Effective Decision-Making Practices

The main objective of Beaumont Hospital is to provide high quality, efficient, accessible services, in a caring environment for Southeastern Michigan residents. Beaumont Hospital believes that patient safety is just as important as medical progression. Therefore, Beaumont Hospital’s risk management program consists of identifying hazard associated risks, controlling risks, and monitoring the effectiveness of procedures/practices. Risk is a part of patient care and services because everything doesn’t always go according to plan. Catastrophic patient injuries often occur because of unanticipated failures. The risk management team is responsible of effective surveillance, analysis, and prevention of events which may injure patients, lead to malpractice claims, or cause loss to the health care system. The risk management staff at Beaumont use the Failure Mode and Effects Analysis (FMEA) as a tool to anticipate what might go wrong with a process or product and how that failure effects the patient. FMEA is designed to dissect a particular process into its individual steps, isolate the potential steps that could cause the problem, assign a specific risk level to each abnormal step, analyze the risk potential for the process, and assign and action plan to correct the problem (Fibuch & Ahmed, 2014). The risk management team also evaluates and modifies potential problems. Beaumont Hospital’s risk management team helps avoid or eliminate risks by identifying an alternate

The most common adverse event that jeopardize patient safety is patient falls, or for documentation purpose, patient found on the floor. The most common preventable adverse event that jeopardize the nurse accountability is patient falls. In my four years of nursing I have had to complete one patient fall incident report, but I have assisted in the documentation of at least four, which was five to many patients fall. Morse fall scale is the fall risk assessment commonly used in the hospital setting. My plan is to shine the light on fall prevention intervention by taking the Morse fall scale 2-steps farther. What nurses may not know is, inpatient falls are the liability of the hospital and not reimbursed by Center for Medical and Medicaid Service (Given, Given & Spoelstra, 2012).

Many researchers have been focusing on safety, quality of care, to explain change in the health care organization. For example, the institute of medicine, the institute of healthcare and the Picker institute outline elements such as environment, patient centered and the needs the need health care to promote safe nursing practice across the nation to improve quality and patient satisfaction outcomes. TCAB is not a traditional quality improvement program; one primary characteristic that sets it apart is its focus on engaging frontline staff and unit managers. Ideas for transforming the way care is delivered on medical/surgical units come not from the executive suite or a quality improvement department, but from the nurses and other care team members who spend the most time with patients and their families (RWJF). The purpose of this work is to assess initiative that has been putting in place to improve TCAB because it helps improve patient and families outcome. Our goal is also to answer the questions related to the case study as specified in the book, page 239.

Patient falls are the leading patient safety event that causes injuries in health care organizations today. The National Database for Nursing Quality Indicators describes a patient fall as an “unplanned descent to the floor”. Inpatient falls account for forty percent of all hospital acquired injuries (Rheaume & Fruh, 2015, p. 318). Fall rates are higher for older adult patients, and half of all falls result in injury. Patient falls contribute to an increased length of stay and an increased cost of hospitalization. The medical costs related to patient falls is approximately $30 billion dollars per year (Centers for Disease Control and Prevention [CDC], 2016). In 2008, the Centers for Medicare and Medicaid Services (CMS) introduced pay-for-performance

In order to assure the number of patient falls are decreasing in the hospital, a fall measurement system is incorporated. Measuring falls is an important part of improving patient outcomes in the hospital (Quigley& White, 2013). Measurement of falls can provide statics, which will set standards and benchmarks within the hospital. While nurses strive to make the necessary changes in patient care to meet the set benchmarks, a constant review of outcomes will remain. This will help identify what is currently helping to reduce fall rates, and focusing on way to keep decreasing the numbers. Patient falls measurements are done electronically within the hospital. In addition, measuring outcomes electronically with other resources such as National

Some falls cannot be prevented, but there are several intrinsic and extrinsic factors can reduce the number of falls in the inpatient setting. Quigley and White (2013) discuss that the trend in patient safety and quality in health care is based on implementing similar ideas of high reliability organizations (HRO). By embedding core characteristics into the organization, leaders shape expectations for daily roles, routines, and strategies to produce direction and predictability around processes and practices (Quigley and White, 2013). The focus of a HRO is safe reliable performance through a constant awareness of the state of the system and processes affecting patient care. The goal is to identify and prevent these risks. Another

With clinical expertise, a nurse can identify gaps in care that would result in critical patient outcomes and fix the gaps in time. Nurses are accountable for speaking up for patients in situations when safety issues arise. For example, when there is a breach in sterilization and a nurse notices the breach, the nurse is accountable to bring awareness of the breach to the staff no matter who is responsible or what the nurse who notices the breaches position or seniority may be. If a medical error hurts a patient, then the involved organization and nurse is accountable and needs to take responsibility. “Providing education about participating in crucial conversations and reviewing culture principles could improve a team’s ability to speak up and be accountable” (BattiÉ, & Steelman, 2014). Being accountable and taking responsibility means informing the patient of the error and damage it caused, apologizing and providing care for the injury or illness, performing a root cause analysis of the error, and learning from the analysis by keeping the error from occurring again. A root cause analysis needs to be done after the error occurs. All staff associated in the error must participate in the analysis in order to keep speculation from happening that will cover up the facts. The goal of the analysis is not to blame an individual for the error, but rather to make changes to keep the error from happening again. Nurses are the most trusted

In addition, there is a need “to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems” (Masters, 2017, p. 238). Nurses play an active role in quality improvement by collecting and analyzing data, and participating in process improvement projects. Nurses often initiate improvement projects based on “clinical issues in daily practice” (Masters, 2017, p. 250). Action plans need to be evidence-based and in alignment with best practice. Measuring patient outcomes assures that patient safety is the top priority. As quality and safety continue to be the top priority in healthcare organizations, RNs from novice to expert, will become more familiar with every aspect of quality

Consequently, from their regular involvement in the skills training and simulation in this perinatal safety program, staff has learned the importance of teamwork and the concise communication of SBAR (situation-background-assessment- recommendation) in critical situations that can occur in the dynamic environments of any of the W&I clinical units. One CETT technique learned and practiced regularly in simulation trainings which is applied to real-time use on all W&I units is that of debriefing serious and near-serious events. Debriefs, conducted as closely as possible to the time of the critical event, have helped to identify trends over time and resulted in action items to improve processes and the delivery of safe patient care. One adverse trend identified from debriefs of neonatal code blue events in 2015 was an increase in the unforeseen number of term infants requiring resuscitations after delivery with admissions to the

Focus: Skylar will learn and make appropriate decision making approaches. Ms. Smalls (MHP), Mrs. Clark (MHS) and Skylar discuss Skylar making poor choices.

Patient falls is a huge nursing issue that requires intervention to promote patient safety at the hospital. My population is inpatient Adult, intervention is fall prevention techniques, comparison is Patient education Vs no education. Finally my outcome is outlined to promote patient’s safety and improve quality of care.

Achieving the goal of providing safer, quality, improved, proportionate, and greater cost efficiency to the entire population is the biggest challenge in the health care field today. Quality and safety are the two most formidable issues that are compromising health care outcomes to the populace today. To prevent harm to patients during their treatment, or from adverse events occurring; about 1% of all hospitalizations, delivery of the best possible result, the knowledge of quality and safety patient care should be at the forefront of the health care industry.

Generating potential solutions, evaluating the solutions, deciding, checking the decisions and communicating and implementing the decisions were the six areas covered during the quiz (cite). Decisions made at the strategic, routine, project/non-routine, or operational levels have different impacts (cite) and consequences if not managed properly. This paper will address each of the six areas evaluated, discuss the four levels that decisions are made and show my improvement plan to improve this competency.

decisions and actions that shape and guide what an organization is, what it does, and why it does

As we live our daily lives, we make decisions on literally anything we do every moment. We even make decisions in the house walking around, for example, whether to go downstairs to get a glass of water now or wait until later. Even though we make many decisions, most of the time, we do not realize it because many of the decisions made are natural things like breathing, and we do not even consider those as making decisions. However, I believe that any activities of daily living involve either conscious or unconscious decision makings, and our brains continue on going through various decision making processes. Decision making is defined as “the process of choosing the best alternative for reaching objectives” (as cited in Chelladurai, 2014, p. 158), and the decision making can be as simple as whether to get out of the bed as soon as you wake up in the morning or stay in bed a little longer, to as complicated as making executive decisions for a business organization as a chief executive officer (CEO). In order to make a decision, we go through certain steps of decision making process which can be simplified or followed through every sing step, depending on the value and the importance of the decision to be made. In this paper, steps of decision making process will be discussed.