MSNFP 6016 CU Data Analysis and Quality Improvement Essay

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MSNFP 6016

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Vila Health™ Data Analysis • • • • • • • Introduction Email from Sienna Pope Hospice Adverse Event Data 2014-2015 Interviews with Stakeholders Email Response to Sienna Pope Conclusion Credits Introduction Quality improvement initiatives are a critical tool in the ongoing effort to improve patient care at health care organizations. But without data, many QI initiatives would fail — or the problem behind them might never be detected. That’s why data, and the dashboards that present data in a comprehensible fashion, are essential for QI efforts to succeed. In this activity, you will assume the role of a quality assurance analyst at St. Anthony Medical Center. You will be offered both a dataset that you can use to outline a quality improvement initiative, and input from stakeholders who can help you contextualize the data. Educational Goals After completing the activity, you will be prepared to: • • • 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. Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work–life quality. Email from Sienna Pope QI Data For You From: Sienna Pope, Director of Medical Support Services To: Prudencia Nganghi Prudencia, Hi! I heard through word of mouth that you were looking for some possible areas of improvement in the hospital. I’ve got some data from SAMC’s in-home hospice program that might be useful. I realize that you may not be familiar with the hospice program, so I also set up some meetings with a few people with a stake in the program. I’m hoping they can give you some context for the data you’re looking at. Let me know if you need anything! Sienna Pope, Director of Medical Support Services Hospice Adverse Event Data 2014-2015 Per Vila Health policy, these figures include near misses as well as events that resulted in some level of harm or potential harm to the patient. This is a summary of the data; a downloadable spreadsheet that provides all the data you will need for your presentation is also available below. Pain Level 7-10 More Unit - Year LOS Less than 7 Days IPU Admission Hospice 2014 50 47 13 Hospice 2015 46 27 17 Download XLS than 24 Hours Interviews with Stakeholders Here is a list of stakeholders that you had the opportunity to interview. 1. Roger Goldenberg Director of Hospice Services 2. Jackie Sandoval Chief Nursing Officer 3. David Brooks Quality Assurance Director 4. Owen Welch CFO Owen Welch CFO • What is the current state of the hospice program’s physical plant? Well, the current technology — secure laptops with remote access to the EHR — is working, although I think there’s always something better out there. We’re thinking about experimenting with video conferencing to improve care on site; for example, when a physician isn’t available but another is available by video link, that’s an opportunity to improve care. I’ve heard of technology that pushes electronic alerts to hospice nurses so that they can coach caregivers to deliver better care. But of course, we can’t have everything. • Do you feel that the hospice program is resourced adequately? Well, of course, as with any offsite program like this, you start to have staff issues when staff are stretched too thin. So are they having to spend too much time traveling to patient’s homes, or feeling that their patient census is too high to give each patient the care they really need? I like to think that we’ve balanced care loads among our hospice nurses pretty well. But we can’t know if we’re wrong — absent adverse events, which we really don’t want — unless our nurses tell us. Roger Goldenberg Director of Hospice Services • What are the overall goals of the hospice program? Well, given the unique mission of hospice, we take a different tack from other practices. Since we’re providing end-of-life care, our goal is comfort care, not urgent or life-saving care. That means we treat the symptoms, not the disease. Unlike other units, the patient is a recipient of care, but so is the family. • What is your approach to meeting those goals? We use a holistic approach, in that we try to address not just physical, but also emotional, psychological, and spiritual needs. With each patient, there’s an interdisciplinary team that delivers care at home. When symptoms arise that need more aggressive management than home care can provide, we do temporary inpatient admissions. Jackie Sandoval Chief Nursing Officer • Roger Goldenberg mentioned that an interdisciplinary team is an important part of the hospice approach. Who do you consider to be part of that team? Many different roles, actually. Of course the nurse, a hospice physician, and a social worker are going to be involved. Often home health aides are part of the team, as well as the volunteer coordinator and the chaplain. Depending on the patient and their circumstances, sometimes music, art, or physical therapists are also engaged in the patient’s care. • What would you consider to be quality-related “red flags” as far as the data categories? One big problem we see in hospice is that patients are referred too late — that is, too close to their end of life. So they aren’t able to receive all of the benefits of being in the hospice program. So length of stay is something you’ll want to look at. Then, of course, the effectiveness of pain and symptom management. • How do hospice nurses document and communicate data between their on-site location and the rest of the team? All of our hospice nurses carry laptops so they can live-chart patient-related data, just like inpatient nurses on site use connected devices to update the EHR. In some homes, where wi-fi isn’t available, those nurses just take notes on their laptops on site and then chart later. David Brooks Quality Assurance Director • What are the processes that the hospice program uses to ensure safety? We’ve got processes and procedures in place for managing movement for patients who are at risk of falls, for maintaining sanitary conditions, for managing medical waste (for example, if a patient has a catheter in place), and for safe storage of pain and other medications. And we have processes for pain assessment, which are also part of our protocol for assessing the need for an IPU admission. • What about quality? That’s somewhat reflected in our adverse event reporting. Obviously, we’re not delivering quality care if all we do is prevent adverse events. But our processes are geared to prevent those events and make sure we’re helping the patient to face the end of life as comfortably as possible. So our nurses monitor pain levels, symptom levels, and the patient’s overall level of comfort, as well as that of the family and caregivers. They ask a lot of specific and general questions to get at the patient’s quality of life, from their own perspective and from that of their loved ones. Email Response to Sienna Pope QI Data For You From: Sienna Pope, Director of Medical Support Services To: Prudencia Nganghi I hope you got what you needed from Jackie, David, Roger, and Owen. Can you send me an email and let me know what your initial thoughts are? It doesn’t have to be anything formal, just your ideas about what the data suggest, and whether there are any QI initiatives that you would recommend based on what you’re seeing. If there are, make sure you explain how the initiatives you recommend might affect the different roles on the hospice team. Thanks! — Sienna Your reply to Sienna's email should summarize what you’ve learned during this activity. It might also be helpful to articulate any questions or research you plan to do. The reply will be available in your activity log and can be used as a pre-writing activity for the unit assignment. Email you sent Conclusion Having met with some stakeholders, you should now have a solid understanding of what the data you gathered is telling you. You should be able to use this information to complete your assignment in the course. Credits Subject Matter Expert: Marylee Bressie Interactive Design: Lori Olson, Estelle Domingos, Mark Bune, Marc Ashmore Interactive Developer: Peter Hentges Instructional Design: Stephen Sorenson Media Instructional Design: Holly Dolezalek Project Management: Nakeela Hall Assessment 3 • • PRINT Data Analysis and Quality Improvement Initiative Proposal • o o o o • Details Attempt 1Available Attempt 2 Attempt 3 NotAvailable NotAvailable Toggle Drawer Overview 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. SHOW LESS By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria: o • • • Competency 2: Plan quality improvement initiatives in response to routine data surveillance. • Outline a QI initiative proposal based on a selected health issue and supporting data analysis. Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures. • Analyze data to identify a health care issue or area of concern. Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and worklife quality. • Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and worklife quality. Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care. • Apply effective communication strategies to promote quality improvement of interprofessional care. • Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. Reference Agency for Healthcare Research and Quality. (2013). Preventing falls in hospitals. Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallp xtk5.html#tiptop Competency Map CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course. • Toggle Drawer 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? Toggle Drawer Resources Required Resources MSN Program Journey Please review this guide for your degree program. It can help you stay on track for your practicum experience, so you may wish to bookmark it for later reference. • MSN Program Journey | Transcript. SHOW LESS Suggested Resources The resources provided here are optional. You may use other resources of your choice to prepare for this assessment; however, you will need to ensure that they are appropriate, credible, and valid. The Nursing Masters (MSN) Research Guide can help direct your research, and the Supplemental Resources and Research Resources, both linked from the left navigation menu in your courseroom, provide additional resources to help support you. Capella Resources Capella provides a thorough selection of online resources to help you understand APA style and use it effectively. • APA Module. Capella Multimedia Use this media piece if you do not have access to dashboard metrics to complete the final assessment. • 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 babyfriendly 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.as px Assessment Instructions • • 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. 8. 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. 9. 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. 10. 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. 11. 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. 12. Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. 13. 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. Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, once your work has been evaluated. • Data Analysis and Quality Improvement Initiative Proposal Scoring Guide VIEW SCORING GUIDEUse the scoring guide to enhance your learning.How to use the scoring guide Data Analysis and Quality Improvement Initiative Proposal Scoring Guide CRITERIA NONPERFORMANC E BASIC PROFICIENT DISTINGUISH ED Analyze data to identify a health care issue or area of concern. 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. Outline a QI initiative proposal based on a selected health issue and supporting data analysis. 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 could improve the proposal). CRITERIA NONPERFORMANC E BASIC PROFICIENT DISTINGUISH ED 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 communicatio n strategies to promote quality improvement of interprofession al care. Does not suggest communicatio n strategies to promote quality improvement of interprofession al care. Suggestions for communicatio n strategies are not sufficient to promote quality improvement of interprofession al care. Applies effective communicatio n strategies to promote quality improvement of interprofession al care. Applies effective communicatio n strategies to promote quality improvement of interprofession al care, and identifies assumptions on which the suggestions are based. Communicate evaluation and analysis in a professional and effective Does not communicate evaluation and analysis in a professional and effective Attempts to communicate evaluation and analysis in a professional and effective Communicates evaluation and analysis in a professional and effective manner, Communicates evaluation and analysis in a professional and effective manner. CRITERIA NONPERFORMANC E BASIC PROFICIENT DISTINGUISH ED manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling. manner, but content is not consistently clear and logical, or errors in use of grammar, punctuation, or spelling distract from the message. writing content clearly and logically with correct use of grammar, punctuation, and spelling. 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 and Data Analysis
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Table of Content
Introduction .................................................................................................................................................. 3
Adverse Events .............................................................................................................................................. 3
The review of the adverse event data ...................................................................................................... 4
Length of Stay ........................................................................................................................................... 5
The admission of the patients................................................................................................................... 6
Pain Level .................................................................................................................................................. 6
Symptomatology Control .......................................................................................................................... 7
Initiatives for Quality Improvement ............................................................................................................. 7
LOS Initiative ............................................................................................................................................. 7
Admission of patients ............................................................................................................................... 8
Pain Control .............................................................................................................................................. 9
Symptomatology Control .......................................................................................................................... 9
Conclusion ................................................................................................................................................... 10
References .................................................................................................................................................. 12

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Quality Improvement and Data Analysis
Introduction
Villa Health facility is recognized for its strong base of caring employees and compassionate
management, allowing it to deliver treatment that is among the best in the country. Despite the
potential, evidence shows that patients and also their members of the family tend to not be
provided with the high-quality holistic treatment they need. As hospice patients pass on, quality
indicators represent the only voice or assessment they have; the numbers suggest that Villa
Health will do a lot more for their patients. To increase the quality of medical caring service
provided in the highly dynamic healthcare industry, healthcare managers should concentrate on
achieving either a very high or outstanding patient satisfaction ratings; as a result, healthcare
managers must characterize the variables which impacts the satisfaction of the patients, which
are approach to measure the quality of the healthcare process. Researchers have looked at
different aspects of perceived service quality as a vital and critical indicators of consumer
perceptions of healthcare quality in order to better grasp the factors that influence patient
satisfaction.
Adverse Events
Four major AE (acronym for adverse events) measurements are used to assess safety; if the
amount of AE is high, it may be assumed that the quality of treatment is poor. For starters, if the
patient is admitted to the medical program for less than several days overall, the duration of stay
is considered detrimental. When patients are admitted to the health institution for a longer period
of time, they get the highest holistic quality. Inpatient admission (acronym for IPU) represents a
form of a quality measure or metric which is used when a patient is unable to monitor their
symptoms at home. Nevertheless, the third consistency metric looks at pain levels that are more

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