In preparation for assessment three, please review the video below. Learners will propose a NEW quality improvement initiative based on a data analysis. This will be a PowerPoint presentation of 7-10 slides and should address the following points:
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· Provide actual data indicating the need for the QI initiative.
· Develop a QI proposal base on the identified health issue and data analysis that focuses on improvement.
· Integrate interprofessional perspectives and actions to enhance patient safety, cost-effectiveness, and work-life quality.
Make a quality initiative proposal (7-10 PowerPoint slides) through a presentation, interpreting and communicating dashboard data to support the proposal.
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Introduction
Health care providers are perpetually striving to improve care quality and patient safety. To accomplish enhanced care, outcomes need to be measured. Next, data measures must be validated. Measurement and validation of information support performance improvement. Health care providers must focus attention on evidence-based best practices to improve patient outcomes.
Health informatics, along with new and improved technologies and procedures, are at the core of all quality improvement initiatives. Data analysis begins with provider documentation, researched process improvement models, and recognized quality benchmarks. All of these items work together to improve patient outcomes. Professional nurses must be able to interpret and communicate dashboard information that displays critical care metrics and outcomes along with data collected from the care delivery process.
Overview
A basic principle of quality measurement is: If you can't measure it, you can't improve it.
–Agency for Healthcare Research and Quality (2021)
In the previous assessment, you analyzed the effectiveness of an existing quality initiative. Now that you've done that, this assessment gives you experience interpreting and communicating dashboard data for the purpose of making a quality initiative proposal of your own. And you'll make your proposal through a PowerPoint presentation, including using speaker notes in the Notes section of the slides, much like you might in your health care setting.
Health care providers are on an endless quest to improve both care quality and patient safety. This unwavering commitment requires hospitals and care givers to increase their attention and adherence to treatment protocols to improve patient outcomes. Health informatics, along with new and improved technologies and procedures, are at the core of virtually all QI initiatives. The data gathered by providers, along with process improvement models and recognized quality benchmarks, are all part of a collaborative, continuing effort. As such, it is essential that professional nurses are able to correctly interpret and effectively communicate information revealed on dashboards that display critical care metrics.
Instructions
In this assessment, you will make a QI initiative proposal based on a health issue of professional interest to you. This proposal will be based on an analysis of dashboard metrics from a health care facility. You have two options:
Option 1
If you have access to dashboard metrics related to a QI initiative proposal of interest to you:
· Analyze data from the health care facility to identify a health care issue or an area of concern. You will need access to reports and data related to care quality and patient safety. If you work in a hospital setting, contact the quality management department to obtain the data you need.
· You will need to identify basic information about the health care setting, size, and specific type of care delivery related to the topic that you identify. You are expected to abide by standards for compliance with the Health Insurance Portability and Accountability Act (HIPAA).
Option 2
If you do not have access to a dashboard or metrics related to a QI initiative proposal:
· You may use one of the links in the following reading list to access a dashboard or metrics for a health care facility to develop the QI initiative proposal:
· Assessment 3: Resources
· You will follow the same instructions and provide the same deliverables as your peers who select Option 1.
Complete the following steps for your proposal:
· Analyze data to identify a health care issue or an area of concern as it relates to a state, national, or accreditation benchmark requirement relevant to your professional setting.
· Evaluate the quality of the data.
· Outline a QI initiative proposal based on the selected health issue or area of concern and supporting data analysis to improve identified dashboard metric. The interactive activity Designing a Quality Improvement Initiative can get you going on the first steps of a QI process and your assessment.
· Identify the target areas of improvement and outcome measures.
· Include the QI model that will be utilized.
· Specify evidence-based strategies that will be utilized.
· Integrate interprofessional perspectives and actions to lead quality improvements in patient safety, cost-effectiveness, and work-life quality.
Full Answer Section
Here is a potential outline for your 7-10 slide PowerPoint presentation:
Slide 1: Title Slide
- Title: Improving Medication Reconciliation to Enhance Patient Safety
- Your Name
- Course Name
- Date
Speaker Notes: Briefly introduce the topic of medication reconciliation as a critical aspect of patient safety.
Slide 2: Introduction - The Importance of Medication Reconciliation
- Bullet point: Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, route, and indication — and comparing that list against the physician's admission, transfer, and/or discharge orders, with the goal of providing correct medications to the patient at all times.
- Bullet point: Inaccurate or incomplete medication lists can lead to adverse drug events (ADEs), medication errors, reduced patient safety, increased hospital readmissions, and higher healthcare costs.
- Image: A visual representation of the medication reconciliation process (e.g., comparing different medication lists).
Speaker Notes: Emphasize the complexity of medication regimens in many patients and the potential for discrepancies at transitions of care. Highlight the significance of accurate medication information for patient safety.
Slide 3: Data Indicating the Need for the QI Initiative
- Title: Analysis of Medication Reconciliation Discrepancy Rates
- Data Presentation (Example):
- Metric: Percentage of patients with at least one medication discrepancy identified during admission medication reconciliation.
- Baseline Data (Past 3 Months): 45%
- Benchmark (e.g., National Quality Forum): < 20%
- Data Source: Electronic Health Record (EHR) audit reports, medication reconciliation documentation review.
- (Optional) Graph: A bar chart comparing the baseline data to the benchmark.
- Bullet point: This data indicates a significant gap between our current practice and the national benchmark, highlighting a critical area for improvement in patient safety.
- Bullet point: A review of incident reports over the past six months revealed that 15% of reported adverse drug events were potentially linked to medication discrepancies at admission.
Speaker Notes: Clearly present the actual (or in this case, hypothetical) data that demonstrates the problem. Explain the metric, the baseline performance, the relevant benchmark, and the source of the data. Connect the high discrepancy rate to potential negative patient outcomes.
Slide 4: QI Proposal - Improving Medication Reconciliation Workflow
- Goal: To reduce the percentage of patients with medication discrepancies at hospital admission by 50% within the next six months, moving towards the national benchmark of < 20%.
- Target Areas of Improvement:
- Standardization of the medication reconciliation process across all admitting units.
- Enhanced communication between nurses, physicians, and pharmacists during the process.
- Improved patient and family engagement in providing accurate medication information.
- Outcome Measures:
- Primary: Percentage of patients with medication discrepancies at admission.
- Secondary: Rate of adverse drug events potentially related to medication errors, patient satisfaction with medication information received at admission.
Speaker Notes: Clearly state the overall goal of the QI initiative and the specific areas that will be targeted for improvement. Define both the primary and secondary outcome measures that will be used to track the success of the initiative.
Slide 5: QI Model and Evidence-Based Strategies
- QI Model: Plan-Do-Study-Act (PDSA) Cycle
- Briefly explain the PDSA cycle (Plan: identify the problem and develop a plan; Do: implement the plan; Study: analyze the results; Act: make adjustments based on the findings).
- Evidence-Based Strategies:
- Pharmacist Involvement: Integrate a pharmacist into the admission medication reconciliation process, particularly for high-risk patients. (Evidence: Studies show pharmacist involvement reduces medication errors.)
- Standardized Documentation Tool: Implement a standardized electronic form within the EHR to guide the medication reconciliation process and ensure completeness. (Evidence: Standardized forms improve data collection and reduce variability.)
- Patient/Family Interviewing Techniques: Train nurses and admitting staff on effective techniques for interviewing patients and families to obtain accurate medication histories. (Evidence: Active patient involvement improves medication accuracy.)
- "Teach-Back" Method: Implement the "teach-back" method to ensure patients understand their medication list before discharge. (Evidence: Improves patient adherence and reduces post-discharge errors.)
Speaker Notes: Identify the QI model that will guide the project and explain why it is appropriate. Clearly list the evidence-based strategies that will be implemented, citing (even generally) the evidence that supports their use.
Slide 6: Interprofessional Perspectives and Actions
- Nursing:
- Lead the initial medication history gathering and reconciliation upon admission.
- Utilize the standardized documentation tool.
- Employ effective patient/family interviewing techniques.
- Participate in ongoing training and feedback sessions.
- Physicians:
- Review and verify the medication list compiled by nursing and pharmacy.
- Clearly document medication orders with accurate doses, routes, and frequencies.
- Collaborate with pharmacists to resolve discrepancies.
- Pharmacy:
- Conduct independent verification of medication histories, especially for complex cases.
- Identify and resolve discrepancies in collaboration with nurses and physicians.
- Provide education to patients and families about their medications.
- Health Informatics:
- Develop and maintain the standardized electronic medication reconciliation form.
- Generate reports to track medication discrepancy rates and other relevant metrics.
- Provide data analysis support for the QI team.
Speaker Notes: Detail the specific roles and responsibilities of each key professional group in implementing the QI initiative. Emphasize how their collaborative actions will contribute to improved patient safety, cost-effectiveness (e.g., reducing ADEs and readmissions), and work-life quality (e.g., streamlined processes, reduced errors and associated stress).
Slide 7: Implementation Plan and Timeline
- Phase 1 (Month 1):
- Form a multidisciplinary QI team.
- Develop the standardized medication reconciliation documentation tool in the EHR.
- Conduct baseline data collection.
- Phase 2 (Months 2-3):
- Provide training to nurses, physicians, and pharmacists on the new process and documentation tool.
- Pilot the new process on one or two units.
- Gather initial feedback and data.
- Phase 3 (Months 4-5):
- Roll out the revised process to all admitting units.
- Continue data collection and monitoring.
- Implement "teach-back" training for relevant staff.
- Phase 4 (Month 6):
- Analyze post-implementation data.
- Share results with stakeholders.
- Identify areas for further improvement and plan for the "Act" phase of the PDSA cycle.
Speaker Notes: Outline a realistic timeline for the implementation of the QI initiative, including key activities and responsible parties for each phase.
Slide 8 (Optional): Budget and Resource Considerations
- Bullet point: Costs associated with pharmacist time for expanded involvement.
- Bullet point: Potential costs for training materials and staff time for training.
- Bullet point: In-kind support from the Health Informatics department for EHR modifications and data analysis.
- Bullet point: Potential cost savings from reduced adverse drug events and readmissions (to be tracked).
Speaker Notes: Briefly address the resources needed for the implementation of the initiative and potential cost implications.
Slide 9 (or 10): Conclusion and Next Steps
- Summary: Reiterate the importance of addressing medication discrepancies to improve patient safety and the potential benefits of the proposed QI initiative.
- Next Steps:
- Seek approval from hospital leadership to proceed with the implementation plan.
- Establish a regular meeting schedule for the QI team.
- Continuously monitor data and adapt the intervention as needed based on the PDSA cycle.
Speaker Notes: Provide a concise summary of the presentation and clearly outline the next steps required to move the proposal forward.
Remember to:
- Replace the hypothetical data and health issue with your own findings.
- Tailor the QI proposal to the specific data and context you analyze.
- Use clear and concise language in your slides.
- Utilize the speaker notes effectively to provide more detailed explanations and context for each slide.
- Ensure your proposal aligns with relevant state, national, or accreditation benchmarks.
- Critically evaluate the quality of the data you are using.
Good luck with your assessment! Let me know if you have any other questions as you work on your proposal.