HPU Digital is Hawai‘i Pacific University’s institutional repository, led by the Library as a center of scholarship and innovation. It preserves and shares the academic work of HPU’s faculty, students, staff, and affiliates, reflecting the university’s diverse, global, and inclusive learning community. This initiative supports access, visibility, and long-term preservation of HPU scholarship and aims to connect the HPU community to academic and professional success.
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Item Patient Education: A Strategy to Patient Empowerment(1998)The health care industry is rapidly changing. Changes include the shift from brand name pharmaceutical products to generic versions, consolidation of health care providers, provision of health care through managed care, and disease management initiatives. One important change has been the growing influence of the patient in the health care arena. Patients play a larger role in the emerging health care environment because they are now being asked to share increasing responsibility for the state and care of their health. Preventing illness and controlling its effects when it does occur requires patient participation. Women's health and its determinants, the role of gender, the social context in which women experience life, all play a role in identifying important issues in women's health. The future of women's health can be positively affected by empowering female voices. Because women are major health consumers, it is important that they have participation in both research and policy decisions. There is increased need and a duty for health professionals to communicate with patients efficiently and effectively. For patients to become educated and empowered, health professionals have a duty to keep the patients current in the fields of medical science and health care delivery.Item Using Generative AI to Design Differentiated Learning in a General Education Course(Educational Designer, 2025-09)This design case explores an instructor's experience redesigning her course using generative artificial intelligence (GenAI) tools to facilitate differentiated learning. The course is part of a general education program that draws students from various disciplines, aiming to create unique, interdisciplinary learning experiences that allow each student to engage meaningfully with the content. The redesign process followed the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model, incorporating differentiated instructional strategies that leverage GenAI for tasks such as researching current leadership trends, crafting learning outcomes, outlining content, and creating assessments tailored to students' diverse mastery levels. This design case reflects on the decisions made during the course redesign process, presents some impact assessments, and discusses critical factors affecting implementation.Item Implementing a Workplace Mindfulness Campaign to Decrease Burnout Levels in Primary Care(2025)Burnout is a leading cause of employees’ poor job satisfaction and performance; while being a source of poor quality of care, influencing turnover, absenteeism, and low morale. An urban primary care clinic in California was experiencing high burnout levels and lacked an evidencebased strategy to support staff members. The purpose of this quality improvement project was to determine if the Palouse mindfulness-based stress reduction (MBSR) program would decrease burnout levels compared to standard practice among staff members of a primary care clinic located in urban California over eight weeks. Kurt Lewin’s Change Model framework served as the project's foundation, encouraging employees to change their behavior. The project determined that the Palouse mindfulness campaign decreased the burnout level of primary care employees. The median scores in each Maslach Burnout Index (MBI) tool subscale improved between the pre- and post-test. Hence, the implementation of Palouse Mindfulness Strategies may decrease the burnout level of employees, which will positively impact their job performance, increase job engagement, and drive high morale. The primary care will have efficient daily clinic operations with tenured and happy employees. By attaining and sustaining a healthcare system fiscal budget, the population needs access to care, and quality patient care is met.Item Implementing the Stop-Bang Assessment Tool to Impact Perceived Stress Among Clinical Staff(2025)Anesthesia-related airway emergencies, particularly those involving failed intubation or ventilation, are a significant concern and contribute to poor patient outcomes. Obstructive sleep apnea (OSA) increases the risk of difficult airway events, further compromising patient safety. Despite its predictive value, the STOP-BANG questionnaire is not currently used to screen for OSA risk in the endoscopy lab of an urban outpatient gastrointestinal clinic in Chicago, Illinois. This gap in practice can lead to procedural delays and safety concerns due to unanticipated equipment needs, insufficient staff readiness, and lack of postoperative awareness. This quality improvement project aimed to determine the impact of implementing the STOP-BANG questionnaire compared to the current practice on stress perception among outpatient gastrointestinal (GI) clinic staff over 8 weeks. The Knowledge to Action (KTA) framework was used as a guide to facilitate this project. A pre- and post-implementation Perceived Stress Survey-10 (PSS-10) was administered to clinical staff (n =10). Also, the STOP-BANG questionnaire was used to evaluate patients for possible undiagnosed OSA prior to anesthesia (n =103). Results showed that the mean pre-intervention score for PSS-10 was lower (M = 13.9, SD = 5.72) than the post-PSS-10 survey mean score (M = 16.8, SD = 4.32). However, implementing the STOP-BANG questionnaire categorically changed perceived stress levels from low to moderate among clinical staff at a low rate (n = 2; 20%). Nevertheless, perceived stress levels did not improve. STOP-BANG scores for colonoscopy patients were at an average of 3.66, whereas the average STOP-BANG scores for patients undergoing an esophagogastroduodenoscopy (EGD) were 3.06. Airway maneuvers were needed for 40.98% of patients who had a colonoscopy and 37.93% of patients who had an EGD.Item Honoring Patient Wishes: Implementing Physician Orders for Life Sustaining Treatment(2025)Purpose Rising healthcare costs are a growing concern for the nation. There are several factors affecting the increased cost of health care. Two major factors are emergency room visits and hospital admissions. Between 20-40% of these patients will have a preventable admission (Browne et al., 2024). Hospital admission rates and the number of emergency room visits are two factors that are important for long-term care facilities. These elements correlate with quality measures through the Center of Medicare and Medicaid. A long-term care facility in Alaska has noticed an increasing number of hospital admissions and emergency room visits in their population over the last two years. This year hospital admission rates for 2024 were 0.49 hospital admissions per resident day which is up from 0.29 in 2023. Emergency room visits are also on the rise. In 2023 there were 0.73 emergency room visits per resident day, by the end of the fourth quarter in 2024 this was elevated to 1.30. The use of physician orders for life sustaining treatment (POLST) forms have shown to benefit long-term care facilities. Jennings (2022) showed those facilities who used POLST forms had higher star ratings by the Centers for Medicaid and Medicare Services, indicating higher quality. Two quality indicators included in this star rating system are hospital admission rates and emergency room usage. POLST forms will help the long-term care population by preventing unnecessary emergency room visits and hospital admissions. Tark (2021) showed that states with fully developed POLST programs had a 12% increase in those who did not return to the hospital or have emergency room visits at the end-of-life. Demonstrating that POLST form completion decreases unwanted and unnecessary emergency room visits and hospital admissions at end-of-life. The gap in literature is identifying what psychosocial factors can help decrease hospital admissions and emergency room visits. In residents in a long-term care facility how does implementing Physician Orders for Life Sustaining Treatment (POLST) forms compared to prior practice impact the rate of hospital admissions and emergency visits in eight weeks? Implementation Plan Implementation took place over an eight-week period. During the first week of implementation staff were educated on the purpose and use of the POLST form using standardized education material through AK POLST. During weeks one through eight the provider met with residents and families to complete POLST forms. During weeks two through eight the provider met with staff once a week to discuss obstacles, questions, and current use of the POLST forms. There was also a provider on call to address any issues regarding POLST forms. Data Collection Data was collected by the quality improvement team using facility software and is available for review. Data was analyzed using paired T-test collecting before and after POLST implementation data for hospital admissions and emergency room visits using simple descriptive statistics.
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