Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice
Identify a quality improvement opportunity in your organization or practice. In a 1,250-1,500 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.
Include the following:
- Provide an overview of the problem and the setting in which the problem or issue occurs.
- Explain why a quality improvement initiative is needed in this area and the expected outcome.
- Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
- Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
- Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
- Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Rubric Criteria
- Problem or Issue in Practice or Organization 7.5 points
- Significance of Quality Improvement in Practice or Organization 15 points
- Demonstration of Support from Previous Research 22.5 points
- Steps Necessary to Implement Quality Improvement Initiative 22.5 points
- Evaluation of Quality Improvement 22.5 points
- Identification of Variables, Hypothesis Test, and Statistical Test 15 points
- Thesis Development and Purpose 10.5 points
- Argument Logic and Construction 12 points
- Mechanics of Writing 7.5 points
- Paper Format 7.5 points
- Documentation of Sources 7.5 points
Total 150 points
Expert Answer and Explanation
Quality Improvement Proposal
Pediatric care centers are crucial in addressing the health needs of children, but they face issues that risk plaguing the entire healthcare industry. Among these issues include care variation, communication breakdown across patients and between providers, patient discharge variations, and avoidable medical errors. The initiation of quality improvement initiatives helps to address some of these issues by devising strategies to better-face the associated challenges (Randmaa, 2016).
Following its quality improvement initiative regarding communication errors, Duke Children’s Hospital in Durham, NC was among the facilities that won the 2013 Pediatric Quality Award Winners (Children’s Hospital Association, 2020). Nurse leasers and other people who are vision bearers in hospitals are expected to lead in these quality improvement projects, which would not only help in saving the associated monetary damages, but would also add to the patient satisfaction.
Overview of the Problem and the Setting in which the Problem Occurs
Communication errors in facilities often have the impact of creating teamwork breakdowns, which results in medical errors as well as poor patient outcomes. Also, facilities with communication breakdowns often have higher costs of care as well as prolonged length of stay. Among the common causes of communication errors in healthcare is the lack of proper education among healthcare providers as well as among patients.
Whenever the patients, for instance, are unable to interpret the message of the healthcare givers, they often create a communication gap that leads to ineffective healthcare. Also, healthcare givers who do not have the right education about dealing with different patient care outcomes are likely to result in communication errors (Boling, 2020).
There are many settings for the problem to occur, but most of the time, communication errors happen where there is interaction between people in the healthcare set up. For instance, during patient discharge, the healthcare providers give various instructions to patients to enhance their wellbeing while away from the facility. If there is a communication challenge, it is likely that they cannot experience the right recovery.
Why a Quality Improvement Initiative is needed in this Area and the Expected Outcomes
A quality improvement initiative is needed in this area because this is an area of care where failure is likely to lead to numerous inefficiencies. If there is no intervention regarding communication errors, it is likely that a facility will be less capable of addressing the patient care demands. Clinicians who communicate wrongly do not have what it takes to listen, explain, and emphasize the effect of functional and biological outcomes.
Also, the fact that clinicians have thousands of patient interactions in the course of their career means that a misunderstanding about a communication error may lead to lifelong effects on their career by repeating numerous mistakes on patients.
Also, in healthcare, there are competing demands that show that communication errors leads to adverse effects on patient privacy, which has recently become a healthcare concern due to the introduction of technology and other modern means of communication. Solving communication errors helps in embracing better evidence-based practice and improving the care outcomes.
How the Results of Previous Research Demonstrate Support for the Quality Improvement Initiative and the Projected Outcomes
Omura et al. (2017) discusses about some of the implication of assertiveness communication training programs among nursing students and healthcare professionals. The research identifies communication errors as part of the reasons why there are numerous negative effects on patient safety. Healthcare providers should acquire the necessary skills to eliminate patient risk through improving the communication methods and avoiding the occurrence of communication errors (Omura et al., 2017).
There is also evidence that interventions improve assertive communication is often more efficient in some groups. Also, teamwork in healthcare is only possible with the help of the relevant communication strategies.
Grahramanian et al. (2017) explains some of the aspects of nurse-physician professional communication that helps in improving the overall quality of healthcare services. The study investigates the relationship of healthcare services from the perspective of patients with nurse-physician professional communication (Grahramanian et al., 2017). Organizational culture which helps in solving medical errors should be made to embrace non-punitive response. Also, efforts that are geared in reduction of communication errors are efficient in the implementation of relevant teamwork practices that help in improving care outcomes.
Hassan (2018) discusses some of the effects of avoiding medication errors by embracing effective communication in healthcare environments. The researchers in this study identify ineffective communication between healthcare personnel and patients as one of the primary causes of medication errors (Hassan, 2018).
Healthcare givers should only use technical language among themselves, but when relating to patients, they should appreciate that this technical language could lead in communication voids in care (Hassan, 2018). Also, constant knowledge and support among patients can help to promote effective practice in hospitals as well as improve the care outcomes.
Steps Necessary to Implement the Quality Improvement Initiative
The quality improvement initiative suggested in this task is the implementation of education on how to improve communication during daily rounds. When this technique was applied in Duke Children’s hospital, it led to numerous outcomes including a 34% increase in provider satisfaction (Children’s Hospital Association, 2020).
While rounding is a common thing to happen in facilities, most healthcare givers do not know how to do it efficiently. In many instances, communication is considered to be a native skill, and people are not taught about how exactly it should be done. As a result, there are often numerous assumptions that lead to enveloping of medical errors.
The first step in implementing this initiative is collecting all the available resources for communication improvement in healthcare. These would include possible human resources to aid in the growth of patient outcomes. Second in the implementation of this quality improvement initiative would be collection of the most recent evidence-based resources to guide in the process. Lastly, different patient and healthcare giver education platforms would be identified, with the relevant time and resource allocation to the same to ensure effective outcomes.
How the Quality Improvement Initiative will be evaluated to Assess whether there is Improvement
A quarterly evaluation is always effective in ensuring that the initiative works efficiently. In the evaluation, various parameters would be checked, such as assessing the quality of communication available in the individual set ups. A standard experimental design should be applied in all the stages of the evaluation, to help check whether there is an improvement in various associated parameters (Foronda, McWilliams, & McArthur, 2016).
For instance, the assessment of whether or not the number of medical errors per a given period reduced over time would be an efficient way to check whether there is an improvement in addressing the problem of communication errors.
A hypothesis test that could prove the findings would be, ‘the number of medical errors in unit X will reduce by 20% after a continuous application of the quality improvement initiative for a period of six months.’ A suitable statistical test that could help in proving the findings would be to set up a study where the patient conditions are investigated in a certain period before running the quality improvement initiative, and trying the same study after the quality improvement initiative have been tried. Here, the researcher would be open to a wide range of variables, but those that can be assessed primarily from patient data such as the use of the number of admissions are more preferred.
Conclusion
The quality improvement proposal of implementing patient education on improving patient communication during the daily rounds is efficient as it has already been proven to have many positive results in different set ups such as Duke Children’s Hospital. This initiative aims at debunking the myth that communication is a native trait, and appreciating the need of embracing various education about how to manage communication protocols in healthcare.
Communication errors are the leading causes of medical errors and has other indirect effects such as the increase in patient admission rates and reducing the quality of healthcare. Nurse educators need to appreciate the value of education about the right communication protocols among nurses and also among patients where possible.
There is need for healthcare givers to appreciate the fact that technical language should only be applied when they are conversing amongst themselves, but when talking to patients and their families, they should employ a high level of simplicity so as to ensure effectiveness of the message. Most importantly, healthcare givers should be open to embrace quality improvement initiatives that help in improving patient care outcomes.
References
Boling, A. (2020). Interprofessional Simulaton among Healthcare Students: A Randomized Controlled Trial to Improve Communication Self-Efficacy. Retrieved from https://mospace.umsystem.edu/xmlui/bitstream/handle/10355/73306/Boling_umkc_0134D_11535.pdf?sequence=1
Children’s Hospital Association, (2020). 4 Quality Improvement Ideas Hospitals Can Implement. Retrieved from https://www.childrenshospitals.org/improvement
Foronda, C., McWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse education in practice, 19, 36-40. Retrieved from https://doi.org/10.1016/j.nepr.2016.04.005
Ghahramanian, A., Rezaei, T., Abdullahzadeh, F., Sheikhalipour, Z., & Dianat, I. (2017). Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication. Health promotion perspectives, 7(3), 168. Retrieved from https://doi.org/10.15171/hpp.2017.30
Hassan, I. (2018). Avoiding Medication Errors through Effective Communication in Healthcare Environment. Movement, Health & Exercise, 7(1), 113-126. Retrieved from http://dx.doi.org/10.15282/mohe.v6i2.157
Omura, M., Maguire, J., Levett-Jones, T., & Stone, T. E. (2017). The effectiveness of assertiveness communication training programs for healthcare professionals and students: A systematic review. International journal of nursing studies, 76, 120-128. Retrieved from https://doi.org/10.1016/j.ijnurstu.2017.09.001
Randmaa, M. (2016). Communication and Patient Safety: Transfer of information between healthcare personnel in anaesthetic clinics (Doctoral dissertation, Acta Universitatis Upsaliensis). Retrieved from http://urn.kb.se/resolve?urn=urn%3Anbn%3Ase%3Auu%3Adiva-278726
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