Final paper 1
Liberty University
Master of Science in Healthcare Administration BUSI
629
Deysi Menjivar
May 9, 2025
Author Note
Deysi Menjivar. I have no known conflict of interest. Correspondence concerning this article
should be addressed to Deysi Menjivar. Email: demenjivar@liberty.edu
Final paper 2
Abstract
Healthcare system has never been perfect, and it has issues that have yet to be solved that
need solutions. Patient safety is vital for individuals to be safe so creating a patient safety
culture, effective communication & teamwork is essential, guidelines and policies,
communication
strategies. Staff shortage can be caused by decline in burnout, aging population, and inability
for organizations to keep their employees. High healthcare costs can include technology, elderly
care, prescription drugs, defensive medicine, administrative costs, supply chain.
Keywords: patients, patient safety, technology
When patients come to seek care, they have expectations of superior quality of care
which means a good health outcome. The expectations that patients have is for their safety to
not be compromised due to multiple factors like staff shortage among other things and have
Final paper 3
low healthcare costs when seeking the necessary care that they need. When patient safety is
present, it allows them to believe that the healthcare system will provide patient-centered care
which include respecting their decisions by listening to them. Healthcare is bound to have issues
that come up that can affect overall healthcare outcome. The biblical principle that comes to
mind is that prayer will help with the issues that can arise. “When my soul fainted within me, I
remembered the Lord: and my prayer came in unto thee, into thine holy temple” (King James
Bible, 1769/2017, Jonah 2:7). God’s children see prayer as an essential part of their lives. They
know that nothing is impossible when it comes to God especially if they are looking for
solutions for problems that can arise in healthcare. It is essential to address the issues of patient
safety, staff shortage and high healthcare costs to improve patient care because everyone
deserves excellent quality of care.
Patient safety has always been a priority for healthcare to achieve but issues can arise
which can cause concern like bad communication and teamwork. Medical errors can occur
when patient safety is compromised which causes loss in trust, harm to the patient and overall
decrease in health outcome. According to Alsabri et al (2022) medical errors are occurring
because of human error that stems from poor communication and teamwork (p.e351). An
example of a medical error can be complications or wrong site from surgery. Ross (2022) wrote
that there has been an increase of wrong site surgery and complications after surgery (p.565).
These two medical errors can cause fear in patients not knowing if they could be next to
experience these errors that can be life-alternating. Losing their good limb means that they will
experience adjustments that they did not that they had to go through. For example, if they
amputated the wrong limb, it will be even more devastating and even an even more
adjustment. Post surgery complications can include an infection that can delay their recovery
Final paper 4
time or even cost them to die. In the human body, there are a lot of arteries and veins and if
one is affected, it can cause massive bleed that would require quick aid. Patients want to feel
safe when they receive care because it allows them to instill trust in the healthcare system.
When a patient does not have trust, they could choose to forego care altogether. Patients are
told the importance of going to seek care when needed like preventative care or unless they
have a medical emergency. While it is good to empathize that seeking healthcare is essential,
trust must be built but also supported because trust can be lost and hard to regain. The
healthcare system needs it to show that they will create an environment that will protect the
safety of patients which can be done with creating a patient safety culture. Creating a patient
safety culture that includes effective communication by combating the barriers which helps
with patient safety, set up safety guidelines & policies and communication strategies could be
effective ways to help build and keep confidence that patient safety is seen as a priority and not
a back thought
It was told by Guttman (2021) that the lack of communication is a barrier to
communication (p.1465). In healthcare, coworkers are always working together when treating
patients because there is not a patient that is only working with just one healthcare provider. An
example of healthcare professionals that work together are nurses and doctors. While nurses
and doctors have different duties to perform, they work as a team when treating their patients.
Nurses are usually the one that provides around the clock care while the doctor will come in
when needed. Both nurses and doctors will clock out and will need to transfer information to
the other healthcare professional that will over for them. The lack of communication between
coworkers could be the reason that patient safety can be compromised. There seems to be
incidences where a provider might not speak up due to self-preservation. It was mentioned by
Final paper 5
Guttman (2021), providers might be practicing self preservation since speaking up has been
seen to cause dismissal, anger, loss of relationship, intimidation, retribution, and
marginalization of information (p.e1466). The fear of dismissal can someone to think twice
about saying anything. For example, safety incidents can occur and if the provider does not
work that, it could be detrimental to the patient. Patients have the right to have the incidents
that has happened to them reported so that providers can be held accountable and learn their
lesson to hopefully not repeat their mistakes. Providers need to understand that withholding
information will make it worse. The fear of retribution is especially if a provider was a witness to
another provider who made a mistake. They might fear that if they spoke up that the other
provider tries to damage their reputation which can cause their job. Leaders need to create an
environment where provider will feel safe to speak up if because if the provider choose self-
preservation, their lives are the only one effect, the patients pay the price.
Language barriers can cause patient care to suffer because of these frequent problem
incorrect interpretation and diverse cultural beliefs. Im and Aaronson (2020) told that the cause
of medical errors can result from family or friends acting as interpreters, cultural beliefs and
tradition that affect patient care and provider trying to communicate with patients while
language ability is limited and by not using trained interpreters (p.699). The issue with using
family or friends is that they have not trained to be an interpreter and could provide inaccurate
translation of what the healthcare professionals told the patient about their care especially if
family or friends have no prior knowledge of medical technology that providers could use.
Healthcare professionals are used to using medical technology when providing care. Medical
interpreters go through training to provide correct interpretation for the patients they provide
their services to. Each culture has different beliefs on patient delivery and are to be respected
Final paper 6
but it is impossible to know about the patients' beliefs if they are unable to communicate with
their provider. When there is not an interpreter present during this time, the cultural beliefs are
likely to be disregarded. Just like using family or friends to interpret, a provider trying to
communicate without the help of qualified interpreters could have patients who might of nor
fully understand the information provided. In the best interest of the patient, it would be best
for providers to have a qualified interpreter to be present either in person or over video chat. A
healthcare facility needs to create different options for interpreters in case the in-person
interpreter was not booked because the provider should care that their patients have what is
needed when seeking care. For individuals who are hard of hearing, the healthcare system
needs to have all languages for sign language since it is not a universal language. Combating
language barriers makes an enormous difference if the patient was able to understand the
information provided by receiving care and what the next steps that need to be taken.
Linguistics is another barrier in communication that affects patient care. According to
Guttman (2021), linguistics consists of different components of speech that can include syntax,
semantics, lexis, tone, tempo, style, pragmatic, and colloquialisms (p.e1468). Each of these
components play a role in making sure that the patient can understand the information was
given properly. When it comes to linguistic barriers, there seems to be two solutions that could
help. Guttman (2021) described that linguistic barriers can be overcome with the use of explicit
and closed loop communication (p.e1468). In closed loop communication, the receiver can be
seen as the patient while the sender would be the provider. Guttman (2021) defines closed loop
communication as sender beginning the information exchange and the receiver will repeat the
information provided which helps the sender know the receiver's attention and that the
information was correct (p.1468). It is vital for patients to understand the information from the
Final paper 7
provider who is caring for them. When individuals understand the information, it allows them
to make an informed decision that would be in their best interest. Each patient will have
different linguistic competences for them but not others so finding the correct one for each
patient is important.
Having patient safety guidelines and policies is another way to help with establishing
patient safety culture. Seo & Lee (2023) wrote that the World Health Organization mentioned
that guidelines and policies are essential to help with patients' safety since it can decrease
unsafe behavior and promote safety performance. An example of unsafe behavior that can be
problematic is violating HIPAA. The health insurance Portability and accountability act was set
up to protect patient information. Hospitals will have systems which check individuals accessing
patient information and will flag someone if they believe they are misusing. Policies about
HIPAA are in place for patients to trust that their information will not be used unless it is needed
to provide care to them. The way to promote safety performance is for employees to train on
fall protection, hygiene protocols and the importance of addressing errors culture. In
healthcare, fall risk is categorized into three groups. There will be patients who are seen as a
patient who is at a minimal, moderate, or severe risk of falling. It would be good for staff to be
trained on how to find each patient and what their fall risk is to know how to aid them. Hygiene
protocols have been in place to protect the patient as well as the provider. Emphasizing the
importance of hygiene can help with the decrease of hospital infections. Hospital infections can
cause devastating consequences. When errors occur, it can be scary to report it, but it is
necessary.
Final paper 8
Addressing errors can help providers learn what they did wrong in the hope they will not make
the mistake again. It is unfair to keep errors that occur from the patient since they have the
right to know that someone went wrong.
A communication strategy that can used for improvement of patient care is AIDET.
Acknowledge, Introduce, Duration, Explanation, and thank you is the acronym of AIDET which is
a communicable tool that a nurse can use when communicating to patient and family that Chu
(2023) wrote in this article (p.36). In the acknowledgment part, this could be the time for the
healthcare worker like the nurse or doctor to greet the patient. Once the healthcare worker
greets the patient, this would be the time for them to introduce who they are. The duration
part is letting the patient know how long it could take for the tests among other things. During
the explanation stage, patients will be explained the procedures and treatments and allow them
to ask questions if they are unsure of something. Allowing patients to ask questions allows them
to hear about the concerns and hopefully get answers. The last step is to thank the patient for
coming to them to receive care. It would be good for patients to be thanked for choosing them
so it will encourage them to come again.
The next communication strategy is SBAR which stands for situation, background,
assessment, and recommendation. Chu (2023) wrote that SBAR is a tool that helps when it
comes to transfer of information that would go from one doctor to another (p.37). When
transferring information to another provider, explaining the situation of the patient is needed to
provide insight about what the patient could be experiencing. Along with the situation of the
patient, providing background information like medical history could offer further insight into
what could be causing the symptoms. The two providers will discuss the possible conditions
Final paper 9
that could be happening with the information provided. Recommendations of the test or
procedures will be provided.
Another communication strategy that can be used is teamstepps. There are five core
principles that include team structure, leadership which can include huddles, communication
like handoffs, situation checking like mutual support & cross monitoring. A leader might decide
to use huddles to check up with their time on what could be working and what is not which will
require a solution. An effective huddle allows employees to feel comfortable sharing what could
be not working in their department. For employees to share, employers need to create an
environment that builds trust between employees and employers that allow them to feel like
the things that they say will not be criticized. Chu et al (2023) wrote that handoff consists of
transferring of information when shift change occurs (p.38) During this time, it is vital for the
other provider to understand the information provided to deliver good and safe care. Mutual
support could help employees help each other when needed. Cross-monitoring is seen as a
monitoring technique to reduce potential errors. It was said by Chu et al (2023) that
crossmonitoring is surveilling the team members and ensuring that the workload is not high
(p.39). A high workload can lead to stress on how they will keep up with the load. By watching
the workload, employers can fairly split the workload to all their employees
Staff shortage can be caused by decline in burnout, aging population, and inability for
organizations to keep their employees. Nurses have been known to experience burnout because
their job is demanding since of their responsibility to directly care for patients under doctor
supervision. Melynk et al (2024) has described burnout has become a huge health issue that
causes their mental and physical wellbeing to be affected that can occur from exhaustion,
depersonalization and personal achievement that is at a decrease (p.456). One example of
Final paper 10
burnout was when the pandemic happened which caused chaos. During the pandemic, an
increase in staff shortage increased. Healthcare workers were the front-line workers who dealt
with the millions that dead that can leave trauma. Dealing with death can be traumatic which
could lead to burnout. People are aging toward retirement which leaves for the demand for
more workers but looking for new employees takes time. Many employees could feel like they
are not being compensated in the areas that matter like work-life balance. Finding short & long-
term solutions can be the next step to help staff shortage
In this article, Chevroni-Krupp (2022) said that possible short-term solutions could
include retention bonuses and offer overtime rates and incentive hourly payments (p.34). Staff
need an incentive to want to make the decision when deciding if staying at their job. They want
to feel like they are being valued and even though this solution is a short-term solution, it can
give management time to look for other staff that they can hire. In some circumstances,
employers might need their employees to stay overtime, and an incentive is necessary to
provide staff motivation to work overtime. Training staff to perform other duties and could be
other short-term solutions. When a staff member is trained in other duties, they could help
their team member that was unable to complete a task especially if they had some free time
pop up in their schedule. The other team members will appreciate the help and be willing to
help them if the time comes up to help.
Chevroni-Knapp (2022) mentioned that the possible long-term goal that could help to
keep their staff is by giving employees the opportunity of flexible schedules and hiring overseas
nurses (p.34). Having the choice to have a flexible schedule allows an employee to create a
schedule that can promote work life balance that can be the best thing for them and their
family. When an individual does not have work life balance, it can cause stress in their lives.
Final paper 11
With nurses that are overseas, health facilities need to make sure that the employees have their
RN licensure that will allow them to practice in the designated state that they will be working in.
Without the proper licensure, the nurse would not be able to work. Overseas nurses will also
need training in the healthcare facility that they are assigned to since they might be unfamiliar
with the place. They will go through orientation with another employee to show them the
system that they have in place. Making sure that nurses have a flexible schedule and hiring
more nurses is not the only way to keep staff. Organizations need to make sure that the mental
health of their employees is taken care of.
High healthcare costs is another issue that needs to be addressed. Examples of high
healthcare costs are technology, elderly care, prescription drugs, defensive medicine,
administrative costs, supply chain. Technology is seen as an essential tool to have in healthcare
because of the benefit that it can provide. Prescription drugs have been around for a while and
provided benefits that can help with management or healing of a condition or disease. The
elderly population is a group that need more extensive care than their counterparts like
younger adults. In the mind of providers, they believe that defensive medicine is the best
solution for them when practicing care to patients. When the supply chain is affected, it not
only arises costs, but healthcare facilities will be low on supplies needed to perform services. In
some cases, the services are a needed procedure or treatment that could save someone’s life.
The price of prescription drugs has been on the rise over the years in the healthcare
industry and it seems like they will keep on rising. It was reported by Rome et al (2022) that in
2020, the spending of prescription drugs exceeded half a trillion dollars which could be the
cause of brand drugs being costly (p.2145). With high-cost brand drugs, it is bound to cause
Final paper 12
issues for patients who have certain prescription drugs that they need to take when it comes to
the maintenance of their condition. The high-cost drugs can cause premiums to be high, out of
pocket costs to be unaffordable or access being restricted by payers. For example, insulin is a
prescription medication that a diabetic will need to control sugar levels. The problem with
insulin is that it can be costly, especially paying out of pocket. It can cause a financial strain in
their lives and cause stress on how they will be able to obtain the treatment or medication that
helps them to remain healthy.
Prescription drugs prices will continue to rise if organizations do not come with an
intervention solution. An intervention that an organization could try is follow up other countries
have done when it comes to drug prices. Other countries are negotiating drug prices instead of
letting the manufacturer set a price (Rome et al. 2022, p.2147). Allowing manufacturers to set a
price gives them control to choose the price that better suits their interest. The attempt to
negotiate drug prices occurred during the Biden Administration. It was said by Rome et al that
on August 29, 2023, the negotiation with the pharmaceutical companies of the first 10 drugs
(p.1621). The Biden Administration believed it was time to negotiate drug prices since it was
working for other countries. The hope with the negotiation for the drug prices was to be
successful and hopefully be able to negotiate the prices of others. With any negotiation being
done, there will be conflicts that can affect the success of the negotiation.
The risk of being sued is high among providers because of their responsibility to proving
excellent quality care. In this article, Pierce et al (2022) said that the estimation of physician is
being use is 1 out of 3 and there has been an increase of 64% for general surgeons (p.234). The
fear of legal consequences has made them feel that defensive medicine is their solution.
According to Strobel et al (2023) the use of defensive medicine has been occurring because of
Final paper 13
fear of legal consequences (p.530). While the providers might see this benefit them, it
negatively affects the patient that they treat. Defensive medicine cause providers to order
unnecessary test and choose to treat patients that can be considered elevated risk. Providers
might think that if they order multiple tests that it will make them seem like they cover all their
bases, but it just drives up the cost that patients must pay afterwards. Avoiding treating
considerable risk patients cause a delay in care that can lead to more complications if not
treated accordingly. It is unfair for providers to do that to a patient because they took an oath to
do no harm and by avoiding treating enormous risk patients, it could be considered doing them
harm and not acting in the interest of the patient wanting to get treatment. With any patient,
there will always be risk because each treatment is never 100% perfect since complications can
arise but by treating the patient, it gives them a chance to get better.
Nowadays, technology plays a crucial role in healthcare setting when it comes to
efficiency and helping with patient experience. Technology in healthcare is used to help with
diagnosis and treatment as well as keeping patient records. For example, electronic health
records have been adopted as the primary way to have patient records. Providers depend on
electronic health record when treating patients. In some instances, technology is used to
provide treatment or produce a diagnosis for the patient. Like an ultrasound can be used to see
if someone has a cardiac stomach condition or check a pregnancy if they are a woman. With
technology, economic, technical, organizational, and social barriers are possibilities that the
healthcare care system needs to consider could affect patient care.
Modern technology can end up being costly. Pakulska & Religioni (2023) told that the
economic barrier with technology is that the cost of modern technology is not a one-time thing
and that more spending like operating costs can happen (p.821). Technology like cars require
Final paper 14
maintenance regularly to make sure that it is functioning properly. The issue is that the
organization could not have the funds to pay at the time to perform operation costs or to pay
for new equipment which can delay a diagnosis or treatment. This can cause patients to seek
care somewhere else that can perform the tests and procedures that they might need. This
creates a loss of revenue that could affect other areas. It would be advisable for organizations to
create other ways to buy funds.
With modern technology, it requires individuals to get new knowledge and skills to use
that some employees might lack. Technology has always been evolving over the years. In this
article, Pakulska & Religioni (2023) describes the same improvement solutions might not be be
able to be used in many entities (p.821). There can never be one solution that would be perfect
for the multiple entities that exist. This could bring down efficiency in getting things done to
provide excellent quality of care when skills and knowledge is not up to date. It is vital for
managers to enroll their employees in the proper training courses to get the knowledge and
skills that their job might require with the implementation of modern technology. Managers will
have to ensure that these training courses are completed promptly because getting the
education from these courses will decide if the employees will be able to do their job.
An organizational barrier that Pakulska & Religioni (2023) wrote about is the
organization barriers stemming from different systems in the organization and the need to
combine the systems and create new rules (p.822). Each system will have different processes
that the other systems will not use. It is good for employees to be also trained in the different
systems in case they were ever asked to perform other duties. When systems must combine,
the rules before might not work. It will take problem solving approaches to figure out what
rules will work for all the systems that have to be combined.
Final paper 15
Pakulska & Religioni (2023) wrote that human factors which include staff attitude, no
faith in improvements and knowledge about the benefits of solutions, seeing change as an issue
and no motivation for change will need to address since it can cause issues when trying to
increase productivity (p.822). For example. primary healthcare is the first step when seeking
access to services. Pakhomova et al (2023) says the World Health Organization wrote that
primary healthcare is seen as the first contact to access services like essential care that helps
with promoting health quality (p.765). There will never be a time that change will not happen.
Staff attitude makes a difference in an organization. The hope is that staff will have a positive
attitude about recent technology but that is not always the case. They could feel that there will
be no improvement especially with technology that is new. Usually, improvements will take
time which can be frustrating at times which can cause staff attitude to feel like no
improvements will ever come. Change is not always bad but when people see it as an issue
because it is something different that is out of norm because they do not know what issue can
come up. If they do not motivation for change, it might be because they do not see why change
must be done if things are able to function. Improvements might be seen as solutions, but they
might not understand the benefits it can provide.
As people age, they can become frailer and require more aid for daily life activities and
overall care. Basic daily life activities could be dressing, bathing, and taking medication like a
chronic condition. It can take the elderly more effect to just perform the daily activities that
were once so easy to do when they were younger. A shower chair could help the elderly be able
to sit down to take a shower without the need of being on their feet. They are also more prone
to falls that can cause serious injuries that do not recover as fast as their counterparts. The
elderly population are susceptible to getting sick more easily because they could have a low
Final paper 16
immune response. Their immune response is like it was when they were babies which means
they are prone to catching any sickness like flu and cold. This population will also require
modifications in their lives to make it easier to move around which allows them to be safer.
When it comes to fall prevention, modification needs to be set up. An assisted device like a
walker might be a clever idea if their gait is causing them to have fall. Compared to their
younger counterparts, they usually need intensive care and will be discharged to a long-term
facility (Lau et al, 2023,
p.184). Children of the elderly might choose the possibility of a nursing home after discharge if
it is better for the elderly to be taken care of with round the clock care that they might not be
able to provide if they work a full-time job.
According to Fogg et al (2024), it would be good to identify the frailty prevention of
people and have proactive management in the hope that it will decrease the progression of
frailty as people age even people who are identified as middle aged. The thought process is that
if there is prevention, it could reduce healthcare costs. It would be good to create a habit of
exercising even if it is low intensity exercise. Exercise has been seen a good thing for individuals'
cardiovascular system. Incorporating good eating habits is also good to address early in life
because it can help decrease the risk of conditions like diabetes. Diabetes has affected millions
of people. There is one type of diabetes that is reversible with lifestyle changes while the other
one is for life. Making sure to perform cancer screening when they are recommended could
help reduce their risk of developing. Each cancer screening is performed at distinct stages of
life. For example, breast cancer screening like a mammogram is performed once a woman turns
40 since this is where they could be most at risk. There are screenings that are completed even
earlier like a Pap smear. Pap smear has been used to detect if there is abnormality that could
Final paper 17
show if a patient might have cervical cancer. Cancer can cause frailty to the point where the
individual is unable to take care of themselves.
Supply chain plays a huge role when it comes to the delivery and maintenance of
supplies that are used in healthcare every day to provide services. For each service, there are
certain supplies that are needed for providers to perform the service. With an effective supply
chain, the services will be able to perform and create profit which means they have excellent
patient experience. It was described Vanvactor (2024) by that the improvement of decision
making comes from have data that is shown (p.250). Data can be described as an effective tool
to use to figure out what is going well and what is not. Using data to control the supply chain
could be good because it allows the organizations to watch the supplies that are being used and
let them know when they need to stock up on new supplies. According to Nartey (2024),
healthcare organizations look for ways to make supply chain resilient and be able to withstand
issues that come their way (p.1949). Just one disturbance to the supply chain can cause a whole
lot of issues. If there is a delay in supplies and there is already a shortage of the supplies,
provider will not be able to perform services that could have been scheduled. This can cause
the hospital to have a reputation of not being prepared on having the right supplies and that
they are not a reliable place to go when seeking care. There are some services that could have
been scheduled months in advance because they had to wait and with the disturbance of
supply shortage, it makes them must go somewhere else. The issue of looking for somewhere
else is that they could also have a long waitlist can be frustrating.
Administrative costs include salaries of employees, billing, instance related among other
things. It has been shown that 25%-31% of spending in the United States is due to
Final paper 18
administrative costs and about 82% is because of billing and insurance-related expenses
(Richman et al., 2022,
p.1098). This could mean that the United States could have a complex billing and
insurancerelated system that make it prone to multiple coming up that can be costly. “A similar
percentage is consumed for hospital billing, and approximately an additional 15% is retained by
commercial insurers for claims processing and other costs under the Affordable Care Act”
(Scheinker et al, 2021, p.616). Proceeding claims can take time especially if mistakes have been
made. When it comes to salaries of employees, experience usually means wanting an increase
of salary. Employees know that experience is valuable, and it would be unfair to not have a raise
since they usually get new skills and knowledge that can be incorporated in their job. In every
job, everything is always evolving, and it requires more skills and knowledge that allows them to
be successful. Higher salaries are also associated with more benefits which could include a
bonus. For example, a CEO or someone in a higher power position could expect a bonus.
Bonuses could also for more administrative spending since it is an extra cost to provide
bonuses. The idea is that the bonus various among people since some could be higher than
others.
When it comes to patient safety, staff shortage and high healthcare cost, these are
urgent issue that need to be addressed to ensure that excellent quality of care is delivered to
everyone. The hope is that prayer can help with these issues. Prayer has been seen as a crucial
thing to have in the lives of God’s children. In their mind, nothing is impossible since God will be
there to find solutions for these issue can greatly affect patient care. When people think of
getting care, they are looking for good quality care that will lead to a overall good health
Final paper 19
outcome. It is ideal for their safety is not compromised that result from distinct factors like staff
shortage and that there will be low healthcare cost. A healthcare system that proves the
importance of patient safety will be act in the best interest of the patient especially when it
comes to actively listening which means respected their wishes. These issues have been around
for some time so it will take time for these issues to lessen which will improve patient care.
References
Alsabri, M., Boudi, Z., Lauque, D., Dias, R. D., Whelan, J. S., Östlundh, L., Alinier, G., Onyeji,
C., Michel, P., Liu, S. W., Jr Camargo, C. A., Lindner, T., Slagman, A., Bates, D. W.,
Tazarourte, K., Singer, S. J., Toussi, A., Grossman, S., & Bellou, A. (2022). Impact of
teamwork and communication training interventions on safety culture and patient
safety in emergency departments: A systematic review. Journal of Patient Safety, 18(1),
e351e361.
Chervoni-Knapp T. (2022). The Staffing Shortage Pandemic. Journal of radiology nursing,
41(2), 74–75.
Chu, R. (2023). Team communication improves patient safety. Nursing made Incredibly Easy!
21(6), 34-40.
Fogg, C., England, T., Zhu, S., Jones, J., de Lusignan, S., Fraser, S. D. S., Roderick, P., Clegg, A.,
Harris, S., Brailsford, S., Barkham, A., Patel, H. P., & Walsh, B. (2024). Primary and
secondary care service use and costs associated with frailty in an aging population:
Longitudinal analysis of an english primary care cohort of adults aged 50 and over,
2006–2017. Age and Aging, 53(2).
Final paper 20
Gostin, L. O., Hodge, J. G., & Twinamatsiko, A. J. (2023). Medicare’s historic prescription drug
price negotiations. JAMA: The Journal of the American Medical Association, 330(17),
1621-1622.
Guttman, O. T., Lazzara, E. H., Keebler, J. R., Webster, K. L. W., Gisick, L. M., & Baker, A. L.
(2021). Dissecting communication barriers in healthcare: A path to enhancing
communication resiliency, reliability, and patient safety. Journal of Patient Safety, 17(8),
e1465-e1471.
Im, Dana & Aaronson, Emily. (2020). Best practices in patient safety and communication.
Emergency Medicine Clinics of North America, 38(3), 693-703.
King James Bible. (2017). King James Bible Online.
https://www.kingjamesbibleonline.org/(Original work published 1769)
Lau, L., Ajzenberg, H., Haas, B., & Wong, C. L. (2023). Trauma in the aging population:
Geriatric trauma pearls. Emergency Medicine Clinics of North America, 41(1), 183-203.
Melnyk, B. M., Chenot, T., Hsieh, A. P., & Messinger, J. (2024). Supportive workplace wellness
cultures and mattering are associated with less burnout and mental health issues in
nurse managers. The Journal of Nursing Administration, 54(9), 456-464.
Nartey, E. (2024). Management accounting and control, supply chain resilience and healthcare
performance under disruptive impact. International Journal of Productivity and
Performance Management, 73(6), 1948-1969.
Final paper 21
Pakhomova, T. E., Nicholson, V., Fischer, M., Ferguson, J., Moore, D. M., Salters, K., Lester, R. T.,
Kremer, H., Dawydiuk, N., Barrios, R., & Parashar, S. (2023). Exploring primary healthcare
experiences and interest in mobile technology engagement amongst an urban
population experiencing barriers to care. Qualitative Health Research, 33(8-9), 765-777.
Pakulska, T., & Religioni, U. (2023). Implementation of technology in healthcare entities -
barriers and success factors. Journal of Medical Economics, 26(1), 821-823.
Pierce, A. T., Sheaffer, W. W., Lu, P. G., Davila, V. J., Soh, I. Y., Meltzer, E. C., Aiello, F., Tarsa, S. J.,
Stone, W. M., & Meltzer, A. J. (2022). Impact of “Defensive medicine” on the costs of
diabetes and associated conditions. Annals of Vascular Surgery, 87, 231-236.
Richman, B. D., Kaplan, R. S., Kohli, J., Purcell, D., Shah, M., Bonfrer, I., Golden, B., Hannam,
R., Mitchell, W., Cehic, D., Crispin, G., & Schulman, K. A. (2022). Billing and Insurance–
Related administrative costs: A cross-national analysis. Health Affairs (Millwood, Va.),
41(8), 1098-25.
Rome, B. N., Egilman, A. C., & Kesselheim, A. S. (2022). Trends in prescription drug launch
prices, 2008-2021. JAMA: The Journal of the American Medical Association, 327(21),
2145-2147.
Ross, J. (2022). Nursing shortage creating patient safety concerns. Journal of Perianesthesia
Nursing, 37(4), 565-567.
Scheinker, D., Richman, B. D., Milstein, A., & Schulman, K. A. (2021). Reducing administrative
costs in US health care: Assessing single payer and its alternatives. Health Services
Research, 56(4), 615-625.
Final paper 22
Seo, J., & Lee, S. E. (2023). Effects of nurses’ perceptions of patient safety rules and procedures
on their patient safety performance: The mediating roles of communication about errors and
coworker support. Journal of Nursing Management, 2023.
Strobel, C. J., Oldenburg, D., & Steinhäuser, J. (2023). Factors influencing defensive
medicinebased decision making in primary care: A scoping review.‐ Journal of Evaluation in
Clinical
Practice, 29(3), 529-538.
Vanvactor, J. D. (2024). Data-driven decision making: Informed healthcare supply chain
management. Journal of Supply Chain Management, Logistics and Procurement, 6(3), 246-260.
