Highlights of the Fall 2023 MHA Capstones
As our alumni know, MHA students are required to conduct a capstone project as part of their degree program. Given that the capstone projects require considerable work and result in significant papers, for fall 2023, we are highlighting three capstone projects, as suggested by Professor Erin Sullivan. If you'd like to read any of the full capstone papers, please email Professor Rick Gregg.
Luciana Canestraro
Luciana Canestraro is a native of Brazil who received her bachelor’s degree in communications and journalism from Stonehill College. She briefly worked in the media industry before transitioning to public relations. After years in the public relations field, her passion for languages–and a calling for healthcare–took her on a new career path. Luciana completed education in medical interpreting and soon after became a Portuguese and Spanish medical interpreter at Boston Children’s Hospital. Over the next 16 years, she occupied several roles at Boston Children’s and today is the manager of Interpreter Services. She leads a team of four supervisors and 65 medical interpreters, who combined speak 12 languages. She completed her MHA degree in January.
Luciana’s capstone project is entitled “Promoting Equitable Healthcare Access for Patients With Limited English Proficiency in Diverse Healthcare Settings.” In the Introduction, she states that, ”The findings [of this study] will be of interest to hospital administrators, clinical providers, patients, public and commercial payers, and medical malpractice insurance groups.”
The abstract for her capstone paper states:
According to the US Census Bureau, more than 60 million individuals in the United States speak a language other than English at home, and more than 25 million speak English “less than very well” (Bureau, n.d.). Patients who have limited English abilities experience greater challenges accessing healthcare and are at increased risk for receiving suboptimal care than fluent English speakers. Despite existing laws and regulations intended to protect Limited English Proficiency (LEP) patients’ equitable access to healthcare, adherence to established protocols by healthcare facilities remains unclear.
This study aims to derive insights into whether the type of healthcare facility (e.g., academic medical center, community health center, rural hospital) affects interpreter utilization rates. Interpreter utilization data was extracted from several databases of an urban, pediatric academic medical center that revealed an 83% professional interpreter utilization rate between July and September 2023. Additional qualitative data was obtained via surveys and interviews with interpreter services leaders. The survey and interview responses revealed several differences and similarities between the healthcare facilities related to language services utilization, in addition to four main areas of focus: barriers, use of ad hoc interpreter or no interpreter, innovation, and training.
The noted differences, similarities, and areas of focus helped inform recommendations to increase oversight of current policies and regulations surrounding language access, implement standard provider education both in medical/nursing school and on the job, expand availability of language resources through external funding, and improve professional interpreter education. Although some recommendations such as public and commercial payer reimbursement for language services may not be easily achievable without significant lobbying efforts at state and federal levels, they must be considered for the long-term viability of language services in healthcare.
Learn more about Luciana's work at Boston Children's Hospital.
Maitry Mehta
Maitry Mehta is a practicing dentist who is passionate about enhancing healthcare beyond clinical practice. This is what led her to pursue an MHA degree at Suffolk. The program, rich in diverse subjects, unexpectedly steered her toward the realm of analytics. Intrigued by the potential of data-driven strategies in healthcare, she further expanded my expertise by pursuing a Dual Degree with a Master of Science in Business Analytics (MSBA).
Her combined knowledge and skills from the MHA and MSBA programs, along with experience as a research assistant at Suffolk, were crucial in securing a role at Massachusetts General Hospital as a Patient Safety and Quality Analyst. The capstone research paper is the culmination of her academic journey, and it focuses on the escalating costs of healthcare. This not only sharpened her analytical skills, but also fueled her passion for this field. She is eager to leverage her skills to further explore and contribute to the healthcare sector.
Maitry’s capstone paper is titled “Medicare Spending in Massachusetts: Correlation with Hospital Quality.” The abstract for her capstone paper states:
In the dynamic field of healthcare, this study investigates the crucial link between Medicare spending and care quality in Massachusetts (MA) hospitals. It examines the complex factors affecting hospital performance, focusing on Medicare Spending Per Beneficiary (MSPB) and its relationship with the quality of healthcare delivery. The research also explores Value-Based Care (VBC) and its impact on aligning provider compensation with care quality, equity, and cost-effectiveness.
The key research question investigates how MSPB correlates with healthcare quality and patient outcomes. Utilizing MA's diverse healthcare landscape, the study provides an in-depth analysis of MSPB and its impact on hospital quality, contributing to the broader national healthcare policy debate.
Data analysis, using secondary data from CMS datasets processed with SAS software, reveals that MA hospitals have a lower MSPB compared to the national average. Regression analysis identifies nine quality metrics significantly correlated with MSPB, showing varied directionalities. Insights from interviews with hospital administrators and providers offer perspectives on healthcare spending, MSPB, and the interplay between cost and quality of care.
The findings suggest improvements in healthcare spending and quality, with recommendations for policy refinement and a greater focus on preventative and primary care. These insights aim to guide policymakers, administrators, and stakeholders in optimizing healthcare outcomes.
Liezel Tiples
Liezel Tiples was a part-time student who completed her MHA degree, with a concentration in data analytics, in January. She loves data and using data analytics to help provide solutions to improve health outcomes. She was able to tie her role as a population health specialist to her capstone project and identified barriers contributing to non-adherence for breast cancer screening. Through this research, she is better equipped to push for awareness of barriers to the breast cancer screening measures as well as further develop solutions to improve quality performance within her healthcare organization.
Liezel’s capstone paper is titled, “Identifying barriers affecting performance measures for breast cancer screenings in Boston, Massachusetts.” The abstract for her capstone paper states:
Breast cancer screening (BCS) measures are expected to perform well within a healthcare organization, but the goals set by health plans may seem unattainable. It is my role as a population health specialist to work with primary care teams, by monitoring quality performance and identifying any gaps in care to improve performance for quality measures. The purpose of this study was to identify possible barriers that contribute to non-adherence for the BCS measures, which lowers performance. The study was done within the Beth Israel Lahey Health Performance Network (BILHPN) and six Beth Israel Deaconess Health Center (BIDHC) primary care practices in the Greater Boston region.
Interview data were collected on primary care physicians, radiology staff, and population health specialists working throughout the Beth Israel Lahey Health organization. A randomized sample (n= 299) of Blue Cross Blue Shield patients, who were inclusive of the BCS measure, was extracted from Arcadia. Additional data was collected from electronic medical records, Online Medical Records and Athena. From the interviews, I found six common themes to barriers affecting BCS compliance: 1) access, 2) availability and time, 3) anxiety and pain, 4) lack of education and clarity, 5) no routine care, and 6) mental health. A chi-square test and logistic regression model showed statistical significance (p<0.05) that women who have an annual physical exam (OR = 3.64) are more likely to be compliant, suggesting they are more educated in the risks and benefits of breast cancer screening. Age, employment status, and being outreached showed no statistical significance and were independent of BCS compliance. Through these findings, I hope to push for more awareness to the importance of breast cancer screenings within the Greater Boston region so that more patients would complete this preventive service that could potentially save their lives.