Case 36
jduarteSee attached instructions
2 years ago
20
files (2)Instructions.docx
Chapter21.pptx
Instructions.docx
Instructions
Develop a 4-pages work (excluding references page) to answer the following question:
Refer to Chapter 21 and discuss the importance and impact of common patient safety tools on recent trends with relevant examples (Use 4 examples).
· Include an introduction and conclusion.
· You are to use strict APA Format 7th edition.
· Give at least 3 references published within the last 5 years following strict APA Format
· Less than 15% of similarity index is extremely required.
Note: Chapter 21 power point presentation is attached for your reference.
Chapter21.pptx
CHAPTER 21
Quality Improvement and Essential Tools
INTRODUCTION
The healthcare system needs to drive down costs, improve quality, and improve the health of the nation.
Rapid deployment of electronic health records (EHRs) was done to implement all three phases of meaningful use (MU) as outlined by the Office of the National Coordinator (ONC).
Historically, EHR implementation comprised a core component of the national strategy.
To improve care and drive down costs.
Negative impact reported by clinicians is associated with:
Usability issues, feelings of distress,
Dissatisfaction with EHRs, and impact on clinical workflow for clinical teams.
Quality improvement (QI) strategies and tools coupled with the health information technology (HIT) infrastructure have been created.
To achieve full optimization of technology for the healthcare industry.
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STRATEGIC PLANS FOCUSED ON QI
Organizations can use technology with strategic initiatives.
This can safeguard against patient safety issues arising from technology and improve quality.
Many organizations created plans to improve safety in U.S. hospitals.
Through safer medication management including computerized provider order entry (CPOE) and barcode electronic medication administration.
QI initiatives related to technology are ideally aligned with overall strategic plans.
This improves care within the organization.
These plans should align:
With the vision and mission of the organization.
With goals and objectives to execute a plan of action.
The Health IT tool helps execute health information technology projects.
Within the context of quality improvement science.
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CORE CONCEPTS AND TOOLS FOR QI
The Plan-Do-Study-Act (PDSA) cycle includes four phases of the process.
The first component is planning, and it examines how a process might be modified.
The second component is doing the actual implementation of the improvement.
The third component is studying and analyzing preliminary results.
The fourth component is acting, intended to implement the improvement in the event.
Healthcare issues require multifactorial improvements.
Likely to involve other aspects of the process that need improvement.
The Nursing Process and the Model for Improvement
The nursing assessment aligns with changes.
The nursing diagnosis involves developing changes and the nursing outcomes planning relates to testing changes.
Nursing interventions are the final nursing evaluation in the process of care.
This might result in an update to the plan of care.
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BASIC TOOLS FOR QI
Advanced practice nurses should consider these tools for the “toolkit”:
A project charter, flowcharts, check sheets, histograms,
Pareto charts, cause-and-effect diagrams, scatterplots,
Run charts, control charts, root cause analysis (RCA), and failure mode effect analysis (FMEA).
Patient Safety Tools
RCA is a formalized investigation and problem-solving approach.
Helps identify and understand the underlying causes of:
an event as well as potential events that were intercepted as the cause of the event.
FMEA is a step-by-step approach to identify all possible failures.
Failures in a design, a manufacturing or assembly process, or a product or service.
The failure modes, calculated together, produce the RPN or risk priority number.
It ranges from “1,” the lowest score, to “1,000,” the highest score.
It can be manually calculated as: Occurrence ˊ Detection ˊ Severity = RPN
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FUNDAMENTALS OF SUCCESS FOR QI
The project charter is the project contract with all stakeholders.
It controls the scope of the project.
Aim Statement: Think Steep
The aim statement should be specific, measurable, and addresses these points:
How good? By when? For whom (or for what system)?
To identify an aim, Institute for Healthcare Improvement introduced STEEP.
Safe, Timely, Effective, Efficient, Equitable, Patient-centered
Measures of Success
The outcome measures should be relevant to the aim.
Aim intended for the improvement of individuals within the system.
The process measures are identified closer to the work for improvement.
Balancing measures consider possible unintended consequences to the redesigned process.
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IMPLEMENTING CHANGE WITH QI
Once the aim, measures, and plan for implementing changes are identified, the PDSA cycle is used as the structure to execute the project.
Six Sigma
Six Sigma measures various processes with emphasis on statistical quality control, zero defects, and driving down cost.
It was developed to improve profitability by driving down costs through eliminating defects.
Six Sigma is three defects per million, whereas one sigma is 691,462 defects per million.
Lean
Lean, of Lean Six Sigma, is a collection of techniques to reduce anything.
Reduce that does not provide value to the customer and
Frequently results in decreasing the required time.
Lean Six Sigma is the most effective business performance method developed.
It has its roots in the automobile-manufacturing industry associated with the Toyota Corporation.
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CONTROL CHARTS
Control charts are an important QI tool to measure the process that impacts the overall plan of improvement.
The P-chart, U-chart, C-chart, I-chart/X-MR, and the X-bar or S-chart are commonly used in healthcare.
Workflow redesign is a fundamental technique.
Helps implement and optimize technology, safely and effectively.
Can assist providers and hospitals in mapping processes to target areas for improvement using technology.
The combined use of QI methodology and workflow redesign is imperative.
For the optimum deployment of HIT for use in patient care delivery.
Fundamental elements of QI:
Listening to the voice of the customer, listening to the voice of the process, and
Using statistical process control methods
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APPLICATION OF THE TOOLKIT
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Use of the QI Toolkit in a Clinical Case
Important step in developing skills and competencies:
Executing and utilizing the QI toolkit in practice setting application
QUALITY IMPROVEMENT REVIEW BOARDS (QIRB)
QIRB reviews and approvals are required by organizations for QI projects.
The Doctor of Nursing Practice (DNP) programs across the country have robust methods.
Associated with quality improvement science
DNP students are engaging in QI projects to improve the quality of clinical care.
The projects involve the systematic collection and analysis of data implementation of interventions.
SOFTWARE AS SERVICE FOR QI PROJECTS
The Accelerated Model for Improvement (Ami™) is software.
It can help the advanced practice nursing student and the practice setting organize and execute complex QI projects.
The Ami™ approach was developed within Aimihub.com.
Using the project distinction for “Change Packages” and resulting Collaboratives.
The Aimihub.com Learning Platform houses the Ami™ methods.
For building an online learning platform for practice and academic users.
A Parent Aimi Charter is a strategic tool.
It determines which of the identified “child” Aimi Charters contribute most to the issues or problems to address.
Research is an important step to select an improvement effort.
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SUMMARY
The fundamental tools of QI address:
Challenges of clinical teams.
Optimize technology using HIT projects.
Fundamental tools that advanced practice nurses and other health professionals require when addressing HIT in the clinical setting have been discussed.
This toolkit supports interprofessional teams within organizations while using technology and EHRs.
The essentials of rapid-cycle QI methods using a PDSA model are described.
The importance of methods to QI including the PDSA cycle, Six Sigma, and Lean have been compared and reviewed.
Essential tools to QI methods and toolkit including the project charter to improve healthcare have been described.
Case studies that examine supply chain management, workflow redesign, CPOE, and control-chart methods have been presented.
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