Paw Prints (University of Arkansas - Fort Smith)
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Assessing the Impact of Pay-For-Performance Compensation on Nursing Retention in Acute Care Settings
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.A cross-sectional analysis of current research was performed to determine the impact of pay-for-performance compensation models on nursing retention rates in acute care settings. Factors contributing to low nursing retention rates in acute care settings include low wages, a lack of proper benefits, increased workloads, burnout, and poor job satisfaction. Through this analysis, pay-for-performance compensation models are evaluated to determine their impact on nursing retention rates in acute care departments to improve current nursing retention strategies. Specifically, merit-based pay was assessed as a potential pay-for-performance compensation model that could be used as a nursing retention strategy. Patient satisfaction scores were suggested as a performance indicator for merit-based pay. A brief analysis of current nursing retention strategies has also been discussed. Alternative nursing retention strategies must be explored to improve the stability of the current nursing workforce in acute care departments and improve the organizational commitment of nurses in acute care settings.
Keywords: healthcare, retention rates, registered nurses, acute care, nursing staff, pay-for-performance, compensation, merit-based payDr. Cheryl Holden, Executive Director, Associate Professor
MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
A Contact Centers Effect on Healthcare Organizations
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.This pilot study explores the impact of healthcare contact centers on patient satisfaction, care coordination, and the use of customer relationship management (CRM) systems. With the increasing reliance on contact centers due to the growth and advancement in healthcare, contact centers provide a centralized primary contact point for patients allowing support for patient
interactions. The study conducted revealed a positive correlation between the use of a contact center and patient satisfaction, indicating that those who utilize the contact center generally encounter agent professionalism and caller satisfaction. However, no quantitative data was gathered to measure the effect of a contact center on care coordination but qualitative findings showed healthcare contact centers ability to enhance care coordination through streamlined
communication and information management. Furthermore, the integration of a CRM system is identified in this study as a key factor in improving service delivery, fostering personalized patient care, call volume metrics, and efficient processing while lessening burden on clinical staff. This paper provides insights into the role of healthcare contact centers in facilitating patient engagement and care processes, while highlighting areas for future research.Dr. Cheryl Holden, Executive Director, Associate Professor
MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
UNDERUTILIZATION OF SPIROMETRY IN COPD DIAGNOSIS: A PILOT STUDY ON HOSPITAL READMISSIONS
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration.Chronic Obstructive Pulmonary Disease (COPD) is a major contributor to hospital readmissions and healthcare costs. Although spirometry is the gold standard for diagnosing COPD, it remains underutilized in many clinical settings. This pilot study investigated the extent of spirometry use in a mid-sized hospital and its association with 30-day readmission rates. A retrospective analysis of patient data from May to November 2024 found that 62.22% of readmitted COPD patients did not have a documented spirometry test, indicating a substantial gap in adherence to diagnostic guidelines.
While the initial hypothesis proposed that a lack of spirometry would correlate with higher readmission rates, the data did not support this assumption. A surprising negative correlation (r = -0.68) was observed between the percentage of readmitted patients without spirometry and total COPD readmissions. This suggests that higher readmission volumes may coincide with increased provider responsiveness, including improved adherence to diagnostic protocols. Despite the absence of a direct link between spirometry use and readmissions, underutilization still raises concerns about misdiagnosis, inadequate treatment, and overall care quality. Interviews with hospital leadership revealed that COPD readmissions impact Medicare reimbursements under the Hospital Readmissions Reduction Program (HRRP), with potential financial losses estimated between 25,650 during the study period.
To address these challenges, the hospital has implemented provider education, policy changes, and improved tracking systems. This study emphasizes the need for systematic spirometry integration to enhance diagnostic accuracy, improve patient outcomes, and reduce financial penalties, making it both a clinical and operational priority.Dr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
REDUCING MORTALITY RATES FROM LUNG CANCER IN RURAL PARTS OF SOUTHERN ARKANSAS
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.Lung cancer remains the leading cause of cancer-related mortality in the
United States, with rural populations experiencing disproportionately high death
rates due to a combination of socioeconomic, geographic, and healthcare access
barriers. This paper explores the critical disparities in early detection and treatment
of lung cancer in rural Arkansas, where limited access to screening programs, high
smoking prevalence, and socioeconomic challenges significantly impact survival
outcomes. Through a mixed-methods approach—utilizing national data, peer reviewed literature, and expert interviews—this research identifies key factors
contributing to late-stage diagnoses and elevated mortality rates in rural areas. The
study also examines the role of healthcare deserts, cultural barriers, and lack of
healthcare literacy in screening participation. Findings support the hypothesis that
rural communities face greater challenges leading to worse outcomes, and
emphasize the need for targeted interventions, such as mobile screening units,
education initiatives, and community-based engagement strategies. Healthcare
administrators play a pivotal role in addressing these disparities through program
implementation, resource allocation, and policy advocacy. This research aims to
inform future public health strategies and promote equitable cancer care for
underserved rural populations.Dr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
Impact of Continuous Glucose Monitoring Systems on Quality of Care in Rural Communities
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.Continuous glucose monitoring (CGM) systems have revolutionized diabetes management by providing real-time glucose data, enabling more precise control of blood sugar levels. However, access to these advanced technologies remains unequal, particularly in rural America, where healthcare resources are often limited. This paper examines the impact of CGM systems on individuals with diabetes living in rural areas of the United States. It explores how these systems improve diabetes management, health outcomes, and quality of life, as well as the challenges rural residents face in accessing and affording CGM technology. Through a combination of qualitative interviews and quantitative data, this study highlights barriers such as geographic isolation, limited healthcare infrastructure, and financial constraints, while also showcasing the potential of telemedicine and community health programs to improve access. The findings suggest that while CGM systems offer significant benefits, policy initiatives are essential to ensure equitable access and maximize their impact for rural populations with diabetes.Dr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
The Relationship Between High-Stress Work Environment and Mental Health Among Healthcare Professionals
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.The state and continuous growth of healthcare cannot be ignored, especially with the recent pandemic that has occurred, there is a need to try and make healthcare more accessible while providing value of care, mental health plays a pivotal role in the effective delivery of care. Whether it is a healthcare organization or an institution of higher learning, mental health is being discussed at all levels within an organization and this paper seeks to continue that conversation by providing valuable input to the mental health discussion. This study provides insight into the impact high stress environments like emergency departments have on healthcare professionals. Further analysis also looks at the impact COVID-19 had on healthcare professionals, which played a significant role in bringing attention to frontline healthcare employees and the stressors that need to be addressed. There are numerous studies that discuss the impact of mental health on healthcare professionals but there are not many articles that focus on implementation policies to improve motivation. This research paper utilizes secondary resources to bridge the gap between the numerous mental health studies and the impact work environment improvements have on motivation. Healthcare continues to improve with emerging technologies that seek to revolutionize the way medicine is provided; healthcare professionals need to be motivated to provide effective healthcare.Dr. Cheryl Holden, Executive Director, Associate Professor
MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
GEOGRAPHICAL REGIONAL ASSESSMENT OF HOSPITAL-ASSOCIATED INFECTIONS IN PRE VS POST COVID-19 PANDEMIC
Full text linkSpring 2024 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.Nosocomial or healthcare associated infections (HAI) impact patient safety, healthcare financial performance, and quality improvement in acute care hospital settings. With a $45 billion price tag, the mission to reduce or prevent HAIs is a concern for the healthcare industry, federal and state agencies, policymakers and providers. This capstone project evaluated HAI occurrences pre (2018) and post (2022) COVID-19 to determine if implementation of the new clinical guidelines have reduced HAI occurrences in acute hospital settings. With the use of statistical analysis, geographical regional differences in standardized infection ratio (SIR) were evaluated to determine if there was a statistical significance in the mean SIRs for each region. An analysis of variance (ANOVA) was conducted to evaluate overall differences in mean SIR among the regions. In addition, pairwise comparisons between regions were performed using the Wilcoxon rank-sum test. In the analysis comparing SIRs between year for each region, Wilcoxon signed-rank test was applied. For all analysis, statistical significance was defined as p<0.05. The results indicated that HAIs occurrence have decreased since COVID-19 for some HAIs but not all infections. Future studies are needed to determine what aspect of the new guidelines played a significant role is reducing HAI and strategies to improve infection rates for HAI that showed no reduction in occurrence.Dr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
IMPROVING OUTCOMES THROUGH INTEGRATED BEHAVIORAL HEALTH FOR CHRONIC DISEASE/ILLNESS PATIENTS
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.Treatment for chronic diseases and illnesses has long been focused on management. While this approach is still necessary at times, the focus of this project is to draw attention to the potential effectiveness of ensuring that behavioral health screening and treatment are integrated into the initial diagnosis and treatment plan formation of chronic disease/illness. This integrated behavioral health (IBH) can lead to significantly improved outcomes in patients diagnosed with various chronic diseases or illnesses. The obstacles to mental health treatment are addressed as well as the potential treatment options. This project will show that improved outcomes are attainable, and in some cases, chronic disease/illness is preventable, with the aid of mental health treatment. The importance of training and education for patients and medical professionals alike is addressed as well as the potential cost savings associated with inclusion.Dr. Cheryl Holden, Executive Director, Associate Professor
MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
Psychological Effects of Bariatric Surgery and The Lack of Standardization of Psychological Evaluation and the Effects on Bariatric Patients
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.The rise of obesity has driven the uptick of major weight loss-related methods being used such as bariatric surgery. Otherwise known as weight loss surgery that has serious effects on one’s body as it involves surgically performing on one’s stomach or intestines to induce overall weight loss. With the rise in obesity and the rise of other related weight loss tools, bariatric surgery has become common for those needing to lose weight fast. As bariatric surgery does have many pros with helping obesity and being able to improve overall quality of life. Stigma still plays a role in any conversation or outlet that is related to weight loss. There needs to be more emphasis on the psychological effects of bariatric surgery and how it potentially impacts the overall success of the procedure overall. As there is more focus put on the pros such as improved mortality and reduction of obesity-related comorbidities, there is a lack of study being put on long-term effects of bariatric surgery. Being able to put focus on the psychological effects of bariatric surgery gives attention to the emotional responses that can occur when significant changes happen in one’s body and appearance after a major surgery. There needs to be conversations that focus on a patient’s pre-existing mental condition, unrealistic expectations that can occur, body image concerns, and the social impacts of weight related changes. Research needs to focus more on the long-term effects that can happen psychologically when one is obese and proceeds with this type of life altering surgery. As it can trigger complex emotional responses that could end up impacting the procedure itself along with the patient’s life if none of these preexisting or sudden mental conditions are not being addressed properly.Dr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin
The Impact of Workplace Strategies on Employee Mental Health
Full text linkSpring 2025 Graduate Project/Thesis/Capstone in Healthcare Administration. Student ID redacted.Employee well-being now depends on workplace mental health, which also affects job satisfaction, productivity, and overall organizational success. Through the use of semi-structured interviews and document analysis to evaluate employee experiences this study investigates the efficacy of workplace mental health strategies using a qualitative research methodology. Results show that tactics like leadership involvement, mental health programs, and flexible work schedules enhance workers' mental health. The widespread acceptance is restricted by issues like organization variability, lack of funding, and cultural resistance to change. The study emphasizes how important healthcare administrators are in promoting mental health policies, assigning funds, and guaranteeing adherence to mental health guidelines. Future studies should examine how these strategies affect employee retention over the long run and how new technologies can be incorporated into workplace mental health services. By addressing these issues, organizations can create a more welcoming, and encouraging workplace, which will enhance employee
outcomes and workplace.
Keywords: workplace mental health, employee well-being, leadership, organizational
engagementDr. Cheryl Holden, Executive Director, Associate Professor MHCA 6104: Graduate Project in Healthcare Administration-Faculty Dr. Jim Dockin