Defining Quality
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NURS 4220: Leadership Competencies in Nursing and Healthcare
Full Guide: Practice Experience Quality and Safety Project
Learning Outcomes
· Apply definition of quality to work setting
· Identify a quality improvement practice problem
· Identify measurement standards for a problem identified in healthcare
· Summarize the purpose, methods, and findings from the evidence-based literature that relate to a practice problem
· Apply a quality improvement model to a practice problem
· Apply a quality improvement process to an improvement plan
· Recommend strategies to reduce the cost of care
· Develop a quality improvement storyboard to address a practice problem
Suggestions for Discussions
The more you discuss your project with your group the better it will turn out. Consider posting earlier than Thursday to have a better discussion. Provide honest, respectful feedback to each other. ( Picture yourself as someone practicing in the other student’s work setting, working with and listening to your colleagues’ ideas weekly (as your read each other’s posts). You are responsible for helping your colleagues make the best decision in class in the same you would be if you were working side-by-side.
Each week’s activities are geared to help you move along with your proposal. Use this time well and utilize some aspect of your capstone paper to support your proposal as well. R ead about the whole project before you start.
Practice Experience Quality and Safety Project
The purpose of the Practice Experience Quality and Safety Project is for you to design and offer an evidence-based change in practice to improve a quality and safety problem specific to your work setting to possibly be implemented once the course is over and once approved by management at your setting. The team discussion provides an avenue for you to share ideas, to critique each other’s work, and to offer support to each other as a team. Your instructor acts as the preceptor to facilitate your team discussions to offer guidance as needed.
Each week, your instructor will assign a discussion to the class. Within an instructor-assigned discussion team, you will participate in a total of five discussions for this project. Satisfactory completion of these five discussions, Storyboard Presentation of your Practice Experience Quality and Safety Project, and satisfactory mentor feedback will satisfy the requirement for the practice experience.
Throughout your practice experience you are expected to collaborate with leaders and other colleagues in your practice setting. Your approved mentor will electronically verify your participation in the Practice Experience. This verification must occur by the last day of the course. All students who do not have mentor feedback in Meditrek or the designated electronic system by the last day of the term, will receive a grade of F regardless of points earned on other course assignments. If a student receives a grade of F due to lack of mentor feedback it is the student’s responsibility to work with the faculty, mentor, and or Field Office to correct the situation within 60 days of the last day of the course and notify the faculty mentor feedback has been submitted to Meditrek. After 60 days if mentor feedback has not been received the grade of F will be final.
Week 1
Practice Experience Discussion: Identifying a Practice Problem in Need of Improvement
In this week’s main discussion, you shared your experiences with healthcare practice problems as a consumer and/or as a practitioner. Now, consider your current practice setting and think about something specific and relevant to your practice setting that you would like to see improved or changed. Interview a key leader in your practice setting who can confirm that your practice problem is needed for enhancing delivery or performance in the field. It is important to remember from the beginning that your practice problem must be measurable.
The practice problem identified will be the topic of both your practice experience project, capstone paper, and your storyboard. The capstone paper will be the detailed written explanation of the steps needed to address the practice problem using a quality improvement model. These steps will be explained during the practice experience discussion during Weeks 1 – 5 and presented on the quality improvement storyboard in Week 6.
By Day 4
Identify a measurable patient-centered practice problem related to quality or safety and relevant to your practice setting that you will also focus on in your Capstone Paper and post a brief description of the problem and an explanation of why you selected it. Explain how the conversation you had with the key leader in your practice setting impacted your decision to address this particular practice problem. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from your practice area and describe the data that is available.
You will not be collecting any data during the practice experience project; you will use data already available to you in your workplace or other practice setting. Think about the different kinds of data that is shared with you in your work area. For example, data may include patient satisfaction scores, medication error rates, fall, CLABSI or CAUTI rates. Analyzing the data available to you is how you will identify that a quality problem exists. Data identifies potential areas for improvement and monitors the effectiveness of any changes. It is important to obtain baseline data before beginning a quality improvement project and to analyze results during and at the end of a project.
Note: The practice problem must be related to patient outcomes. ( Staffing cannot be your main practice problem for the completion of the Practice Experience Project and Capstone Paper.)
Note: If you use the same practice problem that was presented in the Week 1 Discussion on quality theories, keep in mind that you must be much more specific in this post and explain how it is relevant to your setting and nursing practice.
By Day 7
Read two or more of your colleagues’ postings from the Discussion question.
Respond to at least two of your classmates. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project. Provide support and suggestions on the importance of the practice problem in improving patient outcomes.
Post a Discussion entry on three different days of the week.
Week 2
Practice Experience Discussion: Applying Measurement Tools to a Practice Problem
Conduct a collaboration interview with two or three key leaders in your practice setting to determine the measures for your practice problem and associated challenges impacting measurement for your practice problem (include confidentiality, anonymity, access issues, etc.). Perform a literature review on your practice problem that elicits how this problem is measured across the country.
By Day 4
Post a description of the measures identified from the interviews, the challenges to obtaining the data that were discussed, and a summary of how this quality indicator is measured in the literature. Discuss any gaps in the data that were identified and additional sources that might be needed to obtain this data. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from practice and data that is available.
By Day 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on the quality of data that was obtained and recommendations on where additional sources of data might be found. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week
Week 3
Practice Experience Discussion: Applying Process Improvement Models to your practice problem.
Choose a Quality Improvement Model from Chapter 5 in the Spath (2018) textbook and apply this model to your practice problem. Please do not choose Lean or Six Sigma as your quality model unless you have an expert in these quality models in your organization to guide you through the process.
PDSA (p.124). RCI (p.127). FOCUS PDCA (p.128). FADE (p.129).
By Day 4
Post a Discussion entry describing the model that you selected and how each step of the model will be used to develop the plan for the Practice Experience Project. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
By Day 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on the selected model, and offer other models if appropriate for their project. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week.
Week 4
Practice Experience Discussion: Developing the Quality Improvement Plan
The next step in the process is to begin identifying the challenges and impediments to implementing a quality improvement plan. In the analysis consider the individuals affected by the change as well as the cost of implementing the quality improvement plan.
By Day 4
Post a description of some of the proposed action steps for implementing improved practice and explain where potential challenges might compromise your proposed improvement project. Describe what resources are needed for your solution and explain whether those resources are cost-effective or not. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
By Day 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback on potential challenges you see might compromise the improvement project and what other resources might be more cost effective. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week.
Looking Ahead: Discuss this potential project with a leader or manager in your facility and incorporate their feedback into the quality improvement storyboard you will submit in Week 6.
Week 5
Practice Experience Discussion: Applying Key Interventions to a Practice Problem
The final step is to develop the plan discussing the steps clearly and succinctly. The plan must be evidence-based.
By Day 4
Post an explanation of how you could apply key interventions supported by the scholarly research evidence to potentially help resolve the issue in measurable ways. Continue to collaborate with the selected individuals in your practice environment as needed in the development of the Practice Experience Project and share this information with your group.
By Day 7
Read and respond to two or more of your colleagues’ postings from the Discussion question. Provide feedback about the selected measures or provide suggestions for improving how the patient quality and safety outcomes could be addressed by care coordination techniques and effective leadership style. As a member of a community of practice, help each other refine and clarify the patient-centered Practice Experience Project.
Post a Discussion entry on three different days of the week.
Looking Ahead: Discuss this potential project with a leader or manager in your facility and incorporate their feedback into the quality improvement storyboard you will submit in Week 6.
Week 6
Practice Experience Discussion: Presenting a Quality Improvement Plan
Storyboard Instructions
The Practice Experience Project Storyboard is a brief, visual summary of a completed quality improvement initiative. The storyboard highlights key aspects of a quality improvement effort by documenting the Practice Experience Project from beginning to end.
The course template uses a PowerPoint format to complete this assignment. You only need to provide two slides, no more. The first slide is the summary of your project; the second slide is the reference page. You will need to choose the most pertinent information from your practice experience and Capstone Paper to complete the Storyboard. No voiceover is required.
The completed storyboard is submitted for grading. Optional: You may submit your storyboard to the group discussion area and share your presentation with your classmates and instructor.
By Day 4
Submit your quality improvement storyboard using the provided template.
Revised 07/2021
