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dc.contributor.advisorSchachter, Kenneth A.
dc.contributor.authorGabriel, Alejandra
dc.creatorGabriel, Alejandra
dc.date.accessioned2018-05-21T19:27:36Z
dc.date.available2018-05-21T19:27:36Z
dc.date.issued2018
dc.identifier.urihttp://hdl.handle.net/10150/627694
dc.description.abstractOver 59 million US residents live in rural areas where they cannot easily access healthcare services. Well-documented disparities between rural and urban healthcare access led the federal government to certify and financially support Critical Access Hospitals (CAHs), which offer rural healthcare services and 24/7 emergency care. Many CAHs are in dire financial distress, and some are looking to increase their patient population volume to improve financial health and ensure continued operations. It is a well-known business truism that satisfied customers are return customers. Today many patients’ first encounter with a hospital is with the emergency department (ED). Thus, it is likely that increasing patient satisfaction with their ED visits in a CAH can be expected to increase the chance that they will return for additional care. All hospitals engage in quality improvement (QI) activities. Many papers outline efforts by QI teams to implement one or a few predetermined interventions with mixed results. Because patients in an ED are subject to a variety of processes in the ED and other hospital departments, improving patient satisfaction in the ED demands a comprehensive approach. This paper focuses on the QI processes and tools used by the QI team in a CAH that developed a comprehensive list of (56) short- and long-term interventions to take place over five years to improve patient satisfaction in the ED. For this hospital, two aspects of the project deserve mention: 1. The use of Failure Mode and Effects Analysis (FMEA): The FMEA is a QI tool developed by the military to address complex problems. Although it has been adapted for use in healthcare QI, in the author’s experience, it has not always been fully implemented. The QI team completed a traditional, full, two-part FMEA. In completing both parts of a traditional FMEA, the team first identified and individually analyzed each known or potential failure in the care of an ED patient and potential interventions that could prevent each failure. Then, after careful analysis of all potential interventions, the QI team chose those most likely to succeed and began implementing a sequenced schedule of interrelated interventions deemed most likely to improve care and patient satisfaction. 2. Learner-Centered Teaching: QI projects typically use learner-centered teaching methods that, according to Social Cognitive Theory, improve participants’ general self-efficacy, which is the likelihood of choosing difficult problems to solve and persisting when faced with challenges. The hospital’s project team members’ self-efficacy scores increased after participating on the team. Post-project interviews with team members indicate they feel better equipped to solve other problems and have begun to plan other QI projects because they understand other areas’ processes, they know who should participate on projects, and they better understand QI processes and tools.en_US
dc.language.isoen_USen_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.subjectFailure Mode and Effects Analysis (FMEA)en_US
dc.subjectGeneral Self-Efficacyen_US
dc.subjectHealth Administrationen_US
dc.subjectLean Managementen_US
dc.subjectQuality Improvement (QI)en_US
dc.subjectSocial Cognitive Theoryen_US
dc.titleIncreasing Patient Satisfaction in a Rural Hospital Emergency Department: A Quality Improvement Project Using Failure Mode & Effects Analysisen_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
thesis.degree.grantorUniversity of Arizonaen_US
thesis.degree.leveldoctoralen_US
dc.contributor.committeememberBarraza, Leila
dc.contributor.committeememberRainie, Stephanie C.
dc.contributor.committeememberDokter, Erin
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePublic Healthen_US
thesis.degree.nameD.P.H.en_US
refterms.dateFOA2018-05-21T19:27:36Z


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