Browsing by Subject "Hospital"
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Item Bounded by repertoires and roles : communication through multiple ICTs in a health care organization(2020-03-24) Harrison, Millie Archer; Stephens, Keri K.; Treem, Jeffrey W.; Donovan, Erin E.; Carmack, Heather J.Health care has become the largest employer in the United States, and health care organizations are looking to ICTs as a solution to facilitate interprofessional communication and patient care. Yet extant findings show mixed results on the efficacy of ICT use for coordination, and little is known about how health care professionals use their collection of ICTs, as opposed to a singular device, to communicate. Inspired by the theoretical underpinnings of communication media repertoires and boundary theory, this dissertation provides an empirical link between the use of multiple ICTs, that are both organizationally-issued and personally-owned, and the complexities of coordinating patient care. Drawing on qualitative data collected from observations, interviews, and focus groups at a pediatric hospital in the Southern U.S., this research investigates the communicative practices of different teams of allied health professionals—an underexplored population making up approximately 60% of the health care workforce. Differences in technological access, managerial expectations, and workflows emerged within and across the professional groups in the health care organization studied. The findings reveal how allied health professionals experienced repertoire misalignment, a situation where ICTs and routines of use clashed. Furthermore, many people were overloaded by learning which ICTs their colleagues used and how they used them— defined as communication load issues—which impeded the efficiency and quality of their work. This dissertation further shows how ICT repertoires are situated at the crossroad of multiple role boundaries, complicated by organizational rules and norms that were inconsistent across teams. These allied health professionals held strong professional identities, and they were asked—or required—to use personal mobile phones for work purposes. When organizational, professional, and personal boundaries were at odds, employees did not feel empowered to enact their ICTs in ways that privileged professionalism or personal preferences. Thus, although the use of ICT repertoires can facilitate communication within and across professional teams, this dissertation exposes how health care professionals’ work practices are being challenged and constrained by organizational demands for ICT repertoire useItem Breaking the cycle : evidence-based diversion for homeless individuals with mental illness(2019-09-17) Gray, Bailey Douglas; Springer, David W.; Streeter, Calvin L.The resources and infrastructure in place to serve our nation’s homeless is spread thin. Issues of capacity, funding, and lack of individualized treatment plans create limited opportunities for individuals to escape their current, often cyclical circumstances. For many, this results in continuous interactions with the justice system and physical-behavioral health systems. This Professional Report seeks to examine the effectiveness of evidence-based diversion strategies used to keep individuals experiencing homelessness from cycling in and out of correctional facilities and unnecessary hospitalization, in both general and psychiatric settings. As a community, we have an ethical and moral responsibility to support homeless individuals suffering with mental illness who may require additional support. This report seeks to determine the most effective way to meet this obligation. Austin is rapidly changing its approach to solving homelessness, which has the potential to increase the number of unsheltered individuals experiencing homelessness, even if only for a brief amount of time. This can in turn lead to negative social determinants of health and an increased need for diversion from crisis settings. Individuals experiencing homelessness are unique—their needs, conditions, and mitigating circumstances are different. In order for successful diversion to take place, Austin must be robust in its approach. This report surveyed diversion strategies used nationwide in order to examine strategies and resources currently available in Austin and Travis County. Although Austin has a strong capacity for diversion, findings show there is room for improvement. Recommendations to improve Austin’s ability to divert homeless individuals with mental illness from unnecessary crisis system interactions include: increased outreach capacity; expansion of the Combined Transportation, Emergency, & Communications Center, Austin’s current central dispatch center; creation of a crisis stabilization unit; and 24/7 availability of Integral Care’s Expanded Mobile Crisis Outreach TeamItem Cats don't sleep at night(2021-08-18) Xu, Beibei; Shea, Andrew Brendan; Howard, Don; Lewis, AnneThis report will summarize the process of writing, developing, directing, and finishing the short film, Cats Don’t Sleep at Night. This film was produced as my graduate thesis film in the Department of Radio-Television-Film at the University of Texas at Austin in partial fulfillment of my Master of Fine Arts in Film Production degree.Item Hospital to home : family caregiver perspectives of discharge transitions of seniors with dementia(2016-05) Martin, Ellen Marie Endress; Volker, Deborah L.; Acton, Gayle; Carter, Patricia; Taxis, J. Carole; Fredholm, LeighHospital discharge transitions can be challenging for seniors and their caregivers. Seniors with dementia are particularly vulnerable and are at increased risk for adverse outcomes from poorly executed hospital to home discharge transitions. Family caregivers play a vital role in supporting seniors with dementia by coordinating care among healthcare providers across the continuum of care. Research suggests there is significant opportunity for improvement in hospital discharge processes to ensure that patients with dementia and their family caregivers are prepared to resume care at home after hospital discharge. Family caregivers of hospitalized patients with dementia continue to report unmet needs and the extent to hospital discharge interventions are provided and how they are perceived by family caregivers of patients with dementia is unknown. Guided by Meleis’ middle-range theory of transitions, a critical incident technique study was designed to explore family caregiver perceptions of the hospital discharge process for seniors with dementia. Five categories of healthcare provider activities were identified as important to the hospital discharge process for persons with dementia. Providing person-centered dementia care involved recognizing dementia in the patient and the importance of taking a different approach. Getting on the same page emphasized the crucial role of communication and involved seeing a capable person and knowing the plan. Caregivers expressed concern for Maximizing function and strong enough to go home. Managing medications was critical to ensure behavioral symptoms of dementia were well managed. Post-discharge support involved getting needed information, arranging for services after discharge, and calling for help. These categories are consistent with the literature regarding hospital to home discharges for seniors and their caregivers. Family caregivers of hospitalized patients with dementia have additional needs beyond those of typical patients and collaboration with healthcare providers is vital to ensure patient needs are met. These findings highlight the importance of person-centered care delivery so that hospital discharge processes are tailored to the unique circumstances of each patient and caregiver.