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Stage 1: Developing a Healthcare Administration Practice-based Problem

The first step to solving a practice problem is to identify, describe, and justify the practice-based problem. The practice-based problem presents a detailed description and outline of the proposed healthcare administration problem and describes a specific idea, the related literature, and the initial research alignment for the project.

Students should consult with their project mentor early and frequently when developing a practice-based problem. With guidance from their mentor, students conceptualize a topic, organize and synthesize the literature, and determine the theoretical framework.

Problem of Interest

Describe the industry-wide problem related to your healthcare service organization type. This element looks at a particular sector of the healthcare industry that provides unique services, such as acute care, primary care, long-term care, medical devices, pharmaceuticals, healthcare insurance, etc... Provide what is known about the problem and why it continues to be a problem for healthcare administrations in that sector. This should be a macro or meso-systems discourse about the problem and how it is negatively impacting the industry.

The Problem of Interest should be one to two impactful paragraphs that create an urgency for the problem and highlight the importance of the problem for the industry, organizational leaders, and communities.

Scenario : You are at a conference being attended by administrators running Healthcare Service Organizations (HSO) like yours, but some are larger, some are smaller, some specialize in key services, some are urban, some are rural, etc... The conference topics highlight current and relevant problems all HSO leaders are facing, but they are not providing specific solutions to the problems because they know all organizations are unique and will need to address the problems at the local level according to their specific HSO.

Required Evidence : Students should provide at least 1 credible source supporting the importance of this problem within the HSO’s sector.

Healthcare Administration Problem

In this section, students will narrow down the industry-wide problem of interest to a very specific operational, business, or administration problem that is specific to their organization's location, size, services, funding, workforce, and populations they serve. Students should expand upon the sources provided in the project plan significantly but also remember that the sources need to be related to the very specific healthcare administration problem and their HSO.

Scenario : After attending the national conference, you are meeting with your CEO, and he/she is asking you to develop an evidence-based strategy to address one of the industry-wide problems highlighted at the conference. Although your organization is experiencing the same industry-wide problems as other organizations, the specific obstacles and operational problems are not the same as those other HSOs are encountering. Your organization provides services to a unique population in a rural region with a small 50-bed facility. You are experiencing unique challenges with staffing, funding, and patient outcomes that large, urban HSOs do not experience.

Students will conduct a literature search that is specific to the HSO type, healthcare administration problem, and professional practice gap. This section is designed to provide the background and history of the very specific healthcare administration problem by searching medical databases, professional associations, and the library. As students locate potential articles or other credible evidence, they should screen the evidence to make sure they relate to the study by using the “Preliminary Screening Questions”. It is not uncommon for search results to include evidence that is not specifically related to your study. The following steps should be used to complete this Healthcare Administration Problem section:

Steps 1: Conduct a Literature Search using keywords from your HSO type, healthcare administration problem and professional practice gap. The information below may assist you in getting started.

· Start Your Research (Searching the literature, databases, and other sources)

· Examples of medical databases to consider.

· Cumulative Index to Nursing and Allied Health Literature (CINAHL)

· MEDLINE

· PubMed

· The Cochrane Library

· Joanna Briggs Institute (JBI)

· PsychINFO

· Health and Psychosocial Instruments (HaPI)

· Search Professional Associations or other agencies that serve your profession.

Step 2: Complete the “Preliminary Screening Questions”. This will ensure your list of sources is directly related to your project, as well as identify if the source is a research or non-research course. The Preliminary Screening Questions are listed below:

“Is the source empirical research?” (Does the source name and use a known research methodology?)
Yes	No
If an empirical research article (quantitative or qualitative methodology): 1. The research findings, results and interpretation only addressed a practice-based problem and not a solution. (Solution articles should be used in stage 2.) 2. Are the purpose and research question(s) aligned with your specific HSO problem? 3. Are the methods clearly described and results aligned with the stated research question(s)?	If a non-empirical research document: 1. The source focused on and identified a practice-based problem and not a solution. (Solution articles should be used in stage 2.) 2. Is the purpose of the source aligned with your specific HSO problem? 3. Does the document fill a gap or add context to the purpose of your review that is, to date, unsubstantiated by empirical research?
“No” to either question: Remove the Source from the study. “Yes” to both questions: Include Source on the Literature Review Matrix	“No” to either question: Remove the Source from the study. “Yes” to both questions: Include Source on the Literature Review Matrix

Below are some brief descriptions of each type of literature:

· Empirical Research Literature – articles that use qualitative, quantitative, and mixed-methods research designs. They also involve a process that requires a consensus of 2-3 experts to substantiate the rigor and validity of the research before it can be published.

· Explore Methodologies Click Here .

· Establishing a Research Design Click Here .

· Quantitative research - is the process of collecting and analyzing numerical data. It can be used to find patterns and averages, make predictions, test causal relationships, and generalize results to wider populations. For more information, Click Here

· Qualitative research - involves collecting and analyzing non-numerical data (e.g., text, video, or audio) to understand concepts, opinions, or experiences. For more information, Click Here

· Mixed Methods research - combines elements of quantitative research and qualitative research to answer your research question.

· These can be found primarily in professional journals and databases such as Medline, PubMed, NIH, and other collections that clearly state their publications are peer-reviewed.

· Non-empirical Research (Grey) Literature – is any type of source other than peer-reviewed published research. Types of Grey literature include:

· Non-peer-reviewed publications (White papers, agency newsletters, etc..)

· Agency reports (Reports from Medicare, Joint Commission, etc..)

· Organizational reports (Cost analysis, operational quality, etc..)

· Expert testimony or opinions (Opinion papers, interview transcripts, presentations, etc..)

Step 3: List the included evidence on the Practice-based Problem Literature Review Matrix. Make sure to embed the matrix in the appendix.

Step 4: Using the sources from the Practice-based Literature Review Matrix, write the Healthcare Administration Problem section of the project, focusing on the background, history, and current issues related to the problem. Remember that this section should be very specific and identify the HSO type, location, size, and any other unique characteristics that set it apart from other organizations in the same sector.

Required Evidence : There should be many sources listed on the matrix that provide the history and background on the problem and end up in the reference list and are cited as intext citations in the body of this section, but at a minimum of 3 sources within the last 5 years are required to clearly state the problem currently exist and needs to be solved.

Required appendix :

· Practice-based Problem Literature Review Matrix

Professional Practice Gap Statement

Once the healthcare administration problem has been clearly identified, students must locate sources that describe or outline what the desired ideal state of operations should be related to the problem so that a practice gap can be identified. Although only one credible source is needed for this section, the more support you have delineating the desired ideal state of operations, the better you will be able to describe or measure the changes to the professional practice gap and what is needed to close that gap.

It is important to understand that two elements are needed to establish a professional practice gap. Those elements are as follows:

1. Justified healthcare administration problem using at least 3 credible sources within the last 5 years …And

2. 1 credible source that provides a reasonable description (qualitative or quantitative) of what the ideal desirable state of operations should be.

By having these two elements identified, a practitioner can determine if a professional practice gap exists. If a gap exists, a practitioner can search for tangible ways to move from the undesirable state of operations to the ideal desirable state. Without these two elements present, the endeavor is more aspirational than operational.

Using these two elements, a Professional Practice Gap Statement can be created.

Evidence Required : At least 1 credible source stating the ideal desirable state of operations. (Keep in mind that the healthcare administration section should already have the 3 credible problem sources within the last 5 years)

Summarizing the Evidence

In this section, students will summarize the problem of interest, healthcare administration problem and professional practice gap. This should be a concise and focused statement of the evidence related to the problem of interest, healthcare administration problem and professional practice gap.

Purpose of the Integrative Review

In this section, students will provide the key elements of the healthcare administration problem to be studied, the healthcare administration impact of the review, and the relationship to social determinants of health.

Resources :

· Read Chapter 2 in the Step-by-Step Guide to IR (2020).

Integrative Review Question(s)

In this section, students will state the integrative review question(s) the key elements of the healthcare administrative problem being studied and how the review questions address a possible solution. Review questions should not be closed-ended questions (Yes or No responses).

Resources :

· Read Chapter 2 in the Step-by-Step Guide to IR (2020).

Theoretical and/or Conceptual Framework

Under this heading, students will identify the theory(ies) or conceptual framework and provide the origin or source of the theory or conceptual framework. Describe the key constructs of the healthcare administration problem and logical connections between the elements of the theoretical or conceptual framework. Students should make sure to explain the alignment of the theoretical or conceptual framework with the practice-based problem, practice gap, purpose, and review question(s).

In addition, students should state how the key constructs are related to the in-depth literature review of the key variables/constructs in this section.

Resources :

· Read Chapter 2 in the Step-by-Step Guide to IR (2020).

· Theoretical Frameworks