Nursing Assignment Sample Essay.
- Imagine you are the Quality improvement specialist at your organization who is responsible for some or all QI initiatives. Please answer the following questions:
- What is the role & overall responsibilities of a quality improvement specialist?
- What types of QI initiatives are conducted in the healthcare setting? (Are these for a unit, location or organization?)
- Could you describe one in more detail the process and time required?
- How are QI initiatives chosen (patient health outcomes, Return On Investment – ROI)?
- What kinds of data is used to improve healthcare?
- Who works on a QI team (roles needed here, not names)?
- Are most QI initiatives cost-effective?
- Do some QI initiatives focus on the health outcomes of diverse, underserved populations?
- What type of ethical issues are encountered when planning or implementing a QI initiative?
- How are QI initiatives sustained over time? What’s done if they are or aren’t?
- SUMMARY: Write a 1–2-page memo to your instructor. Single-spaced, 11-point Calibri font (or similar). Include the answers to the questions and add a 3-4 sentence reflection (The impact of QI specialist in healthcare delivery?).
1. QI Overview
- What is QI? Slide Deck
- Reavy (2016). Ch 1. [This course is not tied to your DNP project, but the QI project you will tackle in the course is a mini DNP project. The rest of this text will be helpful as you complete the course.]
- IHI: Dr. Mike Evans Video: An Illustrated Look at Quality Improvement in Health Care (8:10)
- IHI: Why Do Errors Happen? How Can We Prevent Them? (4:41)
- AHRQ. Practice Facilitation Handbook. Module 4. Approaches to Quality Improvement
- Schroeder, P., Parisi, L., Foster, R. (2019). Healthcare quality improvement: then and now, Nursing Management (Springhouse): 50(9), 20-25. doi: 10.1097/01.NUMA.0000579004.87116.35 [This is a good overview article. Read it carefully and note the references.]
- McDonald, K., Graham, I., Grimshaw, J. (2004). Toward a Theoretic Basis for Quality Improvement Interventions. In K. Shojania, K. McDonald, R. Wachter, et al. (Eds.), Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies (Vol. 1: Series Overview and Methodology). Rockville, MD: Agency for Healthcare Research and Quality.
- Shenoy, A. (2021). Patient safety from the perspective of quality management frameworks: a review. Patient Safety in Surgery, 15(1). https://doi.org/10.1186/s13037-021-00286-6 [why call it a “framework”]
- Busse, R., Klazinga, N., Panteli, D., & Quentin, W. (Eds.) (2019). Improving healthcare quality in Europe: Characteristics, effectiveness and implementation of different strategies. Health Policy Series, No. 53. Copenhagen (Denmark): European Observatory on Health Systems and Policies. ISBN-13: 9789289051750 [only Part 1, chapters 1 & 2 are required reading]
- NOTE: Yes, this is an online book geared for Europe, but chapters 1-2 are universal. Focus on definitions, theory, frameworks, and models. This is what is important.
- Lapointe-Shaw, L. & Bell, C. M. (2019). Measuring the cost of adverse events in hospital. CMAJ: Canadian Medical Association Journal, 191(32), p. E877+. http://dx.doi.org.akin.css.edu/10.1503/cmaj.190912
- Rodziewicz T., Houseman B., & Hipskind J. (2021). Medical Error Reduction and Prevention. In: StatPearls [ebook]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
- Smartsheet (2019). Quality Improvement in Nursing 101: Strategies, Examples, and Tools [This is a practical overview and reference with a quality checklist.]
The Why and How to Write a Quality Improvement Manuscript. Pediatric Nursing, 46(6)2020, p. 308+. [This is the format you will be using for your DNP project.]
Requirements: please see assignment instructions
From: QI Specialist (Student’s Name)
Date: 15 September 2021
Subject: Elaborating On the Role and Impact of Qi Specialist
The purpose of writing this memo is to highlight the role of a QI specialist and their impact within the healthcare facilities in a question and answer format.
Role & Overall Responsibilities of a Quality Improvement Specialist
The role of the quality improvement specialist within an organization is to play as a highly engaged team player in change implementation; management approaches for different contracted work initiatives with significant partners of the organization. A quality improvement specialist operates in the health industry to help facilities and clinical facilities run more efficiently. Quality improvement specialists often do not interact directly with patients, instead of collaborating with directors and other executives to evaluate the medical facility’s operational efficiency. A quality improvement specialist’s primary goal is to improve a patient’s overall care and experience while at the institution. A quality improvement expert is concerned with the facility’s overall health and its potential to improve patient health. A quality improvement specialist collects data on care methods and systems, analyzes it for areas where improvements can be made, and then makes recommendations based on the findings. The quality improvement specialist is responsible for ensuring proper communication to the key stakeholders and team players regarding the improvement implementation process.
Types of QI Initiatives Are Conducted In the Healthcare Setting
In a health care setting, quality improvement initiatives may focus on organization operations, patient service, and technological innovations at large. It is not easy for a quality improvement specialist that focuses on every aspect of the organization. Instead, quality improvement specialists come with initiatives that focus on the sections of the organization. Some of the types of health care QI initiatives include process-specific, patient-specific, and technology-based projects.
Process-specific projects – the process-specific projects in the QI process include initiatives that focus on bringing effectiveness to the health care delivery process. Some of the Process-specific initiatives include changes in the organization processes such as protocol to be more effective in a manner that ensues, accessibility safety, and effectiveness within an organization.
Patient-specific projects – Patient-specific projects are patient-centered initiatives; they focus on improving the patients’ experience within healthcare. The patient-centered initiative includes measures of ensuring better patient engagement. In patient-centered initiatives, the key factors include patient engagement, compassionate care, and safety.
Technology-specific projects – technology-based initiatives include all the QI efforts that aim to improve the facility’s technological innovation to improve the facility’s overall efficiency. Technology initiatives include improving the facility systems and introducing new ones to facilitate ease and efficiency in providing top-quality healthcare to the patients while reducing the running costs.
One in More Detail the Process and Time Required
The process-specific projects are reactive initiatives taken after the quality improvement specialist realizes various hiccups within the institution. Process-specific projects may take considerable time, even over a year. QI specialist comes up with the process-specific initiatives as a response to a practical problem within the healthcare. For instance, if the QI specialist notices poor quality services within the facility, they focus on process-centered initiatives to address the problem. The process-specific initiatives include developing a board-level commission, coming up with the best practices team, substituting key leaders, and bringing in new clinical procedures and guidelines to enhance safety, transparency, and communication. Besides, the process-specific projects help in reducing the patients’ mortality within a health care.
How Are Qi Initiatives Chosen
A quality initiative within health care systems is based on the problems that a facility aims to reduce. The QI specialist must first acknowledge there are problems within the healthcare, and they need to improve. Therefore, once the QI specialist acknowledges the need to choose the QI improvement initiatives, they have to consider two critical factors in the process, patient health outcomes and return on investment.
Patient health outcomes
The health care facility’s primary goal is to provide that patients with the utmost health care services. Therefore, whenever the QI specialist chooses the QI initiatives to implement, that first considers the patient health outcome. The QI specialist and the team have to evaluate whether the initiative will positively or negatively impact patients’ health outcomes. For an initiative to be considered feasible, it should facilitate better patient health outcomes.
Return On investment
Like in any other business institution, health care facilities also have to consider the profitability of the various initiatives they choose to implement. For a health care facility to progress, its financial status is essential, hence, the need to choose the QI initiatives that focus on a good return on investment. Some initiatives may weigh heavily on the financial position of the health facility and account for no return on investment. With such initiatives, the QI specialist can choose alternative sources of funding or postpone their actualization.
Kinds of Data Are Used To Improve Healthcare
Institutes of health can gather information on services and their payment during clinical treatment. These information are often collected on the basis of specific patients’ demands, patient contacts or membership in the wellness program. For instance, supply species and duration of stay may be provided. Administrative data can help health organizations to better understand and distribute resources to their populations.
Electronic health records
An individual’s complete clinical history, including past diagnoses, treatments, and outcomes, is stored in electronic health records (EHRs). Doctors, nurses, and administrators contribute to the creation and upkeep of these records. Clinicians can utilize EHRs to treat patients more effectively. Different experts and providers can communicate information, ensuring that everyone has a complete picture of a patient’s requirements.
Nursing homes, for example, are mandated to provide standardized clinical data. Medicare or regulatory bodies may utilize this information to analyze needs and make resource allocation modifications. It can also be used to examine the performance of a given facility.
Data on Insurance Claims
Health institutes may study insurance claims data and trends and provide insight into the therapies that their patients require. This information may be utilized for several purposes, including the identification of pricey treatments to be phased out for something more cost-effective.
Healthcare companies might survey their patients in advance, asking about areas of their care that were excellent or unsatisfactory. Although this data is more qualitative than quantitative, it can nonetheless assist clinicians and executives improve their processes.
Who Works On a QI TEAM?
For the QI process to be effective, the team must include professionals representing different areas of practices affected by the proposed QI initiative. The role of the team members is to meet and review the performance data regularly, point out the areas that require improvement, and implement and follow up on the improvement process. The team should have a clear champion committed to seeing the change happen in that area. This person should be passionate about improving the ability for continuous improvement and putting in place effective “systems” to do so. Gathering and reflecting on data, finding out best practices, and involving the voices and perspectives of those involved in all elements of the process under examination are examples of such procedures. The QI team champion’s role is to make sure the team runs efficiently and stays true to the organization’s mission.
Are Most Qi Initiatives Cost-Effective
Yes, most QI initiatives are cost-effective in the end. The QI initiatives can be costly to implement, but in the end, they become cost-effective. For instance, a QI initiative that is patient-centered may be costly to implement in the first instance. Still, in the long-run, the initiative saves the facility the operational costs and financial losses that are likely to arise from the systems and operations in that area.
Focus On the Health Outcomes of Diverse, Underserved Populations
Yes, some QI initiatives focus on the health outcomes of diverse and underserved populations. A healthcare facility may realize that it is not performing well because of its location, so it may choose to focus on a better location and meet the needs of the diverse and underserved populations. Besides, in some health care facilities, the QI specialist may focus on a diversified patient population by diversifying its task force. An example may include hiring Muslim nurses to ensure cultural diversity within the facility and improve the public image among Muslim patients.
Ethical Issues Are Encountered When Implementing a QI Initiative
Reviewing design and purpose of the initiative
It would be unethical to continue with QI initiatives that were poorly designed or conducted, as the study would be unlikely to result in healthcare benefits.
The primary motivation for informed consent is to safeguard participants from project hazards that they have not chosen to accept. In hospital settings, however, QI activities are routinely implemented. A hospital, for example, could develop a QI study to evaluate the adoption of evidence-based interventions, and consent to treatment would imply permission to the intervention and participation in the QI project in this situation.
Protection to participants’ privacy
While QI activities often represent a little risk to participants regarding physical, mental, social, or financial harm, the threat to confidentiality and the loss of health data confidentiality are relevant considerations. Confidentiality includes everything a member of the QI team learns about a patient from health records or observation while working on the project.
QI Initiatives Sustainability over Time
QI initiatives are sustained over time through regular monitoring and further improvements. Regular monitoring and adjustments help in improving the quality at a progressive rate leaving no room for regression. When monitoring and further improvements are omitted, the initiatives tend to fall out of line with facility needs and changes in the organization and industry at large.
The QI specialist is critical in healthcare delivery. The QI specialist ensures that the facility operates as a system and processes are effective by streamlining the “input-process-output,” which helps meet the needs of the service delivery within the facility. QI specialist in healthcare helps ensure processes focus on the patient, where the facility meets the needs and expectation of the patients. Another relevant impact of QI specialists is that they ensure reduced cost of operations with the available data in developing various initiatives.