Welcome to Paw Prints
Paw Prints organizes, preserves, and makes accessible the scholarly and creative outputs of the University of Arkansas - Fort Smith. For more information see the Paw Prints guide, or contact repository@uafs.edu
Recent Submissions
Item The Izard County Historian: January 1970(Made digitally available by the Boreham Library at the University of Arkansas - Fort Smith., 1970)Item Interdisciplinary collaboration(2026-05)Interdisciplinary collaboration is a well-established concept of delivering high-quality health care systems, yet the operationalization of collaborative action within various professional roles remains a major challenge in healthcare environments. Communication breakdowns and inconsistent teamwork among physicians, nurses, and allied health professionals have been linked to adverse patient safety events, reduced care coordination, and inefficiencies within healthcare systems. While the literature discusses interdisciplinary collaboration often, there is still a gap between conceptual understanding and the implementation of evidence-based administrative strategies that consistently support coordinated team processes. This capstone combines peer-reviewed literature and nationally recognized healthcare guidelines to investigate administrative practices that create interdisciplinary collaboration at the organizational level of health care. Focus is on measures that advance communication skills, define roles among professionals, and facilitate team effort at different care environments. Emphasizing system-level barriers to communication and patient safety, this study details practicable solutions as well as the steps that healthcare administrators can take to improve team performance and organizational results.Item Comparative Analysis of Telehealth Services for both Providers and Patients(2026-05)This capstone project presents a comparative analysis of telehealth access to healthcare to the utilization of rural hospitals. The patient demand on access to care, affordability, and quality of healthcare management is a critical component to healthcare reform in America. As the healthcare industry is faced with many policy implications and the changing of legislation, it is imperative to address the issue of access and quality to care. Utilizing telehealth medicine to bridge the gap for health disparities to be an effective method for healthcare organizations to implement in a manner that improves quality and value. Exploring mixed-method studies, and meta-analysis studies revolving around telehealth medicine of secondary qualitative and quantitative data is retrieved where it is then compared to local data in the form of a pilot study. The hypothesis being tested in this project is that healthcare organizations do not show patient satisfaction, reduced spending leading to decreased prevention, performance, and more patient wait time/less provider break time with telehealth services. Findings of this project indicate that utilization of telehealth medicine does improve patient access, time saving, cost-efficiency, and creating value to the healthcare delivery without impairing quality. Both pilot study and secondary data indicates in this research project that there is enough evidence to reject the null hypothesis; therefore, key policy implications must be enacted to regulate access, cost, and quality to implement a framework moving forward. Limitations of this project include limited generalizability, small sample size, selection bias, short study duration, technology access, and digital divide. Organizations should implement/expand telehealth medicine to rural healthcare sustainability, and make telehealth a permanent component of healthcare delivery in which policymakers enact legislation to maintain high standards of care and prevent misuse. Long-term success of telehealth will depend on sustainable, equitable, and well regulated policy frameworks.Item EVALUATING ON-DEMAND INTERPRETER AVAILABILITY AND ITS INFLUENCE ON ACCESS TO CARE IN RURAL PRIMARY CARE SETTINGS(2026-05)Limited English proficiency (LEP) remains a significant barrier to equitable access to healthcare in the United States, particularly in rural primary care settings where resource constraints and workforce shortages already limit service availability (U.S. Census Bureau, 2022; Probst et al., 2004). While professional interpreter services are known to improve communication, patient safety, and quality of care (Flores, 2005; Karliner et al., 2007), less is understood about how interpreter availability models influence operational access metrics. This quantitative capstone project evaluated whether on-demand interpreter services are associated with improved timeliness of care compared with scheduled interpreter-only models in rural primary care clinics. Using retrospective operational data, the study examined two key outcomes: time-toappointment and visit start-time delays among LEP patients. Findings demonstrated that clinics utilizing on-demand interpreter services experienced shorter intervals between appointment request and scheduled visit, as well as reduced delays in visit initiation. These results suggest that interpreter availability functions as a structural determinant of access to care, influencing both scheduling efficiency and clinic workflow. The findings support the integration of on demand interpreter modalities as an evidence-informed strategy to improve operational performance and advance health equity (Jacobs et al., 2004). Implications for healthcare administrators include the need for standardized language access protocols, investment in interpreter infrastructure, and alignment with federal language access requirements (U.S. Department of Health and Human Services [HHS], Office of Civil Rights, 2025). Further research is recommended to evaluate long-term clinical and financial outcomes associated with interpreter service models.Item Transportation Insecurity as an Operational Barrier to Care: Impacts on Appointment Adherence and Discharge Efficiency at Mercy Hospital Northwest Arkansas(2026-05)Transportation insecurity is a persistent social determinant of health that directly affects patients’ ability to access care and creates downstream operational challenges for healthcare systems. This capstone project examined transportation insecurity as an operational barrier to care at Mercy Hospital Northwest Arkansas, with specific emphasis on its impact on outpatient appointment adherence and inpatient discharge efficiency. Using a retrospective descriptive analysis, administrative and clinical data from 2021 through 2025 were reviewed, including outpatient scheduling records, cancellation reason codes, payer mix data, work relative value units (wRVUs), documented transportation assistance, and discharge-related workflows. Results demonstrated a substantial increase in transportation-related appointment cancellations concurrent with rapid growth in clinic volume. Although transportation-related cancellations represented less than one percent of total visits, the absolute number increased sharply and was associated with an estimated $462,215 in lost clinic revenue and 4,879 lost wRVUs over the study period. Transportation barriers were observed across all major payer groups, indicating a systemwide access issue rather than a challenge limited to Medicaid beneficiaries. In the inpatient setting, transportation-related discharge delays were historically under-documented; however, recent implementation of standardized transportation screening by Case Management represents a critical advancement toward proactive discharge planning. Findings suggest that transportation insecurity contributes to inefficiencies in access, throughput, and resource utilization and is currently addressed through largely reactive and fragmented interventions. This project underscores the need for healthcare administrators to integrate proactive transportation risk identification, hospital-coordinated transportation supports, and transportation metrics into operational and population health strategies to improve access, efficiency, and equity across the continuum of care.
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