Date on Master's Thesis/Doctoral Dissertation

5-2024

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Industrial Engineering

Degree Program

Industrial Engineering, PhD

Committee Chair

Logan, Mawuena Kossi

Committee Co-Chair (if applicable)

McCormack, Michael Brandon

Committee Member

McCormack, Michael Brandon

Committee Member

Story, Kaila

Committee Member

Siddiqui, Tasneem

Author's Keywords

W.E.B. Du Bois; Audre Lorde; pan-african development; problem of othering

Abstract

Interruptions during dental treatment are frequent, and often have detrimental effects on quality of care, patient safety and processing times, and have an impact on provider satisfaction and performance. Interruptions can significantly increase the cognitive load on dental providers, making it hard for them to concentrate on complex procedures. Frequent interruptions also disrupt the workflow in general, leading to delays in treatment, which can reduce the overall throughput of a clinic. Unfortunately, there is no comprehensive approach to collectively (i) analyze interruptions in dental healthcare, (ii) design an intervention, and (iii) implement and sustain it. This research proposes a comprehensive conceptual framework designed to address this challenge. Our framework, which we term Design Science and Implementation Research (DSIR), comprises Design Science Research (DSR) and the most advanced framework in implementation science – the Consolidated Framework of Implementation Research (CFIR). Our framework fills a gap between the existing frameworks from DSR, which address creation of new innovations and interventions, and CFIR, which focuses on

pursuing process steps that extend from the creation of an innovation throughout its practical application, without going into much detail about how it should have been designed. We illustrate the application of DSIR in a dental healthcare setting. Our first contribution (Chapter 2) provides details of our proposed DSIR framework that provides guidance on how to design an innovative intervention and implement the created artifact in a real-world environment. We discuss the four stages (Environment, Knowledge Base, Design and Development, and Implementation) and five cycles (Relevance, Rigor, Design-Implementation, Change Management, and Sustainability) in the DSIR. Our second contribution (Chapter 3) illustrates the practical application of the DSIR framework. Here we study interruptions in a dental clinic, analyze the data, design an intervention to reduce the negative impact of interruptions on the clinic, its staff and patients, especially by reducing interruption frequency, and pilot it for several months. We analyze the impact of the intervention on processing time and provider satisfaction. The total number of interruptions dropped by 72.5% after the intervention; short interruptions (

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