Date of Award

Summer 5-23-2018

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Deborah A. DeLuca, JD

Committee Member

Terrence Cahill, Ed.D.

Committee Member

Genevieve Zipp, Ed.D.

Keywords

Healthcare Leadership, Organizational Sustainability, Partnership, Adaptation, Strategic Planning, Communication

Abstract

Background and Purpose of the Study: Healthcare costs in the United States has continued to increase annually, and new policy's attempt at protocol changes in healthcare practices does not ensure quality care delivery. An example of these policies include provisions and new guidelines under the 2010 healthcare legislation, - The Patient Protection and Affordable Care Act (ACA). The premise with the Affordable Care Act (ACA) is increased healthcare access for patients. However, not responsibly balancing the increased demand with the escalating cost of care creates an unsustainable system (Department of Health & Human Services, 2015). Healthcare organizations, including hospitals and medical practices, are challenged as they seek to balance between being a diagnostic, clinical entity, and one that can effectively and affordably resolve issues. The synopsis of care delivery in the US thus became one of high-cost pressure and high administrative burden, invariably leading to low-quality patient care. The purpose of this study is to understand the factors affecting healthcare organizational sustainability. Secondly, to determine if the varying perception of healthcare organizations among healthcare professionals (HCPs) affect how they support the implementation of programs in building sustainable organizations. The perception levels were broken into four dependent groups: Unsustainable, Somewhat Sustainable, Moderately Sustainable and Very Sustainable.

Methods: This study utilized a quantitative methodology with a descriptive, exploratory, cross-sectional and correlational research design to measure the differences in perception levels of program implementation processes and determine the relationship between the factors of organizational sustainability. Eight (8) dependent variables were identified: Funding, Communication, Environmental, Partnerships, Evaluation, Adaptation, Strategic Planning, and Organization Capacity. A sample of 301 healthcare professionals participated in the study with a completion rate of 53%.

Results: All variables had a positive relationship to organizational sustainability in the small (r=0.29, p<0.001) to moderate rate (r=0.42, p<0.001) correlation. As scores for each of the sustainability variable increases, so does perception of the program within healthcare organizations. The results of the Multivariate Analysis of Variance (MANOVA) across the 4 perception groups (IV) and 8 dependent variables were statistically significant at an alpha level of 0.01 but for the Environmental, Partnerships and Evaluation variables.

Conclusion: Healthcare policies might continue to change in an attempt to resolve issues around quality care delivery, but organizational cultures and design have a greater impact on healthcare organizational sustainability. The eight sustainability factors proved essential further highlighting their inter-relatedness and mutually reinforcing attributes. There were subtle inconsistencies in the perception of these variables and how they manifest across organizations among HCPs. The implementation of programs requires engagement from all employee levels and multi-disciplinary teams within a healthcare organization. If healthcare programs are deliberately structured with the eight sustainability factors in mind, organizations – including physician offices, and multi-system hospitals can be more successful. Further research is needed to determine categorical predictors for perception levels of organizational sustainability in light of healthcare policy changes. With a holistic framework for sustainability, healthcare managers can implement strategies to respond to policy changes, fine-tune operations and successfully manage the quality delivery of care.

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