UMD Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/1903/3

New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a given thesis/dissertation in DRUM.

More information is available at Theses and Dissertations at University of Maryland Libraries.

Browse

Subject: search.filters.subject.Hospital

Search Results

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Modeling of HVAC Configurations for De-Carbonization in a Mid-Size Hospital
    (2022) Grant, Zachary; Hwang, Yunho; Mechanical Engineering; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    As the threat of climate change becomes more imminent, there has been increasing emphasis on technologies that reduce carbon emissions in the HVAC sector. The clear path forward given existing technologies is electrification since electricity production has future potential to become cleaner. In terms of building type, high ventilation requirements and near continuous occupancy make healthcare facilities some of the highest energy users. HVAC equipment runs all day and night in these facilities with little change. Conventional HVAC equipment such as a boiler is proven to consume more energy than heat pump systems. More specifically, the Variable Refrigerant Flow (VRF) heat pump and the Ground Source Heat Pump (GSHP) are areas of ongoing research. This analysis included creating whole-building energy models using EnergyPlus and OpenStudio to compare the energy consumption for these heat pump configurations and some cheaper electrification alternatives. The results suggested that the GSHP system possessed the greatest potential for energy savings and thus decarbonization given its higher efficiency during times of extreme ambient temperatures compared to other options.
  • Thumbnail Image
    Item
    Connecting the Dots Across the Care Continuum: Addressing Behavioral Health in ACO Networks
    (2019) Anderson, Andrew; Franzini, Luisa; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Accountable Care Organizations (ACOs) represent a shift from traditional fee-for-service payment systems that reward volume to payment models that reward providers for value (e.g. quality improvement and cost reduction). Hospitals that lead or participate in ACOs have the potential to work with other providers to bridge the gap between traditional medical and behavioral health services. The goal of this dissertation was to examine the structures, processes, and outcomes of care for hospitals that lead or participate in ACO networks. The overarching hypothesis was that ACO-affiliated hospitals provide better behavioral health care due to increased care coordination and increased connections to behavioral health providers. This dissertation had three aims: 1) compare the implementation of care coordination strategies between ACO affiliated hospitals and unaffiliated hospitals and examine whether the implementation of care coordination strategies varies by hospital payment model types; 2) compare the use of care coordination strategies between ACO-affiliated hospitals with and without in-network behavioral health providers; and 3) compare rates of follow-up after a hospitalization for mental illness between ACO-affiliated and unaffiliated hospitals. These aims build on each other to illustrate how hospitals that participate in ACOs are improving care coordination and the provision of behavioral health services. There were several meaningful findings. ACO-affiliated hospitals were more likely to use care coordination strategies compared to unaffiliated hospitals. Participation in global capitation and shared savings models was associated with greater use of care coordination strategies. Nearly two-thirds of ACO-affiliated hospitals did not have in-network behavioral health providers. ACO-affiliated hospitals had a significantly higher average unadjusted rates of follow-up after a hospitalization for mental illness at 7 days and 30 days post-discharge compared to unaffiliated hospitals. Hospitals are important components of the care continuum and will play a critical role in improving outcomes for patients with behavioral health conditions. Policy makers should include behavioral health related performance measures tied to performance-based payment arrangements in ACO programs. ACOs can be used as way to bridge behavioral, clinical, and social services to address the unique needs of individuals with behavioral health conditions.
  • Thumbnail Image
    Item
    PROGRAM VS. CONTEXT: UNDERSTANDING THE ROLE OF INSTITUTIONAL BUILDINGS IN THE CITY
    (2004-05-20) Pancham, Satya; Schumacher, Thomas L.; Architecture
    Institutional buildings are necessary in any community whether it is an urban or suburban setting. Typically, these are large program driven buildings that do not relate very well to their surrounding communities because they are often envisaged as large object buildings that create vast undefined spaces. In order to positively promote buildings that are beneficial to the urban fabric, institutional buildings must be studied as a contextual and space defining type instead of being an isolated object in an amorphous field. The institutional building type to be studied is the hospital because these are often large program driven buildings. The area of interest is southeast Washington DC and the site is located at the end of Massachusetts Avenue and 19th Street. This site is significant because of its accessibility and its larger impact on the healthcare network of the city.