Defense Date

2020

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Health Related Sciences

First Advisor

Stacey Reynolds

Second Advisor

Joyce (Addie) Middleton

Third Advisor

Timothy Reistetter

Fourth Advisor

Rebekah Walker

Fifth Advisor

Lauretta Cathers

Sixth Advisor

Kelli Williams

Abstract

The United States (US) health care system is faced with the daunting challenge to make healthcare payments commensurate with quality of care provided. To assess quality, metrics for reimbursement have been established by Medicare. One such quality metric is hospital readmissions (readmissions). Readmissions are associated with poor patient outcomes and costly. Associated poor patient outcomes include higher risk for mortality, deconditioning, nutritional issues and cognitive impairments. As a result, readmissions cost Medicare $26 billion annually. Current strategies for reducing readmissions in the US are fragmented and hospital-specific. While specific strategies may vary, hospitals that have low readmissions rates tend to prioritize interdisciplinary care. It is unknown how the individual disciplines contribute to the interdisciplinary care needed to reduce readmissions. Evidence has shown that Occupational Therapy (OT) has strong potential to be a leading profession in the nation-wide effort to reduce readmissions but the exact mechanisms in the acute care setting that may result in readmission reduction have yet to be determined. This dissertation aims to address gaps in the literature through three separate studies.

Comments

The author wishes to thank several people. First and foremost, I would like to thank my husband, Adam, for his love, support, and amazing editing skills. Pursuing my PhD would not have been possible without him. I would also like to thank Dr. Stacey Reynolds for the structure and guidance she provided to me through countless phone calls and emails while creating and executing my dissertation. She made it possible for me to complete the dissertation I had planned on the timeline I had created for myself. Last but certainty not least, I would like to thank my entire dissertation committee for their expertise and time.

Rights

© Jessica Edelstein

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

11-11-2020

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