Essay on "Quality Improvement Project"

Essay 6 pages (1818 words) Sources: 3

[EXCERPT] . . . .

Quality Improvement Project

The medical profession can probably be regarded as the most intensely caring profession there is. Doctors and nurses are faced with patients and families who are traumatized, afraid, or hurt in some way. For this reason, doctors and nurses are in a position to help these families work through their trauma. However, the nature of the profession often precludes the truly caring quality that should be expected from these professionals. Factors like stress, overwork, and high workloads often make it impossible for medical professionals to truly connect with their clients, even in a non-trauma setting. Indeed, the general overwork of medical professionals often preclude the caring and listening attitudes that they should display towards those they are obliged to treat. To remedy this, a good quality improvement program is required. One of the main elements of a caring attitude is displayed by means of communication. Families of the injured or ill need information, which they are often not receiving from stressed or overworked carers. The quality improvement program will therefore focus on improving the communication paradigm within the medical care setting. Quality improvement programs will be discussed in terms of how to improve communication with patients and their families by means of the PDSA model, process mapping, and addressing the challenges that medical professionals face in an often harsh work environment.

1. MODEL OF QUALITY IMPROVEMENT

All businesses require improvement at some point in their existence, and the hospice setting is no exception. The first step towards improvement is to investigate the current state of af

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fairs and determine areas of possible or needed improvement. The current state of affairs is that families and patients are not receiving the full information they need to make informed decisions or to at least have peace of mind. In addition the attitudes of doctors and nurses towards patients and their families are not sufficiently caring to help them through the difficulty of illness and dying. The main aim of a quality improvement program will therefore be to improve the communication platform between medical professionals and those they work with. To accomplish this, a model for improvement should be constructed. One of the models that can be applied in this way has been developed by Associates in Process Improvement (IHI.org, 2011), and is focused upon accelerating improvement. It has been specifically used by health care associations to improve health care processes and outcomes.

The model includes a "plan-do-study-act" (PDSA) cycle, through which changes are implemented and tested in the work setting.

The First step in this planning process is to assemble teams who can meet the needs of the organization. In the hospice and health care setting, such teams can be allocated to various parts of the work to prevent overwork and stress. One of these teams can also be responsible for scheduling to prevent fatigue. Because communication is at the heart of the improvement project, this platform should be improved on two levels: Communication among staff and between staff and management should be optimized. Two-way communication strategies should be implemented to ensure that all personnel members are aware of the importance of their duties and their responsibilities towards patients and their families.

Once sound communication practices in the workplace setting itself is optimized, it can also be optimized within the relationships of professionals with patients and their families as well. When the improvement system is fully implemented, the PDSA model can be applied to accelerate the improvement program.

The first step in the model is then to set aims. Aims involve time-specific improvement measures, as well as determining the populations that will be affected. Initially, the aims can be set for a specific population, i.e. The families of dying patients in the hospice setting. Communication strategies for helping patients and families through the difficult time during which they are in the care setting should be implemented. These strategies should include providing all the information patients and their families need to help them cope with their situation.

Another important factor is how the information is disseminated. Doctors and nurses should project a caring, sympathetic, and compassionate attitude to both patients and their family members at all times. Because of the difficulties associated with the profession, including stress, fatigue, and workload, this is not always possible. For this reason, a specific scheduling program should be implemented to ensure that staff are not overloaded with work responsibilities that could impact upon their stress and fatigue levels, and thus upon their ability to provide information in a compassionate and caring manner.

The PDSA cycle then requires planning, as mentioned above, implementation, studying the process to determine which changes work, and implementing what does work. The first phase of the planning will then be to improve communication among staff and management, which will be used as a platform for improving communication among staff and patients and their families. One of the underlying strategies for this will be scheduling to prevent excessive fatigue and stress. These can also be mitigated by means of workplace communication among staff and management.

2. IOM QUALITY IMPROVEMENT AIMS

There are six quality improvement aims listed by the Institute of Medicine. These include safety, timeliness, effectiveness, efficiency, equity, and patient-centeredness. The most important of these aims in terms of improving communication with patients is patient-centeredness. The medical professional's fatigue levels are not the concern of the patient or family members. They come to the hospice setting to receive a caring service. Professionals should provide this by means of effective communication. The most important person in the setting is the service receiver: the patient and the family.

Another important component of communication is effectiveness. Medical practitioners should be able to communicate effectively with their patients and their family members. This effectiveness means that both patients and family members feel that they have received sufficient information to put them at ease and make them as comfortable as possible during a difficult time.

This is one component of health care, regardless of its current level of excellence, that needs to be constantly improved (Victorian Quality Council, 2007). Process mapping is a valuable tool in which to accomplish this quality improvement in an optimally effective way.

One challenge in health care is that it is an integrated, multiple-system process. This contributes to the often overworked stress-inducing environment that health care workers face on a daily basis. Within this emotionally eroding environment, these professionals are still obliged to communicate effectively and compassionately with patients. Service processes therefore need to be adapted to accommodate this requirement, despite the harsh work environment that professionals are often subject to.

Process mapping also accommodates the fact that most health care processes occur by means of multiple professional or service groups. Improving communications among these can address the underlying issues related to the experiences of patients who feel that they do not receive adequate communication from medical professionals.

Process mapping outlines the basic premises and functions within an organization in such a way that commonly experienced problems become clear. Suggestions can then be provided on how to overcome these problems, for example, by creating work groups specifically set up to target the components of the workplace that would lead to better communication with patients and their families.

Specifically, process maps involve a sequence of steps created to provide a clear picture or "map" of improving a process. For the communication process in the hospice setting, a process map might, for example begin with improving communication between management and staff, with the next component being improvement communications among staff members themselves. Once these are established, scheduling issues can be addressed, along with potential stress factors, after which effective communication with patients and their families can be addressed.

Leavitt (2009, p.4) confirms that health care is an integrated process that involves not only staff and their patients, but also a wider network of management, external agencies, and overseeing corporate bodies. In addition, patients come with a network of families and acquaintances, all of whom need to be reassured in a compassionate and effective way. This is why process maps would be an effective way as a means of graphically presenting a very complicated setting.

3. MEASURING IMPROVEMENT

To quantitatively measure improvement, patient satisfaction levels can be quantified by means of close-ended questionnaires. These can specifically focus on patients' experiences of the amount of information they received in terms of their illness and how to deal with their situation. The number of mainly positive responses can be measured on a monthly basis to determine the improvement of communication processes.

Another way to measure improvement is by external monitoring, where external agencies determine the effectiveness of the communication measures used at the establishment. This can also be used as an improvement tool for future staff-patient interactions.

To accomplish this, Leavitt (2009, p. 4) suggests interacting with Quality Improvement Organizations. These organizations use process maps as one of the measures of the existing quality in the processes in the hospice setting. Quality Improvement Organizations also work with… READ MORE

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Quoted Instructions for "Quality Improvement Project" Assignment:

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GUIDELINES FOR QI ASSIGNMENT

Patient and families always feel no one listens to them or tells them everything. My quality improvement will revolve around responding to patient concerns providing information and concerns for their care and following through. follow the guidelines below 4-6 pages no more with apa format and no direct quotes. Paraphase only will need at least 4 reference site correctly in apa format. I am emailing some power points on patient and family concerns and recovery methods to regain lost confidence.

The paper should be carefully written in a formal style, based on primary sources, provide an integration of ideas, and be 4-6 pages in length, excluding title page & reference list. Organized flow, logical progression of ideas, and clarity in thought are essential.

Criteria Points

1.

Introduction paragraph (one paragraph). There must be a thesis statement at the end of the paragraph that tells the reader the purpose of paper and what will be discussed.Summary of practice improvement initiative; organizational background/context;Hospice is the background stakeholders; measure(s) of quality. (How are you measuring quality?) /3

2.

Model(s) of quality improvement initiative. (What model(s) are you using to conceptualize quality?). /4

3.

Integrates at least two (2) aims from IOM as it relates to quality improvement. /3

4.

Proposed evaluation method(s) of quality measures. (What qualitative and quantitative methods are identified to determine if quality achieved?)

5.

Conclusions: summarize the essential points of paper (one paragraph). How would a process map be useful in the steps of implementation and evaluation. /3

Scholarly Writing: Appropriate grammar and spelling is expected. Deductions for APA errors will be .25 per error.

/2

Quality improvement may be defined as a formal approach to the analysis of performance and systematic efforts to improve it. Quality improvements in health care can be measured using available recognized measures of quality at the appropriate levels of intervention. The Institute of Medicine (IOM) describes quality using six domains: safety, timeliness, effectiveness, efficiency, equity and patient-centeredness. Appropriate data sources must be available in order to measure quality. Structure, process and outcomes provide a framework for understanding and conceptualizing quality. Process maps are also excellent quality improvement tools (see Victorian Quality Council reference). Select a practice improvement issue within your organizational system and within the realm of your practice area. My Parctice impr Using the grading rubric as a guide, develop a quality improvement plan to address the identified issue and describe how quality within your system will be improved with this initiative.

Helpful Resources:

http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html (FADE Model)

http://www.cms.hhs.gov/QualityImprovementOrgs/ (CMS Quality Improvement)

http://www.ahrq.gov/whatsnew.asp (Innovation Exchange)

http://www.innovations.ahrq.gov/content.aspx?id=1807 (Rapid Cycle Improvement Process)

http://www.innovations.ahrq.gov/qualitytools (Quality Tools)

http://www.innovations.ahrq.gov/searchSummary.aspx?term=Quality+Improvement+Process (Quality Improvement Process)

http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods (Improvement Methods)

Victorian Quality Council. (2007). Process mapping: A guide for health service staff. Retrieved from http://www.health.vic.gov.au/qualitycouncil/downloads/process_mapping.pdf

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