Leading Organizations for Quality Improvement Initiative

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Leading Organizations for Quality Improvement Initiatives 

Applying Project Management Approaches for a Quality Improvement Practice Gap

Quality Improvement Gap

The quality improvement practice gap I have identified in my nursing organization is medication management without physical monitoring of vital signs, weight, or blood levels for illicit drugs. This practice gap is not only noticeable in my organization but is also evident in many organizations providing mental health assistance and medical care in general. In research carried out in England, it was found that only 40% of patients on lithium prescriptions in mental hospitals received the necessary checks in primary care (Ayre, Lewis, and Keers, 2023). Many health care providers undermine medication management resulting in medical errors in healthcare settings because of undermining the need for monitoring vital signs and physical patient monitoring.

Sapra, Malik, and Bhandari (2020) state that vital signs are important for present and future care and their monitoring at any medical appointment can provide an outlook of the intensity of the medical issue and the body’s ability to cope with the resulting stress on the physiological wellbeing of the patient. Physical patient monitoring is also critical for medication management, especially in my organization, where patients may have indulged in one or more illicit drugs and this may interfere with the medicine, they are to receive for their mental health care.

SMART Objectives for Quality Improvement Project

One objective for quality improvement for closing the gap in medicine management in mental health practice and my organization specifically is to ensure that the vital signs are checked. Another objective is to ensure the monitoring of the physical factors of patients before the administration of medicine for effective medicine management. The following is the SMART breakdown of the objectives;

· Specific- The objectives will target care providers, where nurses like myself and other members of healthcare teams will be expected to carry out vital signs checks before the administration of any medication. Those who fail to undertake the process of monitoring patients will be at risk of disciplinary followings to review their conduct in providing mental health services in the organization.

· Measurable- To measure whether these objectives are being attained or not, feedback will be gained from administrative records on the checking of vital signs and physical patient monitoring. According to the World Health Organization (2019), administrative records are one of the sources of data for identifying quality improvement gaps and quantifying the outcomes of related programs for closing the gaps.

· Attainable- The objectives are attainable as they only require the nurses and other care providers in my organization to comply and act accordingly.

· Relevant- These objectives will close the practice gap in the care setting thus reducing medical errors and promoting positive care outcomes for patients dealing with mental health issues.

· Time Bound- Timing such a change in quality improvement and closing the gap in medication management in my organization will require about 3 months as such time is enough to track the critical changes in the practice gap and any more time will undermine the safety of patients and the quality of care provided in the organization.

Activities for Quality Improvement Project

Closing the practice gap in medicine management in my organization will require consideration of the objectives and the resources at hand. In this case, since the organization is still hiring nurses and other healthcare providers, a relevant activity for the mental health facility will be to hire nurses and other healthcare professionals with consideration and competency for medicine management for the patients. This process will involve finding nurses from reputable institutions who demonstrate appreciation for evidence-based practice through the integrity and reliability of the research projects they undertook while studying the course.

The human resource management of the facility will be responsible for this project by thoroughly going through the transcripts and the CVs of the nurse applicants to check for their experience with medicine management. Another activity for closing the gap in medicine management in the organization will be to train the present staff on the need for vital signs and physical patient monitoring before medicine administration. Training the present staff will remind them of the importance of patient monitoring while hiring staff knowledgeable in the same will ensure the culture is retained for closing the gap in the long run.

References

Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review.  BMC Psychiatry,  23(1), 1-17.

Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.

World Health Organization. (2019). Maintaining and improving quality of care within HIV

Leading Organizations for Quality Improvement Initiatives 

DISCUSSION

QUALITY IMPROVEMENT INITIATIVE

Your organization has recently discovered there have been too frequent errors in medication distribution. After launching an investigation in the matter, and discovering the reasons for the errors, your organization is ready to launch a quality improvement initiative. What might this initiative entail?  What is included, and how will it assist in eliminating these errors?

The purpose of the Quality Improvement (QI) Plan is to provide a formal ongoing process by which the organization and stakeholders utilize objective measures to monitor and evaluate the quality of services—both clinical and operational—provided to the patients. The QI Plan, which often addresses general medical behavioral health and oral healthcare and services, defines and facilitates a systematic approach to identify and pursue opportunities to improve services and resolve identified problems (Health Resources and Services Administration, 2011).

For this Discussion, review the Learning Resources. Then, reflect on how adverse events impact your organization and/or nursing practice. Consider the use of quality improvement initiative in the error rate, using scholarly articles to analyze.

Reference:

· U. S. Department of Health and Human Services Health Resources and Services Administration. (2011).  Developing and implementing a QI plan. https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/developingqiplan.pdf 

RESOURCES

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

TO PREPARE:

· Review the Learning Resources for this week, and reflect on the types of quality improvement (QI) initiatives that might be most relevant to your healthcare organization or nursing practice.

· Select a QI initiative, you are most familiar with, that has received support from your senior leaders in your healthcare organization or nursing practice.

· Consider how adverse events are handled in your healthcare organization or nursing practice. Reflect on how this may impact the public—as well as the internal—perspective on healthcare quality.

· Find a scholarly article or one from the public press, published within the last 5 years, that recounts a serious error. Reflect on this error, and consider how it may relate to your healthcare organization or nursing practice.

BY DAY 3 OF WEEK 6

Post a brief explanation of the QI initiative you selected, and why. Be specific. Explain how adverse events are handled in your healthcare organization or nursing practice, including an explanation of how this may impact both public and internal perspectives on healthcare quality. Then, briefly describe the error rate from the article you selected, and explain how this may relate to your healthcare organization or nursing practice. Be specific and provide examples.

BY DAY 6 OF WEEK 6

LEARNING RESOURCES

Required Readings

· Agency for Healthcare Research and Quality. (2022).  Primary care practice facilitation curriculum Links to an external site. . https://www.ahrq.gov/ncepcr/tools/transform-qi/deliver-facilitation/curriculum/index.html

· Association of Maternal and Child Health Programs. (2017).  Quality improvement in maternity care via project ECHOLinks to an external site. . https://amchp.org/wp-content/uploads/2021/05/Project-ECHO_Practice-Handout_Emerging.pdf

· Knox, L., & Brach, C. (2015).  Module 20. Creating quality improvement teams and QI plans Links to an external site. . In,  Primary care practice facilitation curriculum Links to an external site. . Agency for Healthcare Research and Quality. https://www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-20-creating-qi-teams.pdf

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Leading Organizations for Quality Improvement Initiatives 

Applying Project Management Approaches for a Quality Improvement Practice Gap

Quality Improvement Gap

The quality improvement practice gap I have identified in my nursing organization is medication management without physical monitoring of vital signs, weight, or blood levels for illicit drugs. This practice gap is not only noticeable in my organization but is also evident in many organizations providing mental health assistance and medical care in general. In research carried out in England, it was found that only 40% of patients on lithium prescriptions in mental hospitals received the necessary checks in primary care (Ayre, Lewis, and Keers, 2023). Many health care providers undermine medication management resulting in medical errors in healthcare settings because of undermining the need for monitoring vital signs and physical patient monitoring.

Sapra, Malik, and Bhandari (2020) state that vital signs are important for present and future care and their monitoring at any medical appointment can provide an outlook of the intensity of the medical issue and the body’s ability to cope with the resulting stress on the physiological wellbeing of the patient. Physical patient monitoring is also critical for medication management, especially in my organization, where patients may have indulged in one or more illicit drugs and this may interfere with the medicine, they are to receive for their mental health care.

SMART Objectives for Quality Improvement Project

One objective for quality improvement for closing the gap in medicine management in mental health practice and my organization specifically is to ensure that the vital signs are checked. Another objective is to ensure the monitoring of the physical factors of patients before the administration of medicine for effective medicine management. The following is the SMART breakdown of the objectives;

· Specific- The objectives will target care providers, where nurses like myself and other members of healthcare teams will be expected to carry out vital signs checks before the administration of any medication. Those who fail to undertake the process of monitoring patients will be at risk of disciplinary followings to review their conduct in providing mental health services in the organization.

· Measurable- To measure whether these objectives are being attained or not, feedback will be gained from administrative records on the checking of vital signs and physical patient monitoring. According to the World Health Organization (2019), administrative records are one of the sources of data for identifying quality improvement gaps and quantifying the outcomes of related programs for closing the gaps.

· Attainable- The objectives are attainable as they only require the nurses and other care providers in my organization to comply and act accordingly.

· Relevant- These objectives will close the practice gap in the care setting thus reducing medical errors and promoting positive care outcomes for patients dealing with mental health issues.

· Time Bound- Timing such a change in quality improvement and closing the gap in medication management in my organization will require about 3 months as such time is enough to track the critical changes in the practice gap and any more time will undermine the safety of patients and the quality of care provided in the organization.

Activities for Quality Improvement Project

Closing the practice gap in medicine management in my organization will require consideration of the objectives and the resources at hand. In this case, since the organization is still hiring nurses and other healthcare providers, a relevant activity for the mental health facility will be to hire nurses and other healthcare professionals with consideration and competency for medicine management for the patients. This process will involve finding nurses from reputable institutions who demonstrate appreciation for evidence-based practice through the integrity and reliability of the research projects they undertook while studying the course.

The human resource management of the facility will be responsible for this project by thoroughly going through the transcripts and the CVs of the nurse applicants to check for their experience with medicine management. Another activity for closing the gap in medicine management in the organization will be to train the present staff on the need for vital signs and physical patient monitoring before medicine administration. Training the present staff will remind them of the importance of patient monitoring while hiring staff knowledgeable in the same will ensure the culture is retained for closing the gap in the long run.

References

Ayre, M. J., Lewis, P. J., & Keers, R. N. (2023). Understanding the medication safety challenges for patients with mental illness in primary care: a scoping review.  BMC Psychiatry,  23(1), 1-17.

Sapra, A., Malik, A., & Bhandari, P. (2020). Vital sign assessment.

World Health Organization. (2019). Maintaining and improving quality of care within HIV