dc.identifier.uri | http://hdl.handle.net/11401/78291 | |
dc.description.sponsorship | This work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree. | en_US |
dc.format | Monograph | |
dc.format.medium | Electronic Resource | en_US |
dc.language.iso | en_US | |
dc.type | Dissertation | |
dcterms.abstract | Motivation: The Affordable Care Act (ACA) has focused attention on the team approach for the delivery of health care. Interdisciplinary teams may be this mechanism to improve health care delivery practices and clinical outcomes. The literature states the driving forces for team collaboration are; the need to care for chronically ill patients, sponsorship by professional organizations, safety and quality initiatives and health care policy. Restraining forces for team collaboration are; lack of expertise, cultural silos, the existing academic infrastructure and reimbursement. One of the issues in identifying the potential gain in outcomes from using a team approach has been the definition of the team, with this in mind, a survey design was used to examine attributes of the Amyotrophic Lateral Sclerosis (ALS) team in order to classify homogeneous types among ALS clinics. These findings were then used to assess outcomes based on attributes within the team environment. Contribution: To date, this is the first study to develop classifications of teams as comparison groups for outcome assessment. Model and survey development as well as use of relevant measures of team collaboration was used. This study focused on the outpatient setting and applied novel methodologies to uncover team types and how they affect outcomes. Data/Methods: Each of 110 Amyotrophic Lateral Sclerosis Association or Muscular Dystrophy Association sponsored clinics were invited to participate in the study. Instruments such as the Relational Coordination and Compassion Fatigue helped to inform the data collection process. In addition, survey instruments were designed to capture individual clinic characteristics, information about outpatient service visits and outpatient procedures. Results: The latent indicators of team type were uncovered by using both exploratory and confirmatory factor analysis. This was accomplished from survey responses of team members regarding attributes of the team. Multivariate analysis was performed to examine the relationship between team type, size of clinic and clinic experience on outcome measure of interest such as time to obtain a wheelchair. Latent indicators of team type were discovered by using both exploratory and confirmatory factor analysis. This was accomplished from survey responses of team coordinators regarding attributes of the team. Multivariate analysis was performed to examine the relationship between team type and Relational Coordination in order to assess efficiency measures of team function. I do find evidence of success among more coordinated teams. | |
dcterms.available | 2018-06-21T13:38:54Z | |
dcterms.contributor | Cimino, Linda | en_US |
dcterms.contributor | Dwyer, Debra | en_US |
dcterms.contributor | Pourmand, Rahman | en_US |
dcterms.contributor | Noack, Pamela | en_US |
dcterms.creator | DANOWSKI, LORRAINE E | |
dcterms.dateAccepted | 2018-06-21T13:38:54Z | |
dcterms.dateSubmitted | 2018-06-21T13:38:54Z | |
dcterms.description | Department of Technology, Policy, and Innovation | en_US |
dcterms.extent | 110 pg. | en_US |
dcterms.format | Application/PDF | en_US |
dcterms.format | Monograph | |
dcterms.identifier | http://hdl.handle.net/11401/78291 | |
dcterms.issued | 2017-12-01 | |
dcterms.language | en_US | |
dcterms.provenance | Made available in DSpace on 2018-06-21T13:38:54Z (GMT). No. of bitstreams: 1
DANOWSKI_grad.sunysb_0771E_13592.pdf: 1328513 bytes, checksum: 00ed957b6f3f336afa9914f9132a8835 (MD5)
Previous issue date: 12 | en |
dcterms.subject | Medical sciences | |
dcterms.subject | Amyotrophic Lateral Sclerosis | |
dcterms.subject | Compassion Fatigue | |
dcterms.subject | Economics | |
dcterms.subject | Hybrid | |
dcterms.subject | Interdisciplinary | |
dcterms.subject | Multidisciplinary | |
dcterms.subject | Relational Coordination | |
dcterms.title | Quality of Care and Cost Differences in Models of Care for the Treatment of Patients with Amyotrophic Lateral Sclerosis (PALS) | |
dcterms.type | Dissertation | |