Date of Award

Summer 8-1993

Document Type


Degree Name

Master of Science (MS)


Community & Environmental Health


Community Health Professions

Committee Director

Gregory H. Frazer

Committee Member

John L Echternach

Committee Member

Gail C. Grissetti

Call Number for Print

Special Collections LD4331.C48C75


Hospitals are facing change in today's environment. In order to meet these growing challenges, they are responding by providing value added services. Value added services have been defined as reducing inefficiencies and improving quality and service. Operational restructuring in the form of a new concept called patient-focused care has become the paradigm shift and structural revamping at several hospitals across the nation. Sentara Hospitals have adopted this program to improve the clinical and service quality delivered to the patient. An integral component of this new approach is the multiskilling of staff to reduce duplication, inefficiencies, and improve the quality provided to patients. This is accomplished by reducing the number of staff the patient encounters and enhancing the skills of those care-givers so they can meet the varying needs of the patient. Under patient-focused care, the hospital staff are divided into three categories; clinical, administrative, and service associates. Each associate must be trained to meet the service level required in the multiskilled health care environment.

An internal CIPP evaluation study which focused on the CONTEXT, INPUT, PROCESS, and PRODUCT of the administrative associate training program is discussed in the following research. The evaluation study was prepared as a graduate thesis and also to assist the stakeholders of Sentara Hospitals in determining if the training program met the goals established at its conception. Attitudinal questionnaires were distributed to 35 past students of the program with a 68.5% return rate. An item analysis was performed on the survey tool, resulting in a quantifiable measurement of the respondents' attitudes toward specified goal attainment.

The questionnaire contained close-ended and open ended questions. On a scale of 1-5 with 1 being not at all and 5 being excellent, the overall rating on the achievement of the training goals was 3.2 (3.0 good and 4.0 very good).

The research validated the goal attainment of the first phase of the training. In addition, it questioned whether the training program was the only method to accomplish these Patient Focused Hospital goals of multiskilling, improved employee job satisfaction, and increased employee competencies, or if these goals could have been achieved through on-the-job training.

All of the administrative associates given the training were experienced hospital employees with varying backgrounds, consequently, there was no other control group of administrative associates to provide research data. However, the future administrative associate may be a new hire and the benefit of the training program versus on-the-job learning could demonstrate further information.

It is recommended that this training program continue and a control group of administrative associates function without attending the program. The questionnaire should subsequently be administered to the group undergoing the training program, and another questionnaire be administered to the on-the-job group of learners. This control group questionnaire should substitute administrative associate training program (AATP) for on-the job training. Follow-up audits of the work performed should also be compared for any significant differences in the knowledge and competency of the administrative associates to provide a comprehensive picture of the efficacy of the AATP.


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