Quality Improvement, Patient Safety, And Cost Containment

Policy analysis is an assessment of specific healthcare policy to determine its effectiveness in improving patient care outcomes. As an organization continues to grow in complexity; health status indicators provided gauges for process to be assessed and evaluated for restructuring. This provides new opportunities for evaluating policies, guidelines and procedures that enhances patient care to benefit all stakeholders. Transformational leaders are healthcare professionals whose knowledge and experience are required when policies analysis is needed that may require examination, designing, implementation, and evaluation for a practice change. In healthcare systems globally, transformational leaders are task with

Patient Safety and Quality Improvement Act (PSQIA) was signed into law on July 29, 2005, published on November 21, 2008 and became effective on January 19, 2009 (U.S. Department of Health & Human Services, n.d). PSQIA catalyzes sharing of healthcare data, information and patient safety practices between health care organizations by creating Patient Safety Organizations (PSO). Providers can report or share information related to patient safety events with PSO without the fears of liability, because “ PSQIA provides federal privilege and confidentiality protections for patient safety information, called patient safety work product” (USDHMS, n.d ). This means protected information cannot be introduced in any federal, state, local, or tribal civil,

In the United States alone there are 98,000 deaths per year caused by low quality health care (Ignatavicius & Workman, 2013, pg. 2). This statistic is disturbing because the errors that resulted in death were errors that were preventable. The intent of this chapter is to bring awareness to health care providers that are able to make a change in the quality of health care. In current practice patients are subjected to medication errors, preventable hospitalizations, premature death, and poor care provided due to racial, ethical, or low-income factors.

Complexity science is the study of complex adaptive systems (CASs) and the relationships that occur within them. CASs are a function of what has previously occurred, what is currently occurring, and are open to energy and information from the environment all around them (Chaffee & McNeill, 2007). The boundaries that define theses systems are fuzzy; each individual is their own CAS that is influenced by a multitude of other CASs, all of which may belong to increasingly larger CASs. The health care system is a CAS in and of itself that is made of a multitude of smaller CASs – hospitals, floors, units, and individuals. There are a many characteristics that help to make up and define what a CAS is. Understanding these

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

The main objective of healthcare professionals is to provide the best quality of patient care and the highest level of patient safety. To achieve that objective, there are many organizations that help improve the quality of care. One of the best examples is the Joint Commission. Unfortunately, the healthcare system is not free from total risks. In healthcare activities, there are possible errors, mistakes, near miss and adverse events. All of those negative events are preventable. But, it is clear that errors caused in healthcare result in thousands of deaths in the United States.

Quality improvement is defined by Kelly (2012) as “a systematic process of organization wide participation and partnership in planning and implementing continuous improvement methods to understand, meet, or exceed customer needs and expectations and improve patient outcomes” (p.477). The women’ unit can receive thirty patients from age eighteen to late adulthood. The unit is a receiving facility for everyone Baker acted in the state of Florida. Like any other organization, change is always happening in the women’s unit. One of the areas that need improvement on the unit is a reduction in the number of seclusion and restraint that we do every month. Patients that are violent and present a danger to either

The National Patient Safety Goals were created in response to the IOM article, To Err is Human: Building Safer Health Systems. These goals were written to address patient safety and are tailored depending on the health care setting to which they are written for. They address system wide solutions rather than focusing on whom or how the error was made. Medical errors have been noted as being the 8th leading cause of death in the U.S. with the most frequent of these errors being medication related (Johnson, K., Bryant, C., Jenkins, M., Hiteshew, C., & Sobol, K. 2010). Therefore a great focus on these goals is needed across the health care continuum. The goals are updated and amended on a regular basis using evidence-based research, in response to areas with high errors in patient safety.

My experience in both my previous career in nursing and human resources has dealt with approaches in quality improvement in patient safety and different metrics in the turning up organizational behavior as well as up swinging the operations of the organizations respectively. We live in a rapidly changing world, and healthcare industry is not exempted from it. Because I will be playing an indispensable role in the future, I am very interested on the concept of quality improvement and what not and identify possible future challenges and draw lessons from healthcare organizations that has spearhead innovative changes to providing healthcare by pursuing the triple dimensions of the improvement of healthcare in general that is Improving the patient experience of care (including quality and satisfaction); Enriching the health of populations; and Reducing the per capita cost of health care.

This paper will discuss the National Patient Safety Goal NPSG 0.7.06.01 entitled “ Use proven guidelines to prevent infection of the urinary tract that are caused by catheter” (The Joint Commission, 2015). It will identify reasons why this National Patient Safety Goal was chosen as well as the type of organizations that utilize urinary catheters. It will look into the cost of implementing an educational process compared with the hospital cost of Catheter-Associated Urinary Infections (CAUTI). The Advanced Practice Nurse (APN) will demonstrate a method on how to gather data, design educational tool, implement standard practice and create a committee by collaborating with other health care disciplines. The effectiveness of the educational process will be evaluated through data collection and analysis. Finally, future health care delivery implications will be explored.

This paper, will discuss the National Patient Safety Goal NPSG 0.7.06.01 entitled “ Use proven guidelines to prevent infection of the urinary tract that are caused by catheter” (The Joint Commission, 2015). It will identify reasons why this National Patient Safety Goal was chosen as well as the type of organizations that utilize urinary catheters. It will look into financial implications of implementing educational process versus the hospital cost of Catheter-Associated Urinary Infections (CAUTI). The Advanced Practice Nurse (APN) will demonstrate method on how to gather data, design educational tool, implement standard practice and create a committee by collaborating with other health care discipline. Effectiveness of the educational process will be evaluated through data collection. Finally, future health care delivery implications will be explored.

Quality improvement in health care has been and will continue to be a beneficial process in helping with many problems faced in healthcare. According to U.S Department of Health and Human Services (2011) “quality improvement consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups” (p.1). These systematic and continuous actions have indeed led to many health care improvements throughout the years including reductions in infection rates, medication errors, and health care costs. One major current concern in the health care field is the presence of catheter associated bloodstream infections (CABSI’s). Provonost, Marsteller, and Goeschel (2011)

Delivering excellent care for health maintenance and acute illness, which meets quality, safety and patient experience standards, while reducing costs is the focus of health care organizations across the country (Kara, Johnson, Nicley, & Niemeier, 2015; IHI, 2016). Healthcare organizations are under deep scrutiny by public and government sectors to meet the IHI Triple Aim to improve patient experience, improve the health of populations and reduce cost of health care (IHI, 2016). However, these sectors use different measures to evaluate the effectiveness of healthcare organizations. Carolinas Healthcare System, which consists of over 900 care locations, including thirty-three hospitals within North and South Carolina, works to meet the Triple Aim and be viewed by the public and governmental sectors as a healthy organization. The question is how does one measure the health of an organization? Is Carolinas Healthcare System an example of a healthy organization, one that integrates leadership principles and concepts, utilizing fiscal responsibility within the organization’s climate, culture and behaviors? Or, is Carolinas Healthcare System an organization without a mission, vision, goals or strategic plan, on the brink of failure and without public and governmental approval?

Health leaders can use different strategies to create a culture for change in the health organization. A health transformation leader would have to be able to create trust, admiration, loyalty, and respect from their followers through the leader’s actions, behaviors exhibited and persona exemplified. Once a culture of change is learned and the pattern is exhibited it is shared by the members about what is right and what is good. Health leaders should be able to develop a predetermined organizational culture

Fixing problems that face health care in many health facilities demand a system wide set of solutions. The systems used in these facilities must be assessed and redesigned to identify factors that will aid in the achievement of the set goals. The enormous task of achieving the goals should be undertaken collaboratively by all the key stakeholders, who include, health care professionals, planners and policy makers, administrators, payers, and patients and their families. These partnerships must begin with a common understanding of the problems together with a shared commitment to cooperate and work together to eliminate the problems. With this knowledge, therefore, an action plan for redesigning the health care system can be developed and later implemented. For a successful health care service to be realized, there are various factors which should be employed and which are not found in the traditional business setting. These include unique economic processes, proper regulatory requirements and the perfect quality indicators. This creates a need for every leader within the healthcare industry to create or develop unique skill sets that will harmonize both organizational leadership and the inter-professional team development. It is, therefore, important to understand the comprehensive approach to the management of patient care and also how the concepts of team development and organizational leadership support healthcare leaders in creation of a patient-centric