Queen Essays

Working Title

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Provide a concise (aim for 12 words or fewer) working title for this study. (Be sure to include your HSO type and practice-based problem.)

Addressing Workforce Shortages in Long-Term Care Facilities: Strategies for Improving Retention and Patient Outcomes.

Section 1: Practice-based Problem

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Healthcare Services Organization (HSO) Type

Long-term care (LTC) facilities are healthcare organizations that provide extended care to elderly or disabled patients requiring nursing care.

HSO Problem of Interest

The long-term care industry is facing severe workforce shortages, particularly after the COVID-19 pandemic, leading to reduced quality of care and facility closures.

Healthcare Administration Problem

In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.

A critical healthcare administration problem is the inability of long-term care facilities to attract and retain enough qualified healthcare professionals, particularly registered nurses.

Health Administration Research Domains

Which DHA research domain does your healthcare administration problem align with?

Human resource management and quality improvement.

Healthcare Administration Research Problem Justification Sources

Provide a minimum of 3 sources that clearly state in the conclusion or research findings of the published source that a healthcare administration problem currently exists.

Source 1

(Required)

Full APA Citation:

Gleckman, H., & Favreault, M. M. (2021). Reforming Long-Term Care with Lessons from the COVID-19 Pandemic.

Purpose of Research (1 sentence only):

To examine workforce shortages in LTC facilities post-COVID-19.

Author’s Conclusion or Results of Research (1 sentence only):

The study found that LTC facilities are experiencing critical workforce shortages, especially in nursing positions.

How this relates to my study (1 sentence only):

This source highlights the workforce challenges that contribute to my research problem of interest.

Source 2

(Required)

Full APA Citation:

American Health Care Association. (2024). State of the sector: Nursing Home Labor staffing shortages persist despite unprecedented efforts to attract more staff. Press Releases. https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/State-Of-The-Sector-Nursing-Home-Staffing-Shortages-Persist-Despite-Unprecedented-Efforts-To-Attract-More-Staff-.aspx

Purpose of Research (1 sentence only):

To evaluate the current state of staffing in nursing homes and LTC facilities.

Author’s Conclusion or Results of Research (1 sentence only):

Nearly 90% of nursing homes report staffing shortages, leading to compromised care quality.

How this relates to my study (1 sentence only):

The findings support the existence of staffing issues in LTC, which is central to my study.

Source 3

(Required)

Full APA Citation:

Sun, W., Sparks, D., Rahman, F., & Fevry, M. W. (2021). Staffing Stability in Long-Term Care Homes. Cureus Journal of Medical Science.

Purpose of Research (1 sentence only):

To investigate how workforce stabilization can impact care quality in long-term care.

Author’s Conclusion or Results of Research (1 sentence only):

Workforce stabilization leads to improved patient outcomes and operational efficiency.

How this relates to my study (1 sentence only):

This research directly relates to strategies for improving workforce retention in LTC facilities.

Practice Gap Statement

Now that you have identified a current healthcare administration problem you will compose a Practice Gap Statement (PGS) following the example and instructions in the appendix. Your PGS should not be longer that 2-3 sentences.

Workforce shortages in long-term care facilities are leading to increased staff burnout and poor patient outcomes. This gap highlights the need for effective strategies to improve workforce retention and overall care quality.

Practice Gap Sources

Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.

Source 1

(Required)

Full APA Citation:

American Health Care Association. (2024). State of the sector: Nursing home staffing shortages persist despite unprecedented efforts to attract more staff. American Health Care Association. https://www.ahcancal.org/News-and-Communications/Press-Releases/Pages/State-Of-The-Sector-Nursing-Home-Staffing-Shortages-Persist.aspx

Desired Ideal State of Professional Practice:

The desired ideal state is for long-term care facilities to maintain adequate staffing levels to ensure quality patient care, reduce staff burnout, and minimize the negative impact on admissions and operations, ensuring a sustainable and efficient healthcare system.

Source 2

(Optional)

Full APA Citation:

Centers for Medicare and Medicaid Services (CMS). (2024). Hospital quality initiative public reporting: Nursing home care standards. CMS.gov. https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/hospital-compare

Desired Ideal State of Professional Practice:

The desired ideal state is for all long-term care facilities to meet national benchmarks for staffing levels and quality care standards as outlined by CMS to ensure consistent, high-quality care for vulnerable patient populations.

Section 1: Feedback and Scoring

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

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Section 2: Purpose and Review Questions

(Click here for instructions and examples)

The research purpose and review questions must be derived entirely by the sources provided in section 1.

Research Purpose

To address your stated problem, what is the purpose of your study using no more than 1-2 sentences??

To identify and evaluate strategies for improving workforce retention in long-term care facilities, with the aim of enhancing patient care and reducing operational challenges

Review Question(s)

Conclude with your review question. (1 sentences)

What are the most effective workforce retention strategies that can be implemented in long-term care facilities to address staffing shortages and improve patient outcomes?

Section 2: Feedback and Scoring

Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included on how to successfully revise the specific elements above.

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 3: Framework

(Click here for instructions and examples)

Framework (Conceptual or Theoretical)

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference.

Source 1

(Required)

Full APA Citation:

Rogers, E. M., Singhal, A., & Quinlan, M. M. (2014). Diffusion of innovations. In An integrated approach to communication theory and research (pp. 432-448). Routledge.

Purpose of Framework (1 sentence only):

To explain how innovations and new ideas are adopted over time within organizations.

Key Constructs of Framework (1 sentence only):

The model includes categories like innovators, early adopters, and the majority, which determine the rate of innovation adoption.

How this relates to my study (1 sentence only):

The diffusion of innovation framework will guide the study in understanding how new retention strategies can be adopted by LTC facilities.

Source 2

(Optional)

Full APA Citation:

Click or tap here to enter text.

Purpose of Framework (1 sentence only):

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Key Constructs of Framework (1 sentence only):

Click or tap here to enter text.

How this relates to my study (1 sentence only):

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How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)

The diffusion of innovation model is critical to understanding how new workforce retention strategies can be effectively adopted in LTC facilities to reduce staff turnover and improve patient care.

Section 3: Feedback and Scoring

Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included on how to successfully revise the specific elements above.

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 4: Significance

(Click here for instructions and examples)

Significance

How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change?

This study will contribute to the field of healthcare administration by providing actionable strategies for addressing workforce shortages in long-term care, thereby improving both the quality of patient care and operational efficiency.

Significance of study related to social determinants?

By addressing workforce shortages in LTC facilities, this study will have a positive impact on vulnerable populations such as the elderly and disabled, ensuring better access to consistent, high-quality care

Section 4: Feedback and Scoring

Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included on how to successfully revise the specific elements above.

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Section 5: Research Alignment Table

Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours

Healthcare Administration Problem

Practice Gap

Purpose

Review Question

Theoretical Framework

List the theories and/or conceptual framework.

Workforce shortages in long-term care facilities

Workforce shortages lead to staff burnout and compromised patient care.

To identify strategies that improve workforce retention in LTC facilities to enhance patient care and operational efficiency.

What are the most effective workforce retention strategies that can be implemented in LTC facilities to improve care quality?

Diffusion of Innovation

Section 5: Feedback and Scoring

Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included on how to successfully revise the specific elements above.

Mentor

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Program

Met ☐

Not Met ☐

Detailed Feedback:

Click or tap here to enter text.

Working Title Instructions and Example

Instructions: The working title should include the HSO type and DHA research domains. Provide a concise (aim for 15 words or fewer) working title for this study. (Be sure to include your HSO type.)

Titles should be concise (aim for 15 words or fewer), be a statement, not a question, and no colons please. The title should indicate the main topic and the variables/concepts under study and the relationship between them. A title should be fully explanatory when standing alone and include the most critical key words (a searchable statement of what the manuscript contains). Avoid words that serve no purpose (such as methods, results, a study of…, or investigation of… ), use full terms (avoid abbreviations), and capitalize any word of four or more letters, and all parts of a verb.

Improving a Rural Hospitals Readmission Rates for Heart Failure Patients

Section 1: Research Problem Instructions and Examples

Healthcare Services Organization (HSO) Type

Instructions: At the beginning of the DHA program students were asked to select an HSO type to research in each course in preparation for the Doctoral study. Identify and describe your selected HSO type and any unique characteristics that help provide specificity to your research.

With no more than 1-2 sentences identify and describe your selected HSO type.

Examples of HSO types can be located on the DHA Project Completion page.

Hospitals/Health systems – rural hospitals

HSO Problem of Interest

What is the healthcare services organization (HSO) problem of interest that prompted you to search the literature to find out more? The problem of interest is a high-level problem that all HSO of the same type are experiencing.

Write only 1-2 complete sentences using a scholarly tone.

The need to improve readmission rates in a hospital system.

Healthcare Administration Problem

Instructions: A healthcare administration problem is a focused topic of concern, a condition to be improved upon, or troubling question that is supported in published research-based articles and/or grey literature like reports (annual, research, technical, project), white or working papers, government reports, and organizational evaluations. 

In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.

The healthcare administration problem is high readmission rates for heart failure patients within the last 30-days of discharge for rural hospitals with 20-25 beds.

Which DHA research category does your healthcare administration problem align with?

A list of DHA research domains can be located on the DHA Project Completion page.

Quality improvement

Healthcare Administration Problem Justification Sources

Instructions: Students are required to provide at least 3 credible sources that state a healthcare administration problem exist. Students should read all sources completely but pay special attention to what the authors state the conclusion or research results are from their work. To build on the previous research in the field students must have at least three sources within the last 5 years that clearly state a problem exist. One example is provided below:

Provide a minimum of 3 sources that clearly state in the conclusion or research findings that a healthcare administration problem currently exists.

Source 1

(Required)

Full APA Citation:

Hamner A. (2021). Readmission rates for rural hospitals and their challenges. University of Homenlin, Growley.

Purpose of Research (1 sentence only):

The purpose of the study was to research hospital rates in rural hospital systems.

Author’s Conclusion or Results of Research (1 sentence only):

Rural hospitals are experiencing challenges with 30-day readmission rate for heart failure patients.

How this relates to my study (1 sentence only):

It supports that rural hospitals are experiencing an undesirable readmission rate for a particular population.

Source 2

(Required)

Full APA Citation:

Coldaw B.A., Hawkins J.W. & Davlin R. (2021) From theory to practice: identifying authentic opinion of leaders to improve care using evidence-based practice. Managed Care 12(7), 156–162.

Purpose of Research (1 sentence only):

The purpose of this study was to survey organizational leaders about their organizational cultures related to improving quality related to hospital readmission rates.

Author’s Conclusion or Results of Research (1 sentence only):

The research findings revealed that hospital leaders in rural hospitals are experiencing high readmission rates for heart failure patients despite attempts to improve care delivery using evidence-based practices.

How this relates to my study (1 sentence only):

This study provides further justification that rural hospitals and health systems have unique struggles with readmissions rates.

Source 3

(Required)

Full APA Citation:

Buch D.T., Gerald B. & Kelley D. (2022). The breakdown of CMS readmission rates categories. Johnson Taylor & Franklin Group, Australia.

Purpose of Research (1 sentence only):

The purpose of this study was to examine the different types of CMS readmission rates categories.

Author’s Conclusion or Results of Research (1 sentence only):

The research findings reported that rural organizations struggle to meet the national average for readmission rates for many of the CMS categories.

How this relates to my study (1 sentence only):

This relates to my study because it shows that rural hospital has a higher readmissions rate for heart failure patients.

Gap in Practice

Instructions: The need to address an identified ga p in practice must be clear and there must be current relevance to the discipline and area of practice.

In no more than 1-2 sentences what meaningful gap in practice have you identified?

Learn more about a Practice Gap Statement on the DHA Project Completion page.

Evidence shows that 30-day readmission rates for heart failure cases is 16.10% for rural hospitals with 20-25 beds. This study will study research methods to bring the readmission rates down to the CMS national average of 15.59% for rural hospitals.

Practice Gap Sources

Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.

Full APA Citation:

CMS Hospital Compare. (2022). Hospital Quality Initiative Public Reporting. Retrieved on January 10, 2023, from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalCompare.

Desired Ideal State of Professional Practice:

The Centers for Medicare an Medicaid Services provides public data on hospital readmissions and the national average for heart failure readmissions is 15.59% (data is for illustration only)

Section 2: Purpose and Review Questions Instructions and Examples

Research Purpose

To address your stated problem, what is the purpose of your study using no more than 1-2 sentences?

Learn more about the purpose of research by Clicking Here

The purpose of this research is to search the existing body of knowledge related to rural hospital admission rates for heart failure patients and provide strategies for leaders to reduce their readmissions rates for heart failure patients.

Review Question

Conclude with your review question. (1 sentence)

What are best practices to improve the adoption and implementation of evidence-based quality improvement strategies to reduce heart failure patient’s readmission rates in rural hospital settings?

Section 3: Framework Instructions and Examples

Framework (Conceptual or Theoretical)

Instructions: The framework includes the theories and/or concepts relevant to your topic. Align the framework with the problem of interest, healthcare administration problem, purpose, and review question. This theoretical or conceptual framework is the basis for understanding, designing, and analyzing ways to investigate your healthcare administration problem. Provide the original scholarly literature (citing original authors) on the theory and/or concepts, even if it is more than 5 years old. Please do not cite secondary sources.

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference.

To locate additional information on DHA Conceptual and Theoretical Frameworks on the DHA Project Completion page.

Source 1

(Required)

Full APA Citation:

Rogers, E. M. (2010).  Diffusion of innovations. Simon and Schuster.

Purpose of Framework (1 sentence only):

The purpose of this framework was to reveal the various elements contributing to the adoption and diffusion of new innovations in an organizational setting.

Key Constructs of Framework (1 sentence only):

The key constructs outline the various segments of the innovation adoption model: innovators, early adopters, early majority, late majority and laggards.

How this relates to my study (1 sentence only):

This relates to my study because the adoption of evidenced-based practices has shown to improve patient outcomes and the quality of care.

Source 1

(Optional)

Full APA Citation:

Purpose of Framework (1 sentence only):

Key Constructs of Framework (1 sentence only):

How this relates to my study (1 sentence only):

How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)

Spread of evidence-based practices follows the diffusion of innovations which is the process through which an innovation, defined as an idea perceived as new, spreads via certain communication channels over time among the members of a social system.

There are prerequisites that must be met to successfully spread innovations and best practices in a healthcare system. These processes also determine the rate and speed of the spread. By improving the adoption rate of innovative, evidence-based practices for heart failure patient’s readmission rate may be decreased.

Section 4: Significance Instructions and Example

Significance

Instructions: Here you explain how your study addresses the meaningful, discipline-specific issue that you identified and will therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change. Detail how your findings might support professional practice or allow practical application (answer the So what? question).

How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change?

More information on helping rural hospital adopt and implement evidence-based practice strategies will decrease the 30-day readmission rate for heart failure patients in rural hospitals.

Significance of study related to social determinants?

Proposing solutions for rural hospitals to reduce their 30-day readmission rates for heart failure patients will have a positive impact on patient recovery, families and rural hospitals that serve their communities.

Section 5: Research Alignment Table Instructions and Example

Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours

Healthcare Administration Problem

Practice Gap

Purpose

Review Question

Theoretical Framework

List the theories and/or conceptual framework.

The healthcare administration problem is high readmission rates for heart failure patients with the last 30-days of discharge for rural hospitals with 20-25 beds.

Evidence shows that 30-day readmission rates for heart failure cases is 16.10% for rural hospitals with 20-25 beds. This study will study research methods to bring the readmission rates down to the CMS national average of 15.59% for rural hospitals.

The purpose of this research is to search the existing body of knowledge related to rural hospital admission rates for heart failure patients and provide strategies for leaders to reduce their readmissions rates for heart failure patients.

What are best practices to improve the adoption and implementation of evidence-based quality improvement strategies to reduce heart failure patient’s readmission rates in rural hospital settings?

Diffusion of Innovation