefits to career development and scholarship as well as the pitfalls of requiring a thesis component within health professions education graduate programs. Programs that choose to implement a thesis requirement would be wise to include a structured program of accountability and mentorship that facilitates completion and promotes professional development.

Acknowledgments

We would like to thank the UIC MHPE graduates for participating in our study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Topics & Ideas: Healthcare

100+ Healthcare Research Topic Ideas To Fast-Track Your Project

Finding and choosing a strong research topic is the critical first step when it comes to crafting a high-quality dissertation, thesis or research project. If you’ve landed on this post, chances are you’re looking for a healthcare-related research topic , but aren’t sure where to start. Here, we’ll explore a variety of healthcare-related research ideas and topic thought-starters across a range of healthcare fields, including allopathic and alternative medicine, dentistry, physical therapy, optometry, pharmacology and public health.

NB – This is just the start…

The topic ideation and evaluation process has multiple steps . In this post, we’ll kickstart the process by sharing some research topic ideas within the healthcare domain. This is the starting point, but to develop a well-defined research topic, you’ll need to identify a clear and convincing research gap , along with a well-justified plan of action to fill that gap.

If you’re new to the oftentimes perplexing world of research, or if this is your first time undertaking a formal academic research project, be sure to check out our free dissertation mini-course. In it, we cover the process of writing a dissertation or thesis from start to end. Be sure to also sign up for our free webinar that explores how to find a high-quality research topic.

Overview: Healthcare Research Topics

• Allopathic medicine
• Alternative /complementary medicine
• Veterinary medicine
• Physical therapy/ rehab
• Optometry and ophthalmology
• Pharmacy and pharmacology
• Public health
• Examples of healthcare-related dissertations

Allopathic (Conventional) Medicine

• The effectiveness of telemedicine in remote elderly patient care
• The impact of stress on the immune system of cancer patients
• The effects of a plant-based diet on chronic diseases such as diabetes
• The use of AI in early cancer diagnosis and treatment
• The role of the gut microbiome in mental health conditions such as depression and anxiety
• The efficacy of mindfulness meditation in reducing chronic pain: A systematic review
• The benefits and drawbacks of electronic health records in a developing country
• The effects of environmental pollution on breast milk quality
• The use of personalized medicine in treating genetic disorders
• The impact of social determinants of health on chronic diseases in Asia
• The role of high-intensity interval training in improving cardiovascular health
• The efficacy of using probiotics for gut health in pregnant women
• The impact of poor sleep on the treatment of chronic illnesses
• The role of inflammation in the development of chronic diseases such as lupus
• The effectiveness of physiotherapy in pain control post-surgery

Topics & Ideas: Alternative Medicine

• The benefits of herbal medicine in treating young asthma patients
• The use of acupuncture in treating infertility in women over 40 years of age
• The effectiveness of homoeopathy in treating mental health disorders: A systematic review
• The role of aromatherapy in reducing stress and anxiety post-surgery
• The impact of mindfulness meditation on reducing high blood pressure
• The use of chiropractic therapy in treating back pain of pregnant women
• The efficacy of traditional Chinese medicine such as Shun-Qi-Tong-Xie (SQTX) in treating digestive disorders in China
• The impact of yoga on physical and mental health in adolescents
• The benefits of hydrotherapy in treating musculoskeletal disorders such as tendinitis
• The role of Reiki in promoting healing and relaxation post birth
• The effectiveness of naturopathy in treating skin conditions such as eczema
• The use of deep tissue massage therapy in reducing chronic pain in amputees
• The impact of tai chi on the treatment of anxiety and depression
• The benefits of reflexology in treating stress, anxiety and chronic fatigue
• The role of acupuncture in the prophylactic management of headaches and migraines

Topics & Ideas: Dentistry

• The impact of sugar consumption on the oral health of infants
• The use of digital dentistry in improving patient care: A systematic review
• The efficacy of orthodontic treatments in correcting bite problems in adults
• The role of dental hygiene in preventing gum disease in patients with dental bridges
• The impact of smoking on oral health and tobacco cessation support from UK dentists
• The benefits of dental implants in restoring missing teeth in adolescents
• The use of lasers in dental procedures such as root canals
• The efficacy of root canal treatment using high-frequency electric pulses in saving infected teeth
• The role of fluoride in promoting remineralization and slowing down demineralization
• The impact of stress-induced reflux on oral health
• The benefits of dental crowns in restoring damaged teeth in elderly patients
• The use of sedation dentistry in managing dental anxiety in children
• The efficacy of teeth whitening treatments in improving dental aesthetics in patients with braces
• The role of orthodontic appliances in improving well-being
• The impact of periodontal disease on overall health and chronic illnesses

Tops & Ideas: Veterinary Medicine

• The impact of nutrition on broiler chicken production
• The role of vaccines in disease prevention in horses
• The importance of parasite control in animal health in piggeries
• The impact of animal behaviour on welfare in the dairy industry
• The effects of environmental pollution on the health of cattle
• The role of veterinary technology such as MRI in animal care
• The importance of pain management in post-surgery health outcomes
• The impact of genetics on animal health and disease in layer chickens
• The effectiveness of alternative therapies in veterinary medicine: A systematic review
• The role of veterinary medicine in public health: A case study of the COVID-19 pandemic
• The impact of climate change on animal health and infectious diseases in animals
• The importance of animal welfare in veterinary medicine and sustainable agriculture
• The effects of the human-animal bond on canine health
• The role of veterinary medicine in conservation efforts: A case study of Rhinoceros poaching in Africa
• The impact of veterinary research of new vaccines on animal health

Topics & Ideas: Physical Therapy/Rehab

• The efficacy of aquatic therapy in improving joint mobility and strength in polio patients
• The impact of telerehabilitation on patient outcomes in Germany
• The effect of kinesiotaping on reducing knee pain and improving function in individuals with chronic pain
• A comparison of manual therapy and yoga exercise therapy in the management of low back pain
• The use of wearable technology in physical rehabilitation and the impact on patient adherence to a rehabilitation plan
• The impact of mindfulness-based interventions in physical therapy in adolescents
• The effects of resistance training on individuals with Parkinson’s disease
• The role of hydrotherapy in the management of fibromyalgia
• The impact of cognitive-behavioural therapy in physical rehabilitation for individuals with chronic pain
• The use of virtual reality in physical rehabilitation of sports injuries
• The effects of electrical stimulation on muscle function and strength in athletes
• The role of physical therapy in the management of stroke recovery: A systematic review
• The impact of pilates on mental health in individuals with depression
• The use of thermal modalities in physical therapy and its effectiveness in reducing pain and inflammation
• The effect of strength training on balance and gait in elderly patients

Topics & Ideas: Optometry & Opthalmology

• The impact of screen time on the vision and ocular health of children under the age of 5
• The effects of blue light exposure from digital devices on ocular health
• The role of dietary interventions, such as the intake of whole grains, in the management of age-related macular degeneration
• The use of telemedicine in optometry and ophthalmology in the UK
• The impact of myopia control interventions on African American children’s vision
• The use of contact lenses in the management of dry eye syndrome: different treatment options
• The effects of visual rehabilitation in individuals with traumatic brain injury
• The role of low vision rehabilitation in individuals with age-related vision loss: challenges and solutions
• The impact of environmental air pollution on ocular health
• The effectiveness of orthokeratology in myopia control compared to contact lenses
• The role of dietary supplements, such as omega-3 fatty acids, in ocular health
• The effects of ultraviolet radiation exposure from tanning beds on ocular health
• The impact of computer vision syndrome on long-term visual function
• The use of novel diagnostic tools in optometry and ophthalmology in developing countries
• The effects of virtual reality on visual perception and ocular health: an examination of dry eye syndrome and neurologic symptoms

Topics & Ideas: Pharmacy & Pharmacology

• The impact of medication adherence on patient outcomes in cystic fibrosis
• The use of personalized medicine in the management of chronic diseases such as Alzheimer’s disease
• The effects of pharmacogenomics on drug response and toxicity in cancer patients
• The role of pharmacists in the management of chronic pain in primary care
• The impact of drug-drug interactions on patient mental health outcomes
• The use of telepharmacy in healthcare: Present status and future potential
• The effects of herbal and dietary supplements on drug efficacy and toxicity
• The role of pharmacists in the management of type 1 diabetes
• The impact of medication errors on patient outcomes and satisfaction
• The use of technology in medication management in the USA
• The effects of smoking on drug metabolism and pharmacokinetics: A case study of clozapine
• Leveraging the role of pharmacists in preventing and managing opioid use disorder
• The impact of the opioid epidemic on public health in a developing country
• The use of biosimilars in the management of the skin condition psoriasis
• The effects of the Affordable Care Act on medication utilization and patient outcomes in African Americans

Topics & Ideas: Public Health

• The impact of the built environment and urbanisation on physical activity and obesity
• The effects of food insecurity on health outcomes in Zimbabwe
• The role of community-based participatory research in addressing health disparities
• The impact of social determinants of health, such as racism, on population health
• The effects of heat waves on public health
• The role of telehealth in addressing healthcare access and equity in South America
• The impact of gun violence on public health in South Africa
• The effects of chlorofluorocarbons air pollution on respiratory health
• The role of public health interventions in reducing health disparities in the USA
• The impact of the United States Affordable Care Act on access to healthcare and health outcomes
• The effects of water insecurity on health outcomes in the Middle East
• The role of community health workers in addressing healthcare access and equity in low-income countries
• The impact of mass incarceration on public health and behavioural health of a community
• The effects of floods on public health and healthcare systems
• The role of social media in public health communication and behaviour change in adolescents

Examples: Healthcare Dissertation & Theses

While the ideas we’ve presented above are a decent starting point for finding a healthcare-related research topic, they are fairly generic and non-specific. So, it helps to look at actual dissertations and theses to see how this all comes together.

Below, we’ve included a selection of research projects from various healthcare-related degree programs to help refine your thinking. These are actual dissertations and theses, written as part of Master’s and PhD-level programs, so they can provide some useful insight as to what a research topic looks like in practice.

• Improving Follow-Up Care for Homeless Populations in North County San Diego (Sanchez, 2021)
• On the Incentives of Medicare’s Hospital Reimbursement and an Examination of Exchangeability (Elzinga, 2016)
• Managing the healthcare crisis: the career narratives of nurses (Krueger, 2021)
• Methods for preventing central line-associated bloodstream infection in pediatric haematology-oncology patients: A systematic literature review (Balkan, 2020)
• Farms in Healthcare: Enhancing Knowledge, Sharing, and Collaboration (Garramone, 2019)
• When machine learning meets healthcare: towards knowledge incorporation in multimodal healthcare analytics (Yuan, 2020)
• Integrated behavioural healthcare: The future of rural mental health (Fox, 2019)
• Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis (Gilmore, 2021)
• Mindfulness-Based Interventions: Combatting Burnout and Compassionate Fatigue among Mental Health Caregivers (Lundquist, 2022)
• Transgender and gender-diverse people’s perceptions of gender-inclusive healthcare access and associated hope for the future (Wille, 2021)
• Efficient Neural Network Synthesis and Its Application in Smart Healthcare (Hassantabar, 2022)
• The Experience of Female Veterans and Health-Seeking Behaviors (Switzer, 2022)
• Machine learning applications towards risk prediction and cost forecasting in healthcare (Singh, 2022)
• Does Variation in the Nursing Home Inspection Process Explain Disparity in Regulatory Outcomes? (Fox, 2020)

Looking at these titles, you can probably pick up that the research topics here are quite specific and narrowly-focused , compared to the generic ones presented earlier. This is an important thing to keep in mind as you develop your own research topic. That is to say, to create a top-notch research topic, you must be precise and target a specific context with specific variables of interest . In other words, you need to identify a clear, well-justified research gap.

Need more help?

If you’re still feeling a bit unsure about how to find a research topic for your healthcare dissertation or thesis, check out Topic Kickstarter service below.

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15 Comments

I need topics that will match the Msc program am running in healthcare research please

Hello Mabel,

I can help you with a good topic, kindly provide your email let’s have a good discussion on this.

Can you provide some research topics and ideas on Immunology?

Thank you to create new knowledge on research problem verse research topic

Help on problem statement on teen pregnancy

This post might be useful: https://gradcoach.com/research-problem-statement/

can you provide me with a research topic on healthcare related topics to a qqi level 5 student

Please can someone help me with research topics in public health ?

Hello I have requirement of Health related latest research issue/topics for my social media speeches. If possible pls share health issues , diagnosis, treatment.

I would like a topic thought around first-line support for Gender-Based Violence for survivors or one related to prevention of Gender-Based Violence

Please can I be helped with a master’s research topic in either chemical pathology or hematology or immunology? thanks

Can u please provide me with a research topic on occupational health and safety at the health sector

Good day kindly help provide me with Ph.D. Public health topics on Reproductive and Maternal Health, interventional studies on Health Education

may you assist me with a good easy healthcare administration study topic

May you assist me in finding a research topic on nutrition,physical activity and obesity. On the impact on children

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Dissertations / Theses on the topic 'Quality of care'

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Frankema, Sander Pieter Gerard. "Quality in trauma care systems." [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10548.

Mongado, Blair Coja. "Essays in Child Care Quality." Diss., Virginia Tech, 2007. http://hdl.handle.net/10919/26186.

Yildiz, Ozkan. "A Comprehensive Model For Measuring Health Care Process Quality: Health Care Process Quality Measurement Model (hpqmm)." Phd thesis, METU, 2012. http://etd.lib.metu.edu.tr/upload/12614318/index.pdf.

Fortune, Darla. "An Examination of Quality of Work Life And Quality of Care Within a Health Care Setting." Thesis, University of Waterloo, 2006. http://hdl.handle.net/10012/2798.

Steel, Nicholas. "National Population Evaluation Of Quality Of Health Care: Developing And Using Quality Of Health Care Indicators." Thesis, University of East Anglia, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490364.

Svartbo, Boo. "The elusive quality of health care." Doctoral thesis, Umeå universitet, Institutionen för samhällsmedicin och rehabilitering, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-96909.

Hebert, Christopher J. "Measuring Quality of Care for Hypertension." Case Western Reserve University School of Graduate Studies / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=case1231883022.

Cronsioe, Carl. "Optimization of Quality in Home Care." Thesis, KTH, Optimeringslära och systemteori, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-209671.

Kirkegaard, Amy J. "Quality Management in Primary Care Dietetics." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/420903.

Fickel, Jacqueline Jean. "Quality of care assessment : state Medicaid administrators' use of quality information." Full text (PDF) from UMI/Dissertation Abstracts International Access restricted to users with UT Austin EID, 2002. http://wwwlib.umi.com/cr/utexas/fullcit?p3077639.

Chavez, Maria Magdalena. "Improving Diabetes Care in Family Care Practice: A Quality Improvement Project." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/593612.

Flores, Cristina. "The quality of care in residential care facilities for the elderly." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3261238.

Youn, Kyung II. "ORGANIZATIONAL SLACK, EFFICIENCY, AND QUALITY OF CARE IN ACUTE CARE HOSPITALS." VCU Scholars Compass, 1995. https://scholarscompass.vcu.edu/etd/5059.

Kiessling, Anna. "Quality of care and quality of life in coronary artery disease /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-205-5/.

Habjanic, A. (Ana). "Quality of institutional elderly care in Slovenia." Doctoral thesis, University of Oulu, 2009. http://urn.fi/urn:isbn:9789514291869.

Chana, Navtej. "Quality of care amongst hospital nursing staff." Thesis, University of Oxford, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.531831.

Williams, Cynthia. "Home Care Quality Effects of Remote Monitoring." Doctoral diss., University of Central Florida, 2014. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/6383.

Jackson, Anne Margaret. "Explaining hydrotherapy outcomes : quality in health care." Thesis, University of Surrey, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.324076.

Symons, Nicholas. "Quality of care in emergency general surgery." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/18617.

Lee, Yuna Swatlian Hiratsuka. "Fostering creativity to improve health care quality." Thesis, Yale University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10633255.

Eliciting and evaluating new ideas to improve the quality of health care are important processes for health care organizations. Creativity, which refers to the generation of novel and useful ideas, is required for innovation and is valued by many organizations. Health care staff (e.g., primary care providers, nurses and medical assistants) can be an important source of creative ideas. In my dissertation, I conducted a longitudinal, mixed methods study of 220 improvement ideas generated over 18 months by improvement team members from 12 federally qualified community health centers. I also analyzed the experiences of 2,201 patients cared for by these individuals. I used data from patient surveys, quality improvement team meeting transcripts, staff surveys and wearable sociometric sensors.

Part one of this research draws on organizational theory to develop hypotheses and tests empirically the impact of creative idea implementation on patient care experiences, the relationship between idea creativity and implementation, and moderators of this relationship. Results suggest that the implementation of creative ideas is positively associated with better patient care experiences, but such ideas are less likely to be implemented. Three staff-level characteristics - more collaborative relationships, longer organizational tenure, and higher network centrality (a more central position in the organization's social network) – increase the likelihood that staff's creative ideas will be implemented. Part two of this research assesses the health care staff characteristics associated with idea creativity. The results show that staff with a peripheral perspective on care delivery (behavioral health provider and medical assistant), and staff with lower satisfaction and who have a shorter organizational tenure, are significant correlates of idea creativity. Part three of this dissertation focuses on the tactics that quality improvement leaders use to foster idea creativity, evolution, and implementation in their groups. The results suggest that the leader tactic of brainstorming is associated with groups having more creative, rapidly implemented, low-engagement ideas, which might be an effective tactic for leaders seeking disruptive change. The tactic of group reflection on process is associated with slower implemented, high-engagement ideas, which might help leaders elicit well-considered and deliberated solutions. I develop a conceptual framework for understanding creativity in health care organizations based on these findings, which may help scholars and health care professionals improve their understanding of health care innovation and how better to facilitate the expression and implementation of creative ideas.

This dissertation contributes to health services and organizational research by elucidating how creativity in health care organizations is fostered and facilitated, and how it affects outcomes. Understanding how creative ideas may improve the organization and delivery of quality care could facilitate efforts to discover and evaluate new ideas regarding the quality of health care delivery.

Mee, Jenny. "Australian home care quality : a political tango." Thesis, Federation University Australia, 2020. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/179509.

Lynch, Dorine A. "Basic Quality Care Blood Pressure Teaching Plan." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7821.

Magner, MaryBeth. "The Effects of Managed Care on the Quality of Dental Hygiene Care." TopSCHOLAR®, 1998. http://digitalcommons.wku.edu/theses/344.

Daskein, Robyn. "Nursing Documentation and Quality of Care in Residential Aged Care in Queensland." Thesis, Griffith University, 2008. http://hdl.handle.net/10072/367277.

Glover, Gloria. "Relationships Between Nursing Resources, Uncompensated Care, Hospital Profitability, and Quality of Care." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7142.

Noble, Marilynn. "Integrating Health Care Systems to Maintain Quality Care and to Manage Cost." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6851.

Wallace, Amanda. "Effects of Telemedicine in the Intensive Care Unit on Quality of Care." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1612.

Gunnarsdottir, Sigrun. "Quality of working life and quality of care in Icelandic hospital nursing." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2006. http://researchonline.lshtm.ac.uk/682349/.

English, Christine. "Judging quality : parents' perspectives of the quality of their child's hospital care." Thesis, Northumbria University, 2017. http://nrl.northumbria.ac.uk/31608/.

Senot, Claire. "Combining Conformance Quality and Experiential Quality in the Delivery of Health Care." The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1397407599.

Prater, Laura C. prater. "Advance Care Planning: Implications for Health Care Quality at the End of Life." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1534344349446923.

Parand, Anam. "The role of acute care managers in quality of care and patient safety." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/11677.

Newell, Amy Noël Abell Ellen Elizabeth. "Quality in family child care the voice of the family child care provider /." Auburn, Ala, 2009. http://hdl.handle.net/10415/1632.

Kocman, David. "Quality matters : re-formatting the boundaries of care in Czech social care policy." Thesis, University of Kent, 2013. https://kar.kent.ac.uk/47654/.

O'Connor, Pauline. "Providing quality care : exploring contextual influences and ethical issues inherent in the delivery of quality care for people with dementia." Thesis, University of Edinburgh, 2006. http://hdl.handle.net/1842/29304.

Martin, Sedeeka. "Quality care during childbirth at a midwife obstetric unit in Cape Town, Western Cape: Women and midwives’ perceptions." University of the Western Cape, 2018. http://hdl.handle.net/11394/6892.

D'Ambruoso, Lucia. "Care in obstetric emergencies : quality of care, access to care and participation in health in rural Indonesia." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=165859.

Plauché, Leneé Michele. "Eliminating waste in US health care: evaluating accountable care organizations as a model for quality sustainable care." Thesis, Boston University, 2013. https://hdl.handle.net/2144/12191.

Whiteford, Chrystal Michelle. "Early child care in Australia : quality of care, experiences of care and developmental outcomes for Australian children." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/81298/1/Chrystal_Whiteford_Thesis.pdf.

Urassa, David Paradiso. "Quality Aspects of Maternal Health Care in Tanzania." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distrubutör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4221.

Petersson, Håkan. "On information quality in primary health care registries /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/tek805s.pdf.

Ekström, Anette. "Amning och vårdkvalitet = Breastfeeding and quality of care /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-240-3/.

Murton, Catherine S. "Profiling the quality of end of life care." Connect to this title online, 2007. http://etd.lib.clemson.edu/documents/1202410105/.

Momanyi, Kevin. "Enhancing quality in social care through economic analysis." Thesis, University of Aberdeen, 2019. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=240815.

Mycroft, Matthew. "An Information System for Health Care Quality Measures." Digital Commons at Loyola Marymount University and Loyola Law School, 2016. https://digitalcommons.lmu.edu/etd/426.

Scharpf, Tanya Pollack M. S. "Functional Status and Quality in Home Health Care." Case Western Reserve University School of Graduate Studies / OhioLINK, 2005. http://rave.ohiolink.edu/etdc/view?acc_num=case1112905040.

Minich, Lisa. "Quality of Diabetes Care: Linking Processes to Outcomes." University of Cincinnati / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1291051784.

Lee, Hyang Yuol. "Quality of care: Impact of nursing home characteristics." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3352465.

Mattila, Marja-Leena. "Quality-related outcome of pediatric dental health care." Turku : Turun Yliopisto, 2001. http://catalog.hathitrust.org/api/volumes/oclc/48714198.html.

Hutchinson, Allen. "Exploring safety, quality and resilience in health care." Thesis, University of Sheffield, 2014. http://etheses.whiterose.ac.uk/6574/.

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Improving Quality of Care for Older Adults

A q&a with snigdha jain, snigdha jain, md, mhs.

When Snigdha Jain, MD, MHS , became an ICU physician, she found that two-thirds of the individuals she cared for in the ICU were older adults. She also found that illness did not end with survival and discharge from the hospital for these patients. The realization prompted her to better understand how the lives of older adults change after a critical illness.

Now committed to a career in aging research, Jain, an assistant professor of medicine in the Section of Pulmonary, Critical Care, and Sleep Medicine at Yale , recently won the American Geriatrics Society Health and Aging Foundation New Investigator Award. The honor recognizes individuals conducting new and relevant studies in geriatrics.

In an interview, Jain discusses the inspiration behind her research focus on older adults, the role of social factors in quality of care, and why people of all ages should strive to be active during hospital stays.

What inspired you to pursue research in aging?

I was interested in improving outcomes after critical illness, which matters to many older adults because they value independence and quality of life, not just survival. Older adults may be at higher risk of decline after hospitalization because of pre-existing issues such as cognitive impairment, frailty, or chronic conditions.

I didn't realize how the questions I was interested in were the mainstay of geriatric research until I was introduced to the geriatric epidemiology training program at Yale. Working with Drs. Thomas Gill and Lauren Ferrante showed me how function and cognition are measured and helped me gain the tools to ask research questions that addressed the clinical problems I was seeing.

How can we improve the quality of care for older people?

It’s important to listen to older adults, validate their concerns, and understand that they may have lingering symptoms and problems because of a critical illness. We need to provide them with all kinds of support, such as referral to a specialist or rehab. We also need to make sure that everyone, including low-income older adults, receives this support. For example, I might want a patient to go to an outpatient physical therapy center to strengthen their muscles, but the patient might not have the caregiver support or the transportation to do those things. Understanding how effective care processes, such as rehabilitation, are delivered across the continuum of care can help us design interventions to ensure equitable access and quality of care during and beyond hospitalization.

If patients are hospitalized in a skilled nursing facility or admitted to a nursing facility after staying in the ICU, as happens with a third of older adults, we need to ensure the quality of care they receive in skilled nursing can assist their recovery. It’s important to provide patients with support beyond the ICU and medical diagnostics to assist them in their journey to recovery.

What research discoveries have you made that you wish every person, regardless of age, knew?

One of my recent studies with Dr. Gill found that when many older adults leave the hospital after a critical illness, they still have symptoms like shortness of breath or fatigue within the first three months after hospitalization that restrict them to bed for more than half a day or that make them cut down their activities. We discovered that such symptoms are associated with downstream disability. How much dependence these adults develop over the next six months is linked to the symptoms that restrict their activity. If you're not moving around much, there is a possibility you’ll become more disabled down the road.

I encourage older adults and everybody who’s in the hospital to advocate for themselves about the need to be active. Being in the hospital should not mean inactivity. Studies support the value of mobilization in preserving downstream function and cognition in critically ill patients.

My research also shows that older adults with low income or limited English proficiency or those who live in rural areas are less likely to be mobilized or offered physical therapy. I hope to build on this work to advocate for systemic and policy changes to make sure everyone can get equitable access to therapy services. We need to take into account social vulnerability to improve outcomes for everyone, not just a select few.

The Section of Pulmonary, Critical Care and Sleep Medicine is one of the eleven sections within Yale School of Medicine’s Department of Internal Medicine. To learn more about Yale-PCCSM, visit PCCSM's website , or follow them on Facebook and Twitter .

• Internal Medicine
• Awards & Honors
• Pulmonary, Critical Care and Sleep Medicine

Featured in this article

• Snigdha Jain, MD, MHS Assistant Professor; Assistant Professor, Internal Medicine
• Thomas M. Gill, MD Humana Foundation Professor of Medicine (Geriatrics) and Professor of Epidemiology (Chronic Diseases) and of Investigative Medicine; Director, Yale Program on Aging; Director, Claude D. Pepper Older Americans Independence Center; Director, Yale Center for Disability and Disabling Disorders; Director, Yale Training Program in Geriatric Clinical Epidemiology and Aging-Related Research
• Lauren Ferrante, MD, MHS Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine); Director, Operations Core, Yale Claude D. Pepper Older Americans Independence Center; Student Thesis Chair, Internal Medicine

Configuration Analysis of Influencing Factors of Technical Efficiency Based on DEA and fsQCA: Evidence from China's Medical and Health Institutions

Affiliations.

• 1 School of Economics and Management, Anhui University of Chinese Medicine, Hefei, Anhui, People's Republic of China.
• 2 King's Business School, King's College London, London, UK.
• PMID: 33447109
• PMCID: PMC7802899
• DOI: 10.2147/RMHP.S282178

Purpose: This paper aims to measure the technical efficiency of China's medical and health institutions from 2012 to 2017 and outline the path to achieve high-quality development.

Methods: The DEA-Malmquist was used to evaluate the total factor productivity of medical and health institutions in 31 provinces. A fuzzy set Qualitative Comparative Analysis (fsQCA) was used for configuration analysis of determinants affecting technical efficiency.

Results: The average total factor productivity (TFP) of those institutions was 0.965, namely TFP declined averagely by 3.5% annually. The efficiency change and the technical change were 0.998 and 0.967, respectively. The realization paths of high technical efficiency are composed of high fatality rate and high financial allocation-led, high population density and high GDP-led. Low dependency ratio and low financial allocation-led, low fatality rate and low financial allocation-led are the main reasons for low technical efficiency.

Conclusion: Due to advanced medical technology and economic development, major cities like Beijing, Shanghai, and Guangdong have attracted a large number of high-level health personnel, achieving long-term and stable health business growth. Hubei, Anhui, and Sichuan also have made rapid development of health care through appropriate financial subsidies and policy supports. The technical changes in Qinghai, Yunnan, and Inner Mongolia are higher than the national average, but the operation and management level of the medical and health institutions is relatively weak. Henan, Jiangxi, and Heilongjiang have a prominent performance in the efficiency change, but the technical change is weaker than the national average.

Keywords: China’s medical and health institutions; DEA-malmquist; configuration; efficiency; fsQCA.

© 2021 Li et al.

Grants and funding

Content Search

Technical director for health service delivery, usaid/nigeria/strengthening quality of care through primary health care.

• Management Sciences for Health

Management Sciences for Health (MSH) saves lives and improves health by helping public and private organizations throughout the world to effectively manage people, medicines, money, and information. Working from more than 30 country offices and our Arlington, Virginia and Medford, Massachusetts US headquarters, our staff from 65 nations is highly regarded for its technical expertise, integrity, and commitment to making a lasting difference in health. We live our mission to save lives and improve the health of the world’s poorest and most vulnerable people by closing the gap between knowledge and action in public health.

MSH is seeking a Technical Director for Health Service Delivery (TD HSD) for a USAID-supported health program in Nigeria. The proposed program will support USAID’s approaches strengthening Quality of Care (QoC) through Primary Healthcare (PHC) with an emphasis on reproductive, maternal, newborn, and child health (RMNCH) to improve the capacity of the Federal and State Ministry of Health (F/SMOH), local organizations, and communities to deliver quality, integrated health services. Building on the achievements of current and past USAID-supported activities, MSH will work through partnerships with the Government of Nigeria, civil society, and local implementers to 1) increase resiliency, responsiveness, and accountability of the health system; 2) increase coverage and equitable access to essential primary health care interventions; and 3) work to increase the quality of evidence-based primary health interventions, toward the ultimate goal of sustainable improvements to the health status of the Nigerian population.

This position is subject to project award and funding.

OVERALL RESPONSIBILITIES:

The TD (HSD) is a member of the senior leadership team and will support the project at the central level and oversee state teams to ensure quality technical service is provided as needed. The TD HSD will provide technical oversight and direction of integrated health service delivery and technical assistance activities for quality improvement and RMNCH/FP at the facility and community levels. The TD HSD will support the program to deliver high-quality integrated health interventions and ensure that project activities align with relevant international standards and national/state policies, strategies, and plans. The TD HSD will coordinate among USAID, donors, contractors and implementers, and Government of Nigeria institutions and representatives, particularly at the national, state, and community levels, for integrated health service delivery activities. The Technical Director will supervise a team of technical advisors that will manage direct service delivery and cross cutting areas as needed in the project.

SPECIFIC RESPONSIBILITIES:

• In collaboration with the COP, ensure that the program is delivered according to donor and government policies.
• Collaborate with the Chief of Party, Director of Finance and Operations, and State Team Director and the MSH Headquarters to allocate and utilize project resources in the most efficient way and ensure effective technical, budgeting and financial management.
• Provide overall technical direction, leadership and technical expertise for the team in designing and delivering evidence-based, high impact reproductive, maternal, newborn, child health, nutrition and malaria (RMNCH+NM) services in public and private health facilities, that are responsive to the needs of the National, State and USAID.
• Support and oversee the introduction of appropriate quality improvement approaches that improves PHC service delivery.
• Provide technical advice on the integration of RMNCH+NM into established service delivery systems across service levels and life course continuum.
• Provide technical assistance and guidance on the latest health developments, publications, and other information generation activities nationwide and globally.
• Represent program at national and state level stakeholder meetings and technical working groups in relation to RMNCH+NM and related technical areas.
• Develop and regularly update detailed annual work plans and ensure the team monitors progress towards completion and achievement of program objectives.
• Coordinate project’s technical work across clinical content-specific and cross-cutting areas at the national and state levels.
• Coordinate the technical expertise of MSH and its subcontractors, which will include international, national, and local organizations (civil society, faith-based organizations [FBOs] and local partners).
• Link with technical counterparts in Federal and State Governments, Local Government Areas, Ward Development Councils, local NGOs, FBOs, and civil society to coordinate and leverage the project’s technical interventions.
• Build capacity through training, mentoring, supervision, and technical exchanges that support F/SMOH, civil society, faith-based, and local partner development.
• Supervise Technical Advisors.
• Ensure strategies are developed and implemented to increase sensitivity to gender equity and female empowerment; accountable for ensuring that gender and capacity development activities are integrated into all project activities.
• Coordinate the project’s work with the private sector.

QUALIFICATIONS

• Medical Doctor, Registered Nurse, or Midwife with a Master’s degree in public health, social sciences or related field, and 10+ years of successful experience as senior-level technical or program manager of health projects of equivalent size and complexity,
• USAID experience strongly preferred.
• Proven exceptional leadership in the design, management, implementation, monitoring, and evaluation of health programs) in Nigeria,
• Including experience in the design and implementation of large-scale programs across the national health system in Nigeria with a strong working background at the subnational level. Must have technical experience in the fields of reproductive, maternal, newborn, child health, nutrition, malaria (RMNCH+NM).
• Familiar with the national and sub-national primary health care context in Nigeria and designing and implementing activities and projects with a focus on PHC and quality of care
• Demonstrated ability to lead multidisciplinary, multicultural teams, manage complex programs and ensure that project staff adhere to the highest standards of quality, relevance, and timeliness,
• Including experience leading technical staff and consultants within a consortium of international and local subcontractors to achieve measurable results within a technically complex and integrated health program.
• Proven ability to build and maintain technical and collegial relationships with host-country (national and sub-national) government officials, civil society organizations, and international development organizations in a variety of forums where technical implementation is discussed.
• Demonstrated capacity to develop technical materials and strengthen local clinical and non-clinical capacities to improve service delivery, advocacy and resource mobilization for quality RMNCH+NM services.
• Proven ability in conflict management, team building, written and oral communication, and negotiation skills.
• Fluency in written and spoken English, and demonstrated capacity to effectively communicate and document, including the writing of quality reports and detailed analysis of strategic information. Fluency in a local language is a distinct advantage.
• Willingness to travel throughout Nigeria as necessary.

Qualified local, female candidates are strongly encouraged to apply.

How to apply

Please apply on the MSH website: https://msh.wd1.myworkdayjobs.com/en-US/External/job/Technical-Director-for-Health-Service-Delivery--USAID-Nigeria-Strengthening-Quality-of-Care-through-Primary-Health-Care_R4070?locationCountry=db69d536446c11de98360015c5e6daf6

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