Leading organizations for quality improvement initiative

IdentifyingPracticeGapsforQualityImprovement1.docx

1

4

Identifying Practice Gaps for Quality Improvement

Student’s name

Institution

Course name and number

Instructor’s name

Date

Identifying Practice Gaps for Quality Improvement

Quality improvement refers to the systematic approach to improving quality, where performance is measured using standardized indicators and challenges their root causes are identified and the appropriate solutions are implemented and later assessed for effectiveness (World Health Organization, 2019). One of the ways of identifying practice gaps for quality improvement is the use of data on previous care performance and this data can be from patients or hospital records. World Health Organization (2019) indicates that going through patients' surveys on their experiences, administrative databases, and medical records provides critical data for looking at quality improvement projects. Quality improvement requires data collection and reporting, where inter-operable systems can measure the quality of service and identify quality improvement gaps. Older data can be compared to newer data to find gaps and respond to them and the data can be collected from various stakeholders in psychiatric health settings.

A potential quality improvement practice gap I might use for my DNP project is the undertaking of service evaluation. According to Backhouse and Ogunlayi (2020), the purpose of a service evaluation is to compare a service with its stated aims or to assess the quality of patient care. Service evaluation provides an opportunity for quality improvement in a health setting or care situation by highlighting the opportunities for change. It is also an assessment tool for the outcomes of the changes made during or after QI to know how sustainable the changes are (Backhouse and Ogunlayi, 2020). Such an evaluation in my organization would assess how vital monitoring of vital signs or physical patient monitoring is undertaken and whether quality improvement interventions on the same have been meaningful. Some other areas related to service evaluation in a mental health care setting are communication during service provision, service provision with dignity and compassion, and satisfaction with service in clinical settings among the recipients of care.

One of the tools for addressing the quality improvement gap in healthcare service provision is the SERVQUAL instrument. This model is a multidimensional survey instrument with many items for understanding clients’ expectations and perceptions of service and for identifying gaps to improve service (Lu et al., 2020). The tool is essential in gathering and measuring the opinions of patients in nursing care in health care settings. Another tool for addressing the quality improvement gap in healthcare service provision is importance-performance analysis. (IPA). This tool focuses on attribute importance and performance to highlight strengths and weaknesses in service provision and for the development of meaningful marketing strategies (Lu et al., 2020). IPA is important as it can be used in general practice and is relevant for measuring quality improvement gaps for my DNP project.

According to Lu et al. (2020), the SERQUAL instrument and IPA can be used to gain feedback from family members. These tools can be used on both patients accessing psychiatric care through telemedicine and their family members to find out their perception of the care services they have received and the areas they would like the providers to improve on. The application of the tools will allow organizations to improve service delivery in areas like outsourcing to laboratory testing centers and treating mental care patients with dignity and compassion for the best care delivery and the closing of quality improvement gaps in service delivery in psychiatric settings.

References

Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice.

Lu, S. J., Kao, H. O., Chang, B. L., Gong, S. I., Liu, S. M., Ku, S. C., & Jerng, J. S. (2020). Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan. BMC Health Services Research, 20(1), 1-11.

World Health Organization. (2019). Maintaining and improving quality of care within HIV clinical services (No. WHO/CDS/HIV/19.17). World Health Organization.

TOOLSANDMETHODSFORQUALITYIMPROVEMENT1.docx

TOOLS AND METHODS FOR QUALITY IMPROVEMENT

Leading Organizations for Quality Improvement Initiatives

The role of quality improvement allows for continual improvement. The goal is not perfection—an impossible feat—but rather the goal is for continual improvement, continual growth, and continual learning. Understanding the need to improve, and identifying the tools and methods needed for improvement, are what characterizes success in practice.

As a future DNP-prepared nurse, you will demonstrate the importance of quality improvement in healthcare through your desire to improve on day-to-day workflows and processes in delivering nursing care. Furthermore, utilizing the tools and methods for quality improvement will allow you to deliver patient care that is both effective and efficient. Throughout your program of study, you will strengthen your practice through analysis of these tools and methods.

Reference:

· Tracy, B. (2008). Effective leadership. Jaico Publishing.

Module 2: Tools and Methods for Quality Improvement is a 2-week module—Weeks 3 and 4 of the course—in which you focus on quality improvement, specifically the tools and methods used in nursing practice. In the Discussion for Week 3, you will explore the gaps in practice for quality improvement. In Week 4, you will continue to explore the use of the tools used to measure quality. As you engage with the content for this module, you will explore your understanding and ability to analyze and examine approaches for promoting quality improvement in practice.

How might you identify quality improvement practice gaps in your practice or organization? What tools and methods might you recommend to address these gaps?

Successful quality improvement relies on appropriate data and its analysis. It is not enough to just want to improve care and safety. Instead, measures and tools must be considered, analyzed, and evaluated to ensure that their implementation aligns with what the data demonstrates as a potential area for quality improvement. Furthermore, the application of quality improvement measures and tools must also be considered in light of the and with the quality improvement goals and expectations set forth by the needs of the organization or nursing practice. This week, you will explore and analyze the different approaches of data collection and analysis as it relates to identifying an area for quality improvement. You will consider the importance of identifying practice gaps and explore recommendations for improvement.

Discussion

IDENTIFYING PRACTICE GAPS FOR QUALITY IMPROVEMENT

What should be happening in practice? What is happening or observed in practice?

These two questions help to identify where quality improvement practice gaps might exist in nursing practice. If we know what should be happening does not coincide with what is happening, we know there is an issue, or more appropriately, a practice gap.

A practice gap is the difference between a desirable or achievable state of practice and current reality. For example, a common gap in practice in healthcare organizations today, are healthcare associated infections (HAIs), such as central line associated blood stream infections (CLABSIs), or catheter associated urinary tract infections (CAUTIs).

The ongoing identification of practice gaps is critical to quality improvement and involves identifying the current state, comparing that current state to the desired state, identifying the causes of the gaps in practice, and validating those gaps to develop a process for improvement.

For this Discussion, reflect on quality improvement practice gaps that may exist in your practice or organization. Consider what quality improvement methods and/or tools might be useful in improving this practice gap. Then, think about how you might address these challenges and what strategies you might implement as a future DNP-prepared nurse.

TO PREPARE:

· Review the Learning Resources on tools and methods for quality improvement.

· Reflect on a potential quality improvement practice gap, you have seen in your practice or organization, which you might consider using for your DNP project.

· Consider the tools and methods you might use to address this quality improvement practice gap.

Post a brief explanation of how you would identify a quality improvement practice gap in your practice or organization. Describe a potential quality improvement practice gap you might use for your DNP project, and explain why. Then, explain at least two types of tools and/or methods you might use to address this quality improvement practice gap, and explain why. Be specific and provide examples.

MY PRACTICE

TELEMEDICINE

Our customized Telemedicine solutions bring the best specialty care to our partners and our clinics. Our Telepsychatrists currently provide clinical care remotely to Indiana, with expansions to other states coming shortly.

PSYCHIATRY

· MEDICATION MANAGEMENT A person sitting in a chair holding a clipboard Description automatically generated

· DIAGNOSTICS & TREATMENT

· ADHD Testing

· Genetic Testing

· Ketamine Therapy

· Transcranial Magnetic Stimulation

· PSYCHOTHERAPY

· Cognitive Behavioral Therapy

· Dialectical Behavioral Therapy

· EMDR

· Grief Counseling

· Mindfulness Based Cognitive Therapy

· Motivational Interviewing

· Solution Focused Therapy

· Trauma Focused Therapy

· Virtual Reality Therapy

· CONDITIONS WE TREAT

·

· ADHD

· Autism Spectrum Disorder

· Anxiety & Stress Disorders

· Bipolar Disorder

· Cognitive Disorders

· Child & Adolescent Psychiatry

· Depression

· Eating Disorders

· LGBTQI+ Mental Health

·

· Obsessive Compulsive Disorders

· Oppositional Defiant Disorder

· Personality Disorders

· Psychotic Disorders

· Sexual Dysfunction

· Sleep Disorders

· PTSD & Traumatic Disorders

· Women’s Mental Health

GAPS FOR QUALITY IMPROVEMENT

What should be happening in practice? On site VITAL SIGNS / PYSICAL PATIENT MONITORING/ monitoring for illicit drug levels

What is happening or observed in practice? Outsourcing to laboratory testing centers for. MEDICATION MANAGEMENT WITHOUT PYSICAL MONITORING OF VITAL SIGNS/ WEIGHT/ MONITORING blood levels for illicit drugs.

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 4, “Data Collection” (pp. 107–26)

· Chapter 5, “Statistical Tools for Quality Improvement” (pp. 127–169)

· Agency for Healthcare Research and Quality. (2018)). Key driver 2 Links to an external site. : Implement a data-driven quality improvement process to integrate evidence into practice procedures. https://www.ahrq.gov/evidencenow/tools/keydrivers/implement-qi.html

Required Media

· Institute for Healthcare Improvement. (n.d.). Quality improvement essentials toolkitLinks to an external site. [Multimedia file]. http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx

image1.jpeg

IdentifyingPracticeGapsforQualityImprovement1.docx

1

4

Identifying Practice Gaps for Quality Improvement

Student’s name

Institution

Course name and number

Instructor’s name

Date

Identifying Practice Gaps for Quality Improvement

Quality improvement refers to the systematic approach to improving quality, where performance is measured using standardized indicators and challenges their root causes are identified and the appropriate solutions are implemented and later assessed for effectiveness (World Health Organization, 2019). One of the ways of identifying practice gaps for quality improvement is the use of data on previous care performance and this data can be from patients or hospital records. World Health Organization (2019) indicates that going through patients' surveys on their experiences, administrative databases, and medical records provides critical data for looking at quality improvement projects. Quality improvement requires data collection and reporting, where inter-operable systems can measure the quality of service and identify quality improvement gaps. Older data can be compared to newer data to find gaps and respond to them and the data can be collected from various stakeholders in psychiatric health settings.

A potential quality improvement practice gap I might use for my DNP project is the undertaking of service evaluation. According to Backhouse and Ogunlayi (2020), the purpose of a service evaluation is to compare a service with its stated aims or to assess the quality of patient care. Service evaluation provides an opportunity for quality improvement in a health setting or care situation by highlighting the opportunities for change. It is also an assessment tool for the outcomes of the changes made during or after QI to know how sustainable the changes are (Backhouse and Ogunlayi, 2020). Such an evaluation in my organization would assess how vital monitoring of vital signs or physical patient monitoring is undertaken and whether quality improvement interventions on the same have been meaningful. Some other areas related to service evaluation in a mental health care setting are communication during service provision, service provision with dignity and compassion, and satisfaction with service in clinical settings among the recipients of care.

One of the tools for addressing the quality improvement gap in healthcare service provision is the SERVQUAL instrument. This model is a multidimensional survey instrument with many items for understanding clients’ expectations and perceptions of service and for identifying gaps to improve service (Lu et al., 2020). The tool is essential in gathering and measuring the opinions of patients in nursing care in health care settings. Another tool for addressing the quality improvement gap in healthcare service provision is importance-performance analysis. (IPA). This tool focuses on attribute importance and performance to highlight strengths and weaknesses in service provision and for the development of meaningful marketing strategies (Lu et al., 2020). IPA is important as it can be used in general practice and is relevant for measuring quality improvement gaps for my DNP project.

According to Lu et al. (2020), the SERQUAL instrument and IPA can be used to gain feedback from family members. These tools can be used on both patients accessing psychiatric care through telemedicine and their family members to find out their perception of the care services they have received and the areas they would like the providers to improve on. The application of the tools will allow organizations to improve service delivery in areas like outsourcing to laboratory testing centers and treating mental care patients with dignity and compassion for the best care delivery and the closing of quality improvement gaps in service delivery in psychiatric settings.

References

Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice.

Lu, S. J., Kao, H. O., Chang, B. L., Gong, S. I., Liu, S. M., Ku, S. C., & Jerng, J. S. (2020). Identification of quality gaps in healthcare services using the SERVQUAL instrument and importance-performance analysis in medical intensive care: a prospective study at a medical center in Taiwan. BMC Health Services Research, 20(1), 1-11.

World Health Organization. (2019). Maintaining and improving quality of care within HIV clinical services (No. WHO/CDS/HIV/19.17). World Health Organization.

TOOLSANDMETHODSFORQUALITYIMPROVEMENT1.docx

TOOLS AND METHODS FOR QUALITY IMPROVEMENT

Leading Organizations for Quality Improvement Initiatives

The role of quality improvement allows for continual improvement. The goal is not perfection—an impossible feat—but rather the goal is for continual improvement, continual growth, and continual learning. Understanding the need to improve, and identifying the tools and methods needed for improvement, are what characterizes success in practice.

As a future DNP-prepared nurse, you will demonstrate the importance of quality improvement in healthcare through your desire to improve on day-to-day workflows and processes in delivering nursing care. Furthermore, utilizing the tools and methods for quality improvement will allow you to deliver patient care that is both effective and efficient. Throughout your program of study, you will strengthen your practice through analysis of these tools and methods.

Reference:

· Tracy, B. (2008). Effective leadership. Jaico Publishing.

Module 2: Tools and Methods for Quality Improvement is a 2-week module—Weeks 3 and 4 of the course—in which you focus on quality improvement, specifically the tools and methods used in nursing practice. In the Discussion for Week 3, you will explore the gaps in practice for quality improvement. In Week 4, you will continue to explore the use of the tools used to measure quality. As you engage with the content for this module, you will explore your understanding and ability to analyze and examine approaches for promoting quality improvement in practice.

How might you identify quality improvement practice gaps in your practice or organization? What tools and methods might you recommend to address these gaps?

Successful quality improvement relies on appropriate data and its analysis. It is not enough to just want to improve care and safety. Instead, measures and tools must be considered, analyzed, and evaluated to ensure that their implementation aligns with what the data demonstrates as a potential area for quality improvement. Furthermore, the application of quality improvement measures and tools must also be considered in light of the and with the quality improvement goals and expectations set forth by the needs of the organization or nursing practice. This week, you will explore and analyze the different approaches of data collection and analysis as it relates to identifying an area for quality improvement. You will consider the importance of identifying practice gaps and explore recommendations for improvement.

Discussion

IDENTIFYING PRACTICE GAPS FOR QUALITY IMPROVEMENT

What should be happening in practice? What is happening or observed in practice?

These two questions help to identify where quality improvement practice gaps might exist in nursing practice. If we know what should be happening does not coincide with what is happening, we know there is an issue, or more appropriately, a practice gap.

A practice gap is the difference between a desirable or achievable state of practice and current reality. For example, a common gap in practice in healthcare organizations today, are healthcare associated infections (HAIs), such as central line associated blood stream infections (CLABSIs), or catheter associated urinary tract infections (CAUTIs).

The ongoing identification of practice gaps is critical to quality improvement and involves identifying the current state, comparing that current state to the desired state, identifying the causes of the gaps in practice, and validating those gaps to develop a process for improvement.

For this Discussion, reflect on quality improvement practice gaps that may exist in your practice or organization. Consider what quality improvement methods and/or tools might be useful in improving this practice gap. Then, think about how you might address these challenges and what strategies you might implement as a future DNP-prepared nurse.

TO PREPARE:

· Review the Learning Resources on tools and methods for quality improvement.

· Reflect on a potential quality improvement practice gap, you have seen in your practice or organization, which you might consider using for your DNP project.

· Consider the tools and methods you might use to address this quality improvement practice gap.

Post a brief explanation of how you would identify a quality improvement practice gap in your practice or organization. Describe a potential quality improvement practice gap you might use for your DNP project, and explain why. Then, explain at least two types of tools and/or methods you might use to address this quality improvement practice gap, and explain why. Be specific and provide examples.

MY PRACTICE

TELEMEDICINE

Our customized Telemedicine solutions bring the best specialty care to our partners and our clinics. Our Telepsychatrists currently provide clinical care remotely to Indiana, with expansions to other states coming shortly.

PSYCHIATRY

· MEDICATION MANAGEMENT A person sitting in a chair holding a clipboard Description automatically generated

· DIAGNOSTICS & TREATMENT

· ADHD Testing

· Genetic Testing

· Ketamine Therapy

· Transcranial Magnetic Stimulation

· PSYCHOTHERAPY

· Cognitive Behavioral Therapy

· Dialectical Behavioral Therapy

· EMDR

· Grief Counseling

· Mindfulness Based Cognitive Therapy

· Motivational Interviewing

· Solution Focused Therapy

· Trauma Focused Therapy

· Virtual Reality Therapy

· CONDITIONS WE TREAT

·

· ADHD

· Autism Spectrum Disorder

· Anxiety & Stress Disorders

· Bipolar Disorder

· Cognitive Disorders

· Child & Adolescent Psychiatry

· Depression

· Eating Disorders

· LGBTQI+ Mental Health

·

· Obsessive Compulsive Disorders

· Oppositional Defiant Disorder

· Personality Disorders

· Psychotic Disorders

· Sexual Dysfunction

· Sleep Disorders

· PTSD & Traumatic Disorders

· Women’s Mental Health

GAPS FOR QUALITY IMPROVEMENT

What should be happening in practice? On site VITAL SIGNS / PYSICAL PATIENT MONITORING/ monitoring for illicit drug levels

What is happening or observed in practice? Outsourcing to laboratory testing centers for. MEDICATION MANAGEMENT WITHOUT PYSICAL MONITORING OF VITAL SIGNS/ WEIGHT/ MONITORING blood levels for illicit drugs.

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 4, “Data Collection” (pp. 107–26)

· Chapter 5, “Statistical Tools for Quality Improvement” (pp. 127–169)

· Agency for Healthcare Research and Quality. (2018)). Key driver 2 Links to an external site. : Implement a data-driven quality improvement process to integrate evidence into practice procedures. https://www.ahrq.gov/evidencenow/tools/keydrivers/implement-qi.html

Required Media

· Institute for Healthcare Improvement. (n.d.). Quality improvement essentials toolkitLinks to an external site. [Multimedia file]. http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-Essentials-Toolkit.aspx