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Review detailed instructions in the DHA Integrative Review Doctoral Study Guidebook

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Part 1: Practice-Based Problem

Problem of Interest

Healthcare Administration Problem

Background

 Using 1 source dated within the last 5 years, write 1 paragraph describing the industry-wide problem.

 Source must be listed in the reference list and Appendix A.

 Using the industry-wide problem, write 1 paragraph focusing on the historical impact of the operational problem on your selected organization.

2 Operational Problem

 Using only 3 sources dated within 5 years, describe a very specific operational problem in less than 1 page. All sources must be listed in the reference list and Appendix A.

Operational Problem Core Elements to be Corrected (Constructs)  List at least 2 core elements of the operational problem to focus on solving and why.

Core Element Briefly Explain Connection to the Problem

3 Ideal State of Operations

Professional Practice Gap Statement

 Using 1 source, any date, any industry, describe the ideal state of operations your organization is aiming to achieve.

 Source must be listed on the reference list and Appendix A.

 Using 1 sentence, summarize the operational problem, cite using 3 sources from the operational problem.

 Using 1 sentence, summarize the ideal state of operations, cite using 1 source from above.  All 4 sources must be in the reference list and Appendix A.  This must only be 2 sentences.

4 Summary of Evidence

 In less than 1 page, summarize all the evidence collected to this point; • the problem of interest • the negative impact of the operational problem on your selected organization • the ideal state of operations

5

Purpose of the Integrative Review

Integrative Review Question(s)

 Write 1 open-ended question aimed at solving your organization's operational problem.

 Using 3-5 sentences, state the purpose of this study.

6

Theoretical and/or Conceptual Framework

Description

Theoretical Alignment Table

Practice-based Problem Constructs Theoretical Framework Elements

 Using 1 source, describe the theoretical framework that aligns with your operational problem constructs (elements).

 Source must be listed in the reference list and Appendix

 List at least 2 core problem elements (constructs) and 2 theoretical framework elements that align.

7

References

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Problem of Interest Source

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

Operational Problem Source #1

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

Operational Problem Source #2

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Operational Problem Source #3

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Ideal State of Operations Source

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

Appendix A: DHA Practice-Based Problem Literature Review Matrix

Theoretical Framework Source

Author/Date:

Theoretical Framework:

Research question(s)/ hypotheses:

Methodology: Analysis & results:

Conclusion:

Implications for future research:

Implications for practice:

Empirical Research: Yes No

1. Problem Background: Telemedicine has become essential to healthcare delivery after the pandemic by providing virtual medical services. Despite its benefits the healthcare industry still faces challenges with technology adoption and staff burnout. Lack of proper digital tool training and the emotional burden of online care has decreased healthcare provider satisfaction and made patient care less effective. HSOs over the years have faced difficulties providing necessary technology training and enough support for their workforce's wellbeing. Telemedicine development will likely make these problems worse and healthcare organizations may struggle to address patient needs. Addressing the limited workforce is essential for future growth of telemedicine services.
2. Operational Problem: The telemedicine health services organization experiences a serious operational challenge because it lacks enough qualified staff to support its growing telemedicine services. Healthcare providers lack proper training programs which affect how they use telemedicine platforms and leads to poor patient care outcomes. Healthcare providers feel pressured by rapid advancements in technology and do not trust themselves enough to operate new systems properly (Rincon, 2023). Virtual patient interactions cause high stress levels that lead to burnout which decreases workplace performance and lowers job loyalty rates. Staff members reject telemedicine tools since they believe implementing new technologies will disrupt their normal procedures. Training and leadership support are necessary to overcome staff resistance when implementing telemedicine programs (Ftouni et al., 2022). Organizations that fail to support their employees' mental health needs for telemedicine experience higher burnout rates and more staff members leaving their positions. HSOs experience further operational complications when team members do not have reliable communication methods to work together. Staff feel distant from management's goals and face struggles that affect their morale and interest in work (O’Hara & Reid, 2024). These operational issues hamper HSOs from delivering high-quality care to patients while preventing them from growing successfully. HSOs need to create training sessions that teach telemedicine tools while providing mental health support to help staff handle stress. Leadership plus effective communication and adaptation support can help build a workforce ready to handle change effectively (O’Hara & Reid, 2024). Telemedicine needs continuous maintenance to become a trusted and efficient system for healthcare delivery.
3. Ideal Strate of Operations: The ideal state involves a well-trained workforce adept at using telemedicine technologies, with robust emotional support systems to minimize burnout. Employees would exhibit high adaptability to change, ensuring efficient patient care delivery through telemedicine platforms (Gajarawala & Pelkowski, 2021).
4. PPGS: Healthcare professionals in HSOs lack adequate training for telemedicine technologies, leading to inefficient care delivery. This gap highlights the need for comprehensive training programs and burnout mitigation strategies.
5. Summary of Evidence: The telemedicine health services industry has multiple problems caused by untrained staff and their resistance to digital changes. Studies show that healthcare providers lack proper training in telemedicine technology which adversely affects both patient care and medical staff confidence. Medical teams face difficulties using digital equipment because they get no educational direction or hands-on training. The quick progress of technology makes healthcare workers feel unready and burdened with their jobs. Healthcare professionals face burnout due to the emotional strain from handling patients digitally. Research data shows that medical staff using telemedicine suffer more emotional fatigue since they lack face-to-face interactions and spend more hours looking at screens. Workers experiencing burnout become less satisfied at work and frequently quit their positions which creates uncertain operations. The hesitance of staff to use new technology adds another problem to overcome. Staff resistance to telemedicine grows when healthcare teams face implementation challenges without proper guidance. Organizations that use effective leadership and communication tactics tend to defeat technology adoption hesitations better. Effective telemedicine programs provide thorough training that develops both technical competence and personal wellness. Studies indicate employee success programs with mentors plus stress training successfully lower pushback and reduce burnout rates. Organizations with adaptive cultures and employee development programs receive positive feedback from their staff and customers. Successful telemedicine implementation depends on both system efficiency skills and healthcare worker emotional care. HSOs can achieve better telemedicine delivery results and operational success through proper handling of these main challenges.
6. Purpopse of IR: This research seeks to find successful ways to handle workforce difficulties in telemedicine HSO environments. The study will research the effects of educational programs on employee readiness and explore ways to prevent burnout. This study will also examine how employees react against new technology and suggests ways to make them better prepared. The collection of research findings, it aims to assist HSOs in streamlining their operations and improving telemedicine service quality.
7. IR Review Question: What strategies effectively address workforce training gaps and burnout in telemedicine health services organizations?
8. Theoretical Framework: The Technology Acceptance Model (TAM) aligns with the operational problem by addressing perceived ease of use and usefulness of telemedicine technologies (AlQudah, et al., 2021). Additionally, the Maslach Burnout Inventory (MBI) framework guides understanding of burnout dimensions and informs mitigation strategies.
9. References: AlQudah, A. A., Al-Emran, M., & Shaalan, K. (2021). Technology acceptance in healthcare: a systematic review. Applied Sciences, 11(22), 10537. Chauhan, P., Bali, A., & Kaur, S. (2024). Breaking Barriers for Accessible Health Programs: The Role of Telemedicine in a Global Healthcare Transformation. In Transformative Approaches to Patient Literacy and Healthcare Innovation (pp. 283-307). IGI Global. https://doi.org/10.4018/979-8-3693-3661-8.ch014 Ftouni, R., AlJardali, B., Hamdanieh, M., Ftouni, L., & Salem, N. (2022). Challenges of telemedicine during the COVID-19 pandemic: a systematic review. BMC medical informatics and decision making, 22(1), 207. https://doi.org/10.1186/s12911-022-01952-0 Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218-221. O’Hara, C., & Reid, M. (2024). Characterizing the Telehealth Nursing Workforce. Journal of Nursing Regulation, 15(1), 80-87. Rincon, T. A. (2023). Telehealth and Virtual Nursing: Solutions That Challenge the Status Quo. AACN Advanced Critical Care, 34(4), 312-313. https://doi.org/10.4037/aacnacc2023637
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13. Problem of Interest: The telemedicine health services organization is having workforce challenges because of how quickly telemedicine technology is advancing. Three main problems - staff not trained enough in new technology, not enough staffing, and medical staff feeling overworked - prevent telemedicine from working at its best (Chauhan et al., 2024). The emotional strain of virtual patient interactions exacerbates these issues, leading to suboptimal care delivery.
14. Enter Problem Construct1: Technology Training
15. Enter Problem Construct2: Resistance to Change
16. Enter Problem Construct3: Burnout Mitigation
17. Enter Aligning Framework Element1: Perceived ease of use (TAM)
18. Enter Aligning Framework Element2: Perceived usefulness (TAM)
19. Enter Aligning Framework Element3: Emotional exhaustion (MBI)
20. Enter Aligning Framework Element4: Depersonalization (MBI)
21. Enter Problem Construct4: Emotional Strain
22. Enter Aligning Framework Element5:
23. Enter Problem Construct5:
24. Text3: Not explicitly mentioned
25. Group15: Choice2
26. Text2: Chauhan, P., Bali, A., & Kaur, S. (2024)
27. Text4: How does telemedicine improve healthcare access and address deficits in underserved areas?
28. Text5: Chapter analysis in healthcare innovation studies. Evaluated telemedicine’s impact, benefits, and barriers during the pandemic.
29. Text6: Telemedicine enhances access, reduces costs, and supports underserved areas but requires improvements in digital readiness and regulation.
30. Text7: Study specific outcomes of telemedicine in diverse populations
31. text8: Enhance digital competency and update regulatory frameworks.
32. Operational Problem Source2: Ftouni, R., AlJardali, B., Hamdanieh, M., Ftouni, L., & Salem, N. (2022)
33. Operational Problem Source3: Not explicitly mentioned
34. Operational Problem Source4: What are the barriers and challenges to telemedicine adoption during the COVID-19 pandemic, and what solutions can improve its use?
35. Operational Problem Source5: Systematic review (PRISMA guidelines) Analysis & results: Barriers categorized into seven themes: technical issues, privacy concerns, lack of training, etc.
36. Operational Problem Source6: Telemedicine faces adoption barriers, but stakeholder collaboration and research can address these.
37. Operational Problem Source7: Further study on policy and technology integration.
38. Operational Problem Source8: Implement proposed solutions to optimize telemedicine.
39. Operational Problem Source9: Rincon, T. A. (2023)
40. Operational Problem Source10: Not explicitly mentioned
41. Operational Problem Source11: How can telehealth and virtual nursing address global staffing shortages?
42. Operational Problem Source12: Methodology: Case studies and historical analysis Analysis & results: Explored the evolution and potential of telehealth in improving nurse efficiency and care quality.
43. Operational Problem Source13: Innovative virtual nursing solutions can address staffing shortages and improve patient outcomes.
44. Operational Problem Source14: Investigate the scalability of virtual nursing models.
45. Operational Problem Source15: Promote technology use among nurses for situational awareness and cross-boundary care.
46. Operational Problem Source16: O’Hara, C., & Reid, M. (2024)
47. Operational Problem Source17: Not explicitly mentioned
48. Operational Problem Source18: How is the telehealth nursing workforce evolving post-pandemic?
49. Operational Problem Source19: Methodology: National Nursing Workforce Study, clustering analysis Analysis & results: Telehealth usage varies by nursing profiles; rural RNs use it differently than urban counterparts.
50. Operational Problem Source20: Workforce planning must address distinct telehealth usage patterns and multistate licensure benefits.
51. Operational Problem Source21: Examine telehealth adoption across varying professional profiles.
52. Operational Problem Source22: Tailor telehealth interventions to nursing roles.
53. Ideal State of Operations Source1: Gajarawala, S. N., & Pelkowski, J. N. (2021)
54. Ideal State of Operations Source2: Not explicitly mentioned
55. Ideal State of Operations Source3: What are the benefits and barriers of telehealth adoption?
56. Ideal State of Operations Source4: Methodology: Narrative analysis of telehealth trends and practices Analysis & results: Identified benefits (cost-effectiveness, patient satisfaction) and barriers (legal, regulatory issues).
57. Ideal State of Operations Source5: While telehealth adoption has grown, addressing regulatory and reimbursement issues is essential for sustainability.
58. Ideal State of Operations Source6: Explore long-term effects of telehealth on patient outcomes.
59. Ideal State of Operations Source7: Advocate for legislative advancements in telehealth.
60. Theoretical Framework Source1: AlQudah, A. A., Al-Emran, M., & Shaalan, K. (2021)
61. Theoretical Framework Source2: Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT)
62. Theoretical Framework Source3: What factors influence the acceptance of healthcare technologies?
63. Theoretical Framework Source4: Methodology: Systematic review of 142 empirical studies Analysis & results: TAM and UTAUT are the dominant frameworks. Additional factors include anxiety, computer self-efficacy, and trust.
64. Theoretical Framework Source5: Acceptance of healthcare technologies varies based on user groups, settings, and influencing factors.
65. Theoretical Framework Source6: Focus on under-researched contexts and user behaviors.
66. Theoretical Framework Source7: Design training programs to reduce anxiety and increase trust in healthcare technologies.
67. Text8: Technology Training
68. Text9: Equip staff with comprehensive telemedicine training programs
69. Text10: Burnout Mitigation
70. Text11: Implement strategies to address emotional well-being and reduce burnout