Improving Quality Metrics Ad Maximize Reimbursement Rates, And Increased Emphasis On The Patients Perception Of Care

The Author did use one graph to identify the most common use for the call light and another graph was used to identify the frequency of call light usage in baseline one- hour rounding and two-hour rounding. Author used t test for comparisons of patient satisfaction scores. The researcher used statistical software to identify the difference between two independent means. Two vendors at the hospital were tracking patient satisfaction score, the sample size and standard deviations. These scores used for t calculations (Meade, Bursell, Ketelsen , 2006).

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Hourly rounding, also known as “intentional” or “comfort” rounding is essentially when the nurse or tech routinely checks on a patient at scheduled times to anticipate individual needs prior to the activation of the call bell alarm (Harrington et al., 2012). In a recent study, authors imply that hourly rounding is an effective process for improving patient satisfaction and clinical outcomes (Brosey and March, 2015). I feel that the implementation of hourly rounding will improve multiple aspects of care, including patient and nurse

Healthcare is a complex industry that is consistently changing to meet the demand of improving quality patient care. As a member of the healthcare team, we are obligated to provide safe patient-centered care. However, patient care within the facility this nurse is employed is not as effective as it should be. The organization currently utilizes three different charting systems, two electronic health information systems and a paper chart. Each with its own purpose of use. To make matters worse, not all healthcare providers have access to both electronic health information system. Depending on the individuals professional role within the organization, access would be limited to one or the other. Nurses are the only one

Leader patient rounding (LPR) is an evidence-based practice that allow leaders to be actively involved in the patient care system provided within the healthcare organization, and allowing real time for leaders to resolve issues that the patient / family may deem inappropriate care. LPR is not only for the patient / family, it enables leader visibility for the staff to interact with the leader. Therefore education / learning can be provided to the staff immediately when problems are identified. During LPR visits leaders address the 3 Ps: pain, position, and potty, the patient’s comfort, assess their environment, and identify the time someone will return before leaving the room. If follow up is warranted please ensure it happens.

Patient satisfaction is an important phenomenon that affects hospital ratings and reimbursements. Hospitals across nation are seeking measures to improve patient satisfaction, decrease patient falls and call light usage. A medical surgical clinical nurse specialist (CNS) at a northeast hospital collected data on the rate of patient falls, patient satisfaction for a period of 15 months and usage of call light for 4 weeks, which showed that this is a crucial problem that the hospital is facing and there is a lot of opportunity for improvement. The CNS assembled a team to identify measures to improve the current situation and decided to replicate the study on rounding conducted by Meade and colleagues (2006).

Dr. Stephen Bekanich presented an overview of the Better Quality & Improved Patient Outcomes report (attachment III).

The broad purpose of the evaluation is to improve the effectiveness of the current hourly rounding process. By conducting an evaluation, information was gathered about potential obstacles to performing hourly rounding. Another purpose of the evaluation is to determine if patient satisfaction, the rate of falls, and call bell usage were impacted by the purposeful hourly rounding initiative. The evaluation may suggest a revision to the current hourly rounding tool that is being utilized on the medical unit.

Conducted a randomized controlled study to answer the question “which format on rounds is preferred by residents and parents beside rounds and conference room rounds? Patients who planned to have two consecutive mornings in the pediatric intensive care unit (PICU) were randomized on day one into either conference room rounds (CCR)or bedside round (BSR). On day two, rounds were conducted on either format. Parents clearly preferred bedside rounds so they could be included in the discussion (81% wished all rounds were at the bedside), and residents were satisfied with either site, with comfort is asking questions slightly higher in the conference room setting. (84% vs

Although it is a systematic review, some of the research utilized were qualitative studies. The studies reviewed were a quasi-experimental study, a randomized descriptive study, a qualitative descriptive study, and a literature review. All were described in detail as a basis for the study performed in the article. The other studies used for research purposes in this study included one randomized controlled trial (RCT), one quasi-experimental study, one qualitative study, and three literature reviews. If all the studies used for research in the article were RCT’s or “a combination of RCT’s and quasi-experimental or quasi-experimental only” (jhnebp) this research would have garnered a ranking of level I or level II. The inclusion of even one qualitative study dropped the ranking to level

Quality measures are strategies that gauge, evaluate or compute health care processes, results, discernments, patient insight, and administrative structure. In addition, quality measures are frameworks that are connected with the capacity to deliver first-class health care and/or that are able to identify with one or more quality objectives for medicinal services. These objectives include: compelling, protected, effective, quiet focused, impartial, and opportune consideration. Quality measures can be used to measure quality improvement, public reporting, and pay-for-reporting programs specific for health care providers (CMS.gov, 2016). There are an assortment of quality measures in which health care organizations can use to determine the status of the care they are delivering. Many are appropriate, but few are chosen for this research paper. Among them are: National Health Care Surveys, Hospital IQR Programs, Scorecards, and Political, Power, and Perception/Data for Decision-making tools.

Health care systems are reporting and monitoring quality of care indicator data with increasing regularity.

The rating system for level of evidence would be level 3. This type of study examines evidence from well-designed controlled studies with results supporting a specific intervention and or treatment (Henson, 2011).

By focusing on overall patient care and satisfaction many areas patients are surveyed on can be improved. Once a performance standard is selected staff must develop a plan for improvement. The first step would be to research as many sources as possible to find the best evidence based practices that would work for the specific facility. This can be divided into two the two categories of direct nursing care and indirect nursing care. Direct nursing care would include implementing hourly rounding, adequate nursing staff and SBAR communication. Indirect nursing care includes availability of technology such as wireless communication, real time locating, wireless monitoring, and electronic medical records. The second step would contain education of the staff on what is to be implemented and why. The why is important for nurses to overcome any barriers that might be encountered. While nursing practice has grown based on evidence Vanhook (2009) explains the greatest barriers to evidence based practice, such as difficulty interpreting findings, limited time, and misunderstanding of research itself, and how to overcome these barriers. With phase one and two completed facilities can move forward with implementation and evaluation.

-Examine at least three (3) examples of quality initiatives that could increase patient satisfaction and potentially reduce healthcare cost. Support your response with examples of the successful application your chosen quality initiatives.