Health Systems, Leadership, & Quality

We examine factors that impact quality, safety, and cost within health systems.

A health system refers to organizations that provide healthcare services, conglomerates/partnerships of health care-providing organizations, and the interconnection of healthcare providers in a state, region, or nation. The complexity of health systems requires modern approaches to leadership and practice, as well as laws and regulations that address problems stemming from that complexity.

In the U.S., quality and cost problems plague the healthcare system:

• The Health Resources & Services Administration forecasts a shortage of over 23,000 primary care physicians–the first-line point of health care for many Americans–by 2025.
• 21% of American adults have personally experienced a medical error, according to an Institute for Healthcare Improvement/NORC at the University of Chicago survey.
• The Centers for Medicare & Medicaid Services projects that health spending in the U.S. will grow around 5.5% every year between 2018 and 2027, by which the cost will be nearly $6 trillion.

Kent State nurse researchers are examining factors impacting quality, safety, and cost within health systems, including the makeup of teams, leadership, environmental design, nursing practice models, and governance.

Affiliated Faculty

• Mary K. Anthony, Ph.D., RN
  Focus: High-performing nursing organizations; processes of nursing practice models, such as delegation, teams, and interruptions and their effects on outcomes; impact of relational capital as a strategic resource.
• Kimberly Cleveland, JD, MSN, RN, C-MBC
  Focus: Healthcare regulation, policy, and legal issues.

Recent Publications & Presentations

Bayramzadeh, S., Anthony, M. K., Sterling, M., & O’Donnell, K. (in press). The role of the physical environment in shaping interruptions and disruptions in complex healthcare settings: A systematic literature review. American Journal of Medical Quality.

Cleveland, K. A., Vernaglia, L., Knoblauch, D., Nibling, M., & Bonder, J. (2021). Duty calls: The NP as board member. The Nurse Practitioner, 46(8), 12-16.

Distelhorst, K. S., Heifner Graor, C., & Hansen, D. (2021). Upstream factors in population health: A concept analysis to advance nursing theory. Advances in Nursing Science, 44(3), 210-223. doi.10.1097/ANS.0000000000000362

Bayramzadeh, S., Mazharul, M., Leong, T., & Anthony, M. K. (2021, June). Exploring healthcare workers’ perception on the role of the physical environment in causing disruptions and interruption in trauma rooms. Paper presentation for the European Healthcare Design Congress (virtual).

Bayramzadeh, S., Anthony, M. K., Ghazinour, K., & Mallat, A. F. (2021, August). Towards a model of safety for trauma room design. Webinar for the Agency for Healthcare Research and Quality, Washington, D.C.

Cleveland, K., Rudisill, P., & Benson, L. (2021, July). Assessing, amplifying, and leveraging the positive power of nurse leadership. Paper presentation for the American Organization for Nurse Leadership (AONL) Annual Conference (virtual).

Motter, T., Hassler, D., & Anthony, M. K. (2021). The art of nursing becomes a celebration for nurses. OJIN: Online Journal of Issues in Nursing, 26(2). doi.0.3912/OJIN.Vol26No02PPT72

Cleveland, K., Magyar, S., Justice, J., & Truong, S. (2020, October). Adolescent vaping:  A literature review to inform policy initiatives. Poster presentation for The American Association of Nurse Attorneys (TAANA) annual conference (virtual). 

Cleveland, K. (2020, October). Open educational resources:  One solution for educating pre-licensure nurses regarding their role in health policy. Poster presentation for The American Association of Nurse Attorneys (TAANA) annual conference (virtual).

Smith, Y., Cleveland, K., Fisher, J., & Kleman, C. (2020). The use of faculty policy teams for advancing policy advocacy and colleagueship. Nursing Forum, 55(4). doi.org/10.1111/nuf.12473

Cleveland, K., & Harper, K. (2020). Prepare and pursue board opportunities: A practical guide for nurse leaders to serve on a board. Nursing Economics, 38(2), pp. 94-97.

Amato, S., & Anthony, M. (in press). Hospital environmental effects on sleep in adults with traumatic brain injury in rehabilitation. Rehabilitation Nursing. doi.10.1097/rnj.0000000000000220

Cleveland, K. A., Motter, T., & Smith, Y. M. (2019). Affordable care: Harnessing the power of nurses. OJIN: The Online Journal of Issues in Nursing, 24(2).

Cleveland, K., & Smith, Y. (2019, August). Nurses on boards research: The time is ripe to expand the goals of counsel. Poster presentation for the American Association of Nurse Attorneys National Conference, San Diego, California.

Cleveland, K. (2019, August). Nurses on boards: The time is ripe to expand the goals of counsel. Podium presentation for the American Association of Nurse Attorneys National Conference, San Diego, California.

Kopf, R., Dolan, C., & Cleveland, K. (2019, August). Organizational leadership through mentoring: A perspective from TAANA members. Poster presentation for the American Association of Nurse Attorneys National Conference, San Diego, California

Cleveland, K. A. (2019, June). Formation, consideration and breach: Oh my! Podium presentation for the Flying Physicians Annual National Conference, Washington, D.C. 

Smith, Y. M., & Cleveland, K. A. (2019, May). Nurses on boards: The value of prior experiences. Poster presented at the Sigma Theta Tau 2019 Annual Research Collaborative, Kent, Ohio.

Smith, Y. M., & Cleveland, K. A. (2019, April). Nurse leaders serving on boards: Experiences and effectiveness. Podium presentation for the American Organization of Nurse Executives (AONE) 2019 Annual Meeting, San Diego, California.

Anthony, M., Motter, T., & Hassler, D. (2019, March). Nursing research: Science meeting creative pathways. Poster presented at the 43rd Annual Research Conference of the Midwest Nursing Research Society, Kansas City, MO.

Smith, Y., & Cleveland, K. (2018, September). The trifecta: The integration of policy, financial and legal literacy to prepare nurse executives. Podium presentation for the Sigma Theta Tau International Leadership Connection 2018, Indianapolis, Indiana.

Smith, Y. M., & Cleveland, K. A. (2018, September). Finding our voice through interdisciplinary policy teams: Strategies for compelling change. Podium presentation for Sigma Theta Tau Leadership Connection 2018, Indianapolis, Indiana.

Cleveland, K. A., & Knoblauch, D. J. (2018). Ensuring a return on your professional investment: The importance of a contract (part 1). Nurse Practitioner, 43(10), 14-17. doi.10.1097/01.NPR.0000545003053382.d8

Cleveland, K. A., & Kearney, S. (2018, August). To regulate or license: The essential questions regarding essential oils. Poster presented at the American Association of Nurse Attorneys Annual Meeting and Educational Conference, Denver, Colorado.

Cleveland, K. A., Watral, T., & Fisher, J. (2018, August). Nurse staffing: To regulate or not to regulate. Is that a serious question? Poster presented at the American Association of Nurse Attorneys Annual Meeting and Educational Conference, Denver, Colorado.

Cleveland, K. A., Watral, T., Fisher, J., & Kearney, S. (2018, August). Undergraduate health care policy education: The power to teach, mentor and inspire. Poster presented at the American Association of Nurse Attorneys Annual Meeting and Educational Conference, Denver, Colorado.

Cleveland, K. A., & Smith, Y. M. (2018, August). Preparing nurses on boards: A call to action. Poster presented at the American Association of Nurse Attorneys Annual Meeting and Educational Conference, Denver, Colorado.

Cleveland, K. A. (2018, August). Board service, advocacy and accountability. Poster presented at the Flying Physicians’ Annual Meeting, Sulfur Springs, West Virginia.

Smith, Y. M., & Cleveland, K. A. (2018, May). Professional identification: The foundation of nurses’ consideration of governing board experiences. Poster presented at the Delta Omega, Delta Xi, & Pi Chi Chapters Collaborative 2018 Annual Research Conference, North Canton, Ohio.

Smith, Y. M., & Cleveland, K. A. (2018, April). Nurse-identified experiences relevant to governing board service. Paper presented at the 42nd Annual Research Conference of the Midwest Nursing Research Society, Cleveland, OH.

Cleveland, K. A., & Smith, Y. M. (2018, April). Financial literacy, nurse leadership, nursing presence. Poster presented at the 9th Annual Celebration of Nursing, Canton, Ohio.

Smith, Y. M., & Cleveland, K. A. (2018, April). Compelling change through interdisciplinary policy teams. Poster presented at the 9th Annual Celebration of Nursing, Canton, Ohio.

Smith, Y. M., & Cleveland, K. A. (2018, April). Relevant experiences of nurses on governing boards. Poster presented at the Ohio Nurses Foundation Nurses Choice Awards Luncheon, Columbus, Ohio.

Recent Grants