Significate Improvement Process

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

Quality improvement data is followed in all health care setting. The use of Cerner EHRs allows data to be obtained from patient charts to analyze core measures. According to the joint commission influenza and pneumococcal vaccinations measures should be addressed in all hospital in-patients (The Joint Commission, 2015). Data can be retrieved on those patient who were diagnosed with pneumonia to determine if they received the vaccinations for pneumonia and influenza. As well as tracking the time frame between diagnosis and treatment, and additionally the patient outcome. This is captured through the documentation of the clinical staff. The information can be analyzed to determine the quality improvement changes that need to be implemented to improve patient outcomes.

Improvement plan must be in place in order to decrease the likelihood of a reoccurrence of the outcome of the Mr. B scenario. The model for Improvement gives us the foundation and the frame work for doing improvement work. It is structured around several key components. There are 3 questions that are presented on this model. First question is what is your aim? We have also ask ourselves how good we want to be and by when we will like to achieve it. Second question is how would you know a change is an improvement? Which gets to measurements, we want to look at process and outcome measures. The third question is what changes can we put in place to achieve the aim? What change we can put into place that you can tract with data and you can match back up against your aim (Lloyd, 2009).

Falls are a major cause of injury and death in the frail older population with Alzheimer’s disease. Residents in the long-term care settings experience falls for many reasons and are likely to endure injuries more than those in other settings. Preventing falls in this setting posed significant challenge, many have cognitive problems, aged related changes, chronic medical conditions, medication effects, and physical limitations requiring dedicated interdisciplinary efforts (Vance, 2011).

The modern day health care system is currently faced with a wide array of challenges, such as the aging of the population and the intensified need for medical care, the rapidly evolving technologies and the increasing costs of the medical act.

While serving as an instructor for the Husky and Buffalo Doctrine and Tactics Training (DTT), SSG Ross oversaw the training of over 15 Active Duty BEB’s and 10 Reserve Component Combat Engineer Clearance Companies, also helped redesign the training by using his combat experience to create a more realistic training environment. SSG Ross’s impact on route clearance training impacted the entire force’s ability to detect and clear explosive hazards, resulting in countless coalition and civilian lives saved.

Proper training provides any organization with the fundamental base for successful operations. The importance of training is even more crucial when teams are expected to deploy in small elements and provide commanders with operational and strategic options for the conduct of UW. The modern Jedburghs provide Joint Force Commanders with the capability to conduct the most difficult aspects of UW campaigns by understanding, influencing, and shaping the operational environment, deterring adversary forces, and when necessary, defeating threats to U.S. national security. The operational tempo that 4th BN’s face today obstructs from the operator’s ability to receive advanced unconventional warfare training, military training directly related to the

From the top to the bottom, everyone is responsible to maintain safety throughout health care organizations. This is one of the fundamental reasons for having these six goals in an attempt to improve the quality in patient care (Finkleman, 2012). We must work consistently and collaboratively adhere to these goals in order to achieve quality improvement. Also, health care professionals need to understand the rationale for applying these concepts into their scope of practice. According to our lesson this week, (Chamberlain College of Nursing, 2016) “Quality Improvement is about inspiring change.” It is never easy to implement change because you are always going to face obstacles.

Numerous appendices were created to aid in planning, training, and response to high-risk incidents. Contact lists, maps, 3D tours, equipment lists, triage and treatment guidelines, and a transport log are included in the appendices. These appendices are key to ensuring that incident/unified command have access to necessary and accurate information regarding personnel, apparatus, building layouts, and equipment in a timely

As stewards of our profession, commanders ensure that military expertise continues to develop and be passed on to aspiring professionals through operational development. It is during this developmental phase that Professional Soldiers put their knowledge and skills to the test. Operational Army units certify and recertify their Professional Soldiers through repetitive and realistic training events including the Combat Life Saver Course, platoon live fires, and exercises at the National Training Center. In the course of these challenging and realistic experiences, the Army’s operational units develop Soldiers and leaders prepared to maintain high standards, discipline, and operational readiness. Operational development and adaptability will continue to drive changes in Army doctrine, organization, leadership, and education as we enter the post-war era. Without this kind of development, the Army could not maintain a well-disciplined professional fighting force.

The successful aspect of this quality improvement plan was staff compliance to the checklist and selected EBP interventions. Collaboration with high management to improve quality and nurse performance lead to a developed system with the changing needs of performance improvement initiatives. The project keeps surgical knowledge up to date and relevant with the support from the staff and managers. The ability to provide feedback during huddle meeting intiated open communication. The quality management team reported the data that led the direction for implementing the quality checklist. Firstly, the nurse inclusion for routine surgical practice resulted in effective compliance, as every nurse was able to accomplish all the EBP standards on the surgical checklist. This enhanced a nurse buy in for efficient surgical patient care. The process worked due to agreement and helpfulness from all stakeholders. Secondly, nurses appreciated the training and additional education needed to become compliant for SSI reduction. This assisted in refreshing the knowledge of surgical information for seasoned and new nurses. Some nurses used the education session to accomplish their performance evaluation process. Thirdly, collaboration improves sharing of information between the nurses, surgeons and high management. Furthermore, increasing communication between the nurses, patients, and their family who then reported increased satisfaction with the surgical care. Lastly, the monitoring,

For this discussion board assignment I have chosen to further research the key term of continuous improvement. My main reason for wanting to do further research into this topic is out of a general curiosity and interest of mine as well as how it is relevant to my current job. Ever since learning about the Toyota Production System (TPS) and lean manufacturing a year ago while taking another class at Liberty University, I have been continuing to learn as much as I can about it. I think that lean manufacturing is so interesting and has a lot of value for manufacturing as well as many other fields and even in my daily life. Continuous improvement is a big part of lean manufacturing, so that is why I chose to write about this topic.

From the article we read about Toyota I loved the quote; “You can't solve problems unless you admit them” (Fishman, 2006). To me this is what quality improvement is all about. I would apply principles of quality improvement in my current practice a few different ways. First, I would look at the big picture. What needs to be changed? How can I take better care of my patients? After answering these questions implementing new techniques would need to occur. Lastly, I would make sure that my team and myself were all on the same page. Every team member needs to know what is going on and the objectives we are trying to meet in the long run. “At Toyota, there is a presumption of imperfection. Perfection is a fine goal, but improvement is much more realistic, much more human” (Fisher, 2006).

A primary key component of an improvement plan is the sustainability plan. This is developed to assist with obtaining goals and objectives of the organization and maintaining. It is broken into four distinct sections: Bundle of Actions, Data Analysis and Results, Communication, and Training. The sustainability plan will address the procedural Sedation procedure, documentation audit, data gathering, data analysis, result reporting, the project team, department leaders, certification renewal and department huddles and miscellaneous activities. Each of these elements within the sustainability plan, will have an assigned action, responsible person, and frequency. Following this lay-out makes it clear and in written documented form what the

In order to make improvements in one’s negotiating skills, it is necessary to determine one’s current communication skills and negotiating style. The use of tools, such as The Personal Bargaining Inventory and Communication Competence Scale questionnaires can assist one in determining these skills. Developing an improvement plan, taking into consideration the five negotiating strategies, ten best practices of negotiating skills, and current communication skills and negotiating style will provide one with a tool to assist in improving one’s negotiating skills.