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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 –the first-line point of health care for many Americans–by 2025.
  • have personally experienced a medical error, according to an Institute for Healthcare Improvement/NORC at the University of Chicago survey.
  • The 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.

ÌìÌì³Ô¹Ï 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

Cleveland, K., Rudisill, P., Vander Horst, A., & Benson, L. (April 2024). Getting nurses on boards: Why health care organizations should consider adding nurses to their boards. American Hospital Association Trustee Insights.

Boss, K., Wilk, C., Gorsuch, P., & Motter, T. (2024). Development of a clinical nurse specialist internship to promote evidence-based practice and improve outcomes. Nurse Leader. 

Kosar, C., & Cleveland, K. (2024). NCPD Tests: Navigating the litigation experience. Orthopaedic Nursing, 43(2), E7. doi.10.1097/NOR.0000000000001021

Cleveland, K., Rudisill, P., Harper, K. J., Vander Horst, A. (2023). Building evidence that demonstrates a need for increasing the number of nurses on boards. Nursing Economic$, 41(6), 296-300. 

Anthony, M. K. (2023). Philanthropy: The innovation and the fun. Western Journal of Nursing Research, 45(3), 284-285. 

Cooks, E., Vilaro, M. J., Dyal, B. W., Wang, S., Mertens, G., Raisa, A., Kim, B., Campbell-Salome, G., Wilkie, D. J., Odedina, F., Johnson-Mallard, V., Yao, Y., & Krieger, J. (2022). What did the pandemic teach us about effective health communication? Unpacking the COVID-19 infodemic. BMC Public Health, 22(1), 2339. 

Anthony, M. K. (2022) Philanthropy in action: Making a difference. Western Journal of Nursing Research, 44(6) 629–630 doi:10.1177/01939459221094114

Anthony, M. K. (2022). News: Gifts in motion for grants in action. Western Journal of Nursing Research, 44(12), 1195.

Anthony, M. K. (2022). Philanthropy: Inspiration starts with WHY.  Western Journal of Nursing Research, 44(10), 985–986. doi:10.1177/01939459221113398

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.

Recent Grants

Investigator(s)Grant TitleFunding Agency
Sara Bayramzadeh, Mary K. Anthony, Kambiz Ghazinour, and Doug DelahantyTowards a Model of Safety and Care for Trauma Room DesignAgency for Healthcare Research and Quality (AHRQ) Center for Quality Improvement and Patient Safety