Posted: May 1st, 2025

DDHA-9013-1 (05/27/2024-08/1

In this Assignment, you will complete the Supporting Sources and Practice Gap sections of the Prospectus form. Remember that a practice gap makes your research meaningful to practitioners by providing a solution to a justified healthcare administration professional problem. Below are a few details to remember when completing the Practice Gap Sources and Practice Gap Statement.

First, understand fully the healthcare administration problem that was justified using at least 3 credible sources within the last 5 years.

Second, fully understand the desired ideal state of professional practice using at least 1 credible source.  This Assignment will complete the requirements for Section 1: Research Problem in the Prospectus Form. If your instructor does not approve any part of this Section 1 you will be able to resubmit required changes before the final submission in Week 11. Remember that this is an iterative process, and you will likely need to edit multiple times to arrive at a feasible Capstone topic.

1. The Assignment: Prospectus Form Draft
2. Complete the required information related to the Practice Gap sources and Practice Gap Statement according to the instructions in the form’s appendix.
3. The Practice Gap Statement should only include details that come from the previous parts of the research problem section.

Make sure to do the following:

Review the example provided in the appendix.

Make sure to include Practice Gap sources that specifically and clearly state what the ideal state of professional practice should be for your healthcare administration problem.

DHA Integrative Review Project Prospectus Form
(For Students that started the DHA program in Fall 2021 or after)
Students | Complete your DHA project planning using this form. This form must be completed exactly as instructed in the appendix to be
approved. For additional information and resources, refer to the DHA Project Completion page. There are five sections on the form to complete
that must be approved by your committee. The six sections include:
1.
2.
3.
4.
5.
6.
Research Problem
Purpose and Review Question
Framework
Significance
Research Alignment Table
Appendix (The appendix provides examples and instructions on how to complete this form)
Submit this completed form into MyDR for formal evaluation and feedback when your project mentor indicates that you are ready to do so.
Student’s Name | Princess Stewart
Program | DHA
Student ID | Click or tap here to enter text.
Submission Date | Click arrow to select a date.
*Remember that your study focus must be within the realm of your program and specialization area.
Evaluators Only | Complete this section and provide feedback on responses and rubric scores in the form where noted.
Mentor’s Name | Click or tap here to enter text.
Co-Mentor’s Name | Click or tap here to enter text.
Overall Assessment: Choose an item.
Overall Assessment: Choose an item.
Working Title
(Click here for instructions and examples)
Provide a concise (aim for 12 words or fewer) working title for this study. (Be sure to include your HSO type and practice-based problem.)
Enhancing Patient Safety & Quality in Acute Care
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Section 1: Practice-based Problem
(Click here for instructions and examples)
Healthcare Services Organization (HSO) Type
With no more than 1-2 sentences identify and describe your selected HSO type.
Acute care hospitals give short-term treatment to those who have traumatic injuries or sudden episodes of sickness, emergencies, or after
surgical operations. Hospitals in these categories are vital in offering essential healthcare services to patients who need urgent and intense
treatment.
HSO Problem of Interest
What is the healthcare services organization (HSO) problem of interest that prompted you to search the literature to find out more? Write only 1-2
complete sentences using a scholarly tone.
This study proposed that one of the most persistent issues in acute care hospitals is enhancing patient safety and quality of care due nursing
shortages, specifically, the application and efficacy of CQI practices. However, while CQI practices are widely considered essential for quality
healthcare service delivery, acute care hospitals frequently face challenges whenever they attempt to adopt aspects of CQI, mainly because of
such factors as lack of resources, nursing staff shortages, and organizational opposition.
Healthcare Administration Problem
In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.
Acute care hospitals face a significant healthcare administration problem such as nurse shortages.
Health Administration Research Domains
Which DHA research domain does your healthcare administration problem align with?
The healthcare administration problem of enhancing patient safety and quality of care through continuous quality improvement (CQI)
practices in hospitals aligns with the DHA research domain of “Quality Improvement.” Also, a healthcare administration problem that relates
closest to the chosen DHA research domain is the scarcity of nursing human capital in hospitals. For instance, the domain highlighted as “human
resource” aimed at understanding how to guarantee an adequate and competent healthcare workforce. It involves areas like demand and supply
of employees, staff acquisition and loyalty, as well as the process of staff coaching and mentoring. Together with focusing on this particular
research domain, the study reveals urgent problems of guaranteeing a sufficient number of nurses, which is one of the main prerequisites for
maintaining the quality and safety of patient care in acute care hospitals.
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Healthcare Administration Research Problem Justification Sources
Provide a minimum of 3 sources that clearly state in the conclusion or research findings of the published source that a healthcare administration
problem currently exists.
Source 1
(Required)
Source 2
(Required)
Source 3
(Required)
Full APA Citation:
Tamata, A. T., & Mohammadnezhad, M. (2023). A systematic review study on the factors affecting shortage of nursing
workforce in the hospitals. Nursing open, 10(3), 1247–1257. https://doi.org/10.1002/nop2.1434
Purpose of Research (1 sentence only):
This research aims to synthesize the leading causes of the shortage of nursing staff in hospitals, as documented in the
literature.
Author’s Conclusion or Results of Research (1 sentence only):
According to the research, staffing shortages in hospitals are caused by several factors, including insufficient staffing levels,
turnover rates, and burnout.
How this relates to my study (1 sentence only):
This paper focuses on the problem of nursing scarcity that threatens hospitals and their capabilities to institutionalize CQI,
which explains the idea that when nurses are overworked or are experiencing burnout, they cannot effectively participate in
CQI activities, resulting in poor patient care and safety.
Full APA Citation:
de Vries, N., Boone, A., Godderis, L., Bouman, J., Szemik, S., Matranga, D., & de Winter, P. (2023). The Race to Retain
Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals. Inquiry :
a journal of medical care organization, provision and financing, 60, 469580231159318.
https://doi.org/10.1177/00469580231159318
Purpose of Research (1 sentence only):
This systematic review seeks to review the specifics of turnover determinants that would help understand the specifics of
healthcare workers’ decision to stay or leave their duties in their organization to contribute to improving turnover rates in the
healthcare industry.
Author’s Conclusion or Results of Research (1 sentence only):
The research found that aspects such as work environment, job satisfaction, and organizational support influence healthcare
worker retention directly, and enhancements in these matters could help eliminate staff deficits.
How this relates to my study (1 sentence only):
The results stress that a positive organizational climate is crucial for effective CQI adoption in hospitals and for nurses’
satisfaction and staff engagement.
Full APA Citation:
Griffiths, P., Saville, C., Ball, J. E., Jones, J., Monks, T., & Safer Nursing Care Tool study team (2021). Beyond ratios flexible and resilient nurse staffing options to deliver cost-effective hospital care and address staff shortages: A simulation
and economic modelling study. International journal of nursing studies, 117, 103901.
https://doi.org/10.1016/j.ijnurstu.2021.103901
Purpose of Research (1 sentence only):
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This research aims to identify ways to flexibly and sustainably staff to overcome existing deficits in nursing services and
provide affordable and quality hospital services.
Author’s Conclusion or Results of Research (1 sentence only):
The research concludes that fluid staffing approaches can influence the effects of poor nurse staffing and enhance patients’
care quality and safety.
How this relates to my study (1 sentence only):
The findings of this study affirm the need for the utilization of new-generation staffing strategies to enhance CQI and improve
the safety of patients and the quality of their care.
Practice Gap Statement
Now that you have identified a current healthcare administration problem you will compose a Practice Gap Statement (PGS) following the
example and instructions in the appendix. Your PGS should not be longer that 2-3 sentences.
Despite the recognition of the importance of continuous quality improvement (CQI) practices in healthcare administration, there remains
a gap in understanding the specific organizational readiness factors and health outcomes measurement strategies necessary to effectively
implement CQI initiatives in hospitals, hindering efforts to enhance patient safety and quality of care.
Practice Gap Sources
Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.
Full APA Citation:
Source 1
(Required)
Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: a new health system for
the 21st century. National Academies Press.
Desired Ideal State of Professional Practice:
The desired ideal state of professional practice in healthcare administration involves the implementation of
continuous quality improvement (CQI) practices to ensure safe, effective, patient-centered, timely, efficient,
and equitable care delivery, thereby achieving higher quality outcomes and improved patient experiences.
Source 2
Full APA Citation:
(Optional)
Click or tap here to enter text.
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Desired Ideal State of Professional Practice:
Click or tap here to enter text.
Section 1: Feedback and Scoring
Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included
on how to successfully revise the specific elements above.
Mentor
Met ☐
Not Met ☐
Program
Met ☐
Not Met ☐
Detailed Feedback:
Click or tap here to enter text.
Detailed Feedback:
Click or tap here to enter text.
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Section 2: Purpose and Review Questions
(Click here for instructions and examples)
The research purpose and review questions must be derived entirely by the sources provided in section 1.
Research Purpose
To address your stated problem, what is the purpose of your study using no more than 1-2 sentences??
The purpose of this integrative review is to examine current evidence-based strategies employed by acute care hospitals to enhance
patient safety and improve the overall quality of care.
Review Question(s)
Conclude with your review question. (1 sentences)
What evidence-based strategies are effective in reducing adverse events and improving quality of care measures within the acute care
hospital setting?
Section 2: Feedback and Scoring
Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included
on how to successfully revise the specific elements above.
Mentor
Met ☐
Not Met ☐
Program
Met ☐
Not Met ☐
Detailed Feedback:
Click or tap here to enter text.
Detailed Feedback:
Click or tap here to enter text.
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Section 3: Framework
(Click here for instructions and examples)
Framework (Conceptual or Theoretical)
What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the
complete APA reference.
Full APA Citation:
Grol, R., Wensing, M., Eccles, M., & Davis, D. (Eds.). (2013). Improving patient care: The implementation of
change in health care. Wiley. https://doi.org/10.1002/9781118525975
Purpose of Framework (1 sentence only):
Source 1
(Required)
This framework provides a practical approach to understanding the factors that influence the successful
implementation of evidence-based practices in healthcare settings.
Key Constructs of Framework (1 sentence only):
It emphasizes factors like innovation characteristics, provider behavior, organizational context, and
implementation strategies as key influences on successful change.
How this relates to my study (1 sentence only):
Will help analyze how effectively different strategies are implemented in acute care settings and identify
factors contributing to their success or failure in improving patient safety and care quality.
Full APA Citation:
Edwards Deming, W. (1988). Out of the crisis (2nd ed.). Cambridge University Press.
Purpose of Framework (1 sentence only):
Promote continuous quality improvement (CQI) in organizational processes.
Source 2
(Optional)
Key Constructs of Framework (1 sentence only):
The key elements of the Deming framework are the Plan-Do-Study-Act (PDSA) cycles, which are used to
implement and evaluate quality improvements.
How this relates to my study (1 sentence only):
This framework relates to my study by providing a methodology for continuous quality improvement to
enhance patient safety in acute care hospitals.
How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)
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Donabedian’s SPO model provides a framework for understanding the components of quality healthcare, while Grol and Wensing’s
implementation science framework helps to understand how to successfully put effective strategies into practice. Examining the interplay
between these frameworks will offer a comprehensive understanding of how to effectively implement strategies that target structure,
process, and outcome improvements for enhancing patient safety and quality of care within acute care hospitals
Section 3: Feedback and Scoring
Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included
on how to successfully revise the specific elements above.
Mentor
Met ☐
Not Met ☐
Program
Met ☐
Not Met ☐
Detailed Feedback:
Click or tap here to enter text.
Detailed Feedback:
Click or tap here to enter text.
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Section 4: Significance
(Click here for instructions and examples)
Significance
How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional
practice, etc. contributing to positive social change?
This study holds significant implications for the field of healthcare administration and the practice of improving patient safety and
quality of care in acute care settings. By synthesizing evidence on effective strategies and implementation factors, this review will provide
healthcare leaders and practitioners with actionable knowledge to:
Reduce Adverse Events: Implement strategies proven to minimize preventable harm and enhance patient safety, leading to better health
outcomes.
Improve Quality of Care: Identify and adopt best practices that demonstrably elevate the quality of care delivered in acute care hospitals,
leading to greater patient satisfaction and improved overall healthcare experiences.
Inform Policy and Resource Allocation: Provide evidence to support data-driven decision-making in healthcare policy development and
resource allocation, ensuring that efforts to improve patient safety and quality are based on the most impactful approaches.
Significance of study related to social determinants?
While not directly addressing specific social determinants of health, this study has the potential to contribute to positive social change by
promoting health equity and reducing disparities in care. By identifying and promoting the implementation of effective patient safety and
quality improvement strategies, this review can help ensure that:
Vulnerable populations who are disproportionately affected by adverse events and lower quality of care benefit from improved safety
measures and better care coordination.
Healthcare systems adopt practices that are culturally sensitive and responsive to the diverse needs of all patient populations.
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Section 4: Feedback and Scoring
Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included
on how to successfully revise the specific elements above.
Mentor
Met ☐
Not Met ☐
Program
Met ☐
Not Met ☐
Detailed Feedback:
Click or tap here to enter text.
Detailed Feedback:
Click or tap here to enter text.
10
Section 5: Research Alignment Table
(Click here for instructions and examples)
Complete the Research Design Alignment Table using the information from earlier sections of this form. Using an alignment table can assist with
ensuring the alignment of your research design.
Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours
Healthcare Administration
Problem
Practice Gap
Purpose
Acute care hospitals face
ongoing challenges in
consistently ensuring
patient safety and
delivering high-quality
care, often experiencing
preventable adverse
events and variations in
care quality.
While numerous
evidence-based
strategies exist to
enhance patient safety
and care quality, there is
a gap in the consistent
and effective
implementation of these
strategies within the
acute care setting,
leading to persistent
challenges.
Review Question
Theoretical Framework
List the theories and/or
conceptual framework.
This integrative review
aims to analyze existing
evidence on effective
strategies employed by
acute care hospitals to
enhance patient safety
and improve the overall
quality of care,
identifying common
elements and
implementation factors
What evidence-based
strategies are effective
in reducing adverse
events and improving
quality of care
measures within the
acute care hospital
setting?
1. Donabedian’s StructureProcess-Outcome (SPO)
Model2. Grol & Wensing’s
Framework for
Implementing Change in
Healthcare
Section 5: Feedback and Scoring
Project mentors will provide a scoring of “Met” or “Not Met” for this section. In the case of a “Not Met” scoring detailed feedback will be included
on how to successfully revise the specific elements above.
Mentor
Met ☐
Not Met ☐
Program
Met ☐
Not Met ☐
Detailed Feedback:
Click or tap here to enter text.
Detailed Feedback:
Click or tap here to enter text.
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Once your Research Design Alignment Table is completed, reflect on your design alignment. Ask yourself:
1.
2.
3.
Is there a logical progression from the problem of interest to the healthcare administration problem, practice gap, purpose/review question?
Does the identified framework ground the investigation into the healthcare administration problem?
Do the problem of interest and framework align with the purpose/review question?
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Appendix
The Doctoral Prospectus
The DHA Project Plan is a brief document that provides preliminary information about your doctoral research and is used in two ways:
1.
It serves as the tentative plan for developing the project and is evaluated to ensure doctoral-level work (e.g., feasibility, alignment, etc.).
2.
It provides information used to assign the projects mentors.
DHA Project Plan approval from the project mentor, project co-mentor, and a program-level designee is required for you to move forward and work on your
project. The plan is subject to change, and parts of your research design may need to be adjusted after you complete your exhaustive review of the literature
during proposal development.
Working Title Instructions and Example
Instructions: The working title should include the HSO type and DHA research domains. Provide a concise (aim for 15 words or fewer) working
title for this study. (Be sure to include your HSO type.)
Titles should be concise (aim for 15 words or fewer), be a statement, not a question, and no colons please. The title should indicate the main
topic and the variables/concepts under study and the relationship between them. A title should be fully explanatory when standing alone and
include the most critical key words (a searchable statement of what the manuscript contains). Avoid words that serve no purpose (such as
methods, results, a study of…, or investigation of…), use full terms (avoid abbreviations), and capitalize any word of four or more letters, and all
parts of a verb.
Improving a Rural Hospitals Readmission Rates for Heart Failure Patients
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Section 1: Research Problem Instructions and Examples
Healthcare Services Organization (HSO) Type
Instructions: At the beginning of the DHA program students were asked to select an HSO type to research in each course in preparation for the
Doctoral study. Identify and describe your selected HSO type and any unique characteristics that help provide specificity to your research.
With no more than 1-2 sentences identify and describe your selected HSO type.
Examples of HSO types can be located on the DHA Project Completion page.
Hospitals/Health systems – rural hospitals
HSO Problem of Interest
What is the healthcare services organization (HSO) problem of interest that prompted you to search the literature to find out more? The problem
of interest is a high-level problem that all HSO of the same type are experiencing.
Write only 1-2 complete sentences using a scholarly tone.
The need to improve readmission rates in a hospital system.
Healthcare Administration Problem
Instructions: A healthcare administration problem is a focused topic of concern, a condition to be improved upon, or troubling question that is
supported in published research-based articles and/or grey literature like reports (annual, research, technical, project), white or working papers,
government reports, and organizational evaluations.
In one sentence, what is your healthcare administration problem? This will be more focused than the problem of interest noted above.
The healthcare administration problem is high readmission rates for heart failure patients within the last 30-days of discharge for rural hospitals
with 20-25 beds.
Which DHA research category does your healthcare administration problem align with?
A list of DHA research domains can be located on the DHA Project Completion page.
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Quality improvement
Healthcare Administration Problem Justification Sources
Instructions: Students are required to provide at least 3 credible sources that state a healthcare administration problem exist. Students should read all
sources completely but pay special attention to what the authors state the conclusion or research results are from their work. To build on the previous
research in the field students must have at least three sources within the last 5 years that clearly state a problem exist. One example is provided below:
Provide a minimum of 3 sources that clearly state in the conclusion or research findings that a healthcare administration problem currently exists.
Full APA Citation:
Hamner A. (2021). Readmission rates for rural hospitals and their challenges. University of Homenlin, Growley.
Purpose of Research (1 sentence only):
Source 1
(Required)
The purpose of the study was to research hospital rates in rural hospital systems.
Author’s Conclusion or Results of Research (1 sentence only):
Rural hospitals are experiencing challenges with 30-day readmission rate for heart failure patients.
How this relates to my study (1 sentence only):
It supports that rural hospitals are experiencing an undesirable readmission rate for a particular population.
Full APA Citation:
Coldaw B.A., Hawkins J.W. & Davlin R. (2021) From theory to practice: identifying authentic opinion of leaders to improve
care using evidence-based practice. Managed Care 12(7), 156–162.
Source 2
Purpose of Research (1 sentence only):
(Required)
The purpose of this study was to survey organizational leaders about their organizational cultures related to improving quality
related to hospital readmission rates.
Author’s Conclusion or Results of Research (1 sentence only):
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The research findings revealed that hospital leaders in rural hospitals are experiencing high readmission rates for heart
failure patients despite attempts to improve care delivery using evidence-based practices.
How this relates to my study (1 sentence only):
This study provides further justification that rural hospitals and health systems have unique struggles with readmissions rates.
Full APA Citation:
Buch D.T., Gerald B. & Kelley D. (2022). The breakdown of CMS readmission rates categories. Johnson Taylor & Franklin
Group, Australia.
Purpose of Research (1 sentence only):
The purpose of this study was to examine the different types of CMS readmission rates categories.
Source 3
Author’s Conclusion or Results of Research (1 sentence only):
(Required)
The research findings reported that rural organizations struggle to meet the national average for readmission rates for many
of the CMS categories.
How this relates to my study (1 sentence only):
This relates to my study because it shows that rural hospital has a higher readmissions rate for heart failure patients.
Gap in Practice
Instructions: The need to address an identified gap in practice must be clear and there must be current relevance to the discipline and area of
practice.
In no more than 1-2 sentences what meaningful gap in practice have you identified?
Learn more about a Practice Gap Statement on the DHA Project Completion page.
Evidence shows that 30-day readmission rates for heart failure cases is 16.10% for rural hospitals with 20-25 beds. This study will study research
methods to bring the readmission rates down to the CMS national average of 15.59% for rural hospitals.
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Practice Gap Sources
Provide a minimum of 1 source that clearly states desired ideal state of professional practice related to your healthcare administration problem.
Full APA Citation:
CMS Hospital Compare. (2022). Hospital Quality Initiative Public Reporting. Retrieved on January 10, 2023, from
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalCompare.
Desired Ideal State of Professional Practice:
The Centers for Medicare an Medicaid Services provides public data on hospital readmissions and the national average for heart failure
readmissions is 15.59% (data is for illustration only)
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Section 2: Purpose and Review Questions Instructions and Examples
Research Purpose
To address your stated problem, what is the purpose of your study using no more than 1-2 sentences?
Learn more about the purpose of research by Clicking Here
The purpose of this research is to search the existing body of knowledge related to rural hospital admission rates for heart failure patients and
provide strategies for leaders to reduce their readmissions rates for heart failure patients.
Review Question
Conclude with your review question. (1 sentence)
What are best practices to improve the adoption and implementation of evidence-based quality improvement strategies to reduce heart failure
patient’s readmission rates in rural hospital settings?
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Section 3: Framework Instructions and Examples
Framework (Conceptual or Theoretical)
Instructions: The framework includes the theories and/or concepts relevant to your topic. Align the framework with the problem of interest, healthcare
administration problem, purpose, and review question. This theoretical or conceptual framework is the basis for understanding, designing, and analyzing ways
to investigate your healthcare administration problem. Provide the original scholarly literature (citing original authors) on the theory and/or concepts, even if
it is more than 5 years old. Please do not cite secondary sources.
What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the
complete APA reference.
To locate additional information on DHA Conceptual and Theoretical Frameworks on the DHA Project Completion page.
Full APA Citation:
Rogers, E. M. (2010). Diffusion of innovations. Simon and Schuster.
Purpose of Framework (1 sentence only):
Source 1
(Required)
The purpose of this framework was to reveal the various elements contributing to the adoption and diffusion of new
innovations in an organizational setting.
Key Constructs of Framework (1 sentence only):
The key constructs outline the various segments of the innovation adoption model: innovators, early adopters, early
majority, late majority and laggards.
How this relates to my study (1 sentence only):
This relates to my study because the adoption of evidenced-based practices has shown to improve patient outcomes
and the quality of care.
Full APA Citation:
Source 1
(Optional)
Purpose of Framework (1 sentence only):
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Key Constructs of Framework (1 sentence only):
How this relates to my study (1 sentence only):
How do these theories and/or concepts relate to your healthcare administration problem, purpose, and review question? (no more than 2-3 sentences)
Spread of evidence-based practices follows the diffusion of innovations which is the process through which an innovation, defined as an idea
perceived as new, spreads via certain communication channels over time among the members of a social system.
There are prerequisites that must be met to successfully spread innovations and best practices in a healthcare system. These processes also
determine the rate and speed of the spread. By improving the adoption rate of innovative, evidence-based practices for heart failure patient’s
readmission rate may be decreased.
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Section 4: Significance Instructions and Example
Significance
Instructions: Here you explain how your study addresses the meaningful, discipline-specific issue that you identified and will therefore contribute to your
field, discipline, professional practice, etc. contributing to positive social change. Detail how your findings might support professional practice or allow
practical application (answer the So what? question).
How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional
practice, etc. contributing to positive social change?
More information on helping rural hospital adopt and implement evidence-based practice strategies will decrease the 30-day readmission rate for
heart failure patients in rural hospitals.
Significance of study related to social determinants?
Proposing solutions for rural hospitals to reduce their 30-day readmission rates for heart failure patients will have a positive impact on patient
recovery, families and rural hospitals that serve their communities.
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Section 5: Research Alignment Table Instructions and Example
Complete the Research Design Alignment Table using the information from earlier sections of this form. Using an alignment table can assist with
ensuring the alignment of your research design.
Research Design Alignment Table Video Tutorial (YouTube) | Doctoral Research Design Alignment Appointments or Office Hours
Healthcare Administration
Problem
Practice Gap
Purpose
Review Question
Theoretical
Framework
List the theories and/or
conceptual framework.
The healthcare
administration problem is
high readmission rates for
heart failure patients with
the last 30-days of
discharge for rural
hospitals with 20-25 beds.
Evidence shows that 30-day
readmission rates for heart
failure cases is 16.10% for
rural hospitals with 20-25 beds.
This study will study research
methods to bring the
readmission rates down to the
CMS national average of
15.59% for rural hospitals.
The purpose of this research is
to search the existing body of
knowledge related to rural
hospital admission rates for
heart failure patients and
provide strategies for leaders
to reduce their readmissions
rates for heart failure patients.
What are best
practices to improve
the adoption and
implementation of
evidence-based
quality improvement
strategies to reduce
heart failure patient’s
readmission rates in
rural hospital settings?
Diffusion of Innovation
My Doctoral Research (MyDR)
If you have not done so already, you should familiarize yourself with the MyDR system. The MyDR system was designed to assist you and your mentors in
navigating your doctoral research journey, from the very beginning through the final approval. The various landing pages in MyDR will track your progress and
will serve as a central location for resources to support that progress. There is a process flow tool in which you exchange and store faculty evaluations of and
feedback on your work as you progress along that journey.
You will be entered into the MyDR system when both your mentor and co-mentor are approved by the academic program.
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1
DHA Practice Gap
Name
University Name
Course
Professor
Date
2
DHA Practice Gap
The Healthcare Administration Problem
HSO type
The HSO type of interest is acute care hospitals. These HSOs are dedicated to providing
short-term interventions to patients diagnosed with traumatic injuries or abrupt episodes of
emergencies, sicknesses, or other after-surgical operations (Miyawaki et al., 2022). Therefore,
these HSOs offer essential healthcare services to patients requiring urgent and intense treatment.
Problem of Interest
The problem of interest is hospital-acquired infections, often abbreviated as HAIs. One of
the most important outcomes pursued by acute care settings is enhancing patient safety and
delivering optimized quality of care. However, HAIs tend to prevail in these settings
undermining patient safety and quality of care. The problem occurs due to myriad problems
including the efficacy of CQI practices at acute care facilities. Examples include inferior hand
hygiene practices, as Chitamanni et al. (2023) revealed, and the improper use of indwelling
medical devices. CQI practices are deemed critical for the delivery of quality healthcare services.
While this is the case, acute care settings usually face immense hardships when adopting the
various CQI practice elements.
Healthcare Administration Problem
Acute care facilities often face persistent or ongoing challenges in implementing
sustainable efforts to alleviate HAIs. These challenges result from factors such as lack of proper
training on, for example, strategies to prevent the prevalence of HAIs, and a dearth in resources
designed to address these infections. Yet, these causes are preventable. There have been vast
advancements in medical technology and practices. Nevertheless, Han et al. (2020) documented
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that patient safety incidents have remained the same in general care settings. Continuous quality
improvement efforts, often abbreviated as CQIs, have been shown to work effectively in
improving the efficiency and quality of industrial processes (Hill et al., 2020). As a result, these
practices have greatly interested healthcare leaders and other related stakeholders.
Despite the case, Hill et al. (2020) showed that evaluations in the use of CQIs in the
healthcare sector have been scarce. As a result, the benefits of these efforts have not been certain.
In some situations, CQIs have demonstrated immense effects in enhancing healthcare provision.
However, these outcomes have been limited. In other words, the positive effects have not been
shown in various healthcare settings. This context shows that there is a significant gap in the
consistent and effective implementation of CQIs, especially within acute care settings. True to
this notion, Aktaa et al. (2022), citing a previous study, indicated that there is a lack of certainty
on how clinicians can measure safety and quality in acute care environments, which hints at a
problematic integration of CQIs in this healthcare domain. Thus, performing a study to
determine effective strategies for patient safety and quality improvement to address HAIs in
acute care settings is a fundamental cause.
Research Domain
The healthcare administration problem of interest aligns with the quality improvement
DHA research domain as Defense Health Agency (2019) describes. This is because research into
this challenge focuses on identifying and implementing strategies necessary to enhance patient
outcomes (patient safety), improve the care process, and optimize resource utilization within the
healthcare organization. Furthermore, part of the healthcare administration problem, as a causal
factor, is substandard nurse training on HAIs. Consequently, the problem also aligns with the
DHA research domain of the scarcity of human capital in nursing as illustrated by the Defense
4
Health Agency (2019). Accordingly, to address patient safety and quality improvement in acute
care settings, appropriate staff education must be pursued.
Bibliography
AHRQ (2024). Guide to implementing a program to reduce catheter-associated urinary tract
infections in long-term care. https://www.ahrq.gov/hai/quality/tools/cautiltc/modules/implementation/guide.html
This resource supposes that HAIs, especially catheter-associated UTIs, are prevalent in
acute care facilities, yet these are preventable. Therefore, the article suggests the need for EBPs,
such as comprehensive unit-based safety programs. Part of the program emphasizes infection
prevention through PPEs, proper hand hygiene, and environmental cleanliness. Besides, the
program provides guidelines for appropriate indwelling urinary catheter use, training staff for
catheter use, and implementing surveillance to identify and address CAUTIs.
Alamer, A., Alharbi, F., Aldhilan, A., Almushayti, Z., Alghofaily, K., Elbehiry, A., &
Abalkhail, A. (2022). Healthcare-associated infections (HAIs): Challenges and measures
taken by the radiology department to control infection transmission. Vaccines, 10(12).
https://doi.org/10.3390/vaccines10122060
The article supposes that HAIs are acknowledged as the most common and severe health
problems in the radiology department. This department is highly vulnerable to these infections
because it is a hub for transmitting infected patients, healthcare workers, and non-infected
hospital clients. The use of interventional radiological procedures has increased the risk of HAIs
manifold. The article relays the need for implementing CQI efforts, including availing PPEs and
using them appropriately, improving hand washing habits, and disinfecting radiology devices
5
and equipment. The article also indicates the need for having proper guidelines for recognizing
supposed or actual infected persons.
6
References
AHRQ (2024). Guide to implementing a program to reduce catheter-associated urinary tract
infections in long-term care. https://www.ahrq.gov/hai/quality/tools/cautiltc/modules/implementation/guide.html
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Alamer, A., Alharbi, F., Aldhilan, A., Almushayti, Z., Alghofaily, K., Elbehiry, A., & Abalkhail,
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