NURS FPX 6016 Quality Improvement Initiative Evaluation Essay Example

NURS FPX 6016 Assessment 2 Quality Improvement Initiative Evaluation

NURS FPX 6016 Quality Improvement Initiative Evaluation Assignment Brief

Course: NURS-FPX 6016 Quality Improvement of Inter-professional Care

Assignment Title: Assessment 2 Quality Improvement Initiative Evaluation

Assignment Overview:

In this assignment, you will critically evaluate a quality improvement initiative implemented in a healthcare setting. You will analyze various aspects of the initiative, including its rationale, approaches, success metrics, interprofessional perspectives, and recommendations for further improvement. The goal is to assess the effectiveness of the initiative in enhancing patient care and safety while identifying areas for refinement and optimization.

The Student’s Role:

As a nursing student, your role in this assignment is to act as a critical evaluator of the quality improvement initiative. You will carefully analyze the provided information, considering various factors such as patient safety, healthcare outcomes, and interprofessional collaboration. Your assessment should be objective and evidence-based, focusing on identifying strengths, weaknesses, and opportunities for improvement in the initiative. Additionally, you will provide well-reasoned recommendations for further enhancing the initiative’s effectiveness, drawing on relevant literature and best practices in quality improvement.

You Can Also Check Other Related Assessments:

NURS FPX 6016 Adverse Event or Near-Miss Analysis

NURS FPX 6016 Data Analysis and Quality Improvement Initiative Proposal

NURS FPX 6016 Quality Improvement Initiative Evaluation Essay Example

Introduction

Healthcare facilities worldwide face numerous challenges that necessitate the implementation of Quality Improvement (QI) initiatives to achieve positive patient outcomes. One such initiative aimed at preventing patient falls has been implemented at Miami Valley (MV) Hospital. Patient falls are a common issue globally, with an annual occurrence of 70,000 to 1 million incidents in hospitals, resulting in approximately 250,000 injuries and up to 11,000 casualties (LeLaurin & Shorr, 2019). These falls predominantly affect the elderly population.

Research indicates that falls among older individuals occur at a prevalence rate of 26.5%, with Oceania exhibiting the highest rate at 34.4% and America at 27.9% (Salari et al., 2022). Countrywide benchmarks reveal a ratio of 3.44 falls per 1000 days in medical and surgical units. Alarmingly, about one-fourth of these inpatient falls lead to injuries, costing hospitals roughly $7000 per case. Injurious falls are among the 14 hospital-acquired public health issues, imposing a financial burden on healthcare facilities as they are not reimbursed for these costs (Venema et al., 2019). Consequently, the escalating incidence of patient falls prompted the administration to institute quality improvement initiatives to enhance quality and ensure patient safety.

Approaches and Rationale Behind the Quality Improvement Initiative

The quality improvement initiative at MV Hospital is structured around two main strategies. Firstly, an immediate response protocol is implemented for patients who experience falls. This involves promptly evaluating and analyzing the factors contributing to the fall, aiming to prevent future incidents. Secondly, a long-term management approach is adopted, wherein risk factors are identified upon admission, at three-month intervals, yearly, and whenever there’s a change in the patient’s condition. This continual assessment helps categorize patients at high risk of falls and ensures ongoing interventions tailored to individual needs. While these approaches enable the hospital to develop a comprehensive fall prevention plan, they also come with drawbacks. For instance, the initiative doesn’t address falls resulting from mishandling by healthcare professionals. Additionally, it places an increased burden on nursing staff due to heightened time demands and excessive documentation requirements.

The rationale behind initiating the quality improvement program stems from the alarming prevalence of patient falls globally, which imposes significant financial and healthcare burdens. Miami Valley Hospital recognized the substantial number of annual falls in hospitals, leading to injuries and escalated healthcare costs. Given that falls are preventable adverse events, the initiative aims to enhance patient safety, improve the quality of care, and alleviate the financial strain associated with fall-related injuries.

Evaluation of Quality Improvement Initiative Success

Assessing the effectiveness of a quality improvement (QI) initiative is paramount to ensuring its impact on patient care and safety. As emphasized by the Agency for Healthcare Research and Quality (AHRQ), the success of such initiatives hinges upon measurable outcomes and the ability to discern improvement areas (Taylor et al., 2017). In line with this, the evaluation of Miami Valley Hospital’s fall prevention program is essential to gauge its efficacy and identify areas for refinement.

Key metrics, as outlined by AHRQ, include the number of falls per 1000 occupied beds, fall risk factors, and collaborative practices among healthcare professionals (Taylor et al., 2017). Employing The Tracking Record for Improving Patient Safety (TRIPS) facilitates the systematic monitoring of these indicators, providing insights into the program’s performance.

Central to the assessment are specific indicators related to fall management, including the monthly frequency of falls, the number of patients experiencing falls, occurrences of multiple falls per patient, and incidents resulting in severe injuries. Analyzing data from these metrics at Miami Valley Hospital reveals a notable reduction in monthly fall events, declining from 27 to 15, and a decrease in the number of patients experiencing falls. Remarkably, only one patient suffered a fatal injury, signaling a significant improvement in patient safety.

Furthermore, a biannual review demonstrates a substantial reduction in fall events, accompanied by a 50% decrease in associated costs. These positive outcomes underscore the effectiveness of the QI initiative in enhancing patient safety through proactive risk identification and the implementation of targeted interventions.

However, it is imperative to acknowledge the underlying assumptions shaping this analysis, including bed occupancy rates, fall incidence, and the collaborative efforts of the implementation team. These factors influence the interpretation of outcomes and must be considered in refining future iterations of the program.

In essence, the evaluation highlights the tangible benefits of the QI initiative, emphasizing its role in mitigating fall-related risks and improving patient outcomes. Moving forward, continued monitoring and adaptation based on evolving data will be essential to sustain and further enhance the program’s effectiveness.

Interprofessional Perspectives and Collaboration in Quality Improvement

The success of quality improvement (QI) initiatives heavily relies on effective collaboration among healthcare professionals from diverse disciplines. Research has consistently demonstrated that such interprofessional teamwork enhances patient care, safety, and overall health outcomes, thereby positively influencing the outcomes of QI programs (Brugman et al., 2022). Encouraging frontline staff, particularly nurses, to collaborate seamlessly with colleagues across different specialties is crucial for the successful implementation of QI initiatives.

At Miami Valley Hospital, nurses, nurse educators, quality control personnel, finance experts, and administrators collaborated effectively to implement the fall prevention initiative. Nurses played a pivotal role in identifying risk factors by thoroughly examining patients’ medical and biographical records, and then implementing tailored prevention strategies. Concurrently, nurse educators devised educational curricula aimed at raising awareness among nurses and other healthcare professionals about the significance of risk prevention and encouraging the integration of QI strategies into their practices.

Meanwhile, the finance department meticulously analyzed the financial implications of the initiative, maintaining records of reduced case numbers and associated costs. This data-driven approach allowed for a comprehensive understanding of the economic impact of the QI program. Additionally, the quality control department and hospital administration conducted regular audits of clinical areas, scrutinized records, and utilized clinical data to enhance patient outcomes.

However, an aspect that warrants attention is the potential impact of increased responsibilities on nursing staff, which could lead to burnout and a decline in workforce effectiveness. While the analysis underscores the collaborative efforts across various departments, it overlooks initiatives aimed at alleviating nurses’ workload and reducing time consumption associated with additional responsibilities. Addressing this aspect is crucial to ensuring the sustainability of interprofessional collaboration and the long-term success of QI initiatives.

Recommendations for Enhancing the Quality Improvement Initiative

To elevate the effectiveness of the quality improvement endeavor, it is advised to employ two distinct methodologies: microsystems and the Plan-Do-Study-Act (PDSA) cycle.

The microsystems approach entails the formation of small, cohesive groups dedicated to delivering optimal patient care by focusing on attainable objectives. Research indicates that concentrating on smaller, clearly defined goals yields superior results compared to broader organizational perspectives (Abrahamson et al., 2020). By emphasizing manageable and replicable services, the microsystems strategy aligns with the objectives of the fall prevention QI initiative at Miami Valley Hospital. Assigning minimal additional responsibilities to each team member facilitates efficient implementation and enables straightforward measurement of outcomes. Unlike larger-scale interventions, microsystems prevent the complexities associated with extensive data and responsibilities, minimizing the risk of overlooking critical aspects.

Similarly, the utilization of the PDSA cycle is advocated in healthcare QI efforts due to its emphasis on continuous improvement. This model revolves around iterative cycles of planning, implementation, evaluation, and adjustment, ensuring ongoing enhancement of processes (Knudsen et al., 2019). The PDSA cycle prioritizes continuous data collection and interventions on a small scale, thereby enabling teams to address issues systematically. Breaking down the cycle into distinct phases — PLAN, DO, STUDY, and ACT — facilitates structured problem-solving. While the ACT phase marks the completion of one cycle, it initiates the subsequent cycle, perpetuating the momentum of improvement efforts. It is imperative to recognize that quality improvement is a dynamic process requiring constant action and feedback loops to refine interventions and enhance patient outcomes.

Pros and Cons of the Recommendations

The adoption of microsystems and the PDSA cycle offers several advantages. These methodologies facilitate efficient applicability, enable small-scale interventions that serve as guides for broader implementation, and alleviate workload burdens on teams by promoting focused efforts. Moreover, adhering to SMART criteria (Specific, Measurable, Achievable, Relevant, and Time-Bound) ensures goal clarity and enhances the likelihood of success.

However, these recommendations also pose certain challenges. They may consume considerable time, especially in the initial stages of implementation, and necessitate the formation of multiple small teams, potentially overburdening administrators. Moreover, differences in opinions and contradictory data may arise during the implementation process, requiring careful navigation to ensure consensus and effective decision-making.

Conclusion

In conclusion, the evaluation of Miami Valley Hospital’s Quality Improvement (QI) initiative for fall prevention underscores its significant impact on patient safety and healthcare outcomes. By implementing proactive strategies focused on immediate response and long-term management, the hospital has effectively reduced the incidence of patient falls and associated injuries. The success of the initiative is evident through the substantial decrease in monthly fall events, accompanied by a notable reduction in healthcare costs.

Furthermore, the collaborative efforts of multidisciplinary teams, comprising nurses, educators, quality control personnel, finance experts, and administrators, have been instrumental in driving the initiative’s success. However, while the evaluation highlights the positive outcomes achieved, it also underscores the need to address challenges such as increased workload and potential burnout among nursing staff.

Moving forward, the adoption of microsystems and the Plan-Do-Study-Act (PDSA) cycle presents promising avenues for further enhancing the effectiveness of the QI initiative. These methodologies offer structured approaches to continuous improvement, enabling focused interventions and sustainable progress. While these recommendations offer clear benefits, it is crucial to acknowledge and navigate potential challenges such as time consumption and differences in opinions.

References

Abrahamson, K., Hass, Z., & Morgan, A. (2020). Microsystems in health care: Part 1. American Nurse Journal, 15(8), 30-34.

Brugman, A., Farnan, J., & Manian, F. (2022). Interprofessional collaboration for quality improvement in healthcare: A scoping review. BMJ Quality & Safety, 31(1), 75-86.

Knudsen, J., Davidson, C., & Overgaard, S. (2019). The PDSA cycle at the core of learning in health professions education. Journal of Research in Interprofessional Practice and Education, 9(2), 1-12.

LeLaurin, J., & Shorr, R. (2019). An evidence-based guide to patient fall prevention. Geriatric Nursing, 40(1), 75-80.

Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., & Rasoulpoor, S. (2022). Prevalence of falls among the elderly: A systematic review and meta-analysis. Journal of Aging and Physical Activity, 30(1), 1-12.

Taylor, M., McNicholas, C., Nicolay, C., Darzi, A., & Bell, D. (2017). Systematic review of the application of the plan-do-study-act method to improve quality in healthcare. BMJ Quality & Safety, 26(5), 1-10.

Venema, A., Goodridge, D., Hirdes, J., & Wickson-Griffiths, A. (2019). Balancing investment in cost-saving interventions: A case study of costs associated with hospital-acquired injuries in a Canadian acute care hospital. Healthcare Management Forum, 32(3), 112-118.

Detailed Assessment Instructions for the NURS FPX 6016 Quality Improvement Initiative Evaluation Assignment

Deliver to the interprofessional team a presentation (20 minutes; 12-15 slides) that analyzes an existing workplace quality improvement initiative related to a specific disease, condition, or public health issue of interest. The presentation’s purpose is to inform and get buy-in from the interprofessional team.

Introduction

Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—various groups talking among themselves about results and enhancements. Nurses are critical to the delivery of high-quality, efficient health care. As a result, they must develop their skills in reviewing and evaluating performance reports. They also need to be able to communicate outcome measures related to quality initiatives effectively. Patient safety and positive institutional health care outcomes mandate collaboration among nursing staff members to ensure the integration of their perspectives in all quality care initiatives.

In this assessment, you will have the opportunity to analyze a quality improvement initiative in your workplace. You will then present your analysis to a group of nurses and other health care professionals. The purpose of your presentation is to inform and enlist support for the initiative from your audience.

Preparation

Quality Initiative Selection

In this assessment you will deliver an analysis of an ongoing quality improvement initiative in your workplace. The initiative you analyze must relate to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of your analysis is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. Your audience consists of nurses and selected health care professionals with specializations or interest in your selected condition, disease, or issue. You hope to inform and garner support for the initiative from your audience.

Recording Your Presentation

To prepare to record a voice-over for your presentation:

• Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
• Practice using the equipment to ensure the audio quality is sufficient.
• Consult Using Kaltura for guidance on how to record your presentation and upload it in the courseroom.
• Microsoft PowerPoint also allows you to record your narration with your slides. If you choose this option, simply submit your presentation to the appropriate area of the courseroom. Your narration will be included with your slides.
• Remember to practice delivering and recording your presentation multiple times to ensure effective delivery.

Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact Disability Services at DisabilityServices@Capella.edu to request accommodations.

Instructions

The optional QI Initiative Evaluation Presentation Template [PPTX] is provided to help you prepare your slides. If you choose to work without the template, consider referring to Guidelines for Effective PowerPoint Presentations [PPTX].

In your presentation, you will:

• Analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives.
  • Explain the rationale behind the QI improvement initiative. What prompted the initiative?
  • Detail problems that were not addressed and any issues that arose from the initiative.
• Evaluate the success of a current quality improvement initiative according to recognized national benchmarks.
  • Analyze the benchmarks used to evaluate success. Which aspects of the initiative were most successful? What outcome measures are missing or could be added?
  • Incorporate one appropriate supporting visual (such as a graph or chart) that showcases the most critical aspect of this presentation.
• Incorporate interprofessional perspectives related to initiative functionality and outcomes.
• Integrate the perspectives of interprofessional team members involved in the initiative. Who did you talk to? What are their professions? How did their perspectives impact your analysis?
• Recommend additional indicators and protocols to improve and expand outcomes of a quality initiative.
  • Identify specific process or protocol changes as well as technologies that would improve quality outcomes.
• Ensure slides are easy to read and error free. Provide detailed speaker notes. Also ensure audio is clear, organized, and professionally presented.
• Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).

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