Data Analysis and Quality Improvement Initiative Proposal
The instructions are attached. Citations must be within 5 years old only. There are two options to complete this assignment
Option – 1 use metrics and data from your own workplace or Option -2 use the information given by instructor (which I will have to give you access to if this is chosen). Please let me know what ever you need for this assignment, thank you
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Solution
Data Analysis and Quality Improvement Initiative Proposal
Introduction
In the contemporary world, the healthcare system has continually experienced the need for improvement in the provision of quality care. As a result, there has been a higher pursuit in the quality of care provided by health facilities across the globe. Evidently, an increase in the quality of care leads to tremendous benefits, especially among the patients (Huang et al, 2018). Consequently, health provides also benefit from the quality of care as better working conditions are provided and also, the hospitals that pursue the quality of care tend to raise their reputation and as a result experience an increase in demand as many people desire to have their services (Huang et al, 2018). However, it is important to note that, to realize quality improvement, there has to be properly established quality improvement innovations. Further, the support from medical staff and administration (Huang et al, 2018). Other factors that can promote quality of care include; continuous learning, evidence-based practices, effective communication as well collaboration with other stakeholders. (Evaluation of data quality)
It is important to note that nurses contribute significantly to quality improvement initiatives in hospitals as well as healthcare at large (Taleb & Dssouli, 2018). This is because the first point of contact with a patient is a nurse. Besides, patients tend to interact most times with nurses, thus making nurses a significant asset in improving the quality of care. Normally, dashboard metrics from hospitals assist in the identification of the problems in particular healthcare instituting and as a result, forms the basis for quality improvement initiatives (Taleb & Dssouli, 2018). Essentially, the goal of quality improvement is to enhance and amend the weaknesses found in hospitals to achieve high-quality care to patients. Using the Vila Health dashboard offers hospice data for 2014 and 2015. It is important to note that the information is inclusive of the near events and misses that have led to potential harm to the patients. Some of the quality indicators found in the report include symptoms, length of stay, pain, and inpatient unit.
The Analysis of the Dashboard Metrics
A lot of care is given to patients in hospice by the nurses and physicians in hospitals. To determine the level of care given to patients in hospice is determined by the quality provided at the health facility (Taleb & Dssouli, 2018). The level of care is reflective of how health care facilities tend to vulnerable patients and it can easily be utilized as a benchmark in whether the healthcare facility pursues a high-quality standard. Health professionals such as therapists, nurses, physicians, dieticians, pharmacists, and ancillary medical staff tend to patients in a hospice. Ideally, they collaborate and work together to enhance the comfort and safety of the patients
| Hospice Unit –Year | LOS | IPU | Pain Level | Symptom |
| 2014 | 50 | 47 | 13 | 13 |
| 2015 | 46 | 27 | 17 | 22 |
The information obtained from the Vila Health dashboard showed that length of stay had down from 50 to 46 days, the IPU figures also decreased from 47 to 27. However, there was an increase in patients complaining of high pain levels which moved from 13 in 2914 to 17 in 2015. Also, the symptoms went high from 13 to 22 in 2015.
From the phase value, it appears as the quality indicators depicted an improvement but the high level of patients experiencing pain and symptoms does not depict the quality of care at the health facility. Essentially, high-quality is should always be efficient, effective, equitable, safe, patient-centered, and reliable. The presence of pain means that the hospital had poor management of it and thus, lowering the quality of life of the patients in the hospital. On the contrary, the reduction in how long patients stayed in a hospital is not solid enough to tell whether a hospital has experienced a quality improvement or not (Simamora & Fathi, 2019). Ideally, the length of stay only influences the rate of readmission. Evidently, if a patient stays longer in a hospital, it is directly linked to the rate of readmission. Thus, the need for a health care facility to lower the length of stay of patients so as to improve the quality of care (Simamora & Fathi, 2019). It is important to note that when the rate of readmission is high, it leads to a huge cost for both the healthcare facility and the patient.
For example, in the United States, health care facilities readmit at least 20% of the Medicare patients in 30 days after they have been discharged and it usually leads to a cost of $17 billion every year (Simamora & Fathi, 2019). Further, a high rate of readmission is an indication of low quality of care at the various healthcare facilities and this brings about a bad reputation which may cause patients to seek services elsewhere. To avoid such, most hospitals tend to give quality care and minimize the rate of readmission.
The data on symptoms, length of stay as well as pain level depict the low quality of care and this may adversely impact the quality of care as well as the hospital’s stakeholders. As many clients become dissatisfied with the quality of care the more the number of patients will reduce due to a lack of confidence in the abilities and capabilities of the staff and the health care facility (Kilpatrick & Hains, 2019). Evidently, once a hospital experiences a reduction in the number of patients, this leads to low revenue and as a result, they experience a low reimbursement from the insurance companies. This leads to a demotivated workforce which in return impacts on the quality of care provided by the medical staff. Therefore, Vila health ought to focus on coming up with quality improvement initiatives in the areas of pain level, length of stay as well as symptoms.
Quality Initiative Proposal
Healthcare settings require effective nursing leadership to assist in enhancing the quality of care for the patients in their healthcare facilities. Having a reevaluation of the nursing leadership can be crucial in providing quality care in hospitals. Hospitals experience a negative impact when the rate of readmission increases as it leads to an increase in the level of stays (Kilpatrick & Hains, 2020). Therefore, the nursing leadership can help and encourage the healthcare facilities to minimize the length of stay for the patients while making better other quality measures such as the symptoms and pain level of the patients in hospice. The Centers for Medicare and Medicaid Services (CMS) started the Hospital Readmission Reduction Program (HRRP) (Kilpatrick & Hains, 2020). The HRRP helps Medicaid and Medicare services to minimize the payments of the hospitals that tend to have extreme rates of readmission in 30 days after the discharge of a patient (Shahid & Thomas, 2018). Thus, the need for every hospital to strive to provide and continuously improve the quality of care given to the patients.
From the data obtained, the present quality improvement initiative is serving against the goal of the hospitals and can thus be deemed ineffective. Also, it appears that the leadership style employed does not quite motivate the staff to motivate them to contribute to the quality of care for the hospice patients (Kilpatrick & Hains, 2020). Essentially, effective leadership ought to motivate healthcare staff to pursue quality improvement in the health care facilities, the hole gapes present in the organization are an indication of incompetence in the nursing leadership. Also, it shows that the nurses are not well supported and lack people leading and guiding them as examples. Also, it appears that nurses are not encouraged to pursue and implement quality improvement initiatives.
For the health organization to experience quality improvement, they must consider changing the leadership being utilized at the moment. A leadership style that will equip and empower the nurses to fully participate in the activities designed to promote and enhance quality improvement initiatives (Kilpatrick & Hains, 2020). For example, the nursing leadership can motivate and encourage nurses to further their education so that they acquire more skills that will aid in making better the experience of the employees in the hospice. Also, working closely with experienced nurses can contribute to the improvement of their skills (Kilpatrick & Hains, 2020). Mostly, when employees including nurses feel motivated, they usually feel like they are part of the organization and in return, it leads to increased productivity. The importance of nursing leadership cannot be minimized as leadership can be used to determine the level of trust the medical have with the hospital.
Further, having robust and effective leadership leads to the promotion of trust, and the productivity of the nursing staff is significantly impacted. Therefore, a focus on the change of leadership will lead to positive outcomes of the quality improvement initiatives. This way, the length of stays in healthcare will be reduced (Kilpatrick & Hains, 2020). Also, the high levels of pain among the patients and symptoms will be lowered. The healthcare hospital can adopt a transformational leadership which will significantly contribute to the improvement of the health outcomes. The hallmarks of transformational leaders are motivating the staff as well as establishing effective relationships with them (Vinas et al, 2018). Usually, transformational leaders not only motivate the staff but inspires them and boost their confidence and commitment while helping them to communicate freely. This style of leadership promotes respect and trust of employees towards the hospital. Consequently, this leads to improved employee morale, experience, job satisfaction, and increased productivity. Thus making the hospice outcomes to be more positive.
The model employed for improvement can be adopted as an evidence-based approach to improving the quality of hospice care. This approach will provide the framework required for improvement initiatives and it has two main parts (Vinas et al, 2018). The components of the first section comprised of three questions that question the goal, how to determine improvement, and some of the changes and outcomes that will lead to the required improvement. The goal of the healthcare facility is to ensure they provide a better quality of care for hospice patients. The determination of improvement will be measured using the number of patients who have experienced the different types and measures of quality (Vinas et al, 2018). For instance, a significant reduction in the number of patients who stay long in the healthcare facility or a reduction in levels of pain will show an improvement.
The required change needed at this hospital to improve the quality is the adoption of a transformational leadership style. The Plan-Do-Study-Act (PDSA) cycle will be the model employed for improvement. Further, this model will be used to implement some of the changes at the hospital. The various stages of the PDSA cycle comprise Planning, doing studying as well as acting (Vinas et al, 2018). The first stage is planning for the test. This change can be approached by the hospital establishing various methods of data collection during the test to identify if any changes are being made. A part of the hospice care can be used for the first test. The Do part involves testing on a small scale. For example, a small part of the hospice can be used to test the impact of the change in leadership. This step there it involves a comparing band analyzing the data collected before the study and after the implementation. At the act stage, the change is modified and refined based on the emerging issues from data analysis and comparisons.
Some of the quality indicators approved by the Agency of Healthcare Research and Quality such as volume indicators, mortality as well as utilization can be used to assess the effectiveness of o the level of quality of care being provided at the hospital (Vinas et al, 2018). Since the quality indicators used are only four, it is possible that the interprofessional team can meet the problem of not understanding the scope of the challenge at hand. Other indicators that may be used include utilization indicators and mortality to help fully understand the scope of the problem
Integration of Interpersonal Perspectives to Lead Quality Improvements
The perspectives of interprofessional are important in the improvement of quality care. This is because these professionals have abilities in various areas and they can easily contribute to the skills and knowledge in the particular areas as a way of improving the quality of care in healthcare (Vinas et al, 2018). Therefore, nurses and physicians must work together to improve the quality of care. Therefore, I will ensure that all staff is assigned tasks according to their skills. Therefore, the initiative will use the concept of interpersonal relationships (Shahid & Thomas, 2018). Essentially, it will help build robust relationships that will lead to positive outcomes. Further, the proposed quality improvement initiative will offer a work-life balance for the employees which in return boosts staff’s job satisfaction.
The Communication Strategies used to Promote Quality Improvement
The success of any initiative will require effective communication. Therefore, for this project, The Strategies and Tools to Enhance Performance and Patient Safety (STEPPS) will be employed to help enhance the communication among the members (Obenrader & Jamison, 2019). Ideally, this approach utilizes an evidence-based framework that fosters communication, especially in teams (Simamora & Fathi, 2019). Mostly, these strategies tend to eliminate emotional charge and subjectivity and help the members to work together efficiently. Further, the hospital can make use of the SBAR communication model which helps in the assessment of situations and provide recommendations.
Conclusion
Healthcare has the task of continually pursuing quality care so as to ensure the patients get positive outcomes through their interactions. Adopting an interprofessional team can be of benefit in the improvement of the quality of care. Also, they will help improve the patient’s experience and lower the level of pain while decreasing the length of stay in the hospital which leads to high readmission rates. This way, the quality of care will be improved and will lead to positive outcomes for all the stakeholders involved. To enhance the interprofessional relationships strategies such as SBAR and TeamSTEPPS will help enhance the relationships which result in better outcomes.
References
Huang, G. D., Bull, J., McKee, K. J., Mahon, E., Harper, B., & Roberts, J. N. (2018). Clinical trials recruitment planning: a proposed framework from the clinical trials transformation initiative. Contemporary clinical trials, 66, 74-79. https://doi.org/10.1016/j.cct.2018.01.003
Simamora, R. H., & Fathi, A. (2019). The Influence of Training Handover based SBAR Communication for Improving Patients Safety. Indian journal of public health research & development, 10(9).
Shahid, S., & Thomas, S. (2018). Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care–a narrative review. Safety in Health, 4(1), 1-9. https://safetyinhealth.biomedcentral.com/articles/10.1186/s40886-018-0073-1
Obenrader, C., Broome, M. E., Yap, T. L., & Jamison, F. (2019). Changing team member perceptions by implementing TeamSTEPPS in an emergency department. Journal of emergency nursing, 45(1), 31-37. https://doi.org/10.1016/j.jen.2018.08.006
Kilpatrick, K., Tchouaket, É., Jabbour, M., & Hains, S. (2020). A mixed methods quality improvement study to implement nurse practitioner roles and improve care for residents in long-term care facilities. BMC nursing, 19(1), 1-14. https://link.springer.com/article/10.1186/s12912-019-0395-2
Vinas, E. K., White, A. B., Rogers, R. G., Ridgeway, J. J., & Young, A. E. (2018). Developing best clinical practices through outcomes improvement: an ongoing quality improvement curriculum for faculty and residents. MedEdPORTAL, 14. https://doi.org/10.15766/mep_2374-8265.10676
Taleb, I., Serhani, M. A., & Dssouli, R. (2018, July). Big data quality: A survey. In 2018 IEEE International Congress on Big Data (BigData Congress) (pp. 166-173). IEEE.
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