NURS 8300 Organizational and Systems Leadership for Quality Improvement Assignment Essay Paper
NURS 8300 Organizational and Systems Leadership for Quality Improvement
NURS 8300 Entire Course Weekly Discussions And Assignments
NURS 8300 Organizational and Systems Leadership for Quality Improvement Assignment Essay Paper
NURS 8300 Week 1: Quality Improvement Milestones
Imagine the construction of a tower made from building blocks or the process of assembling a puzzle. In both scenarios, there are foundational blocks or multiple interlocking pieces. These foundational units are responsible for the overall construction of the larger outcome. In health care quality and patient safety, these “building blocks” or “ interlocking pieces” are represented by all the historical events and philosophies that culminate to establish the concepts of quality and patient care. When connected, these interlocking events are combined to form the system of overall health care organization.
This week, you examine the historical developments that have given rise to the increasing scrutiny of clinical service delivery by analyzing two reports published by the Institute of Medicine, To Err is Human and Crossing the Quality Chasm. You begin to examine foundational concepts of quality and patient safety and assess how various events have shaped perspectives on health care quality today.
Learning Objectives
By the end of this week, you will be able to:
- Analyze the history of quality improvement in health care from a systems perspective
- Evaluate the purpose and philosophy of quality improvement within a systems approach
Discussion: Quality Improvement Milestones
Throughout history, major events have influenced quality improvement efforts in health care. For example, the Institute of Medicine’s report To Err is Human: Building a Safer Health System revealed statistics about errors in patient safety that result in thousands of deaths annually. Health care providers must be cognizant of the purpose and philosophy of quality improvement efforts as they lead the charge for improving health outcomes and patient safety. This Discussion is intended to help you understand how various developments have shaped contemporary perspectives and approaches to promoting health care quality.
By Day 3
Post a cohesive scholarly response that addresses the following:
When “To Err is Human” was published in 1999, it marked an important milestone in Quality Improvement Science.
- Analyze how this milestone has influenced the health care delivery system and nursing practice.
- Provide an example from your own work history and experience as to how the patient safety movement has affected your practice.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
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NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
NURS 8300 Week 2: Definitions of Quality
How will you know where you are going if you do not know where you have been? This common cliché is reflective of the influence that early theorists of quality improvement have on health care practices today. Building on theories and philosophies of quality from the field of management, successful health care organizations recognize that quality assessment and improvement are central to clinical service delivery. These organizations integrate this perspective into their day-to-day operations. Leaders in health care and nursing practice benefit from implementing those practices that have been developed by prominent theorists within the management field.
This week, you examine the influence of early theories of quality improvement. You also identify and evaluate health care quality and nurse-sensitive indicators.
Learning Objectives
By the end of this week, you will be able to:
- Analyze the historical development of the theories and philosophies of clinical quality and safety in health care
- Evaluate the influence of nurse-sensitive indicators of quality
Discussion: Quality Indicators
How do you define quality as it pertains to health care and the practice of nursing? Some nurses may define quality as effective interdisciplinary teamwork that results in better patient-health outcomes, while hospital administrators may define quality as appropriately delegated responsibilities, completion of tasks, and effective patient flow. Due to the subjective nature of the term, quality is a topic of great debate.
In an effort to define quality in health care, standards have been developed to establish consistency and provide guidance. The National Database of Nursing Quality Indicators (NDNQI) outlines nursing-sensitive indicators that encompass measurement scales for quality of nurse professionals as well as quality of the services provided by nurses to patients. In this week’s Discussion, you evaluate the determinants of quality,m based on the NDNQI indicators and the theoretical underpinnings of these quality indicators. You apply nursing-sensitive indicators to your current setting and assess how each definition of quality contributes to the idea of quality overall.
To prepare:
- Review the NDNQI indicators presented in the Learning Resources that emphasize quality. Focus on those indicators that pertain to your practice setting.
- Consider the influence of early quality improvement theories and philosophies on the development of those quality indicators.
- Using the Walden Library, locate at least two scholarly research articles that discuss how quality indicators influence your practice setting.
- Select one definition of quality published by any peer-reviewed source that particularly resonates with your thinking about quality.
By Day 3
Post a cohesive scholarly response that addresses the following:
- Identify two nurse-sensitive indicators of quality that relate to patient care and analyze the influence of early quality improvement theories and philosophies on the development of those indicators. For this exercise, do not choose nurse sensitive indicators that relate to staffing levels.
- Find and cite at least 2 nursing research articles you located and evaluate how these indicators influence a practice setting.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
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NURS 8300 Week 3: Drivers of Quality Management in Healthcare
What would our world look like if there were no licensing requirements, accreditation standards, or regulations governing organizations in various fields? Imagine the effect on society if health care provider organizations did not have to be accredited? Would you go to a physician’s office that did not abide by quality measures? As with any field, health care organizations must adhere to accrediting body standards, regulatory, and licensure requirements to ensure consistency, ethical practice, and quality delivery of clinical services. As a nurse leader, it is essential to be aware of these standards, quality indicators, accreditation and reporting requirements so you may ensure that your organization’s systems and initiatives adhere to appropriate regulatory requirements.
This week, you examine the various accrediting agencies and legal and regulatory requirements that guide quality improvement efforts generally and within your own organization. You also consider how these requirements support ethical principles and influence the delivery of clinical services.
Learning Objectives
By the end of this week, you will be able to:
- Analyze regulatory requirements at the state or national level that affect quality outcomes
- Discuss how professional nursing standards and other quality standards and regulatory requirements support ethical principles of patient care and nursing practice
Discussion: Measures of Quality
Health care quality is a nationally recognized topic that is addressed through public policies, licensure, and accreditation standards for health care professionals and organizations. Throughout history, numerous organizations have been involved in developing health care quality and safety initiatives.
The Joint Commission and Centers for Medicare and Medicaid Services (CMS) developed quality and safety indicators for various health care systems. These indicators seek to establish accountability for health care organizations through a reporting system, which is available to the public. For this Discussion, explore various accrediting organizations and specific measures that pertain to quality. In your research on accrediting organizations, consider how these quality measures affect quality outcomes, support ethical principles, and influence the delivery of clinical services.
To prepare: ORDER NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
- Select one specific quality indicator from the Week 2 Discussion and compare it with those outlined in this week’s Learning Resources.
- Review the accrediting body standards that pertain to your organization focusing on those standards that require your organization to define its quality management program.
- Consider regulatory requirements at the state or national level that affect quality outcomes in your organization.
- Ask yourself: How do the Centers for Medicare and Medicaid Services (CMS) restricted reimbursements affect quality management or improvement efforts at my organization? How do these standards and regulations influence or support ethical principles and influence patient care and nursing practice?
By Day 3
Post a cohesive scholarly response that addresses the following:
Choose any measurement and explain the extent to which your chosen measure is affected by CMS driven incentives and disincentives. From a systems perspective, discuss how this measure affects quality outcomes, supports ethical principles, and influences patient care and nursing practice.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8300 Week 4: Specific Measurements in Health Care
You can’t manage what you can’t measure.
-Unknown
This statement has become an emblem for health care organizations across the nation and around the world. In order to assess-and ultimately improve-health care quality, providers and other agencies must be able to accurately measure appropriate indicators of quality and safety. This week, you closely examine organizational tools used for measuring quality within a micro context: balanced scorecards and dashboards.
Learning Objectives
By the end of this week, you will be able to:
- Analyze measurement systems and measurement methods within a micro context
- Evaluate standardized data definitions, external benchmarks, and database comparisons as they relate to an organizational balanced scorecard
Discussion: Measurement Systems and Methods
The process of constructing a balanced scorecard for either financial goal setting or tracking of patient and employee satisfaction can be controversial. For example, a hospital’s financial scorecard provides a snapshot of gathered data for the hospital, but the data may be out of context, which makes it difficult to identify specific problems. It is evident that both scorecards and dashboards have a place in the health care setting; however, will all organizations and accrediting bodies agree on the aspects of implementation, data analysis, and levels of effectiveness?
To prepare:
- Consider the various uses of scorecards and dashboards presented in this week’s Learning Resources and media presentation.
- Reflect on how these measurement systems and measurement methods impact organizational goal setting in the areas of overall performance and financial stability.
- Explore the key indicators involved with scorecards and dashboards as well as the external quality standards to which they are compared.
- Ask yourself: What do the metrics used in the balanced scorecard and dashboard mean to my organization and nursing practice? Has my organization established goals for these metrics and are they currently being met?
By Day 3
Post a cohesive scholarly response that addresses the following:
- Select any setting and describe the extent to which the patient’s experience of care is measured, tracked, and set for improvement goals.
- Evaluate whether goals at your organization are established for these metrics and whether or not they are currently being met.
- Describe some of the provocative issues that have or will emerge. For example, what has been the impact of CAHPS or HCAHPS in the setting described (if applicable).
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8300 Week 5: System Management of Populations
As noted in previous weeks, quality improvement measures are implemented at the macro and micro levels. Using quality indicators and measures, health care providers can compare, evaluate, and identify areas that need improvement to ensure quality care. How do these measures compare when managing chronic illnesses? The Resources from Week 1 revealed that many Americans do not receive quality health care for chronic illnesses, resulting in patients having more than one chronic illness (Institute of Medicine, 2001). How can nurses engaged in advanced practice evaluate the issues around treating chronic illness? How do quality metrics for managing chronic disease improve its management?
Keep your responses to these questions in mind as you proceed through this week, which calls attention to how quality metrics drive change to improve population health through the management of chronic disease.
This week, you examine quality metrics pertaining to the management of chronic illness in various health care settings.
Learning Objectives
By the end of this week, you will be able to:
- Evaluate how quality metrics drive change to create improvement in the management of chronic disease
Discussion: Quality Metrics for Chronic Disease Management
According to the CDC, chronic diseases are the leading cause of death in the United States, with almost 50% of the population suffering from at least one chronic illness. As a result, almost 80% of health care spending is devoted to its management (CDC, 2010). To this end, the National Committee for Quality Assurance (NCQA) developed performance measures. These performance measures allow organizations to compare yearly quality improvement outcomes in the management of chronic diseases. As a nurse engaged in advanced practice, you may find yourself at the forefront of prevention and care management efforts.
To prepare: ORDER NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
- Review the National Committee for Quality Assurance report, presented in the Learning Resources, and examine current trends and measures associated with at least two chronic diseases. This information will form the basis for this Discussion.
- Review examples of measures that address the management of chronic diseases for an inpatient setting that might not be relevant in an outpatient setting. Be sure to explore the companion metrics that influence a patient’s ability to manage chronic disease.
- Consider how these metrics facilitate change and improve the management of chronic disease.
- Examine the efficiency of current automated trigger systems for managing patient safety. Ask yourself: How do these automated trigger systems help improve quality of health care, patient education, and management of chronic illnesses?
By Day 3
Post a cohesive scholarly response that addresses the following:
- Compare one quality metric for managing chronic disease that applies to your practice setting to ametric that applies in a different practice setting (i.e. hospital nurse compared to home health nurse).
- Evaluate how these quality metrics facilitate change and improve the management of chronic disease.
- Take a stance on the efficiency of current automated trigger systems to help manage patient safety. Do you believe these to be proactive or reactive responses when educating patients on disease management?
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective, using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8300 Week 6: Organizational and Leadership Strategies to Improve Patient Safety and Quality
It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm.
-Florence Nightingale
Health care delivery organizations continue to strive to improve quality of care and patient safety. You have explored how health care utilizes theories and philosophies from business to accomplish this important task. This week builds on that foundational awareness with a focus on quality improvement models and the strategies and tools utilized with these models. Using this type of model can assist DNP-prepared nurses with identifying problems within the organization that are impacting patient outcomes.
This week, you critique quality improvement models and tools utilized within the models, such as cause and effect diagrams, control charts and histograms. You apply this knowledge in an authentic setting by planning a quality improvement project.
Learning Objectives
By the end of this week, you will be able to:
- Apply a quality improvement model that utilizes tools and strategies to address a real problem within your practice setting
- Evaluate tools, methods, and strategies for successful improvement of patient safety and other quality dimensions in health care
Discussion: Patient Safety and Quality Improvement Evaluation
A health care organization may have highly qualified doctors and nurses who meet quality indicators for technical quality; however, due to a lack of communication, empathy, and scheduled office hours, patient satisfaction is low. In the corporate world, the phrase “the customer is always right” is frequently used to emphasize the importance of meeting the needs and expectations of the consumer. How does this approach apply to health care?
Health care industries are now using quality improvement models that are very business-centric to improve the quality of care delivery, patient satisfaction, and safety. In this Discussion, you evaluate various quality improvement models and determine which model would best be applied in your practice setting to address a specific need. You also develop a mission statement for addressing the practice problem.
To prepare:
- Reflect on the various quality improvement models and their application in health care presented in the Learning Resources.
- Evaluate the advantages and disadvantages of each model.
- Consider how these metrics facilitate change and improve the management of chronic disease.
- Consider how these models have been, or could be, applied in your practice setting.
- Based on your selected area of need, define a practice problem and create a corresponding mission statement.
- Investigate baseline data, and evaluate why this practice problem is a priority for improvement. Ask yourself: How does this practice problem in my organization compare to other organizations?
By Day 3
Post a cohesive response that addresses the following:
- Summarize any practice problem relevant to your setting of interest and share a potential measurable goal for a QI team. Be sure to include the data that justifies why you feel a change is needed in this specific area.
- Explain how the PDSA model might be applied , giving specific reasoning as to why this model best fits the needs of your practice problem. Describe how the practice problem you describe might be of interest to any accreditation initiative.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Critique their suggestions for quality improvement using the theoretical frameworks and models presented.
- Offer one positive response that highlights how a colleagues’ chosen model works to improve the quality at their practice setting.
- Offer one alternative quality framework that you feel could better solve a colleagues’ chosen problem.
- Apply your own experience to a colleagues’ identified problem. How did your practice setting work to improve quality in that area?
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
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NURS 8300 Week 7: Determining Organizational Priorities for Quality Improvement
In Week 6, you explored quality improvement models as a strategy for identifying health care and patient safety concerns. Once a quality or safety issue is identified, what is the next step to ensure the issue is improved? What internal and external organizational factors will influence the success, or failure, of a quality improvement initiative?
The concepts presented this week relate to how nurse leaders can develop quality improvement initiatives that align with the mission, vision, and values of the organization to engender success and achievement of the goals.
Learning Objectives
By the end of this week, you will be able to:
- Assess how the mission, vision, and values of the organization determine improvement priorities
- Apply the SMART criteria to a quality improvement initiative
- Analyze the influence of the external environment on the priorities of the organization
Discussion: Quality Improvement Initiative
When attempting to garner support for a quality improvement initiative, it is important to demonstrate how the initiative supports the organization’s mission, vision, and values, as well as external factors that influence an organization’s priorities. Delivering a proposal for a quality improvement initiative requires clear, concise communication of the plan.
To prepare: ORDER NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
- Choose a QI initiative which has been the subject of focus in any healthcare setting. Explain the rationale that your senior leaders used in selecting this initiative for attention and focus.
- Explain how adverse events are handled in your organization from the public’s perspective and well as internally.
- Find a scholarly article or one from the public press, published within the last 5 years which recounts a serious error. Relate this error to any organization with which you have some familiarity.
By Day 3
Post your response.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.
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NURS 8300 Week 8: The Role of Teams in Quality Improvement
Effective teamwork is essential for helping a health care organization achieve its objectives and meet patients’ needs. This week provides an opportunity to deepen your knowledge about groups and teams. You explore the characteristics of effective teams, strategies for engaging and keeping team members invested, and how organizational theory can guide and support these efforts. As a DNP-prepared nurse, you will likely play a central role in both establishing and leading interprofessional teams.
Learning Objectives
By the end of this week, you will be able to:
- Define membership and roles for effective quality improvement teams
- Critique the application of organizational theory in team processes
Discussion: Welcome to the Week 8 Small Group Discussion Area!
Note: Weeks 8 and 9 are linked together in an assignment that is completed within your group. Each group will receive the same grade for the final powerpoint submission at the end of Week 9. Each individual will receive a unique grade in Week 8 which is based on your individual contribution to the small group discussion boards in both weeks, and the slides that you contribute to the PowerPoint.
Root Cause Analysis
As a case study team, prepare a 10 slide power-point using tools provided in this case study to present your rationale and validation of the root causes your team has chosen. Be sure to include at least 4 peer reviewed research studies which evoke validation of the latest patient safety evidence in support of your root cause findings. Also address the extent to which this scenario evokes implication for value based purchasing.
To prepare for Week 8:
- Read the case study posted in doc sharing in its entirety.
- Appoint a team facilitator and divide the work between you.
Week 8 Discussion:
- Engage in dialogue to answer the questions posed in the case study.
In order to accomplish the IOM mandate for safe, timely, effective, efficient, equitable, and patient-centered care in a complex environment, healthcare professionals must function as highly collaborative teams …
—AACN (2006, p. 14)
The dynamic and increasingly complex world of health care often requires professionals to work collaboratively on interdisciplinary teams. In the team environment, individuals with unique skills and expertise come together to focus on a common goal, developing solutions that none of them could have accomplished alone. Selecting members to serve on teams and supporting team members as they begin their work are important responsibilities.
What can you as a leader do to engage team members? What conditions motivate individuals to contribute toward quality improvement by participating on a team? How can leadership encourage those working on the team to respond appropriately in a challenging situation? What management theories can support your efforts at developing an effective team? In this Discussion, you consider various strategies for promoting quality in health care organizations through effective team leadership.
Reference: American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. Retrieved from http://www.aacn.nche.edu/publications/position/DNPEssentials.pdf
To prepare:
- Assemble in small groups for the Week 8 and Week 9 Discussions (groups will be assigned by the instructor in week 7).
- Read the Case Study ‘Per-operative Services in major medical centers’, assigned in your Week 8 Learning Resources.
- Assign roles within the group to analyze the case study for week 9, and take a position as a group.
By Day 3
Post your response.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in your small group in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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NURS 8300 Week 9: The Application of Quality Improvement Models in Organizations and Systems
Wrong-side surgeries, hospital acquired infections, medication errors, and wrongful deaths-these sorts of medical mistakes often make headline news. How can these types of errors be prevented? Throughout this course, you have been examining methods for systematically improving the quality of care and patient safety within a health care organization. Another tool that can be used to evaluate medical and system errors is a root cause analysis.
This week, you explore root cause analysis, which is one of the key methods used in health care organizations to understand and address patient safety situations.
Learning Objectives
By the end of this week, you will be able to:
- Apply qualitative and quantitative methods to identify root causes of a specific quality improvement need
- Evaluate adverse events or factors that lead to a specific quality improvement need
- Formulate goals from collected data
Discussion: Root Cause Analysis
Note: Weeks 8 and 9 are linked together in an assignment that is completed within your group. Each group will receive the same grade for the final powerpoint submission at the end of Week 9. Each individual will receive a unique grade in Weeks 8 and 9 which is based on your individual contribution to the small group discussion boards as well as your participation in the final Week 9 discussion as well as the slides that you contribute to the powerpoint.
Root cause analysis (RCA) is a standard tool used to help health care organizations learn from errors, particularly those that result in harm. RCA is applied to address three key questions about a particular situation:
- What happened?
- Why did it happen?
- What can be done to prevent it from happening again?
To prepare for and complete this Discussion:
As a case study team, prepare a 10 slide power-point using tools provided in this case study to present your rationale and validation of the root causes your team has chosen. Be sure to include at least 4 peer reviewed research studies which evoke validation of the latest patient safety evidence in support of your root cause findings. Also address the extent to which this scenario evokes implication for value based purchasing.
To prepare for Week 9:
Continue your small group dialogue in dissecting the case study.
By Day 3
A designated team member will post the team powerpoint and key insights that your team has gained about your choices, this type of sentinel event, and use of root cause analysis in Week 9 discussion board.
By Day 7
Each student will respond to at least two other group PowerPoints and analysis.
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NURS 8300 Week 10: The Application of Process Improvement Models in Organizations and Systems, Part II Recommendation
What separates a successful quality improvement initiative from those that fail to meet their goals? Frequently, it is the application of the process improvement model and development of a well thought-out plan of action.
This week continues the examination of how process improvement models are applied to create and sustain change at the organizational and policy level. You also consider how evidence-based practice models can be used for these same purposes.
Learning Objectives
By the end of this week, you will be able to:
- Apply evidence-based practice models to an identified clinical practice problem
- Formulate recommendations and an action plan for a quality improvement initiative
Discussion: Welcome to the Week 10 Small Group Discussion Area!
Note: Week 10 is a group assignment. Last week, you explored key factors that contribute to patient safety challenges using root cause analysis. This week builds on that foundational awareness with a focus on the application of evidence-based practice models as a strategy to improve patient safety and other quality dimensions. In this Discussion, consider how these strategies can sustain practice changes.
Week 10 is a group assignment. Last week, you explored key factors that contribute to patient safety challenges using root cause analysis. This week builds on that foundational awareness with a focus on the application of evidence-based practice models as a strategy to improve patient safety and other quality dimensions. In this Discussion, consider how these strategies can sustain practice changes.
To prepare:
Read: Newhouse, R.P. (2007) Diffusing confusion among evidence-based practice, quality improvement and research. JONA 37,432-535
Read: Mazurek Melynk B., Gallagher-Ford, L., English Long, L., & Fineout-Overholt, E. (2014) The establishment of Evidence-Based practice competencies for practicing registered nurses and advanced practice nurses in real world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing 11(1),5-15.
We all agree that research is the highest form of reliable evidence, when implemented in an organization that provides the basis for an evidence based practice. As a group: FIND a research study published in a peer reviewed journal related to a clinical practice problem that is of interest to the group, and which would ultimately contribute to an evidence based practice.
The discussion assignment:
ANSWER the following discussion questions as a group: (as a team, post your responses by Sunday at midnight). Include the research study in your post (attach it to the post and post it in doc sharing). See page 11 #15 in Mazurek Melynk, Gallagher Ford, English Long and Fineout-Overholt. In this assignment, you are being asked to critically appraise a single research study for its relevance to a QI practice problem.
Each member of the team must participate (weekly rules for discussion) on the group discussion board in order to get full credit.
Discussion questions:
- What was the purpose of the research?
- Identify the independent and dependent variables in the study.
- Briefly describe the research design, data collection method(s), and instruments used to measure the variables under study.
- Briefly summarize study findings, conclusions and recommendations. Do you agree with these?
- As a DNP prepared nurse, would you recommend a change in nursing practice based on the study? Defend and/or justify your decision based on research evaluation principles. In other words, does the evidence generated by this research article signify a need to change nursing practice? If not, why not; if so, why?
By Day 3
Post your team’s answers in the form of a main post on your group discussion board. Each member of the group must participate in week 10 in order to receive the grade.
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ORDER NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
NURS 8300 Week 11: Measurement for Change
How do quality improvement teams measure a project’s success? What measurement mechanisms can be applied to evaluate the impact of a practice change? To be an effective change agent, and to be able to sustain change, you must be able to measure the progress and outcomes of implementing new practices or procedures. Many measurement tools can be utilized for this purpose: quantitative frequency distribution charts, line graphs, qualitative data analysis, patient surveys, etc. In order to measure success, however, you need to be familiar with evaluation techniques. To that end, this week you appraise measurement mechanisms to evaluate change in organizations and systems, and evaluate the success of quality improvement initiatives in terms of sustainability. Additionally, this week, you will engage in self-assessment and reflection to evaluate your own leadership skills and preferences.
Learning Objectives
By the end of this week, you will be able to:
- Evaluate the extent to which improvement is sustained through leadership and improvement teams
- Determine measurement mechanisms to evaluate the impact of an action plan and quality improvement initiative recommendations
- Interpret the results of a self-assessment to gain insights into leadership preferences within the framework of leadership and management
- Formulate recommendations for leadership development
Discussion: Evaluating and Sustaining Improvement
The downfall of many quality improvement initiatives is the inability to sustain improvements. Last week, you considered the use of evidence-based practice models as a method for sustaining practice changes to improve quality. This week’s Discussion builds on those concepts of sustainability. You evaluate measurement mechanisms and explore strategies that leadership and improvement teams can use to sustain improvement efforts.
To prepare: ORDER NURS 8300: Organizational and Systems-Leadership for Quality-Improvement Essay Assignment
- Review the evaluation tools presented in the Learning Resources and how the tools can be used to promote sustainability.
- Select a measurement mechanism that can be used to evaluate your quality improvement initiative. You may wish to conduct additional research on the use of measurement mechanisms to sustain outcomes of improvement initiatives.
- Consider the influence of leadership and improvement teams in sustaining improvement efforts. Ask yourself: What specific strategies can leaders and my improvement team use to sustain our improvement initiative?
By Day 3
Post a cohesive scholarly response that addresses the following:
- Evaluate the influence of leadership and improvement teams in sustaining improvement efforts. Present a succinct analysis of three or more strategies leaders and teams can use in your response.
Read a selection of your colleagues’ responses.
By Day 7
Respond to two of your colleagues in one or more of the following ways:
- Ask a probing question, substantiated with additional background information, evidence, or research.
- Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
- Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
- Validate an idea with your own experience and additional research.
- Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
- Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
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