Assessment 2 Quality Improvement Initiative Evaluation MSN-FP6016
Qualitative Improvement Initiative Evaluation
Quality improvement initiatives not only ameliorate patients’ experiences but also minimize adverse incidences. According to Grys (2022), these initiatives aim at improving patient outcomes, increasing patient safety and enhancing the quality of nursing care. As a result of quality improvement initiatives, medical errors are minimized and evidence-based practices are implemented to ensure that patients, their families and their caregivers receive good treatment (Mohaimenul & Yu-Chuan, 2019). For patients in hospice care, the importance of quality improvement initiatives cannot be overstated. It ensures that they receive the best end-of-life care and that the nurse takes care of the patient’s family’s emotional and psychological needs (Hermans et al., 2021).
This paper provides an evaluation of the benchmark of hospice patients who always received enough help for pain, sadness, breathing, or constipation from the hospice care team. In evaluating the effectiveness of these quality improvement initiatives, the paper seeks to evaluate whether the initiatives resulted in improved patient outcomes by identifying areas for improvement and implementing evidence-based practices, increased patient satisfaction by addressing patients’ concerns and preferences effectively and ensuring that the needed care is given in a timely and respectful manner.
Thirdly, the evaluation will consider whether the quality improvement initiative resulted in enhanced nursing practice. We will also look at the efficiency and effectiveness of hospice care and whether this improved due to the quality improvement initiative. In so doing, the paper questions whether the benchmark for quality improvement initiatives was met, whether they were effective and whether there is a need and room for improvement.
The National Healthcare Quality and Disparities Report (NHQDR) indicates that as one of the benchmarks for hospice care, hospice patients always receive enough help for pain, sadness, breathing, or constipation from the hospice care team (AHRQ, n.d). According to NHQDR, this benchmark has been successfully met (AHRQ, n.d). The implementation of this quality improvement initiative is particularly meant to ensure the utmost comfort for the patients.
Hospice patients are normally on end-of-life treatment (Mohaimenul & Yu-Chuan, 2019). Whereas the aim is not treatment or to make the patient better, there is a need to ensure that the patient is as comfortable as possible. In the hospice care system, this is done either at the patient’s home or in a home-like setting (Grys, 2022). To ensure that the patient is comfortable and, thus, all the aims of hospice care are met, services ensuring that the patient is not in pain or does not suffer unnecessary discomfort must be put in place.
Therefore, this means that pain alleviation and eradicating certain kinds of discomfort, such as constipation and breathing difficulties, should be guaranteed, fast, and efficient. This benchmark is also important to ensure that the mental well-being of the patient is taken care of. In most instances, patients choose to be given hospice care instead of continuing to receive treatment for their conditions to get better. This is a difficult decision to make both for the patient and for their family. It is, thus, common for patients in hospice care to experience sadness. Providing these patients with services aimed at uplifting their moods is thus critical for their comfort.
A comprehensive program aimed at improving the experiences of patients and caregivers in hospice care is important. While the benchmark set in this quality improvement initiative in hospice care is well-detailed, it does not address all the problems that patients in hospice care might face. Given the gravity of the situation, it is crucial, for instance, to ensure that the patient’s family members receive emotional support (Hermans et al., 2021). Instead of only offering services to alleviate the sadness of the patients themselves, it is important to extend these services to their family members as well.
Secondly, it is vital to ensure that healthcare workers and other caregivers working with the patients in hospice are given excellent working conditions. Healthcare workers and caregivers can only offer exceptional services to patients when their needs are met. For instance, there is a need to ensure that enough healthcare workers and caregivers are offered hospice care to avoid overburdening a few workers with multiple patients. This leads to a lack of personalized care as the caregivers are overworked.
For patients in hospice care to receive exceptional care, certain parameters must be met. First, pain management in hospice care must be extremely efficient. Even though patients in hospice care do not receive treatment for their conditions, it is important to ensure they are not in pain (Grys, 2022). Therefore, effective pain management is critical for improving the quality of life for patients. The core performance measurement related to pain management is the percentage of patients who report that their pain is well managed by the hospice care team.
To ensure the utmost comfort, hospice care must also focus on managing symptoms related to the patient’s disease or condition. Some of these symptoms include shortness of breath, constipation, nausea, and vomiting. The core performance measurement related to symptom management is the percentage of patients who receive timely and effective management of these symptoms.
Thirdly, hospice care should provide emotional and spiritual support to the patients and their families (Hermans et al., 2021). The decision to join hospice care is, in most instances, emotive. Therefore, adequate support for the patient’s and their family’s emotional and spiritual well-being must be provided. The core performance measurement related to emotional and spiritual support is the percentage of patients and families who receive support and assistance from the hospice care team to manage feelings of sadness, depression, anxiety, or other emotional or spiritual needs.
Fourthly, there is a need to ensure effective communication. This will promote the conveying and reception of information by the patients and their families. Information is crucial in hospice care as it enables patients and their families to make informed decisions. The core performance measurement related to communication is the percentage of patients and families who receive timely and effective communication from the hospice care team.
Fifthly, there is a need to ensure that patients are admitted to hospice care as soon as the need arises. This maximizes the benefits that they receive from hospice care. The performance measurement related to timely admissions is the percentage of patients who are admitted to hospice care within a certain time frame after a terminal diagnosis.
Based on AHRQ statistics, hospice patients who always received enough help for pain, sadness, breathing, or constipation from the hospice care team were met. However, the most successful benchmark was hospice patients whose hospice care team always treated them with dignity and respect and cared about them (AHRQ, n d).
An interprofessional team is important for the success of quality improvement initiatives. Different professionals contribute to the success of set benchmarks in various ways. Nurses and doctors are important to ensure that proper medication is administered at the correct time (Schroeder & Lorenzo, 2018). Nurses observe and record patients’ symptoms and the treatments given, including the patient’s reaction to the treatment (Schroeder & Lorenzo, 2018). Doctors can prescribe alternative medication, for instance, in cases of non-effectiveness. Hospice social workers are also integral to the achievement of this benchmark. They can provide a range of services to support patients and their families, thereby ensuring the success of benchmarks.
Social workers can conduct psychosocial assessments, coordinate care, provide counselling and psychotherapy, intervene in crises, and educate patients and their families about their treatment plans and available resources and support systems (Hermans et al., 2021). Conducting psychological assessments is integral to evaluating the success of benchmarks. This enables the identification of the psychological, social, emotional, and spiritual needs of patients and their families. This information is crucial for developing an effective and compassionate care plan.
Similarly, hospice social workers coordinate the care of patients with a team of medical and human service professionals (Hermans et al., 2021). They organize primary and secondary care providers to deliver effective medical, psychological, and social care. For spiritual patients, chaplains are important members of the hospice professional teams. They ensure, in general, that the spiritual needs of the patients and their families are met. Psychologists also form part of the interprofessional hospice care team. They play a critical role in ensuring the psychological well-being of patients and their families.
Obtaining input from various professionals involved in hospice care provides a more comprehensive understanding of whether the quality improvement initiative benchmarks are being achieved. For instance, the director of quality assurance explains that efficient procedures and processes have been put into place to ensure the safekeeping of pain medication and pain assessment. This minimizes abuse of pain medication and ensures efficient pain assessment, leading to fast administration of pain medication.
On the other hand, the Chief Finance Officer explains that human resources are often lacking, which impedes the success of quality improvement initiatives. Inadequate human resources mean that care workers are unable to give each hospice patient the individualized care that they need. According to an interview with the chief nursing, the officer elaborates on the importance of referring patients to hospice when needed. One problem faced is that patients are often referred when they are too close to their end of life and this prohibits them from enjoying the benefits offered by hospice care.
The chief nursing officer also discussed the importance of an interprofessional team in hospice care. Every professional brings unique knowledge and is trained to deal only with specific aspects of patients’ needs. Therefore, having different types of professionals means that patients receive all-inclusive care and do not have to get these services from different providers. Finally, the director of hospice services was also interviewed. He shed light on the hospice program’s overall goal, comfort care. According to the director, hospice care is meant to treat the symptoms and not the illness. A holistic approach is important in the achievement of these goals, and hence, an interprofessional team is important.
It is important to adopt the latest technologies to ensure the achievement of quality improvement initiatives. There is a need to improve the possibility of offering certain services virtually, including psychological support, virtually. This would improve the efficiency of care given. By reducing the commute time spent by hospice care professionals it would allow these professionals to take care of more patients. The achievement of quality improvement initiatives in hospice care also requires that the experiences of hospice care professionals and patient families are considered when evaluating the initiative’s success or failure.
Assessment 2 Quality Improvement Initiative Evaluation MSN-FP6016 References
Grys. C. A. (2022) Evidence-based practice, quality improvement, and research: A visual model. Nursing 52(11): 47–49. DOI: 10.1097/01.NURSE.0000889812.89287.45.
Mohaimenul. I & Yu-Chuan. L, (2019). Quality improvement in healthcare: the need for valid, reliable and efficient methods and indicators, International Journal for Quality in Health Care, Volume 31, Issue 7, 495–496, https://doi.org/10.1093/intqhc/mzz077
Taels, B., Hermans, K., Van Audenhove, C., Boesten, N., Cohen, J., & Declercq, A. (2021). How can social workers be meaningfully involved in palliative care? A scoping review on the prerequisites and how they can be realized in practice. Palliative Care and Social Practice, 15, 26323524211058895. https://doi.org/10.1177/26323524211058895
Schroeder, K., & Lorenz, K. (2018). Nursing and the Future of Palliative Care. Asia-Pacific Journal of Oncology Nursing, 5(1), 4-8. https://doi.org/10.4103/apjon.apjon_43_17
Agency for Health Care Research and Quality (AHRQ). (n.d). National Healthcare Quality and Disparities Reports (NHQDR). https://datatools.ahrq.gov/nhqdr?type=subtab&tab=nhqdrnabe&count=2
Assessment 2 Instructions: Quality Improvement Initiative Evaluation
Deliver to the interprofessional team a presentation (20 minutes; 12-15 slides) that analyzes an existing workplace quality improvement initiative related to a specific disease, condition, or public health issue of interest. The presentation’s purpose is to inform and get buy-in from the interprofessional team.
Introduction
Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—various groups talking among themselves about results and enhancements. Nurses are critical to the delivery of high-quality, efficient health care. As a result, they must develop their skills in reviewing and evaluating performance reports. They also need to be able to communicate outcome measures related to quality initiatives effectively. Patient safety and positive institutional health care outcomes mandate collaboration among nursing staff members to ensure the integration of their perspectives in all quality care initiatives.
In this assessment, you will have the opportunity to analyze a quality improvement initiative in your workplace. You will then present your analysis to a group of nurses and other health care professionals. The purpose of your presentation is to inform and enlist support for the initiative from your audience.
Preparation
Quality Initiative Selection
In this assessment you will deliver an analysis of an ongoing quality improvement initiative in your workplace. The initiative you analyze must relate to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of your analysis is to assess whether specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. Your audience consists of nurses and selected health care professionals with specializations or interest in your selected condition, disease, or issue. You hope to inform and garner support for the initiative from your audience.
Recording Your Presentation
To prepare to record a voice-over for your presentation:
Set up and test your microphone or headset using the installation instructions provided by the manufacturer. You only need to use the headset if your audio is not clear and high quality when captured by the microphone.
Practice using the equipment to ensure the audio quality is sufficient.
Consult Using Kaltura for guidance on how to record your presentation and upload it in the courseroom.
Microsoft PowerPoint also allows you to record your narration with your slides. If you choose this option, simply submit your presentation to the appropriate area of the courseroom. Your narration will be included with your slides.
Remember to practice delivering and recording your presentation multiple times to ensure effective delivery.
Note: If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact Disability Services at DisabilityServices@Capella.edu to request accommodations.
Instructions
The optional QI Initiative Evaluation Presentation Template [PPTX] is provided to help you prepare your slides. If you choose to work without the template, consider referring to Guidelines for Effective PowerPoint Presentations [PPTX].
In your presentation, you will:
Analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives.
Explain the rationale behind the QI improvement initiative. What prompted the initiative?
Detail problems that were not addressed and any issues that arose from the initiative.
Evaluate the success of a current quality improvement initiative according to recognized national benchmarks.
Analyze the benchmarks used to evaluate success. Which aspects of the initiative were most successful? What outcome measures are missing or could be added?
Incorporate one appropriate supporting visual (such as a graph or chart) that showcases the most critical aspect of this presentation.
Incorporate interprofessional perspectives related to initiative functionality and outcomes.
Integrate the perspectives of interprofessional team members involved in the initiative. Who did you talk to? What are their professions? How did their perspectives impact your analysis?
Recommend additional indicators and protocols to improve and expand outcomes of a quality initiative.
Identify specific process or protocol changes as well as technologies that would improve quality outcomes.
Ensure slides are easy to read and error free. Provide detailed speaker notes. Also ensure audio is clear, organized, and professionally presented.
Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years).
Assessment 2 Quality Improvement Initiative Evaluation MSN-FP6016 Scoring Guide
| CRITERIA | NON-PERFORMANCE | BASIC | PROFICIENT | DISTINGUISHED |
| Analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives. | Does not analyze a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives, | Minimally analyzes a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives. | Analyzes a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives. | Analyzes a current quality improvement initiative in a health care or practice setting according to strategic organizational initiatives. Supports analysis with multiple specifics, examples, and references to current, scholarly and/or authoritative sources. |
| Evaluate the success of a current quality improvement initiative according to recognized national benchmarks. | Does not evaluate the success of a current quality improvement initiative according to recognized national benchmarks. | Attempts to evaluate the success of a current quality improvement initiative according to recognized national benchmarks; however, omissions and/or errors exist. | Evaluates the success of a current quality improvement initiative according to recognized national benchmarks. | Evaluates the success of a current quality improvement initiative according to recognized national benchmarks; identifies assumptions on which the evaluation is based. |
| Incorporate interprofessional perspectives related to initiative functionality and outcomes. | Does not incorporate interprofessional perspectives related to initiative functionality and outcomes. | Incorporates interprofessional perspectives related to initiative functionality and outcomes in minimal depth and detail. | Incorporates interprofessional perspectives related to initiative functionality and outcomes. | Incorporates interprofessional perspectives related to initiative functionality and outcomes; identifies areas of uncertainty, knowledge gaps, and additional information needed to gain a more complete understanding. |
| Recommend additional indicators and protocols to improve and expand quality outcomes of a quality initiative. | Does not recommend additional indicators and protocols to improve and expand outcomes of a quality initiative. | Recommends additional indicators and protocols but does not make a case as to how recommendations could improve or expand quality outcomes. | Recommends additional indicators and protocols to improve and expand quality outcomes of a quality initiative. | Recommends additional indicators and protocols to improve and expand outcomes of a quality initiative; impartially explains recommendations’ pros and cons. |
| Slides are easy to read and error free. Detailed speaker notes are provided. Audio is clear, organized, and professionally presented. | Slides are difficult to read with multiple editing errors. No speaker notes or audio provided. | Slides are easy to read with few editing errors. Speaker notes are sufficient to support the slides. No audio provided. | Slides are easy to read and error free. Detailed speaker notes and audio are provided. | Slides are easy to read and clutter free. Slide background is “visually” pleasing with a contrasting color for the text and may utilize graphics. Detailed speaker notes are provided. Audio is clear, organized, and professionally presented. |
| Organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years). | Does not organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years). | Attempts to organize content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years); however, omissions and/or errors exist. | Organizes content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years). | Organizes content with clear purpose/goals and with relevant and evidence-based sources (published within 5 years), exhibiting nearly flawless adherence to APA. |
Assessment 2 Instructions: Quality Improvement Initiative Evaluation
- Prepare an evaluation (5-7 pages) of an existing QI initiative to determine if the initiative is effective.
Introduction
Too often, discussions about quality health care, care costs, and outcome measures take place in isolation—various groups talking among themselves about results and enhancements. Nurses are critical to the delivery of high-quality, efficient health care. As a result, they must develop their skills in reviewing and evaluating performance reports. They also need to be able to communicate outcome measures related to quality initiatives effectively. Patient safety and positive institutional health care outcomes mandate collaboration among nursing staff members to ensure the integration of their perspectives in all quality care initiatives.
Also Read: MSN-FP6016 Assessment 1 Adverse Event or Near Miss Analysis