Quality Improvement: Action Plan Discussion Assignment Paper

Quality Improvement: Action Plan Discussion Assignment Paper

Quality Improvement: Action Plan

 Instructions

Quality measures are methods to appraise health care by using standards. The purpose of these measures are to make sure all patients get the right care at the appropriate time. Refer back to your Fishbone Diagram in the Quality Improvement: Preventable Errors assignment in Week 1 and select two areas of improvement you focused on and identify quality measures that will help decrease a preventable error.Quality Improvement: Action Plan Discussion Assignment Paper

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(Two chosen areas that are selected based on HCAPHS scores (the lowest HCAPHS scores): 1. Quietness at night around a patient’s room--ex. ↑ noise level—>disturb the patient’s healing time, etc & 2. Discharge instructions/education—ex. Did patients understand their care after they left the hospital?

Write a 1,050-word action plan for your Quality Improvement Action Plan identifying the steps you will take to implement the improvement.

Utilize the Quality Improvement Project Action Plan provided by the Office of Mental Health to guide you in completing your Quality Improvement Action Plan (Here is the website for Quality Improvement Action Plan forms:  https://www.omh.ny.gov/omhweb/psyckes_medicaid/initiatives/freestanding/project_tools/cqi/handbook/action_plan_blank.pdf). Quality Improvement: Action Plan Discussion Assignment Paper. Your outline should be structured to address the issue that needs to be changed, the impact the issue has on the organization's quality, and how you will improve quality. Also, need to create an action plan for each selected improvement.

Please address the areas below thoroughly including sub-bullets:

 

  • Compare and contrast quality measures that are appropriate for what you're looking to improve.
    • Which measure did you select for your quality improvement and why?

 

  • What changes can you make that will lead to improvement? Include the PDSA Cycle (one PDSA cycle for each selected areas) in your response.

Quality Improvement: Action Plan Discussion Assignment Paper

  • Consider the organization's mission and vision (I have attached an file to help with Glendale Memorial Hospital’s mission and vision).
    • Does the plan in your PDSA trials fit with the organization's practice and model? For example, do they include thoughtful strategies that fit with the culture of your staff and patients?

 

  • What are the internal and external influences to the organization for each problem? Use supporting details from the textbook to support your answer. (This is our text book:  Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. (2013). Quality Improvement: Action Plan Discussion Assignment Paper. Integrating Quality and Strategy in Health Care Organizations (1st ed.). Burlington, MA: Jones & Bartlett Learning).
  • How do you know a change is an improvement?
  • Summarize your action plan steps and address which area of improvement is more appropriate for you to adopt and which area of improvement you will discard based on the results of your PDSA plan. Quality Improvement: Action Plan Discussion Assignment Paper. Explain why or why not.
Content: 12 points possible Points possible Points earned
Selects 2 areas of quality improvement from Week 1 Fishbone Diagram in the Quality Improvement: Preventable Errors assignment.Quality Improvement: Action Plan Discussion Assignment Paper 1
Identifies an appropriate quality measure for each area of improvement that will help decrease a preventable error. 3
Develops a detailed action plan addressing key points in the assignment instructions

 

Action Plan to include:

Issues to change

Organizational quality improved

How quality improved

Compare/Contrast measures

PDSA cycle applied

Mission/Vision alignment

Factors (Internal/External)

Change aspects regarding idea

Improvement validated

5
Utilizes the PDSA Cycle to test the improvement strategy for each preventable error.Quality Improvement: Action Plan Discussion Assignment Paper 3
Meets 1050 minimum word requirement. APA formatted. 2
Total 14

Quality Improvement: Action Plan Discussion Assignment Paper

Quality Improvement: Preventable Errors

Fishbone diagram

Figure 1. Fishbone diagram identifying the cause and effect of the low quality and preventable errors experienced Glendale Memorial Hospital and Health Center

Definition of quality in healthcare

Quality in healthcare can be defined as the capacity to deliver the best possible medical care given the limitations imposed by capacity in terms of facilities, equipment, technologies, and personnel. In this case, there is a consensus that quality is reliant on the interaction between the different elements in the healthcare environment. Quality Improvement: Action Plan Discussion Assignment Paper. For that matter, high quality can only be guaranteed if the different elements within the environment are optimized for the best outcomes (Ellis, 2016).

To ensure high quality is realized in medical care, protocols are typically presented as the aggregation of the best industry practices and standard operating procedures. Medical procedures should be considered as an agreement of the best care practices. Medical personnel are obliged to observe these protocols and apply them at their discretion and based on the individual cases and situation. Quality Improvement: Action Plan Discussion Assignment Paper. Adherence to these protocols improves the quality of medical services and reduces the risk of errors occurring. Despite the presence of these protocols, high quality is not a guaranteed outcome especially when faced with preventable errors that not only harm the medical facility’s reputation but result in substantial amounts of money and other resources being spent in correcting the errors (Gourdreau & Smolenski, 2014).

While quality assessment programs have made extensive inroads in reducing facility errors and improving quality, not all errors have been eliminated. A shift in minimizing facility errors would not only require an accounting of the quantities involved, but also a willingness to recognize the errors as a challenge and appreciate the need for safe and available medical procedures. Quality Improvement: Action Plan Discussion Assignment Paper. Through this, the errors would no longer be inevitable, but would be actively streamlined and prevented (Gourdreau & Smolenski, 2014).

Given the emphasis placed on quality in healthcare, it is not surprising that the costs of preventable errors is increasingly becoming apparent, especially as medical procedures are revised, more sophisticated medical equipment are made available and particularly complex treatment approaches become possible (Catalano, 2015). Quality Improvement: Action Plan Discussion Assignment Paper. In this respect, quality in healthcare can be construed as the capacity to deliver medical care as per expectation that is reliant on capacity.

GMHHC’s definition of quality and six dimensions

Glendale Memorial Hospital and Health Center (GMHHC) defines quality as its capacity to meet the patients’ expectations in terms of care approach, care outcomes, and the environment. Its intention is to offer compassion and care with the intention of improving the health and quality of life of its patients. This is in line with the facility’s vision of being a vibrant national health care system acknowledged for service delivery, chosen by patients for clinical excellence, and acting in partnership with stakeholders who include physicians, personnel and patient to improve health in the community (Dignity Health, n.d.) Quality Improvement: Action Plan Discussion Assignment Paper. It is clear that the facility recognizes that all stakeholders contribute to the conceptualization of care quality. For that matter, quality is the convergence of care expectations as presented by the different stakeholders.

The facility’s definition of quality can be further decomposed into six aspects. The first aspect is safety whereby the facility ensures that all stakeholders are protected from intentional harm to include ensuring that patients and medical personnel are not exposed to avoidable risks within the medical environment. For instance, the facility has contracted waste disposal specialists to dispose medical waste in the right manner to avoid cross-contamination and infection. Quality Improvement: Action Plan Discussion Assignment Paper. Although it seeks to protect all patients, it has failed in ensuring that the wards are quiet at night.

The second aspect is care effectiveness whereby the facility ensures that only useful and necessary procedures are applied. For example, conducting an X-ray on the leg to check a suspected fracture rather than a blood test that would not be necessary. It has partially failed in this aspect through deficiencies in discharge education. The third aspect is that the facility is keen on providing patient-centered care that focuses on identifying what the patients need and meeting that need. Quality Improvement: Action Plan Discussion Assignment Paper. The organization systemically monitor patient satisfaction levels through in-patient hospital survey and diligently enhance patient experience with patient satisfaction quality improvement projects. The fourth aspect is that the facility is focused on timeliness whereby care needs are evaluated on the basis of urgency with the specific care approach determined by that urgency. For instance, a patient presenting with a cough can wait in line while a patient who was involved in a car accident would be presented with emergency care. Quality Improvement: Action Plan Discussion Assignment Paper

The fifth aspect is efficiency whereby the facility’s personnel are assigned work aspects on the basis of professional capacity in terms of knowledge, experience and skills. For example, a nurse assigned to the surgical department must be skilled, knowledgeable and experienced in completing surgical nursing tasks. The final aspects is equitability whereby the cost that the facility assigns to medical care follows a logical financial and economic model that considers fairness and competition.Quality Improvement: Action Plan Discussion Assignment Paper

Identified problems and considered issues.  A review of GMHHC in terms of capacity to deliver high-quality care has identified three preventable errors as identified using HCAPHS (The Hospital Consumer Assessment of Healthcare Providers and Systems) scores and in-hospital patient satisfaction survey scores. The facility has scored below national average HCAHPS on two categories; having quiet nights around patients’ rooms and nurses’ immediate responsiveness. Quality Improvement: Action Plan Discussion Assignment Paper. The problem relating to night noise level at the facility is an issue as the background hospital noise can restrict patients from sleeping or resting thus making patients irritable and slowing down healing process. The best quality providing hospitals are expected to not only provide exceptional medical services but also provide the exceptional healing environment for their patients.  On the other hand, delayed or improper nurses’ responsiveness to patients asking for help is a problem that is considered a source of concern because the patients often expressed feeling of being ignored or neglected for their medical problems when they did not receive help as soon as they asked. Quality Improvement: Action Plan Discussion Assignment Paper. The last problem identified by the in-hospital patient satisfaction survey concerns discharge education whereby patients complained that they did not understand some of the discharge instructions. This is one of the big issues since the discharged patients who do not comprehend their home care needs are likely to make mistakes that could reverse previous care gains and force them to require readmission.

Patient satisfaction is a factor of quality that converges what the patients consider as the ideal medical care with and what they actually get from the facility. In fact, it is an indicator of the care standards delivered at the health facility (Feldman, 2012). Quality Improvement: Action Plan Discussion Assignment Paper. Thus, the low HCAHPS scores reflect low patient satisfaction and low quality.

 Quality of the organization and aspect of each issue.  As earlier indicated, three issues were identified that limited GMHHC’s capacity to deliver high-quality health. The three issues included noisiness around the patient’s room at night, nurses being nonresponsive, and incompetent discharge education. The three problems are considered to affect quality since they influence the six dimensions of care. Quality Improvement: Action Plan Discussion Assignment Paper. Firstly, incompetent discharge education affects safety by failing to identify what would be considered safe or unsafe thereby creating a situation whereby patients engage in unsafe behavior that worsens their medical condition. Secondly, incompetent discharge education and night noise turns care ineffective by reversing previous care gains. Thirdly, nurses’ unresponsiveness, incompetent discharge education and night noise ensures that care is not patient-centered since the patient needs are not addressed. Quality Improvement: Action Plan Discussion Assignment Paper. Fourthly, nurses’ unresponsiveness and incompetent discharge education would hinder the capacity to provide timely care. Fifthly, nurses’ unresponsiveness, incompetent discharge education and night noise reduces care efficiency. Finally, nurses’ unresponsiveness, incompetent discharge education and night noise create a situation whereby patients receive less value for their money thereby questioning the care equitability. In this respect, the three problems have a negative effect on the quality of GMHHC.Quality Improvement: Action Plan Discussion Assignment Paper