Recent Dissertations

Anna Foucek Tresidder
The Institutional Context that Supports Team-Based Care for Older Adults

This study examined the role of institutional context in supporting interdisciplinary teams (IDT) in the care of older adults through interviews of the management and staff of the Program for All-Inclusive Care of the Elderly (PACE) in six states. A case study approach drawing upon qualitative methods was used to examine policy-regulative, cultural-cognitive, normative, relational, and procedural elements of institutional context and the extent to which they support collaborative teamwork. The findings provide in-depth analysis and discussion of the complexity of supporting teams and actualizing teamwork in practice.

Date Defended: October 2, 2013

Oliver John Droppers V
A Case Study of Collaborative Governance:  Oregon Health Reform and Coordinated Care Organizations

This research explored collaborative governance as a model to form new partnerships among for-profit, nonprofit, and public organizations in an effort to create community-based, locally governed health care entities in Oregon through coordinated care organizations (CCOs). This study developed insights into similarities and differences among CCO governance structures by investigating three CCOs. The significance of this study is that it identified starting conditions that facilitate and hinder the ability of CCOs to effectively solve problems through governance mechanisms. Oregon’s CCOs offer an example of multiple layers of governing institutions—federal, state, and county—using formal authority to influence a specified set of outcomes, the Triple Aim, in a specific policy domain: provision of health care services for underserved Oregonians. This study contributes to the theory of collaborative governance and may inform future policy decisions about CCOs in Oregon and, more broadly, ongoing national health care reform efforts.

Date Defended: May 7, 2014

Carl William Foreman
Impact of a State Evidence-Based Practice Legislative Mandate on County Practice Implementation Patterns and Inpatient Behavioral Health Discharge

This study analyzed the implementation of an evidence-based practice legislative mandate in the State of Oregon, which provided an opportunity to analyze county-level implementation patterns of evidence-based practices and their impact on expected outcomes. As a public policy, ensuring the use of evidence-base practices provides a potential rational method for controlling the quality of provider practices. In theory, provider use of evidence-based practices increases the quality of services provided and improves outcomes. The evidence-based framework provided a rational mechanism for evaluating and categorizing interventions by the level of supporting evidence.  Study results identified some evidence that the policy yielded “rational mechanism” processes and outcomes, but also indicated that other mechanisms may have influenced implementation patterns and that the evidence of a link between policy and outcomes is a best inconsistent. Further research on evidence-based policies using definitional and measurement frameworks applied in this study is clearly warranted.

Date Defended: January 26, 2015