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Patient Safety and Quality Improvement Evaluation

NURS 8300 Week 6: Organizational and Leadership Strategies to Improve Patient Safety and Quality
NURS 8300 Week 6 Discussion
Patient Safety and Quality Improvement Evaluation
Selected Quality Improvement Project
The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a standardized survey that evaluates multiple aspects of patients’ experience during inpatient care, is sent to a random sample of patients discharged from individual acute care facilities that participate in the Centers for Medicaid and Medicare Services (CMS) reimbursement programs (CMS, 2013).  Over the last decade of reporting survey results nationwide, noise levels at night consistently receive the lowest score out of all items evaluated (Noise & Vibration Worldwide Editorial Staff, 2017).  Noisy conditions on inpatient units negatively impact more than patient satisfaction scores; interrupted sleep and increased stress levels due to environmental noise can affect healing and prolong recovery (Connor & Ortiz, 2009). Also, staff can experience higher stress levels and fatigue from frequent breaks in concentration (Noise & Vibration Worldwide Editorial Staff, 2017) that can contribute to lower care quality.
The Plan-Do-Study-Act model is well suited for a noise reduction quality improvement project as it facilitates rapid testing of interventions on a small scale that can be altered and retested based on observed results until goals are met (Provost, Lloyd, & Murray, 2016). During the planning phase, the team sets a measurable goal based on baseline data collected, identifies a change they believe will reduce noise on one small area or unit, determines data collection methods, and assigns tasks. In the doing phase, the team implements the change, gathers data based on the plan, and begins to analyze findings. Following analysis, the team examines the change effect in the studying phase; in the acting phase, they determine if adjustments are required or additional interventions added to meet their goal and, if required, another PDSA cycle is initiated. These steps are repeated until the goal is met at which time the team can examine expanding the initiative to other areas of the facility.  For example, the team may identify significant noise from carts used by food service and environmental staff as a contributor and evaluate the degree of noise reduction when metal cart wheels are replaced with rubber or plastic. This intervention may return reduced noise levels but may not be sufficient to meet the team’s goal. A second cycle is then initiated trialing reducing staff telephone ringer volumes and setting call phones and pagers to vibrate. In addition to examining the effect on noise levels, care should be taken to evaluate the impact on staff and care to ensure calls are not missed and food service workers are able to deliver meals without delay…..

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NURS 8300 Week 6 Discussion PAPER INSTRUCTIONS
Patient Safety and Quality Improvement Evaluation
A health care organization may have highly qualified doctors and nurses who meet quality indicators for technical quality; however, due to a lack of communication, empathy, and scheduled office hours, patient satisfaction is low. In the corporate world, the phrase “the customer is always right” is frequently used to emphasize the importance of meeting the needs and expectations of the consumer. How does this approach apply to health care?
Health care industries are now using quality improvement models that are very business-centric to improve the quality of care delivery, patient satisfaction, and safety. In this Discussion, you evaluate various quality improvement models and determine which model would best be applied in your practice setting to address a specific need. You also develop a mission statement for addressing the practice problem.
To prepare FOR Patient Safety and Quality Improvement Evaluation:

Reflect on the various quality improvement models and their application in health care presented in the Learning Resources.
Evaluate the advantages and disadvantages of each model.
Consider how these metrics facilitate change and improve the management of chronic disease.
Consider how these models have been, or could be, applied in your practice setting.
Based on your selected area of need, define a practice problem and create a corresponding mission statement.
Investigate baseline data, and evaluate why this practice problem is a priority for improvement. Ask yourself: How does this practice problem in my organization compare to other organizations?

By tomorrow 01/03/2018 by 5pm New/York America time, post a minimum of 550 words essay in APA format with at least 2 references from the list of required readings below. Include the level one headings as numbered below: 
By Day 3 OF Patient Safety and Quality Improvement Evaluation
Post a cohesive response that addresses the following:

Summarize any practice problem relevant to your setting of interest and share a potential measurable goal for a QI team. Be sure to include the data that justifies why you feel a change is needed in this specific area.
Explain how the PDSA model might be applied , giving specific reasoning as to why this model best fits the needs of your practice problem. Describe how the practice problem you describe might be of interest to any accreditation initiative.

Read a selection of your colleagues’ responses.
By Day 7 OF Patient Safety and Quality Improvement Evaluation
Respond to two of your colleagues in one or more of the following ways:

Critique their suggestions for quality improvement using the theoretical frameworks and models presented.
Offer one positive response that highlights how a colleagues’ chosen model works to improve the quality at their practice setting.
Offer one alternative quality framework that you feel could better solve a colleagues’ chosen problem.
Apply your own experience to a colleagues’ identified problem. How did your practice setting work to improve quality in that area?

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
Required Readings FOR Patient Safety and Quality Improvement Evaluation

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.
Chapter 19: “Accreditation: Its Role in Driving Accountability in Healthcare”
Menaker, R. (2010). Leadership strategies in healthcare. The Journal of Medical Practice Management, 24(6), 339–343.
From increasing regulation to costs, this article evaluates the challenges that the health care industry faces. It then covers how transformational leadership and leadership strategies can help health care organizations address these challenges.
Boyd, S., Aggarwal, I., Davey, P., Logan, M., & Nathwani, D. (2011). Peripheral intravenous catheters: the road to quality improvement and safer patient care. Journal of Hospital Infection, 77(1), 37–41. doi:10.1016/j.jhin.2010.09.011
A unit within a health care organization implements measures that increase quality of care. This article studies this process and explains the research and results involved.Bottom of Form.
NURS 8300 Week 6 Assignment: Major Assessment 6
For this Assignment, continue to access IHI.org and complete the relevant modules.
Week 6 IHI Open School Modules

PS 104: Teamwork and Communication in a Culture of Safety
PS 105: Responding to Adverse Effects

There is nothing to submit this week.
Please save the certificate you receive upon completion. You will be required to upload this to gradebook in evidence of your completion.

Rubric Detail-Patient Safety and Quality Improvement Evaluation

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Name: NURS_8300_ Week6_Discussion_Rubric

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Excellent
Good
Fair
Poor

RESPONSIVENESS TO DISCUSSION QUESTION
Discussion post minimum requirements:
*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.

8 (26.67%) – 8 (26.67%)

Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.Patient Safety and Quality Improvement Evaluation

7 (23.33%) – 7 (23.33%)

Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.

6 (20%) – 6 (20%)

Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.Patient Safety and Quality Improvement Evaluation

0 (0%) – 5 (16.67%)

Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.

CONTENT KNOWLEDGE-Patient Safety and Quality Improvement Evaluation

8 (26.67%) – 8 (26.67%)

Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.

7 (23.33%) – 7 (23.33%)

Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.

6 (20%) – 6 (20%)

Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course

0 (0%) – 5 (16.67%)

Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.Patient Safety and Quality Improvement Evaluation

CONTRIBUTION TO THE DISCUSSION

8 (26.67%) – 8 (26.67%)

Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.Patient Safety and Quality Improvement Evaluation

7 (23.33%) – 7 (23.33%)

Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature

6 (20%) – 6 (20%)

Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.

0 (0%) – 5 (16.67%)

Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas

QUALITY OF WRITING-Patient Safety and Quality Improvement Evaluation

6 (20%) – 6 (20%)

Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.

5 (16.67%) – 5 (16.67%)

Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.

4 (13.33%) – 4 (13.33%)

Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.

0 (0%) – 3 (10%)

Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.

Total Points: 30

Name: NURS_8300_ Week6_Discussion_Rubric

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