Benchmark - Evidence-Based Practice Project Proposal Final

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EBPP_EvaluationPlan.docx

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Evidence-Based Practice Project Proposal: Evaluation Plan

Grand Canyon University

NUR-590

August 11th, 2021

Project Setting

This RTSL proposed project takes place in a vital access hospital emergency department (ED) that provides care services 24 hours daily and 365 days annually. This proposed facility for implementing the RTSL project includes Phoenix county in rural Arizona and two adjacent counties in rural Arizona.

The Expected Outcomes For The Project Proposal

After successfully implementing the project, the hospital expects to accomplish specific changes or results, mainly the ED. Since the RTSL project is about streamlining the workflow efficiency at the congested ED, the focus is benefiting stranded patients. The particular emphasis is enhancing the automation of the admission and discharge system. Therefore, the project's expected outcomes are; eliminated delays due to shortened waiting time, reduced number of people leaving without being treated, increased revenue collection from the ED unit, and high patient satisfaction scores. These outcomes are aligned with the objectives and goals of the project of delivering quality healthcare services to every patient.

Data Collection Tools and One Data Collection Tool Effective For The Research Design

Since the selected research design is qualitative, the potential data collection tools are non-participant observations, informal conversational interviews, and observational process mapping (De Freitas et al., 2020). However, the best data collection tool effective for this research design is observational process mapping. This effectiveness is because, at the ED, one can observe the clinical pathway firsthand to note patients' experiences while mapping the path to check areas that need improvements to ensure complete patient satisfaction. The observational process mapping employs direct observations to track process phases like ED patient activities, delays, admission decisions, and what happens to the patient. The map portrays the current form of the ED patient process and gets developed when patients experience the process (De Freitas et al., 2020). Thus, this mapping method depends on patient experience rather than perception or assumptions; therefore, making it a valid, reliable, and applicable tool.

Furthermore, during the mapping process, the presentation of different details may emerge. A high-level map will portray only the primary general steps in the process. De Freitas et al., (2020) reveal that a medium-level map presents great or maintained process steps, while a low-level map presents minute details of all stages. For instance, the patient car park lots, the patient seats in the waiting bay.

A Statistical Test For The Project

The selected statistical test for the project is the t-test. This statistical test as one type of inferential statistic determines the major difference between the means of two groups, which share particular features (Xu et al., 2017). In this project, the two groups are patients being admitted and discharged using the manual system and the other group using the automated system. Using the observational process mapping tool, it becomes easy to determine the differences using the t-test since the patient delays and admission activities for the two groups are closely noted and identified. In this qualitative research design, the data set recorded as the outcome from manual and automatic systems would follow a normal distribution (Xu et al., 2017). Thus, a t-test serves as a hypothesis testing tool, enabling testing an assumption that applies to the ED population's challenges.

Methods Applicable To Observational Process Mapping

Group interviews, discovery workshops, direct work observation, and analysis of existing documentation are methods applicable to observational process mapping. Through group interviews, the mapping technique becomes reliable because the content of the process map is straightforward. Thus, a small sample of project participants will create a focused environment that helps collect necessary information via direct questioning of group members. Discovery workshops support the mapping tool when gaining consensus or buy-in from participants (O'Donovan et al., 2020). Generally, discovery workshops give comfort and engagement to the participants to acquire or capture the needed content for study.

Direct work observation becomes more efficient in ED, where the activities such as admission and discharge run manually. The method helps to oversee and observe tasks in real-time. For instance, in the ED, an observer observes the delays caused by using a manual system in entering, storing, and retrieving patient data. As a result of this observation, implementing the automated system guarantees better results since every patient admission process becomes computerized, and the workflow moves smoothly and rapidly.

The Outcomes Measurement and Evaluation

The outcome measurement and evaluation will be through interviews and focus groups based on the observational process mapping tool. Interviews conducted under controlled conditions with individuals or groups of people explore complex problems. Also, these interviews may be structured and performed with an unstructured set of questions asked in an open-ended approach. Similarly, tape-record interviews help measure and evaluate the outcomes since participants can recall a vital incident and describe the changes in detail (O'Donovan et al., 2020). When used to measure and assess outcomes, focus groups involve discussing ideas and insights to respond to open-ended questions of the researcher.

Strategies To Take If Outcomes Do Not Provide Expected Results

Since the research methodology, mainly in the discussion part, leads to unexpected findings or results, the best strategies to undertake are performing a detailed literature review, re-examining the research method and data again, and discussing with other Subject Matter Experts (SME) to explain why (Mancini & Marek, 2017). Also, acknowledging the research limitations, adequate preparation is critical because it allows a researcher to do things differently once given another opportunity to re-do the research.

The Plans To Maintain, Extend, Revise, And Discontinue The Project

The joint plans explain how the RTSL solution fits into the hospital's ED, specifying benchmarks for success and giving comprehensive details for stakeholders to make funding decisions for project maintenance, extension, or review for critical improvements. The first plan of explaining the solution's fitness will cover vital areas such as adaptability/responsiveness to operational changes. This solution must adapt and respond to ED changes while maintaining fidelity to the core components. Similarly, there is a need to set up an effective program leadership competence in giving details and benchmark specifications (Goodman & Steckler, 2019). This leadership will use shared skills and critical strategies for effective program maintenance, extension, or discontinuation.

References

De Freitas, L., Goodacre, S., O'Hara, R., Thokala, P., & Hariharan, S. (2020). Qualitative exploration of patient flow in a Caribbean emergency department. BMJ open, 10(12), e041422.

Goodman, R. M., & Steckler, A. B. (2019). A model for the institutionalization of health promotion programs. Family and Community Health, 11, 63–78

Mancini, L.I. & Marek, J.A. (2017). Sustaining community-based programs for families: Conceptualization and measurement. Family Relations, 53, 339-347.

O'Donovan, R., Van Dun, D., & McAuliffe, E. (2020). Measuring psychological safety in healthcare teams: developing an observational measure to complement survey methods. BMC medical research methodology, 20(1), 1-17.

Xu, M., Fralick, D., Zheng, J. Z., Wang, B., Tu, X. M., & Feng, C. (2017). The differences and similarities between the two-sample t-test and paired t-test. Shanghai archives of psychiatry, 29(3), 184.

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