Description
I want research about quality according to the attachmentQuality Improvement and Patient Safety: Assignment Instructions
1) Introduction
This assignment provides the students with an opportunity to demonstrate the
interrelationship between Quality Improvement and Patient Safety and practice in nursing.
The student will undertake a cortical evaluation of an aspect of their practice from the quality
improvement and patient safety perspectives.
Thinking about quality in healthcare
You might find it helpful to think about what good quality care looks like and where your
care could be better. The Institute of Medicine in the US published a report back in 2001 that
identified six dimensions of quality care: safe, timely, effective, efficient, equitable, and
patient-centered (STEEEP).
Problem
Once you have identified the topic of your assignment, you need to decide what the scope of
your assignment will be and set your assignment aims by asking the question, “What are we
trying to accomplish?” Writing your aims statement is important as it allows you to agree on
clear, defined goals. These can help keep your work focused as you go through your
assignment and help you work out how you will make your improvement happen.
You could use the Institute of Medicine STEEEP domains to inform your aims. Another
approach to setting practical aims is to make them “SMART”:
•
Specific – what are you trying to achieve and for who?
• Measurable – by how much will things have improved? Compared to what?
• Achievable – is this aim within your power to achieve with the resources that you
have available? Sustainable assignments start small and then grow and spread.
• Relevant – what is the point of this goal? How does it improve outcomes,
processes, or structure?
• Timely – by when will you achieve it? Remember, this can be a short time.
A good aims statement might be: “To reduce the number of missed doses of medication for all
patients on six elderly care wards within our hospital by greater than 50% compared to current
practice. This will reduce medication error by ensuring patients get medications in the
prescribed doses and thus aim to improve the effectiveness of their medication”.
Measurement
Having now identified the problem and carried out relevant background research, it is
important to measure the problem. This enables you to answer the second question from the
Model for Improvement, “How will we know change is an improvement?” by allowing
comparison to what currently exists. It will also help build your case for change alongside
your background research by outlining the scale of the existing problem within your local
context.
Decide what your structure, process, or outcome measures will be. It would help to consider
these when setting your aims statement. Some examples of measures might be:
•
•
•
Evidence of local arrangements to monitor creatinine levels and urine outputs for
those at risk of acute kidney injury (structure)
The number of patients on your post-surgical ward who have their creatinine level
and urine output checked within four hours of surgery (process)
The number of patients on your post-surgical ward who develop acute kidney
injury – i.e., the incidence (outcome).
You are likely to collect more than one type of measure during your assignment, but this may
not include structure measures. Try to consider how you can capture outcomes as these
ultimately matter most to patients. However, healthcare must have reliable processes to
deliver the proper care to the right patient every time. You will also need to decide how to
express and communicate these measures most effectively, such as a whole number or
percentage change.
Do not forget that you will be collecting these measures continuously – or frequently throughout your assignment. Therefore, you may wish to start thinking about how you will
obtain continuous measurement throughout your assignment. At the very least, we would
expect data collection at baseline, during every PDSA cycle, and after your final PDSA cycle.
How does the care you provide measure up?
Alternatively, think about what works well and what frustrates you during your work. You
can then brainstorm with you whether this is related to:
•
•
•
Structures – infrastructure that impacts on quality or outcomes of care, e.g.,
staffing ratios on a labor ward
Process – an activity that occurs for patients or populations, e.g., every patient with
a stroke has a brain scan within 24 hours, or every patient with diabetes in a
population receives structured diabetes education
Outcomes – the result of healthcare, e.g., mortality from sepsis. Patient-related
outcome measures (PROMS) and patient experience are important outcomes to
consider.
Improvement models
Many different models and approaches can be used to improve quality in healthcare, such as
lean, six sigma, and PDCA model where you implement and measure change.
Conclusion
You need to pull together everything you have thought before learning, change your own
practice, and improve.
2) Format
The essay should be 2000 words long, excluding the scenario and references.
Font: Times New Roman
Font size: 12
Reference: APA Style
You are welcome to submit a first draft prior to the final submission.
Components
Problem statement
What, where, and
who—the situation
Explanation
Think about the situation in detail: What happened exactly and in what
order, where were you at the time and who else was involved? What part did
you have to play? What was the final outcome?
Now you have thought about the situation in greater detail, and probably
recognized: Human factors lead to this issue, and the type of medical error.
Problem Analysis
Why did it
happen—making
sense of the
situation
Use Nursing Role Effectiveness model to identify the possible KPIs.
Measurements
What is/are the
possible KPI’s?
Nursing Role Effectiveness model
Improvement
models
Could you have
done anything
differently—
critical review and
development of
insight
Conclusion
Referring to the continuous improvement PDCA model, write a plan for
improvement.
With the help of hindsight how would you have managed the situation
differently? Think about what factors you could have influenced: is there
anything you could have tried that may have improved the situation, or is
there anything you did that was particularly important in the situation? It is
easy to remember the things that you did not do and it is often the things that
you did well that are forgotten.
You need to pull together everything you have thought of before to learn,
change your own practice, and improve3. Do not only think about what you
would do differently in that specific situation, but think whether you have
thought of any transferable knowledge or skills you can utilize elsewhere.
What will you do
differently in the
future—how will
this change your
practice
Good Luck!
Dr. Dena Attallah
PLAN: Look at current work and design a plan for the improvement of this work. Set
objectives for this improvement.
DO: Perform the planned improvement in a controlled test set-up.
CHECK: Measure the result of the improvement and compare it with the original
situation and test it against the set objectives.
ACT: Adjust based on the results found at CHECK.
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