The next subsections to focus on drafting are your purpose statement and nature of the doctoral project or dissertation-in-practice. Your focus should be on defining the purpose of your study and providing a summary of the nature of the doctoral project or dissertation-in-practice in the respective subsections. Concentrate on developing clear alignment between the previously developed subsections in Section 1. Your project design is effectively aligned to the problem statement when it ensures that the selected methods will actually measure what they are intended to measure and validates your project topic and design.
Addressing Disparities Among Minorities Through Healthcare Policies
Applied Doctoral Project Proposal
Submitted to National University
School of Health Professions
in Partial Fulfillment of the
Requirements for the Degree of
DOCTOR OF HEALTH ADMINISTRATION
by
SHERMAINE MARCHELLA STUCKEY
San Diego, California
September 2024
Abstract
Acknowledgments
Table of Contents
Conceptual / Theoretical Framework 4
Section 2: Method and Design 10
Materials and Instrumentation 11
Operational Definitions of Variables 1 2
Project Goals and Objectives 1 2
Metrics or Performance Measurements 1 3
Data Collection and Analysis 1 4
Assumptions, Limitations, and Delimitations 1 5
Ethical Assurances …………………………… ….. …… . ……………………………… … … 16
Section 3: Findings, Implications, and Recommendations 1 7
Findings by Project Question(s) 1 7
Evaluation of the Outcomes 1 8
Implications and Recommendations for Practice 1 8
Recommendations for Future Research/Projects 1 9
List of Tables
List of Figures
12
Section 1: Foundation
Addressing the racial and ethnic disparities that exist within healthcare systems is a critical responsibility of healthcare administrators. According to experts, eliminating racial and ethnic disparities include key areas like budgeting, policy and process design, community consultation, and strategic management. The implementation of these measures is imperative to guarantee the establishment of a healthcare system that is inclusive and flexible enough to accommodate the diverse patient populations, especially those belonging to different racial and ethnic backgrounds.
Creating and executing policies that address racial and ethnic disparities in healthcare facilities is the responsibility of administrators. Promoting diversity and inclusivity in healthcare education requires strong leadership (van Diggele, Burgess, Roberts, & Mellis, 2020). This entails putting laws into place to combat discrimination, offering translation services, and funding initiatives to improve the health of underrepresented groups. Establishing a healthcare system that is sensitive to linguistic, cultural, and socioeconomic diversity requires these steps.
Determining racial and ethnic disparities is dependent on empirical research. For example, hospitals can use the information gathered by the American Hospital Association to learn about patients, how they use health services, and the outcomes. They find that this data is useful in identifying differences and developing appropriate measures. Transformational leadership plays a pivotal role in the organization of health care, and that leaders must leverage data to execute strategies aimed at enhancing equity within healthcare facilities (Robbins & Davidhizar, 2020).
Therefore, to gain a culturally relevant understanding of every patient, administrators must support the training and education of healthcare professionals in diversity. In 2020, Rinfret and associates clarify the influence of leadership approaches in the healthcare industry, emphasizing the relationship between transformative leadership and emotional intelligence (Rinfret, Laplante, Claude Lagace, Deschamps, & Prive, 2020). They also emphasize how managers must be able to identify and comprehend the varied backgrounds of their patients to provide appropriate care for them. This would foster positive patient experiences and enhance the relationships between caregivers.
Cooperation and community relations are the administrator's responsibilities. It is imperative for healthcare administrators to establish formal relationships and connections with prominent stakeholders within the minority community. This project may increase accessibility to healthcare services and foster a culture of trust. Improving access to high-quality healthcare is a necessary component of good leadership (Okpala, 2020). Administrators have access to minority populations, which allows them to learn about the unique difficulties these communities encounter and how those difficulties affect their capabilities. This puts the administrator in a better position to deal with these problems and find solutions.
Thus, reducing racial and ethnic disparities in healthcare is a major responsibility of healthcare administrators. Healthcare inequities may be lessened and equitable opportunities for excellent healthcare can be promoted across all demographic groups by putting into practice effective management styles, prioritizing resource management, applying analytical thinking, thoroughly training staff, and fostering strong community interactions. Research on racial and ethnic disparities in healthcare published in leadership and administration journals can offer administrators crucial knowledge and strategies to enhance leaders' engagement in promoting policies that lower health disparities.
Statement of Problem
The problem is there are still persistent racial and ethnic disparities in the availability and utilization of healthcare services in the United States. These disparities present serious obstacles to the management of illness as well as to the maintenance of just and efficient health systems in terms of leadership and management. Examining the implications for healthcare administrators and leaders in addressing and resolving these disparities is the main goal, as it will help improve the healthcare environment and develop policies that will ensure that everyone has access to quality healthcare services. Fair treatment and the availability of healthcare services to individuals from all racial backgrounds define the ideal future state. Healthcare officials need to use effective leadership and policy strategies to address the various obstacles that minority groups face, as the current situation amply illustrates.
This study will use a qualitative secondary research approach to address the research topic, which focuses on the disparities in the consumption of health care across minority populations in the United States of America. Using this approach, administrators in the healthcare industry may gather extensive information on potential solutions to these variations in leadership and management styles. This study will employ secondary data instead of a thorough population survey, drawing on data already collected from earlier research on healthcare leadership and administration.
As this study attempts to understand the experiences and viewpoints of hospital administrators in resolving disparities, the qualitative secondary research method is appropriate. Finding out how these leaders see and respond to issues that affect minority groups in the healthcare sector is made possible by this methodology. The administrative interventions and leadership traits will be examined in this study via a comprehensive review of secondary data and previous research.
Purpose Statement
The purpose of this qualitative doctorate research project study aims to examine how healthcare administrators may successfully adopt strategies and policies to improve healthcare access, quality, and equality for minority communities. At this stage in the project, phenomenology will be used as the method of investigation to analyze the experiences and perspectives of healthcare administrators, leaders, and minority patients. This doctoral research project aims to ascertain and delineate the existing barriers encountered by racial and ethnic minorities while accessing top-notch healthcare in the United States
Nature of the Project
Needs Assessment
Project Questions/ Objectives or Goals
PQ1. What are ways healthcare administrators can create policies that effectively address disparities in healthcare access and quality among racial and ethnic minorities?
This question seeks to explore strategies that may be used to address and eradicate inequities in healthcare access and treatment among minority populations. It focuses on the leadership processes and administrative choices that will have an impact on healthcare services while creating policies that will eliminate the disparities at hand. The biases that currently exist continue to transcend the healthcare system and impact patients through institutionalized procedures, clinical decision-making, and patient-clinician communication (Vela, et al., 2022). Addressing the biases remains an essential responsibility to healthcare administrators. This will allow them to create policies that will not only address the biases but help racial and ethnic minorities receive access to the proper care they need.
PQ2. What leadership and administrative practices contribute to reducing bias and discrimination in healthcare settings, and how do these practices influence the well-being of ethnic and racial minorities?
This question seeks to identify overarching leadership and administrative measures that might effectively mitigate prejudice and discrimination within the health sector. This study examines how effectively implementing these principles may improve the health outcomes of minority populations and decrease bias in healthcare settings. Explicit biases in healthcare often apart of the personal belief systems of healthcare providers. The role of healthcare administrators is to eliminate these biases to ensure that no discriminatory behavior affects the access and quality of healthcare given to patients, regardless of racial or ethnic minorities. An analysis of research involving doctors, nurses, and other medical professionals revealed that implicit racial bias among healthcare providers is linked to a variety of negative outcomes, including views of Black patients as less medically adherent than White patients, undertreatment of pain, negative ratings of clinical interactions, and less patient-centeredness (Sabin, 2022).
Introduction to the Professional and Conceptual / Theoretical Framework
Significance of the Project
Possible Additional Subsections
Evidenced-Based Intervention
Definitions of Key Terms
Discrimination.
Negative actions aimed against a person or group because of preconceived beliefs about their identity. Individuals may experience bias toward a minority group without being a member of that group themselves. (Togioka, Duvivier, & Young, 2024)
Refers to the common experiences, histories, and social and cultural traits of a group of individuals. These include cultural practices, beliefs, values, language, and religion that are often passed down from one generation to the next (Flanagin, Frey, & Christiansen, 2021)
Health inequities.
Avoidable differences in health between various groups of people. Examples include social identity, access to health care, life expectancy (Lee, Kim, Lee, & Fawcett, 2020)
Race.
Describes an individual's affiliation with a group or identity attributed based on physical traits and skin pigmentation (Hamed, Bradby, Ahlberg, & Thapar-Björkert , 2022).
Racial disparities.
Differences in healthcare among various racial and ethnic group that can lead to differences in health outcomes such as life expectancy, mortality, and health status (Macias-Konstantopoulos, et al., 2023)
Literature Review
Applied Project Theme Heading 1
Text…
Applied Project Theme Heading 2
Text…
Summary
Section 2: Method and Design
Methodology and Design
Population and Sample
Materials and Instrumentation
Operational Definitions of Variables
Project Goals and Objectives
Metrics or Performance Measurements
Project Procedures
Data Collection and Analysis
Assumptions , Limitations, and Delimitations
Ethical Assurances
Summary
Section 3: Findings, Implications, and Recommendations
Begin writing here…
Findings by Project Question(s)
Begin writing here…
PQ1.
PQ2.
Evaluation of the Outcomes
Action Plan
Implications and Recommendations for Practice
Recommendations for Future Research/Projects
Conclusions
References Flanagin, A., Frey, T., & Christiansen, S. L. (2021). The Reporting of Race and Ethnicity in Medical and Science Journals. JAMA Network. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2776936 Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert , S. (2022). Racism in healthcare: a scoping review. BMC Public Health. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13122-y Lee, H., Kim, D., Lee, S., & Fawcett, J. (2020). The concepts of health inequality, disparities and equity in the era of population health. Appl Nurs Res. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521436/ Macias-Konstantopoulos, W. L., Collins, K. A., Diaz, R., Duber, H. C., Edwards, C. D., Hsu, A. P., . . . Sachs, C. J. (2023). West J Emergency Medicine, 906-918. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527840/# Okpala, P. (2020). Increasing access to quality healthcare through collaborative leadership. International Journal of Healthcare Management, 229-235. doi:https://doi.org/10.1080/20479700.2017.1401276 Rinfret, N., Laplante, J., Claude Lagace, M., Deschamps, C., & Prive, C. (2020). Impacts of leadership styles in health and social services: A case from Quebec exploring relationships between emotional intelligence and transformational leadership. International Journal of Healthcare Management, 329-339. Retrieved from https://www.tandfonline.com/doi/full/10.1080/20479700.2018.1548153 Robbins, B., & Davidhizar, R. (2020). Transformational Leadership in Health Care Today. The Healthcare Manager, 117-121. Retrieved from https://journals.lww.com/healthcaremanagerjournal/abstract/2020/07000/transformational_leadership_in_health_care_today.2.aspx Sabin, J. A. (2022). Tackling Implicit Bias in Health Care. The New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp2201180 Togioka, B. M., Duvivier, D., & Young, E. (2024). Diversity and Discrimination in Health Care. Stat Pearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK568721/#:~:text=Discrimination%20in%20health%20care%20is,experience%20discrimination%20against%20that%20group. van Diggele, C., Burgess, A., Roberts, C., & Mellis, C. (2020). Leadership in healthcare education. BMC Medical Education. Retrieved from https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02288-x Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annual Review of Public Health, 477-501. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172268/
,
Addressing Disparities Among Minorities Through Healthcare Policies
Applied Doctoral Project Proposal
Submitted to National University
School of Health Professions
in Partial Fulfillment of the
Requirements for the Degree of
DOCTOR OF HEALTH ADMINISTRATION
by
SHERMAINE MARCHELLA STUCKEY
San Diego, California
September 2024
Abstract
Acknowledgments
Table of Contents
Conceptual / Theoretical Framework 4
Section 2: Method and Design 10
Materials and Instrumentation 11
Operational Definitions of Variables 1 2
Project Goals and Objectives 1 2
Metrics or Performance Measurements 1 3
Data Collection and Analysis 1 4
Assumptions, Limitations, and Delimitations 1 5
Ethical Assurances …………………………… ….. …… . ……………………………… … … 16
Section 3: Findings, Implications, and Recommendations 1 7
Findings by Project Question(s) 1 7
Evaluation of the Outcomes 1 8
Implications and Recommendations for Practice 1 8
Recommendations for Future Research/Projects 1 9
List of Tables
List of Figures
12
Section 1: Foundation
Addressing the racial and ethnic disparities that exist within healthcare systems is a critical responsibility of healthcare administrators. According to experts, eliminating racial and ethnic disparities include key areas like budgeting, policy and process design, community consultation, and strategic management. The implementation of these measures is imperative to guarantee the establishment of a healthcare system that is inclusive and flexible enough to accommodate the diverse patient populations, especially those belonging to different racial and ethnic backgrounds. Comment by Linda Mast: Must name who these experts are and include an in-text citation. Throughout your dissertation such statements need to be supported with evidence Comment by Linda Mast: This is a good starting point to organize your research as long as this is an evidence based list of key elements. Carry this through in subsequent paragraphs by using a sub heading for each and provide examples from supporting literature for each. This also needs to carry over to literature review. This is what is called “alignment” and is a critical element of all dissertations. Comment by Linda Mast: What measures are you talking about. Need specifics
Creating and executing policies that address racial and ethnic disparities in healthcare facilities is the responsibility of administrators. Promoting diversity and inclusivity in healthcare education requires strong leadership (van Diggele, Burgess, Roberts, & Mellis, 2020). This entails putting laws into place to combat discrimination, offering translation services, and funding initiatives to improve the health of underrepresented groups. Establishing a healthcare system that is sensitive to linguistic, cultural, and socioeconomic diversity requires these steps. Comment by Linda Mast: Education is not consistent with your intro and focus on administrarors
Determining racial and ethnic disparities is dependent on empirical research. For example, hospitals can use the information gathered by the American Hospital Association to learn about patients, how they use health services, and the outcomes. They find that this data is useful in identifying differences and developing appropriate measures. Transformational leadership plays a pivotal role in the organization of health care, and that leaders must leverage data to execute strategies aimed at enhancing equity within healthcare facilities (Robbins & Davidhizar, 2020). Comment by Linda Mast: This makes sense however it does not align well with our list of key elements such as budgeting and others that you listed at the beginning. Stay consistent on how you are approaching your applied project
Therefore, to gain a culturally relevant understanding of every patient, administrators must support the training and education of healthcare professionals in diversity. In 2020, Rinfret and associates clarify the influence of leadership approaches in the healthcare industry, emphasizing the relationship between transformative leadership and emotional intelligence (Rinfret, Laplante, Claude Lagace, Deschamps, & Prive, 2020). They also emphasize how managers must be able to identify and comprehend the varied backgrounds of their patients to provide appropriate care for them. This would foster positive patient experiences and enhance the relationships between caregivers. Comment by Linda Mast: Again, this is a different direction that your intro sentences
Cooperation and community relations are the administrator's responsibilities. It is imperative for healthcare administrators to establish formal relationships and connections with prominent stakeholders within the minority community. This project may increase accessibility to healthcare services and foster a culture of trust. Improving access to high-quality healthcare is a necessary component of good leadership (Okpala, 2020). Administrators have access to minority populations, which allows them to learn about the unique difficulties these communities encounter and how those difficulties affect their capabilities. This puts the administrator in a better position to deal with these problems and find solutions.
Thus, reducing racial and ethnic disparities in healthcare is a major responsibility of healthcare administrators. Healthcare inequities may be lessened and equitable opportunities for excellent healthcare can be promoted across all demographic groups by putting into practice effective management styles, prioritizing resource management, applying analytical thinking, thoroughly training staff, and fostering strong community interactions. Research on racial and ethnic disparities in healthcare published in leadership and administration journals can offer administrators crucial knowledge and strategies to enhance leaders' engagement in promoting policies that lower health disparities.
Statement of Problem
The problem is there are still persistent racial and ethnic disparities in the availability and utilization of healthcare services in the United States. These disparities present serious obstacles to the management of illness as well as to the maintenance of just and efficient health systems in terms of leadership and management. Examining the implications for healthcare administrators and leaders in addressing and resolving these disparities is the main goal, as it will help improve the healthcare environment and develop policies that will ensure that everyone has access to quality healthcare services. Fair treatment and the availability of healthcare services to individuals from all racial backgrounds define the ideal future state. Healthcare officials need to use effective leadership and policy strategies to address the various obstacles that minority groups face, as the current situation amply illustrates. Comment by Linda Mast: Here you are focusing on access disparities- this does not align with your intro sentences. Decide on a clear focus of your study. If it is access disparities, then you need to revise your intro and identify the specific elements that are factors in access that are supported in the literature. I think the elements you mention in your first paragraph could all play a part in access disparities, you need to make it more clear with supporting references , and examples of the role of administrators in each of the key elements that impact access disparities. Comment by Linda Mast: Need supporting references from healthcare administration journals
This study will use a qualitative phenomenological research approach to address the research topic, which focuses on the disparities in the consumption of health care across minority populations in the United States of America. Using this approach, administrators in the healthcare industry may gather extensive information on potential solutions to these variations in leadership and management styles. This study will employ secondary data instead of a thorough population survey, drawing on data already collected from earlier research on healthcare leadership and administration. Comment by Linda Mast: Phenomenological research will not be suitable for your applied project because it requires primary research. For your DHA, you are doing an applied dissertation using secondary data. So you will need to explore the resources in the library and elsewhere to select a research method using secondary data only
As this study attempts to understand the experiences and viewpoints of hospital administrators in resolving disparities, the phenomenological method is appropriate. Finding out how these leaders see and respond to issues that affect minority groups in the healthcare sector is made possible by this methodology. The administrative interventions and leadership traits will be examined in this study via a comprehensive review of secondary data and previous research. Comment by Linda Mast: This deviates from previous focus on patient experience- is your study focused on administrators and their innovations or best practices to address disparities or is your focus on examining factors impacting the patient experience in access disparities? They are two different things- choose one clear focus and also choose one where you will have access to secondary data for your analysis
Purpose Statement
Nature of the Project
Needs Assessment
Project Questions/ Objectives or Goals
PQ1. What are ways healthcare administrators can create policies that effectively address disparities in healthcare access and quality among racial and ethnic minorities?
This question seeks to explore strategies that may be used to address and eradicate inequities in healthcare access and treatment among minority populations. It focuses on the leadership processes and administrative choices that will have an impact on healthcare services while creating policies that will eliminate the disparities at hand. The biases that currently exist continue to transcend the healthcare system and impact patients through institutionalized procedures, clinical decision-making, and patient-clinician communication (Vela, et al., 2022). Addressing the biases remains an essential responsibility to healthcare administrators. This will allow them to create policies that will not only address the biases but help racial and ethnic minorities receive access to the proper care they need.
PQ2. What leadership and administrative practices contribute to reducing bias and discrimination in healthcare settings, and how do these practices influence the well-being of ethnic and racial minorities?
This question seeks to identify overarching leadership and administrative measures that might effectively mitigate prejudice and discrimination within the health sector. This study examines how effectively implementing these principles may improve the health outcomes of minority populations and decrease bias in healthcare settings. Explicit biases in healthcare often apart of the personal belief systems of healthcare providers. The role of healthcare administrators is to eliminate these biases to ensure that no discriminatory behavior affects the access and quality of healthcare given to patients, regardless of racial or ethnic minorities. An analysis of research involving doctors, nurses, and other medical professionals revealed that implicit racial bias among healthcare providers is linked to a variety of negative outcomes, including views of Black patients as less medically adherent than White patients, undertreatment of pain, negative ratings of clinical interactions, and less patient-centeredness (Sabin, 2022).
Introduction to the Professional and Conceptual / Theoretical Framework
Significance of the Project
Possible Additional Subsections
Evidenced-Based Intervention
Definitions of Key Terms
Discrimination.
Negative actions aimed against a person or group because of preconceived beliefs about their identity. Individuals may experience bias toward a minority group without being a member of that group themselves. (Togioka, Duvivier, & Young, 2024)
Refers to the common experiences, histories, and social and cultural traits of a group of individuals. These include cultural practices, beliefs, values, language, and religion that are often passed down from one generation to the next (Flanagin, Frey, & Christiansen, 2021)
Health inequities.
Avoidable differences in health between various groups of people. Examples include social identity, access to health care, life expectancy (Lee, Kim, Lee, & Fawcett, 2020)
Race.
Describes an individual's affiliation with a group or identity attributed based on physical traits and skin pigmentation (Hamed, Bradby, Ahlberg, & Thapar-Björkert , 2022).
Racial disparities.
Differences in healthcare among various racial and ethnic group that can lead to differences in health outcomes such as life expectancy, mortality, and health status (Macias-Konstantopoulos, et al., 2023)
Literature Review
Applied Project Theme Heading 1
Text…
Applied Project Theme Heading 2
Text…
Summary
Section 2: Method and Design
Methodology and Design
Population and Sample
Materials and Instrumentation
Operational Definitions of Variables
Project Goals and Objectives
Metrics or Performance Measurements
Project Procedures
Data Collection and Analysis
Assumptions , Limitations, and Delimitations
Ethical Assurances
Summary
Section 3: Findings, Implications, and Recommendations
Begin writing here…
Findings by Project Question(s)
Begin writing here…
PQ1.
PQ2.
Evaluation of the Outcomes
Action Plan
Implications and Recommendations for Practice
Recommendations for Future Research/Projects
Conclusions
References Flanagin, A., Frey, T., & Christiansen, S. L. (2021). The Reporting of Race and Ethnicity in Medical and Science Journals. JAMA Network. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2776936 Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert , S. (2022). Racism in healthcare: a scoping review. BMC Public Health. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13122-y Lee, H., Kim, D., Lee, S., & Fawcett, J. (2020). The concepts of health inequality, disparities and equity in the era of population health. Appl Nurs Res. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521436/ Macias-Konstantopoulos, W. L., Collins, K. A., Diaz, R., Duber, H. C., Edwards, C. D., Hsu, A. P., . . . Sachs, C. J. (2023). West J Emergency Medicine, 906-918. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527840/# Okpala, P. (2020). Increasing access to quality healthcare through collaborative leadership. International Journal of Healthcare Management, 229-235. doi:https://doi.org/10.1080/20479700.2017.1401276 Rinfret, N., Laplante, J., Claude Lagace, M., Deschamps, C., & Prive, C. (2020). Impacts of leadership styles in health and social services: A case from Quebec exploring relationships between emotional intelligence and transformational leadership. International Journal of Healthcare Management, 329-339. Retrieved from https://www.tandfonline.com/doi/full/10.1080/20479700.2018.1548153 Robbins, B., & Davidhizar, R. (2020). Transformational Leadership in Health Care Today. The Healthcare Manager, 117-121. Retrieved from https://journals.lww.com/healthcaremanagerjournal/abstract/2020/07000/transformational_leadership_in_health_care_today.2.aspx Sabin, J. A. (2022). Tackling Implicit Bias in Health Care. The New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp2201180 Togioka, B. M., Duvivier, D., & Young, E. (2024). Diversity and Discrimination in Health Care. Stat Pearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK568721/#:~:text=Discrimination%20in%20health%20care%20is,experience%20discrimination%20against%20that%20group. van Diggele, C., Burgess, A., Roberts, C., & Mellis, C. (2020). Leadership in healthcare education. BMC Medical Education. Retrieved from https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02288-x Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annual Review of Public Health, 477-501. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172268/
,
Addressing Disparities Among Minorities Through Healthcare Policies
Applied Doctoral Project Proposal
Submitted to National University
School of Health Professions
in Partial Fulfillment of the
Requirements for the Degree of
DOCTOR OF HEALTH ADMINISTRATION
by
SHERMAINE MARCHELLA STUCKEY
San Diego, California September 2024
Abstract
ii
Acknowledgments
iii
Table of Contents
Section 1: Foundation……………………………………………………………………………………………………….1
Statement of Problem………………………………………………………………………………………………….1 Purpose Statement………………………………………………………………………………………………………2 Nature of the Project……………………………………………………………………………………………………3 Needs Assessment………………………………………………………………………………………………………3 Project Questions………………………………………………………………………………………………………..4 Conceptual / Theoretical Framework…………………………………………………………………………….4 Significance of the Project……………………………………………………………………………………………5 Definitions of Key Terms…………………………………………………………………………………………….6 Literature Review……………………………………………………………………………………………………….8 Summary……………………………………………………………………………………………………………………9
Section 2: Method and Design………………………………………………………………………………………….10
Methodology and Design……………………………………………………………………………………………10 Population and Sample………………………………………………………………………………………………10 Materials and Instrumentation…………………………………………………………………………………….11 Operational Definitions of Variables……………………………………………………………………………12 Project Goals and Objectives………………………………………………………………………………………12 Metrics or Performance Measurements………………………………………………………………………..13 Project Procedures…………………………………………………………………………………………………….13 Data Collection and Analysis……………………………………………………………………………………..14 Assumptions, Limitations, and Delimitations……………………………………………………………….15
Ethical Assurances………………………………..…….……………………………………16 Summary………………………………………………………………………………………………………………….16
Section 3: Findings, Implications, and Recommendations……………………………………………………17
Findings by Project Question(s)………………………………………………………………………………….17 Evaluation of the Outcomes………………………………………………………………………………………..18 Action Plan………………………………………………………………………………………………………………18 Implications and Recommendations for Practice…………………………………………………………..18 Recommendations for Future Research/Projects……………………………………………………………19 Conclusions………………………………………………………………………………………………………………20
References……………………………………………………………………………………………………………………..22
Appendices……………………………………………………………………………………………………………………23
Appendix A: XXX………………………………………………………………………………………………………….24
iv
List of Tables
v
List of Figures
vi
Section 1: Foundation
Introduction Addressing the racial and ethnic disparities that exist within healthcare systems is a
critical responsibility of healthcare administrators. According to experts, eliminating racial and
ethnic disparities include key areas like budgeting, policy and process design, community
consultation, and strategic management. The implementation of these measures is imperative to
guarantee the establishment of a healthcare system that is inclusive and flexible enough to
accommodate the diverse patient populations, especially those belonging to different racial and
ethnic backgrounds.
Creating and executing policies that address racial and ethnic disparities in healthcare
facilities is the responsibility of administrators. Promoting diversity and inclusivity in healthcare
education requires strong leadership (van Diggele, Burgess, Roberts, & Mellis, 2020). This
entails putting laws into place to combat discrimination, offering translation services, and
funding initiatives to improve the health of underrepresented groups. Establishing a healthcare
system that is sensitive to linguistic, cultural, and socioeconomic diversity requires these steps.
Determining racial and ethnic disparities is dependent on empirical research. For
example, hospitals can use the information gathered by the American Hospital Association to
learn about patients, how they use health services, and the outcomes. They find that this data is
useful in identifying differences and developing appropriate measures. Transformational
leadership plays a pivotal role in the organization of health care, and that leaders must leverage
data to execute strategies aimed at enhancing equity within healthcare facilities (Robbins &
Davidhizar, 2020).
Therefore, to gain a culturally relevant understanding of every patient, administrators
must support the training and education of healthcare professionals in diversity. In 2020, Rinfret
1
and associates clarify the influence of leadership approaches in the healthcare industry,
emphasizing the relationship between transformative leadership and emotional intelligence
(Rinfret, Laplante, Claude Lagace, Deschamps, & Prive, 2020). They also emphasize how
managers must be able to identify and comprehend the varied backgrounds of their patients to
provide appropriate care for them. This would foster positive patient experiences and enhance
the relationships between caregivers.
Cooperation and community relations are the administrator's responsibilities. It is
imperative for healthcare administrators to establish formal relationships and connections with
prominent stakeholders within the minority community. This project may increase accessibility
to healthcare services and foster a culture of trust. Improving access to high-quality healthcare is
a necessary component of good leadership (Okpala, 2020). Administrators have access to
minority populations, which allows them to learn about the unique difficulties these communities
encounter and how those difficulties affect their capabilities. This puts the administrator in a
better position to deal with these problems and find solutions.
Thus, reducing racial and ethnic disparities in healthcare is a major responsibility of
healthcare administrators. Healthcare inequities may be lessened and equitable opportunities for
excellent healthcare can be promoted across all demographic groups by putting into practice
effective management styles, prioritizing resource management, applying analytical thinking,
thoroughly training staff, and fostering strong community interactions. Research on racial and
ethnic disparities in healthcare published in leadership and administration journals can offer
administrators crucial knowledge and strategies to enhance leaders' engagement in promoting
policies that lower health disparities.
2
Statement of Problem
The problem is there are still persistent racial and ethnic disparities in the availability and
utilization of healthcare services in the United States. These disparities present serious obstacles
to the management of illness as well as to the maintenance of just and efficient health systems in
terms of leadership and management. Examining the implications for healthcare administrators
and leaders in addressing and resolving these disparities is the main goal, as it will help improve
the healthcare environment and develop policies that will ensure that everyone has access to
quality healthcare services. Fair treatment and the availability of healthcare services to
individuals from all racial backgrounds define the ideal future state. Healthcare officials need to
use effective leadership and policy strategies to address the various obstacles that minority
groups face, as the current situation amply illustrates.
This study will use a qualitative secondary research approach to address the research
topic, which focuses on the disparities in the consumption of health care across minority
populations in the United States of America. Using this approach, administrators in the
healthcare industry may gather extensive information on potential solutions to these variations in
leadership and management styles. This study will employ secondary data instead of a thorough
population survey, drawing on data already collected from earlier research on healthcare
leadership and administration.
As this study attempts to understand the experiences and viewpoints of hospital
administrators in resolving disparities, the qualitative secondary research method is appropriate.
Finding out how these leaders see and respond to issues that affect minority groups in the
healthcare sector is made possible by this methodology. The administrative interventions and
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leadership traits will be examined in this study via a comprehensive review of secondary data
and previous research.
Purpose Statement
The purpose of this qualitative doctorate research project study aims to examine how
healthcare administrators may successfully adopt strategies and policies to improve healthcare
access, quality, and equality for minority communities. At this stage in the project,
phenomenology will be used as the method of investigation to analyze the experiences and
perspectives of healthcare administrators, leaders, and minority patients. This doctoral research
project aims to ascertain and delineate the existing barriers encountered by racial and ethnic
minorities while accessing top-notch healthcare in the United States
Nature of the Project
Working to complete Needs Assessment
Working to complete
Project Questions/ Objectives or Goals
PQ1. What are ways healthcare administrators can create policies that effectively address
disparities in healthcare access and quality among racial and ethnic minorities?
This question seeks to explore strategies that may be used to address and eradicate inequities in
healthcare access and treatment among minority populations. It focuses on the leadership
processes and administrative choices that will have an impact on healthcare services while
creating policies that will eliminate the disparities at hand. The biases that currently exist
continue to transcend the healthcare system and impact patients through institutionalized
procedures, clinical decision-making, and patient-clinician communication (Vela, et al., 2022).
Addressing the biases remains an essential responsibility to healthcare administrators. This will
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allow them to create policies that will not only address the biases but help racial and ethnic
minorities receive access to the proper care they need.
PQ2. What leadership and administrative practices contribute to reducing bias and
discrimination in healthcare settings, and how do these practices influence the well-being of
ethnic and racial minorities?
This question seeks to identify overarching leadership and administrative measures that might
effectively mitigate prejudice and discrimination within the health sector. This study examines
how effectively implementing these principles may improve the health outcomes of minority
populations and decrease bias in healthcare settings. Explicit biases in healthcare often apart of
the personal belief systems of healthcare providers. The role of healthcare administrators is to
eliminate these biases to ensure that no discriminatory behavior affects the access and quality of
healthcare given to patients, regardless of racial or ethnic minorities. An analysis of research
involving doctors, nurses, and other medical professionals revealed that implicit racial bias
among healthcare providers is linked to a variety of negative outcomes, including views of Black
patients as less medically adherent than White patients, undertreatment of pain, negative ratings
of clinical interactions, and less patient-centeredness (Sabin, 2022).
Introduction to the Professional and Conceptual / Theoretical Framework
Significance of the Project
Possible Additional Subsections
Evidenced-Based Intervention
Definitions of Key Terms
Discrimination.
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Negative actions aimed against a person or group because of preconceived beliefs
about their identity. Individuals may experience bias toward a minority group without being a
member of that group themselves. (Togioka, Duvivier, & Young, 2024)
Ethnicity.
Refers to the common experiences, histories, and social and cultural traits of a group
of individuals. These include cultural practices, beliefs, values, language, and religion that are
often passed down from one generation to the next (Flanagin, Frey, & Christiansen, 2021)
Health inequities.
Avoidable differences in health between various groups of people. Examples include
social identity, access to health care, life expectancy (Lee, Kim, Lee, & Fawcett, 2020)
Race.
Describes an individual's affiliation with a group or identity attributed based on
physical traits and skin pigmentation (Hamed, Bradby, Ahlberg, & Thapar-Björkert ,
2022).
Racial disparities.
Differences in healthcare among various racial and ethnic group that can lead to
differences in health outcomes such as life expectancy, mortality, and health status
(Macias-Konstantopoulos, et al., 2023)
Literature Review
Applied Project Theme Heading 1
Text…
Applied Project Theme Heading 2
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Text…
Summary
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Section 2: Method and Design
Methodology and Design
Population and Sample
Materials and Instrumentation
Operational Definitions of Variables
Project Goals and Objectives
Metrics or Performance Measurements
Project Procedures
Data Collection and Analysis
Assumptions , Limitations, and Delimitations
Ethical Assurances
Summary
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Section 3: Findings, Implications, and Recommendations
Begin writing here…
Findings by Project Question(s)
Begin writing here…
PQ1.
PQ2.
Evaluation of the Outcomes
Action Plan
Implications and Recommendations for Practice
Recommendations for Future Research/Projects
Conclusions
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References
Flanagin, A., Frey, T., & Christiansen, S. L. (2021). The Reporting of Race and Ethnicity in Medical and Science Journals. JAMA Network. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2776936
Hamed, S., Bradby, H., Ahlberg, B. M., & Thapar-Björkert , S. (2022). Racism in healthcare: a scoping review. BMC Public Health. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13122-y
Lee, H., Kim, D., Lee, S., & Fawcett, J. (2020). The concepts of health inequality, disparities and equity in the era of population health. Appl Nurs Res. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521436/
Macias-Konstantopoulos, W. L., Collins, K. A., Diaz, R., Duber, H. C., Edwards, C. D., Hsu, A. P., . . . Sachs, C. J. (2023). West J Emergency Medicine, 906-918. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527840/#
Okpala, P. (2020). Increasing access to quality healthcare through collaborative leadership. International Journal of Healthcare Management, 229-235. doi:https://doi.org/10.1080/20479700.2017.1401276
Rinfret, N., Laplante, J., Claude Lagace, M., Deschamps, C., & Prive, C. (2020). Impacts of leadership styles in health and social services: A case from Quebec exploring relationships between emotional intelligence and transformational leadership. International Journal of Healthcare Management, 329-339. Retrieved from https://www.tandfonline.com/doi/full/10.1080/20479700.2018.1548153
Robbins, B., & Davidhizar, R. (2020). Transformational Leadership in Health Care Today. The Healthcare Manager, 117-121. Retrieved from https://journals.lww.com/healthcaremanagerjournal/abstract/2020/07000/ transformational_leadership_in_health_care_today.2.aspx
Sabin, J. A. (2022). Tackling Implicit Bias in Health Care. The New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp2201180
Togioka, B. M., Duvivier, D., & Young, E. (2024). Diversity and Discrimination in Health Care. Stat Pearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK568721/#:~:text=Discrimination%20in %20health%20care%20is,experience%20discrimination%20against%20that%20group.
van Diggele, C., Burgess, A., Roberts, C., & Mellis, C. (2020). Leadership in healthcare education. BMC Medical Education. Retrieved from https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-020-02288-x
Vela, M. B., Erondu, A. I., Smith, N. A., Peek, M. E., Woodruff, J. N., & Chin, M. H. (2022). Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs. Annual Review of Public Health, 477-501. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172268/
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Appendices
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Appendix A: XXX
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- Section 1: Foundation
- Introduction
- Statement of Problem
- Purpose Statement
- Nature of the Project
- Needs Assessment
- Project Questions/ Objectives or Goals
- Introduction to the Professional and Conceptual / Theoretical Framework
- Significance of the Project
- Definitions of Key Terms
- Literature Review
- Summary
- Section 2: Method and Design
- Methodology and Design
- Population and Sample
- Materials and Instrumentation
- Operational Definitions of Variables
- Project Goals and Objectives
- Metrics or Performance Measurements
- Project Procedures
- Data Collection and Analysis
- Assumptions , Limitations, and Delimitations
- Ethical Assurances
- Summary
- Section 3: Findings, Implications, and Recommendations
- Findings by Project Question(s)
- Evaluation of the Outcomes
- Action Plan
- Implications and Recommendations for Practice
- Recommendations for Future Research/Projects
- Conclusions
- References
- Appendices
- Appendix A: XXX
