Leading Organizations for Quality Improvement Initiatives////Research for Evidence Based Practice

Leading Organizations for Quality Improvement Initiatives 

THE FOUNDATIONS OF QUALITY

 

INTRODUCTION

An organization's success depends on the foundation on which it is built and the strength of the systems, processes, tools, and methods it uses to sustain benchmark levels of performance and to improve performance when expectations are not being met.

- Nash et al., 2019, p. 33

Just like any other organization, healthcare requires the use of quality improvement measures and practices. The focus on quality improvement allows for improved patient safety and reduction or elimination of errors. Research, experience, and theory provide the framework for this foundation, and you will explore these foundational components in the first module.

In this module, you will explore quality and safety measures in the healthcare. You will also explore theories and philosophies of quality improvement. For this module, consider how these measures, theories, and philosophies might impact the field of nursing and your personal experience.

Reference:

· Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019).  The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.

WHAT'S HAPPENING THIS MODULE?

This course is composed of five separate modules covering 11 weeks of content. Each module consists of an overarching topic, and each week within the module includes specific subtopics for learning. As you work through each module, you will have an opportunity to draw upon the knowledge you gain in the assessments and components of learning throughout each of the modules.

Module 1: The Foundations of Quality is a 2-week module—Weeks 1 and 2 of the course—in which you will explore quality and safety practices in healthcare. In your Discussions for Week 1, you will explore and analyze your experience with quality and safety measures. In Week 2, you will conduct further research to explore quality improvement theories and philosophies. 

You are a DNP-prepared nurse working in the ICU of your local hospital. A patient is struggling with balance, and you indicate this patient is a “fall risk” in your charts. However, after a long night, caring for many patients, you forget to indicate this risk on the patient’s door, which is procedure at the hospital. You complete your shift and go home for the night.

The scenario presented highlights how easy it is for an error to occur in healthcare. Humans are prone to error, and DNP-prepared nurses are no exception; however, certain policies and procedures can be enacted to improve patient safety and minimize errors. Almost all occupational fields rely on safety and quality practices to ensure employees, customers, etc., are in a safe environment. These quality and safety practices help organizations to limit errors and improve performance; the field of nursing is no different. It is important for the nurse leader to recognize that quality and safety measures help to improve patient safety by installing processes and workflows into nursing practice that may result in fewer errors.  This week, you will examine foundations of quality improvement in healthcare, as well as explore patient safety. You will also review your experience with these practices and consider your role as a future DNP-prepared nurse.

Discussion #1

QUALITY AND SAFETY IN HEALTHCARE AND NURSING PRACTICE

How will you, as a future DNP-prepared nurse, keep patients safe? This is a multi-layered question with many different answers. Yet, it is important to note that as the nurse leader, quality and safety measures are at the forefront of how you deliver nursing practice.

Quality and safety measures are integral components in healthcare. According to Nash et al. (2019), “Around the end of the twentieth century and the start of the twenty-first, a number of reports presented strong evidence of widespread quality deficiencies and highlighted a need for substantial change to ensure high-quality care for all patients” (p. 5). Understanding the prominence of error, it is important to consider your role as a DNP-prepared nurse.

For this Discussion, take a moment to consider your experience with quality and safety in your nursing practice. Reflect on your experience and consider how your role may support quality and safety measures.

Reference:

· Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.

TO PREPARE:

· Review the Learning Resources for this week.

· Reflect on your experience with nursing practice, specifically as it relates to the function of quality and safety. For example, consider whether your current organization supports quality and safety. How might your role help to support these measures in your organization or nursing practice?

· Post a brief description of any previous experience with quality and safety. Then, explain how your role as the DNP-prepared nurse represents a function of quality and safety for nursing practice and healthcare delivery. Be specific and provide examples.

Discussion #2

JUST CULTURE

As an alternative to a punitive system, application of the Just Culture model, which has been widely used in the aviation industry, seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix the system issues.

- American Nurses Association, 2010

Mistakes happen. There is no way to avoid all mistakes, so how might your practice change if the reporting of mistakes was welcomed, versus penalized? How might this lead to a better understanding of quality improvement and safety needs? How might patient safety be improved?

For this Discussion, consider the role of just culture in your organization. Reflect on your experience with just culture and consider how this model might support patient care.

Reference:

· American Nurses Association. (2010). Just culture [Position statement]. https://www.nursingworld.org/~4afe07/globalassets/practiceandpolicy/health-and-safety/just_culture.pdf

TO PREPARE:

· Review the Learning Resources for this week, and reflect on your experiences with just culture.

· Consider how just culture connects to quality and safety. What is the role of the DNP-prepared nurse in promoting just culture in organizations and nursing practice?

Post an explanation of whether your organization uses a just culture. Then, explain how this might impact quality and safety for your healthcare organization, and why. What is the DNP-prepared nurse’s role in supporting a just culture environment in a healthcare organization? Be specific and provide examples.

LEARNING RESOURCES

Required Readings

· Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.

· Chapter 1, “Overview of Healthcare Quality” (pp. 5–47)

· Chapter 2, “History and the Quality Landscape” (pp. 49–74)

· Institute of Medicine (U.S.) Committee on Quality of Health Care in America. (2001).  Crossing the quality chasm: A new health system for the 21st centuryLinks to an external site. . National Academies Press.

· Read the Executive Summary only.

· Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000).  To err is human: Building a safer health systemLinks to an external site. . National Academies Press.

· Barkell, N. P., & Snyder, S. S. (2021).  Just culture in healthcare: An integrative review Links to an external site. . Nursing Forum, 56(1), 103–111. https://doi.org/10.1111/nuf.12525

· Institute for Healthcare Improvement Links to an external site. . (2021). https://www.ihi.org

· PSNet. (2019).  Culture of safetyLinks to an external site. . Agency for Healthcare Research and Quality. https://psnet.ahrq.gov/primer/culture-safety

· Ricciardi, R. (2018).  The next frontier for nurses Links to an external site. . Journal of Nursing Care Quality, 33(1), 1–4. https://doi.org/10.1097/NCQ.0000000000000304

· Walden University, LLC. (2021).  DNP Project Faculty advisor and site identification—matching request form Links to an external site. . https://www.emailmeform.com/builder/form/4t2ba44T6fvw0

· Walden University Oasis: Writing Center. (n.d.).  Citations: Overview Links to an external site. . https://academicguides.waldenu.edu/writingcenter/apa/citations 

· Walden University Oasis: Writing Center. (n.d.).  Common assignments: Discussion post Links to an external site. . https://academicguides.waldenu.edu/writingcenter/assignments/discussionpost 

· Document:  Organization Meeting Summary (Word document)