Beis Medrash Quality Improvement Initiative Pain and Symptom Management Analysis

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Health Medical

Beis Medrash Heichal Dovid

Description

Analyze dashboard metrics related to the selected issue.

  • Provide the selected data set in the proposal.
    • Assess the stability of processes or outcomes.
    • Delineate any problematic variations or performance failures.
  • Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement.
    • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team.
  • Outline a QI initiative proposal based on the selected health issue and data analysis.
  • Identify target areas for improvement.
  • Define what processes can be modified to improve outcomes.
  • Propose strategies to improve quality.
  • Define interprofessional roles and responsibilities as they relate to the QI initiative.
  • Provide recommendations for effective communication strategies for the interprofessional team to ensure the success of the QI initiative. Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team.

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Prepare an 8–10-page data analysis and quality improvement initiative proposal based on a health issue of professional interest to you. The audience for your analysis and proposal is the nursing staff and the interprofessional team who will implement the initiative. "A basic principle of quality measurement is: If you can't measure it, you can't improve it" (Agency for Healthcare Research and Quality, 2013). Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all quality improvement initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret, and effectively communicate information revealed on dashboards that display critical care metrics. Reference Agency for Healthcare Research and Quality. (2013). Preventing falls in hospitals. Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk5.html#tiptop QUESTIONS TO CONSIDER As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment. Reflect on QI initiatives focused on measuring and improving patient outcomes with which you are familiar. • • • How important is the role of nurses in QI initiatives? What quality improvement initiatives have made the biggest difference? Why? When a QI initiative does not succeed as planned, what steps are taken to improve or revise the effort? Preparation In this assessment, you will propose a quality improvement (QI) initiative proposal based on a health issue of professional interest to you. The QI initiative proposal will be based on an analysis of dashboard metrics from a health care facility. You have one of two options: Option 1 If you have access to dashboard metrics related to a QI initiative proposal of interest to you: • Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. If you work in hospital setting, contact the quality management department to obtain the data you need. • You will need to identify basic information about the health care setting, size, and specific type of care delivery related to the topic that you identify. You are expected to abide by HIPAA compliance standards. Option 2 If you do not have access to a dashboard or metrics related to a QI initiative proposal: • You may use the hospital data set provided in the media piece titled Vila Health: Data Analysis. You will analyze the data to identify a health care issue or area of concern. • You will follow the same instructions and provide the same deliverables as your peers who select Option 1. Instructions Analyze dashboard metrics related to the selected issue. • Provide the selected data set in the proposal. • Assess the stability of processes or outcomes. • Delineate any problematic variations or performance failures. • Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement. • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team. • Outline a QI initiative proposal based on the selected health issue and data analysis. • Identify target areas for improvement. • Define what processes can be modified to improve outcomes. • Propose strategies to improve quality. • Define interprofessional roles and responsibilities as they relate to the QI initiative. • Provide recommendations for effective communication strategies for the interprofessional team to ensure the success of the QI initiative. Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team. • Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style. Note: Remember, you can submit all, or a portion of, your draft to Smarthinking for feedback, before you submit the final version of your analysis for this assessment. However, be mindful of the turnaround time for receiving feedback, if you plan on using this free service. The numbered points below correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your Quality Improvement Initiative Evaluation addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels that relate to each grading criterion. 1. Analyze data to identify a health care issue or area of concern. • Identify the type of data you are analyzing (from your institution or from the media piece). • Discuss why the data matters, what it is telling you, and what is missing. • Analyze dashboard metrics and provide the data set in the proposal. • Present dashboard metrics related to the selected issue. • Delineate any problematic variations or performance failures. • Assess the stability of processes or outcomes. • Evaluate the quality of the data and what can be learned from it. • Identify trends, outcome measures and information needed to calculate specific rates. • Analyze what metrics indicate opportunities for quality improvement. 2. Outline a QI initiative proposal based on a selected health issue and supporting data analysis. • Identify benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws. • Identify existing QI initiatives related to the selected issue, and explain why they are insufficient. • Identify target areas for improvement, and define what processes can be modified to improve outcomes. • Propose evidence-based strategies to improve quality. • Evaluate QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and non-governmental bodies on quality improvement. • Analyze challenges that meeting prescribed benchmarks can pose for a heath care organization and the interprofessional team. 3. Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality. • Define interprofessional roles and responsibilities as they relate to the data and the QI initiative. • Explain how you would you make sure that all relevant roles are fully engaged in this effort. • Explain what non-nursing concepts would you incorporate into the initiative? • Identify how outcomes to measure the effect of the intervention affect the interprofessional team. • Briefly reflect on the impact of the proposed initiative on work-life quality of the nursing staff and interprofessional team. Describe how work-life quality is improved or enriched by the initiative. 4. Apply effective communication strategies to promote quality improvement of interprofessional care. • Identify the kind of interprofessional communication strategies that will be effective to promote and ensure the success of this performance improvement plan or quality improvement initiative. • In addition to writing, identify communication models (like CUS, SBAR) that you would include in your initiative proposal. 5. Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. 6. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style. Submission Requirements • • Length of submission: 8–10 double-spaced, typed pages, not including title and reference page. Number of references: Cite a minimum of five sources (no older than seven years, unless seminal work) of scholarly, peer-reviewed, or professional evidence that support your evaluation, recommendations, and plans. • Vila Health: Data Analysis | Transcript. Quality Improvement Examples and Results These resources explore the effectiveness and lessons learned from various quality improvement initiatives. • Ohde, S., Terai, M., Oizumi, A., Takahashi, O., Deshpande, G. A., Takekata, M., . . . Fukui, T. (2012). The effectiveness of a multidisciplinary QI activity for accidental fall prevention: Staff compliance is critical. BMC Health Services Research, 12, 197. • Berman, J., Nkabane, E. L., Malope, S., Machai, S., Jack, B., & Bicknell, W. (2014). Developing a hospital quality improvement initiative in Lesotho. International Journal of Health Care Quality Assurance, 27(1), 15–24. These articles showcase examples of strategic QI projects. • Nazir, A., Dennis, M. E., & Unroe, K. T. (2015). Implementation of a heart failure quality initiative in a skilled nursing facility: Lessons learned. Journal of Gerontological Nursing, 41(5), 26–33. • Schoenfelder, S. L., Wych, S., Willows, C. A., Harrington, J., Christoffel, K. K., & Becker, A. B. (2013). Engaging Chicago hospitals in the baby-friendly hospital initiative. Maternal and Child Health Journal, 17(9), 1712–1717. This resource evaluates a QI initiative based on a communication strategy. • Wysham, N. G., Mularski, R. A., Schmidt, D. M., Nord, S. C., Louis, D. L., Shuster, E., . . . Mosen, D. M. (2014). Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy. Journal of Critical Care, 29(3), 450–454. Benchmarks for Quality Indicators These databases provide recognized benchmarks for quality indicators. • • Montalvo, I. (2007). The national database of nursing quality indicators. Online Journal of Issues in Nursing, 12(3), 1–11. The Joint Commission. (2017). National patient safety goals. Retrieved from https://www.jointcommission.org/standards_information/npsgs.aspx Data Analysis and Quality Improvement Initiative Proposal Scoring Guide CRITERIA NONPERFORMANCE Analyze data to identify a health care issue or area of concern. Outline a QI initiative proposal based on a selected health issue and supporting data analysis. BASIC PROFICIENT DISTINGUISHED Does not analyze data to identify a health care issue or area of concern. Attempts to analyze data, but misses trends or opportunities for quality improvement, or fails to persuasively link data to a health care issue or area of concern. Analyzes data to identify a health care issue or area of concern. Analyzes data to identify a health care issue or area of concern, and evaluates the quality of the data. Does not outline a QI initiative proposal based on a selected health issue and supporting data analysis. Attempts to outline a QI initiative proposal, but proposal is missing benchmarks, is not evidencebased, is impractical, or is not clearly linked to the selected health issue or supporting data analysis. Outlines a QI initiative proposal based on a selected health issue and supporting data analysis. Outlines a QI initiative proposal based on a selected health issue and supporting data analysis, and identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHED could improve the proposal). Integrate interprofession al perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality. Does not integrate interprofession al perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality. Attempts to integrate interprofession al perspectives, but misses relevant roles or concepts, or fails to consider key interprofession al perspectives related to patient safety, cost effectiveness, or work-life quality. Integrates interprofession al perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality. Integrates interprofession al perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality, and identifies assumptions on which the suggestions are based. Apply effective communication strategies to promote quality improvement of interprofession al care. Does not suggest communication strategies to promote quality improvement of interprofession al care. Suggestions for communication strategies are not sufficient to promote quality improvement of interprofession al care. Applies effective communication strategies to promote quality improvement of interprofession al care. Applies effective communication strategies to promote quality improvement of interprofession al care, and identifies assumptions on which the suggestions are based. CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHED Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. Does not communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. Attempts to communicate evaluation and analysis in a professional and effective manner, but content is not consistently clear and logical, or errors in use of grammar, punctuation, or spelling distract from the message. Communicates evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. Communicates evaluation and analysis in a professional and effective manner. Content is clear, logical, and persuasive; grammar, punctuation, and spelling are without errors. Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style. Does not integrate relevant sources to support arguments, correctly formatting citations and references using current APA style. Sources lack relevance or are poorly integrated, or citations or references are incorrectly formatted. Integrates relevant sources to support arguments, correctly formatting citations and references using current APA style. Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style. Citations are free from all errors.
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Quality Improvement Initiative: Pain and Symptom Management- Outline
Thesis Statement: This report details an analysis of existing data and proposes a quality
improvement intervention to increase safety and quality of care at St. Anthony Medical Center.
I. Introduction
II. Healthcare issue or concern identification
A. Data
B. Variations and trends
C. Opportunity for improvement
III. Quality improvement initiative
A. Existing initiatives
B. Target areas
C. Strategies
1. Telemedicine
2. EHR
D. Challenges
IV. Interprofessional perspectives
A. Roles
B. Engagement
C. Measuring outcomes
D. Work-life balance
V. Communication
A. Interprofessional team communication
B. ITIM

VI. Conclusion


Running head: QUALITY IMPROVEMENT INITIATIVE

Quality Improvement Initiative: Pain and Symptom Management
Name
Institution

1

QUALITY IMPROVEMENT INITIATIVE

2

Quality Improvement Initiative: Pain and Symptom Management
Health care providers must strive to continually improve care quality and patient safety in
the organization. Commitment to continuous quality necessitates quality improvement (QI)
initiatives from an analysis of existing data to come up with better care outcomes and safety for
patients. Healthcare organization dashboards present crucial data that can be used to determine
the safety of healthcare as well as point out the crucial areas of improvement. Data displayed on
dashboards is used to detect the sources of safety issues and address them for care improvement.
In this QI initiative, the author assumes the role of a quality assurance analyst at St. Anthony
Medical Center and use the provided dataset as well as responses from executives in the center to
draft a quality improvement proposal for the hospital. This report details an analysis of existing
data and proposes a quality improvement intervention to increase safety and quality of care at St.
Anthony Medical Center.
Healthcare Issue or Concern Identification
As a hospice and home health center, the healthcare organization dashboard data mainly
presents near miss events and events that resulted to some level of harm to the patients. The data
captured in the dashboard includes length of stay less than 7 days, IPU admission, pain level of
7-10 more than 24 hours, and inadequate symptom relief for more than 24 hours (See Figure 1
below). Each of these data categories is important indicator of safety and quality of care. Length
of stay less than 7 days shows that the patient expired before getting the full benefits of hospice
care. It is an indicator of late referral to the hospice and according to Kennedy (2018), the ideal
length of stay in a hospice is 6 months which allow the best possible end-of-life experiences. IPU
admission presents the worsening of patients’ symptoms and hence indicates that the
management of health is not adequate. Moreover, pain levels and inadequate symptom relief

QUALITY IMPROVEMENT INITIATIVE

3

within 24 hours indicate the effectiveness of pain relief and management of symptoms in the
healthcare organization. The dashboard indicators, however, fail to identify sources of the near
miss events and hence cannot be used exclusively to draft a QI proposal. More information from
the executives is thus employed to determine the areas of concern.

Figure 1: Adverse event data summary (Vila Health: Data Analysis)
The data displayed on the dashboard shows some trends and variations which should be
addressed. One of the interesting variations is in the LOS less than 7 days as indicated on the
month by month variations. In both 2014 and 2015, this indicator has the highest variations with
a range of 10 and 11 respectively. For instance, in 2014 March, there were 11 cases and in April,
there were 0 cases. These variations indicate that there is lack of consistency in the referrals to
the hospice. Late referrals lead to high numbers of patients dying within seven days. The referral
program, as indicated by these variations, is unstable. Another interesting trend is the n...


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