ORCID ID
Graduation Date
Spring 5-9-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Programs
Medical Sciences Interdepartmental Area
First Advisor
Brandon Grimm
Second Advisor
Kendra Schmid
Third Advisor
Victoria Kennel
Fourth Advisor
John Lowe
Abstract
Despite the increasing demand for more emphasis on patient-centered care and population health, healthcare leadership competency models incorporate minimal essential skills and strategies for effective community engagement. This dissertation used a sequential exploratory mixed-methods approach to gain a greater understanding of how Critical Access Hospital (CAH) Chief Executive Officer (CEO) in the State of Nebraska assess their competence in conducting community engagement and how important they perceive it to be to their hospital’s performance. The study used a survey instrument to gather quantitative data from CAH CEOs on their self-rated community engagement competency and the importance they assigned to conducting community engagement activities for their hospital’s performance metrics. CEOs were then interviewed to gain an understanding of their perceived strengths and weaknesses, barriers and challenges in conducting community engagement, and the strategies and practices they use to achieve their hospital’s performance metrics. CEOs generally rated themselves strongly on community engagement competencies and identified strengths in building trust, community presence, and civic development. Themes that presented with more challenges were strategic communication, evaluation of community engagement effectiveness, and strategic partnerships. Performance metrics related to quality of care were most impacted by community engagement, while financial metrics were least impacted. These findings illuminate areas where professional development and support may be beneficial. Outcomes of this study provide insights into the CAH CEO’s competency in community engagement practice and where efforts can be aligned to support CEO development and CAH performance.
Rights
The author holds the copyright to this work and any reuse or permissions must be obtained from the author directly.
Recommended Citation
Tschirren, Jessica B., "Community Engagement Competency of Critical Access Hospital Chief Executive Officers in Nebraska" (2026). Theses & Dissertations. 1051.
https://digitalcommons.unmc.edu/etd/1051