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dc.identifier.urihttp://hdl.handle.net/11401/78291
dc.description.sponsorshipThis work is sponsored by the Stony Brook University Graduate School in compliance with the requirements for completion of degree.en_US
dc.formatMonograph
dc.format.mediumElectronic Resourceen_US
dc.language.isoen_US
dc.typeDissertation
dcterms.abstractMotivation: 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.available2018-06-21T13:38:54Z
dcterms.contributorCimino, Lindaen_US
dcterms.contributorDwyer, Debraen_US
dcterms.contributorPourmand, Rahmanen_US
dcterms.contributorNoack, Pamelaen_US
dcterms.creatorDANOWSKI, LORRAINE E
dcterms.dateAccepted2018-06-21T13:38:54Z
dcterms.dateSubmitted2018-06-21T13:38:54Z
dcterms.descriptionDepartment of Technology, Policy, and Innovationen_US
dcterms.extent110 pg.en_US
dcterms.formatApplication/PDFen_US
dcterms.formatMonograph
dcterms.identifierhttp://hdl.handle.net/11401/78291
dcterms.issued2017-12-01
dcterms.languageen_US
dcterms.provenanceMade 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: 12en
dcterms.subjectMedical sciences
dcterms.subjectAmyotrophic Lateral Sclerosis
dcterms.subjectCompassion Fatigue
dcterms.subjectEconomics
dcterms.subjectHybrid
dcterms.subjectInterdisciplinary
dcterms.subjectMultidisciplinary
dcterms.subjectRelational Coordination
dcterms.titleQuality of Care and Cost Differences in Models of Care for the Treatment of Patients with Amyotrophic Lateral Sclerosis (PALS)
dcterms.typeDissertation


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