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Organizational Strategies to Reduce Hospital Readmissions Steven Warchol Walden University

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Organizational Strategies to Reduce Hospital Readmissions Steven Warchol Walden University Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2018 Organizational Strategies to Reduce Hospital Readmissions Steven Warchol Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Health and Medical Administration Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Management and Technology This is to certify that the doctoral study by Steven Warchol has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Roger Mayer, Committee Chairperson, Doctor of Business Administration Faculty Dr. Robert Miller, Committee Member, Doctor of Business Administration Faculty Dr. Matthew Knight, University Reviewer, Doctor of Business Administration Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2018 Abstract Organizational Strategies to Reduce Hospital Readmissions by Steven J. Warchol MBA, Saint Louis University, 2010 BS, Saint Louis University, 2008 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University April 2018 Abstract Reducing hospital readmissions is critical to the success and sustainability of both hospitals and the communities in which they reside. The purpose of this multiple case study was to explore organizational strategies hospital leaders use to reduce hospital readmissions. The study was limited to hospitals in Southwest Missouri with readmission rates below the state average. Complex adaptive systems was the conceptual framework for the study because of the complex nature and numerous stakeholders of the healthcare system. Data were collected from a purposive sample of 15 hospital leaders via semistructured interviews and an analysis of organizational artifacts. Member checking was used to increase reliability and validity of the results. Data analysis was conducted using Yin’s 5 step process including qualitative analysis software to identify major and core themes. The major themes identified in the study included population health, hospital operations and patient interactions, leadership and mission, and barriers to reducing readmissions. The implications for positive social change include the potential to improve services hospital team members provide to patients, which may improve the overall health of the communities they serve. By promoting improved health outcomes for local communities, society benefits through reduction of costs to the federal government and an overall improvement in the health of communities. Organizational Strategies to Reduce Hospital Readmissions by Steven J. Warchol MBA, Saint Louis University, 2010 BS, Saint Louis University, 2008 Doctoral Study Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Business Administration Walden University April 2018 Dedication This study is dedicated to the Warchol family lineage, without whom, I would not be who or where I am today. I am thankful for the love and support of my wife, parents, siblings, friends, and the faithful departed. Thank you to all of you who were willing to listen to me ramble over a drink and provide words of encouragement. I would like to make specific mention of my wife, Shannon, who has been with me through the whole journey. She was able to calm me in times of frustration–of which there were many–and multiply my joy in times of celebration. Thank you. Acknowledgments I would like to acknowledge Dr. Roger Mayer for his constant support and guidance through this journey. Our weekly calls knew no bounds including the occasional holiday. Having your support helped me keep my focus and drive. Additionally, I would like to thank Dr. Robert Miller and Dr. Matthew Knight for their incredible insights and support throughout the review process. Lastly, I would like to acknowledge Jen Tebbe who helped my find my scholarly voice. Like healthcare, I needed the collaboration of an expert team to make this a success. Table of Contents List of Tables ..................................................................................................................... iv List of Figures ......................................................................................................................v Section 1: Foundation of the Study ......................................................................................1 Background of the Problem ...........................................................................................1 Problem Statement .........................................................................................................2 Purpose Statement ..........................................................................................................2 Nature of the Study ........................................................................................................3 Research Question .........................................................................................................4 Interview Questions .......................................................................................................4 Conceptual Framework ..................................................................................................5 Operational Definitions ..................................................................................................6 Assumptions, Limitations, and Delimitations ................................................................7 Assumptions ............................................................................................................ 7 Limitations .............................................................................................................. 7 Delimitations ........................................................................................................... 8 Significance of the Study ...............................................................................................8 Contribution to Business Practice ........................................................................... 9 Implications for Social Change ............................................................................... 9 A Review of the Professional and Academic Literature ..............................................10 Complex Adaptive Systems .................................................................................. 11 Alternative Theory ................................................................................................ 22 i Hospital Readmissions .......................................................................................... 26 Methodological Considerations ............................................................................ 39 Transition .....................................................................................................................43 Section 2: The Project ........................................................................................................44 Purpose Statement ........................................................................................................44 Role of the Researcher .................................................................................................44 Participants ...................................................................................................................46 Research Method and Design ......................................................................................48 Research Method .................................................................................................. 48 Research Design.................................................................................................... 50 Population and Sampling .............................................................................................52 Ethical Research...........................................................................................................54 Data Collection Instruments ........................................................................................56 Data Collection Technique ..........................................................................................58 Data Organization Technique ......................................................................................60 Data Analysis ...............................................................................................................60 Reliability and Validity ................................................................................................62 Reliability .............................................................................................................. 63 Validity ................................................................................................................. 63 Transition and Summary ..............................................................................................65 Section 3: Application to Professional Practice and Implications for Change ..................66 Introduction ..................................................................................................................66
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