Date of Award

Spring 5-6-2018

Degree Type


Degree Name

Executive Doctorate in Business (EDB)



First Advisor

Karen D. Loch

Second Advisor

Pam Scholder Ellen

Third Advisor

Thomas A. Conklin


Nineteen percent of the Cherokee County, Georgia, population is uninsured, and the ratio of population size to the number of physicians is 2,950:1. It is evident from the data that there is a need for more health care practitioners in Cherokee County who can deliver adequate care to the residents of the county. Recognizing the need to help uninsured individuals in the county, a community clinic opened its doors in 2011 to address the gaps in care. However, over the years, the increase in the number of patients being seen without the financial ability to pay has resulted in the decreased viability of the clinic. The board of directors had to consider ways to improve its financial outcomes. One such way was to consider eligibility screening, with sliding scale payments based on the screening. The study was guided by one research question: How does one community clinic implement a process innovation that requires cultural and structural shifts to obtain and sustain financial viability?