Comparison Of Qi Models For Patient Care Changes

The facility my change project has potential impact upon is a teaching hospital which is known for promoting, supporting, and encouraging clinical research and implementing latest evidence-based practice. Erlanger serves as the region's only academic teaching hospital and strives to employ healthcare professionals who are knowledgeable in the latest skill, technique, and evidence based practice (EBP) (Erlanger Health System, 2017). This serves as both a strength and opportunity for the facility. A major strength for the hospital is the support that is has for research and implementation of all change processes. In 2013 the Institute for Clinical Research (EICR), was developed to solidify unity of two objectives, providing patients’ access

* Meet each and every target physician and entire office staff within the first two weeks in the field. Leave contact information. Identify decision makers within clinics.

Quality Improvement Organizations (QIOs), work in partnership with the Centers for Medicare and Medicaid Services (CMS) to advocate for safe, efficient, and quality healthcare for Americans. Working at the community level, QIOs collaborate with providers and interact with beneficiaries to improve patient outcomes. Additionally, QIOs support new models of care and promote healthcare goals endorsed by the National Quality Strategy, and CMS Quality Strategy. CMS has strategically placed QIOs in several regions nationwide, and Mississippi is served by Information and Quality Healthcare (IQH). IQH founded in 1971 as a non-profit organization has strived to improve the quality of care received in Mississippi. IQH participates in a tobacco cessation helpline, behavioral health services, and diabetes education for Medicare beneficiaries.

Other QI models that can potentially be use to implement the proposed change, include the Advancing Research and Clinical Practice Through Close Collaboration (ARCC) and the Promoting Action on Research Implementation in Health Services Framework (PARIHS). ARCC Model is most often use to assess the readiness of an organization to change, in addition to evaluating the outcome of the change (Schaffer, 2013). PARIHS framework, on the other hand, is use to evaluate the ongoing progress of change within an organization.

The training will educate and support nursing facility operators and staff regarding the requirements of participation for nursing homes as it relates to the QAPI plan, process and roles and responsibilities. The training will outline the elements and goals of our QAPI plan set forth in the facilities. The plan/program consist of weekly risk meetings, monthly COR, quarterly QAPI.

“This federally funded project was to facilitate the use of research to improve nursing practice“ (Burns & Grove, 2007, p. 11).

A quality improvement (QI) project involves data-guided activities with short timelines to improve health care delivery systems (Arndt & Netsch, 2012). The setting of QI projects take place in a single setting and are monitored in the institution where the QI project is conducted. The purpose of a QI project is to change practice outcomes and apply known solutions to a known problem in that institution (Arndt & Netsch, 2012). Data obtained from the activities is disseminated through newsletters, flyers, through staff meetings, or submitted for publication and presented in

QI involves the continuous study of practices and processes within an organization. The goal of QI is to improve an internal process in order to enhance patient care outcomes, improve quality of care, and to reduce costs (Potter & Perry, 2012, p. 61). QI projects are specific to a patient population or unit within an organization, and do not require Institutional Review Board approval (IRB). QI is not research and QI projects use existing data from within an organization. Data for QI projects is collected using rapid cycles and unlike research and EBP, QI projects take less time and are less rigorous (Shirey et al., 2011). While research uses the scientific method, QI projects use different methods such as PDSA (plan, do, study, act) or Six Sigma or Lean (Potter & Perry, 2012, pp. 61-62). QI projects are often funded by the healthcare agency conducting the project.

Quality Improvement can be defined as the combined effort of health care professionals including, doctors, nurses, healthcare managers who ensure better patients outcome such as quality care, safety, better system performance and better professional development. Healthcare system always goes through changes, whether its implementation of new systems or diagnosis of new disease. Therefore, health organizations are always in need of some improvement and advancement. In order to achieve improvement, systems have to go through a series of change; however, not all changes can be called an improvement. To ensure the improvement in these systems, some powerful strategies are planned, designed and implemented. These formal strategies analyze the systemic efforts and measure performance in order to improve the entire system and is called quality improvement or QI program.

A program evaluation offers a way to determine if adjustments are needed to improve upon the project in order for it to remain successful. Furthermore, the project evaluation team will analyze and measure each component of the outcome, input, and process in order to clarify the program’s objectives and goals. Thus creating a framework of evaluation methods and questions in addition to setting up a timeline for the evaluation activities will assist in the evaluation (CDC, 2011; HRSA, n.d.; McGonigle & Mastrian, 2015). The goal of outcome measures is to describe the overall performance of the process; therefore, outcome measurement will determine the program cost-effectiveness, attribution, and efficiency (CDC, 2012; HRSA, n.d.; McGonigle & Mastrian, 2015). There will be additional evaluation concerning the input measures, which are the resources that were put into the process. Lastly, the appraisal of process measures will provide data regarding the performance each course of action involved in the implantation of the project (HRSA, n.d.). After a thorough evaluation of the project, recommendations and the dissemination of results will be prepared and

Thank you, Amanda, for the response. The mission of my hospital is to provide the excellent patient-centered healthcare to our community (Valley Hospital Medical Center, 2016). As the evidence-based practice (EVP) movement aims at the best outcome for the patient (Hughes & United States, 2008), my hospital welcomes this movement. Our administrators and the top leaders are ready to do anything for this move. Therefore, I am confident about the stand they may take in supporting my project. Thanks for the encouraging words! Wish you all the best in your future endeavors.

Before understanding the process, it is important to know that research is a systematic approach that attempts to answer a problem through repeated testing with variables to where the same conclusion should be repeated each time an experiment occurs (Arndt & Netsch, 2012). Understanding the research process allows one to properly distinguish between research and a quality improvement (QI) project. Unlike a QI project, the lengthy timeline of research allows a research study to generate new knowledge that can be applied to a broader population, regardless of the different variables (Arndt & Netsch, 2012). If the variables, time, or protocols in a research study are compromised, the results are altered and this cannot be applied to the general population, so there will be no benefit of incorporating these findings into clinical practice, which ultimately compromises patient care. Likewise, if a QI project is mislabeled as a research study, there is a decline in patient safety because of insufficient evidence (Arndt & Netsch, 2012).

Do: We started by creating a fish bone diagram to get an understanding of the many different aspects that lead to a patient being discharged and re-admitted within 30 days. Then we deciding as a team on 2 aspects that we will focus on in implementing a small test of change.

Furthermore, during this week, I met with Linda two times, each time for two hours and discussed in more detailed the "process improvement" project that she is working on. When I began my practicum at Chicago Proton Center, one of my practicum objectives was to be able to describe the Project management and Process improvement.Thus, most of my time this week was spent learning about this project and pleased to say that I successfully achieved this goal. Subsequently, I will explain in more details what are the various parts that go into this project, the general process of how the project was initially planned, developed, and completed. While the center struggles to meet its projected patients volume, Linda's project focuses to increase patients volume by improving communication across the departments within organization, to identify the issues that other departments have that affect the overall patient flow in the Chicago Proton Center.

Health care improvement and high quality care requires more then the technical approach of tools and methods, improvements often require a change in attitude and sense of ownership for the quality of serviced provided by an organization. Many supporting factors must integrate QI into the structure and foundation of the company, these are also known as the building blocks. Improvement also implies that it will be implemented in a variety of settings, circumstances and various levels within an organization. The structure has to also define how the different parts and levels of the QI program fit together and how they will be synchronized.