Executive summary

Write an executive summary, 4-5 pages in length, of existing outcome measures related to a performance issue (hypoglycemia protocol/missing documentation/delays in treatment and assessments of interventions) uncovered in your gap analysis that you intend to address

Introduction
As a nurse leader, you must be able to access, identify, and describe outcome measures as they relate to safety and quality problems in your organization.

This assessment provides an opportunity to examine existing outcome measures, assess their strategic value, and present your findings to executive leaders in a manner that will help you gain their support.

Quality and safety are everyone’s responsibility as a team of interprofessional care delivery partners. Together we develop policies that support quality and safe care delivery. As part of the interprofessional team, nurses are leaders in care and thus are responsible and accountable for leading and providing safe quality care.

Health care delivery is structured around evidenced-based information. Quality is defined by exploring proven, evidenced-based information. After reviewing and defining evidenced-based information, the interprofessional team applies this knowledge to assess the organization’s or the practice setting’s ability to provide evidenced-based care delivery. When a gap in care is identified, it is important to propose an evidenced-based change and to execute a plan for improved care.

Your summary of relevant outcome measures is based on your findings from the quality and safety gap analysis you completed in the previous assessment.

Preparation
Your analysis of the gap between current and desired performance was the first step toward improving outcomes. You now have the information you need to move forward with proposed changes. Your next step is to focus on existing outcome measures and their relationship to the systemic problem you are addressing. For this assessment, you have been asked to draft a summary of existing outcome measures for your organization’s executive team to raise awareness of the problem and the strategic value of existing measures.

Note: Remember that you can submit all or a portion of your draft summary to Smarthinking for feedback before you submit the final version of this assessment. However, be mindful of the turnaround time of 24–48 hours for receiving feedback, if you plan on using this free service.

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.

Building stakeholder support is crucial to fostering and sustaining change. Therefore, as you approach this assessment, think about the stakeholders whose support you will need for the change you want to bring about.

What information is most essential for both the formal and informal stakeholders to understand about the proposed change?
How might you communicate the need for change using just a few sentences (this is often referred to as an “elevator speech”).
The following resources are required to complete the assessment.

APA Style Paper Template [DOCX]. Use this template for your executive summary.
Requirements
Note: The requirements outlined below correspond to the grading criteria in the Executive Summary Scoring Guide. Be sure that your written analysis addresses each point, at a minimum. You may also want to read the Executive Summary Scoring Guide and Guiding Questions: Executive Summary [DOCX] to better understand how each criterion will be assessed.

Composing the Executive Summary
Explain key quality and safety outcomes.
Determine the strategic value to an organization of specific outcome measures.
Analyze the relationships between a systemic problem in your organization or practice setting and specific quality and safety outcomes.
Determine how specific outcome measures support strategic initiatives related to a quality and safety culture.
Determine how the leadership team would support the implementation and adoption of proposed practice changes affecting specific outcomes.
Writing and Supporting Evidence
Write clearly and concisely, using correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
Additional Requirements
Format your document using APA style.

Use the APA Paper Template linked above. Be sure to include:
A title page and reference page. An abstract is not required.
A running head on all pages.
Appropriate section headings.
Properly-formatted citations and references.
Your summary should be 4–5 pages in length, not including the title page and reference page.
Portfolio Prompt: You may choose to save your executive summary to your ePortfolio.

Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Analyze quality and safety outcomes from an administrative and systems perspective.
Explain key quality and safety outcomes.
Analyze the relationships between a systemic problem in an organization and specific quality and safety outcomes.
Competency 2: Determine how outcome measures promote quality and safety processes within an organization.
Determine how specific outcome measures support strategic initiatives related to a quality and safety culture.
Competency 3: Determine how specific organizational functions, policies, processes, procedures, norms, and behaviors can be used to build reliability and high-performing organizations.
Determine the strategic value to an organization of specific outcome measures.
Competency 4: Synthesize the various aspects of the nurse leader’s role in developing, promoting, and sustaining a culture of quality and safety.
Determine how a leadership team would support the implementation and adoption of proposed practice changes affecting specific outcomes.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write clearly and concisely, using correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

Paper must include the following:
1. Explains key quality and safety outcomes, and reflects on the strengths and weaknesses of these outcome measures.
2. Determines the strategic value to an organization of specific outcome measures, and suggests how existing outcome measures could be used to provide additional value to the organization.
3. Analyzes the relationships between a systemic problem in an organization and specific quality and safety outcomes, and suggests additional data that could be collected to gain an expanded understanding of the problem.
4. Determines how specific outcome measures support strategic initiatives related to a quality and safety culture, and comments on the relevance of the organization’s strategic plan in light of the current health care environment.
5. Determines how a leadership team would support the implementation and adoption of proposed practice changes affecting specific outcomes, and highlights opportunities for interprofessional
collaboration.
6. Writes clearly and concisely. Grammar and mechanics are error-free
7. Integrates relevant, credible, and convincing sources of evidence to support assertions. Sources are current, and citations and references are error-free.

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Solution

Executive Summary

            The identified quality gap involves improper hypoglycemia management in the healthcare organization leading to adverse quality and safety outcomes. This paper presents critical quality and safety outcomes, strategic value to an organization, relationships between the clinical issue and quality and safety outcomes, strategic initiatives that connect with outcome measures, the role of the leadership team in supporting the implementation of the proposed practice changes.

Essential Quality and Safety Outcomes

Improper hypoglycemia management is associated with adverse quality and safety outcomes, including acute cerebrovascular disorder, neurocognitive dysfunction, myocardial infarction, death of the retinal cell, and loss of vision (Shukla et al., 2017). Other adverse outcomes attributed to improper hypoglycemia management are a high rate of hospital-acquired infections (HAIs), autonomic failure, delay in wound healing, cognitive, and arrhythmias. Additionally, hypoglycemia is associated with increased morbidity and mortality rates within the first year after discharge (Araque et al., 2018). Furthermore, more extended stays and a higher possibility of being transferred to a skilled nursing facility are reported among diabetes patients with inpatient hypoglycemia. More so, hypoglycemia is attributed to a decline in cognitive and functional capacity, particularly among geriatrics with diabetes (Hermann et al., 2021). Finally, improper hypoglycemia management is associated with a high economic burden, such as a high readmission rate and approximately a 50% increase in hospitalization cost (Araque et al., 2018). Therefore, improper hypoglycemia management compromises quality and safety outcomes among diabetes patients in the healthcare organization.

The Connection between Outcome Measures and Organization’s Strategic Values

Various outcome measures impact an organization’s strategic value, which refers to the extent to which a particular action is significant concerning something it intends to achieve. First, the strategic value of the healthcare organization has a substantial connection with the high rate of hospital-acquired infections among diabetes patients. Thus, the healthcare organization should introduce measures to enhance hypoglycemia management, thus reducing the high rate of hospital-acquired infections among diabetes patients. Secondly, the organization’s strategic value is significantly related to the delay in wound healing among diabetes patients undergoing surgeries. Hence, the healthcare organization should introduce strategies and measures to enhance glycaemic control, thus preventing hypoglycemia management. Therefore, the high rate of hospital-acquired infections and delay in wound healing among diabetes patients promote quality and safety culture in the healthcare organization.

The Relationships between Improper Hypoglycemia Management systemic and Specific Quality and Safety Outcomes

A relationship exists between improper hypoglycemia management and quality and adverse safety outcomes. First, improper hypoglycemia management is associated with a high rate of hospital-acquired infections among diabetes patients. Uncontrolled blood sugar in diabetes patients impacts the body’s immune system adversely, impairing its capacity to generate white blood cells, making it difficult to fight infection and kill microorganisms. Furthermore, improper hypoglycemia management is attributed to delayed wound healing among diabetes patients undergoing surgical procedures. The blood sugar level influences the wound heal process. Nutrients and oxygen fail to reach body cells when blood glucose is uncontrolled, hindering the immune system from functioning appropriately. Therefore, improper hypoglycemia management results in a high rate of hospital-acquired infections among diabetes patients and delays wound healing among diabetes patients undergoing surgical operations.

How Do Specific Outcome Measures Support Strategic Initiatives Related to a Quality and Safety Culture?

            Outcome measures, including the high rate of hospital-acquired infections and delay in wound healing among diabetes patients, influence strategic initiatives related to the healthcare organization’s quality and safety culture. First, the organization will adjust its functions, which will involve assigning nurses particular responsibilities to enhance hypoglycemia management. Proper hypoglycemia management will prevent adverse quality and safety outcomes, including a high rate of hospital-acquired infections, and delay wound healing among diabetes patients.

Secondly, the healthcare organization will introduce new policies to enhance hypoglycemia management among diabetes patients. The new guidelines will recognize factors that trigger hypoglycemia events, proper scheduling of insulin, close blood glucose monitoring, patient education, and ensuring that patients get a timely balanced diet. Implementing these policies will enhance hypoglycemia management, preventing adverse quality and safety outcomes.

Furthermore, organizational processes and procedures will be adjusted to prevent hospital-acquired infections and delay wound healing among diabetes patients. Healthcare workers will ensure a high level of hand hygiene is observed among healthcare workers during a hospital stay. According to Jing et al. (2020), practicing proper hand sanitization is an effective infection control tool since it prevents virus transmission in a healthcare facility. Thus, medical practitioners will wash their hands with soap and water and sanitize using alcohol-based sanitizer regularly to prevent hospital-acquired infections. Additionally, medical practitioners will be using intravenous insulin therapy to control blood glucose levels among diabetes patients before surgery to avoid hypoglycemia events, which might delay the wound healing after surgical operations. According to Pasquel et al. (2021), intravenous insulin therapy has demonstrated efficacy in managing inpatient hypoglycemia. Thus, adopting this therapy in the healthcare organization will regulate blood glucose levels among inpatients with diabetes. Implementing the proposed functions, policies, processes, and procedures will result in highly reliable and performing healthcare organizations.

Nurse Leader’s Role

A nurse leader plays a significant role in developing, promoting, and maintaining a quality and safe culture in a healthcare organization. According to Sfantou et al. (2017), effective leadership strengthens the quality of care in a healthcare facility. Thus, the leadership team will play a significant role in implementing the proposed practice changes in a healthcare organization. First, the nurse leader will influence the development of change initiatives in the organization. The nurse leader will provide details of a gap in patient care quality, including improper hypoglycemia management and associated adverse quality and safety outcomes. This information will guide the change team in developing the most effective change initiatives for resolving this clinical issue. Secondly, the nurse leader will encourage staff members to embrace the proposed changes. The nurse leader will gain staff members’ support by emphasizing the benefits of the proposed change to healthcare providers, patients, and the entire healthcare organization. Furthermore, the leader will supervise and monitor nurse practitioners while implementing the proposed change initiatives to ensure that change is implemented as planned. Regular monitoring of staff members during the implementation of the proposed change will result in the expected outcomes in a healthcare organization (Nilsen et al., 2020). Hence, regular monitoring of staff members will successfully implement the proposed changes, thus improving hypoglycemia management in the healthcare organization. Finally, the nurse leader will play a significant role in sustaining the proposed change in the organization. They will ensure that the proposed change is incorporated into clinical practices, becoming part of the organization’s policies and procedures, thus promoting a culture of quality and safety.

Conclusion

Improper hypoglycemia management is associated with adverse quality and safety outcomes in the healthcare organization. Various outcome measures impact an organization’s strategic value. First, the strategic value of the healthcare organization has a significant connection with the high rate of hospital-acquired infections among diabetes patients. Secondly, the organization’s strategic value is significantly related to the delay in wound healing among diabetes patients undergoing surgeries. Additionally, a relationship exists between improper hypoglycemia management and quality and adverse safety outcomes, including the high rate of hospital-acquired infections among diabetes patients and delay in wound healing among diabetes patients undergoing surgical procedures. Specific outcome measures support strategic initiatives related to a quality and safety culture. First, the organization will adjust its functions, which will involve assigning nurses particular responsibilities to enhance hypoglycemia management. Secondly, the healthcare organization will introduce new policies to recognize factors that trigger hypoglycemia events, including proper scheduling of insulin, close blood glucose monitoring, patient education, and ensuring that patients get a timely balanced diet. Furthermore, organizational processes and procedures will be adjusted to prevent hospital-acquired infections and delay wound healing among diabetes patients. Finally, a nurse leader plays a significant role in developing, promoting, and maintaining a quality and safety culture in a healthcare organization, enhancing hypoglycemia management in the healthcare organization.

 

References

Araque, K. A., Kadayakkara, D. K., Gigauri, N., Sheehan, D., Majumdar, S., Buller, G., & Flannery, C. A. (2018). Reducing severe hypoglycemia in hospitalized patients with diabetes: Early outcomes of standardized reporting and management. BMJ open quality; 7(2): 1-7.

Hermann, M., Heimro, L. S., Haugstvedt, A., Hernar, I., Sigurdardottir, A. K., & Graue, M. (2021). Hypoglycemia in older home-dwelling people with diabetes-a scoping review. BMC geriatrics21(1), 1-11.

Jing, J. L. J., Pei Yi, T., Bose, R. J., McCarthy, J. R., Tharmalingam, N., & Madheswaran, T. (2020). Hand sanitizers: a review on formulation aspects, adverse effects, and regulations. International journal of environmental research and public health17(9), 3326.

Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC health services research20(1), 1-8.

Pasquel, F. J., Lansang, M. C., Dhatariya, K., & Umpierrez, G. E. (2021). Management of diabetes and hyperglycaemia in the hospital. The Lancet Diabetes & Endocrinology; 3 (4): 1-7.

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards the quality of care measures in healthcare settings: A systematic review. Healthcare (Basel); 5 (4): 73.

Shukla, V., Shakya, A. K., Perez-Pinzon, M. A., & Dave, K. R. (2017). Cerebral ischemic damage in diabetes: an inflammatory perspective. Journal of neuroinflammation14(1): 1-22.

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