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PROJECT CHARTER PART 2

ASSIGNMENT EXAMPLE PROJECT CHARTER PART 2

Project Charter Part 2

Learner’s Name

Capella University

21st-Century Health Care Leadership

August, 2019

Project Charter Part 2

Project Overview

Project Description

Heart disease is the leading cause of mortality in the United States. One in every four deaths is caused by heart disease (Centers for Disease Control and Prevention, 2017). Coronary artery disease, or ischaemic heart disease, is one of the top 10 causes of death in the world (“The Top 10,” 2018). Coronary artery disease includes the development of plaque in arteries; this causes compromised blood flow to the heart, leading to a heart attack, or a myocardial infarction (MI). The chief symptom of a MI is heaviness or a sense of pressure in the chest. Coronary artery disease is diagnosed by ascertaining the medical history of a patient and by performing an electrocardiogram (ECG). The ECG of a patient with coronary artery disease shows an elevation in the ST segment of the waveform (Ojha & Dhamoon, 2019). The CADRED (Coronary Artery Disease Reduction and Early Detection) project aims to reduce the mortality rate due to ST segment elevation myocardial infarction (STEMI). The conventional mode of treatment for STEMI is fibrinolytic therapy and percutaneous coronary intervention (PCI). Various research studies report that the mortality rate due to STEMI was reduced by conducting PCI within 90 minutes of diagnosis (Foth & Mountfort, 2018). The CADRED project will focus on the early diagnosis and treatment of STEMI. The project will be implemented in the cardiology department of SG Hospital on August 1, 2020. The mortality rate due to STEMI in the cardiology department of SG Hospital will be recorded before the launch of the CADRED project on July 31, 2020, so that a comparison can be made at the end of 6 months on January 31, 2021, to determine the success of the CADRED project. The project manager will lead the team of a cardiologist, a radiologist, and two nurses, who will execute the project through the diagnosis of STEMI in patients currently seeking care for other ailments such as hypertension. Patients at risk for developing STEMI would be treated with fibrinolytic therapy; those already experiencing symptoms of STEMI would be treated through PCI, which would be performed in the cardiac catheterization lab. The instruments required in the lab are provided by XYZ Health Care Instruments Company Limited. The medication required for fibrinolytic therapy is provided by ABC pharmaceuticals. The CADRED project will be funded by the P50 Center Grant (National Institutes of Health, 2019).

Evidence to Support Need

In their study, Karam et al. (2019) explain that PCI is an important survival indicator and significantly reduces the mortality rate in patients with STEMI. PCI reduced in-hospital mortality in patients with MI regardless of age, sex, diabetes mellitus, chronic kidney disease, and the presence of ST elevation (Dégano et al., 2017). This supports the need for the CADRED project, which aims to reduce the mortality rate due to STEMI at SG Hospital. According to Foth and Mountfort (2018), PCI should be conducted within 90 minutes of diagnosis to reduce the mortality rate due to STEMI. Hence, diagnosis plays a key role in the reduction of mortality due to STEMI. The risks associated with PCI include damage to the blood vessels, bleeding, allergic reactions to the contrast dye, and the clotting of blood in blood vessels (“Percutaneous,” n.d.). Conducting diagnosis on time and the risks associated with PCI are stakeholder concerns. SG Hospital’s mortality rate due to STEMI was 30% according to electronic health records (EHRs). At TS Hospital, the mortality rate due to STEMI reduced by 3% in a span of 3 months after a similar project was implemented. Based on the success achieved by TS Hospital in reducing the mortality rate due to STEMI, SG Hospital anticipates a 12%–15% reduction in the mortality rate due to STEMI in a span of 1 year.

Project Purpose/Business Case

PCI is known to reduce the in-hospital mortality rate due to STEMI. The timely diagnosis of STEMI will help the cardiothoracic surgeon perform PCI within 90 minutes of diagnosis and reduce the mortality rate due to STEMI in SG Hospital. The success of a hospital is determined by the increase in the number of referrals to the hospital. The success of the CADRED project will lead to a reduction in the mortality rate due to STEMI. This will increase the number of referrals to SG Hospital. The success of the project will also bring recognition and monetary benefits to the project team and improve the patient satisfaction experience for patients.

SMART Objectives (Specific, Measurable, Attainable, Relevant, Time-Bound)

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PROJECT CHARTER PART 2

The SMART objectives to achieve the success of the CADRED project are as follows:

1. For of patients presenting with hypertension, a history of cardiovascular disease, or diabetes mellitus, at least 80% will be referred to their Primary Care Provider (PCP) or Cardiologist for follow up within 30 days to identify those with potential risks for developing STEMI

2. For Patients identified at risk for developing a STEMI at least 80% will be prescribed fibrinolytic therapy prior to discharge with instructions to follow up with PCP. This objective indicates preventive treatment and follow up measures to reduce the mortality rate due to STEMI.

3. 100% of patients who present with signs and symptoms of STEMI and ECG confirmation of STEMI, will receive a PCI within 90 minutes of diagnosis. This objective encourages the team to employ timely treatment measures to reduce the mortality rate

4. Mortality rate due to STEMI will be reduced from due to STEMI from 30% to 15% in a span of 1 year

Deliverables

The team will be trained to conduct timely screening and diagnosis of patients at risk for developing STEMI. Timely diagnosis is the most important element in reducing the mortality rate due to STEMI as PCI must be conducted within 90 minutes of diagnosis (Foth & Mountfort, 2018). Time management will be reinforced in the team to reduce the time taken to prepare patients for PCI. The team will be instructed to maintain and update the EHRs of all patients enrolled for cardiac treatments at SG Hospital before and during the CADRED project. This will also enable healthy collaboration among team members as they will be updated about the patients’ prognoses and help compare the mortality rate at the end of the project. The team will also be provided with guidelines for the CADRED project that contain the SMART objectives in a PowerPoint presentation. Compliance audits will be conducted every month to ensure that the team adheres to all guidelines.

Project Scope

The CADRED project aims at reducing the mortality rate caused due to STEMI. This goal will be achieved through timely screening and diagnosis of STEMI in patients at potential risk for developing STEMI. Timely diagnosis is pivotal as PCI must be performed within 90 minutes of diagnosis. However, there are risks associated with PCI such as damage to the blood vessels, bleeding, allergic reactions to the contrast dye, and the clotting of blood (“Percutaneous,” n.d.). These risks can lead to complications and affect the success of the CADRED project.

Commented [CC1]: This should be a deliverable

Commented [SNF2R1]: As suggested, moved the bit to the deliverables section. Thank you.

Commented [SNF3]: Corinne’s Comment:

This should be a deliverable

Commented [SNF4R3]: Addressed.

Commented [CC5]: Monthly compliance audits should be included as a deliverable

Commented [SNF6R5]: Thank you for the suggestion, I have

added it.

PROJECT CHARTER PART 2

Project Milestones

R. S. (CEO) and A. K. (CCO) will appoint a project manager to reduce the mortality rate due to STEMI in the cardiology department of SG Hospital on July 10, 2020 S. R., the project manager, will begin planning a layout for the CADRED project on July 15, 2020, using the EHRs of the cardiology department of SG Hospital. S. R. will get an approval for the CADRED project from R. S. and A. K. on July 20, 2020. R. S. and A. K. will recruit N. F. as the cardiothoracic surgeon in charge of the CADRED project. Simultaneously, A. S. will be recruited as the radiologist in charge and M. P. and F. S. will be recruited as the cardiac nurse practitioners in charge of the CADRED project on July 25, 2020, and the team will be formed. S. R. will hand out guidelines for the CADRED project to the team on July 26, 2020. N. F. will be responsible for the accurate and timely diagnosis of patients at risk for STEMI. N. F. will also be responsible for reducing the risks associated with PCI. A. S. will be responsible for accurate diagnosis and for writing diagnostic reports precisely. M. P. will be responsible for assisting N. F. and A. S. with the screening and diagnosis of patients who are at risk of developing STEMI. F. S. will be responsible for assisting N. F. and A. S. while conducting PCI. S. R. will ensure that the CADRED project team follows the guidelines and conducts timely diagnosis to help reduce the mortality rate due to STEMI at SG Hospital. S. R. will conduct time management training for the team on July 27, 2020. The training will also include specific instructions on updating the EHRs of all patients enrolled for cardiac treatments at SG Hospital during the CADRED project. The mortality rate due to STEMI at the cardiology department will be noted and recorded on 31 July, 2020. The CADRED project will be launched on 1 August, 2020. After the completion of 3 months, the team and all stakeholders will have a meeting on October 31, 2020, to discuss the progress of the project. At the end of 6 months, the mortality rate due to STEMI of the cardiology department of SG Hospital will be evaluated on January 31, 2021.

Timeline

Com

letion Date

The project manager will plan the layout of

the CADRED project on July 15, 2020

July 19, 2020

The project manager will discuss CADRED

with the CEO and CCO of SG Hospital on

July 19, 2020

CEO and CCO approve CADRED on July

, 2020

CEO and CCO recruit the project team—N.

F. (cardiothoracic surgeon), A. S.

radiologist), M. P., and F. S. (cardiac nurse

(

practitioners)—on July 21, 2020

July 25, 2020

Issue of guidelines to CADRED and time

management training for the team by the

project manager on July 26, 2020

July 27, 2020

Roll out mortality rate report on July 31,

2020

July 31, 2020

Launch of the CADRED project on August

, 2020

January 31, 2021

Roll out mortality rate report and

stakeholder meeting on October 31, 2020

October 31, 2020

Roll out and evaluate mortality rate report

on January 31, 2021

January 31, 2021

References

Centers for Disease Control and Prevention. (2017). Heart disease facts. Retrieved from https:/cdc.gov/heartdisease/facts.htm

Dégano I. R., Subirana, I., Fusco, D., Tavazzi, L., Kirchberger, I., Farmakis, D., . . . Marrugat, J. (2017). Percutaneous coronary intervention reduces mortality in myocardial infarction patients with comorbidities: Implications for elderly patients with diabetes or kidney disease.

International Journal of Cardiology, 249, 83–89. https://doi.org/10.1016/j.ijcard.2017.07.054

Foth, C., & Mountfort, S. (2018). Acute myocardial infarction ST elevation (STEMI). Retrieved from https://ncbi.nlm.nih.gov/books/NBK532281/

Karam, N., Batallie, S., Marijon, E., Tafflet, M., Benamer, H., Caussin, C., . . . Lambert, Y. (2019). Incidence, mortality, and outcome-predictors of sudden cardiac arrest complicating myocardial infarction prior to hospital admission. Circulation: Cardiovascular Intervention, 12(1),

1–9. https://doi.org/10.1161/CIRCINTERVENTIONS.118.007081

National Institutes of Health. (2019). Types of grant programs. Retrieved from https://grants.nih.gov/grants/funding/funding_program.htm

Ojha, N., & Dhamoon, A. S. (2019). Myocardial infarction. Retrieved from https://ncbi.nlm.nih.gov/books/NBK537076/

Percutaneous coronary intervention. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/percutaneous-coronary-intervention

The top 10 causes of death. (2018, May 24). Retrieved from https://who.int/en/news-room/fact-sheets/detail/the-top-10-causes-of-death