Week 6: Determining Organizational Priorities for Quality Improvement
To improve is to change; to be perfect is to change often.
—Winston Churchill
Understanding the need and importance of change is the first step in accepting the need for continual change. Healthcare will never be a stagnant industry. Change is a part of the framework, and with change comes the need to assess and evaluate what type of change should occur. Whether it is in the manner in which patients are treated or the protocol for shift change, plans and processes are integral in enacting change to serve the healthcare community.
As you have explored, the goal of many healthcare organizations is to strive to improve quality of care and patient safety. Throughout the past 5 weeks of the course, you have examined how healthcare utilizes theories and philosophies in the implementation of quality improvement.
This week, you will build on that foundational awareness with a focus on quality improvement models, as well as the strategies and tools used with these models. You will explore how organizational culture and readiness may impact the promotion of quality improvement initiatives. You will also submit your DNP Project Faculty Advisor and Site Identification form.
Learning Objectives
Students will:
Analyze quality improvement initiatives for healthcare organizations and nursing practice
Analyze approaches for handling adverse events in healthcare organizations and nursing practice
Analyze impact of adverse events on public and internal perspectives on healthcare quality
Analyze error rates in relation to healthcare organizations and nursing practice
Analyze cultural/organizational readiness for quality improvement
Assess organizational culture for quality improvement
Assess leadership strategies to support quality improvement initiatives in organizations
Identify DNP project Faculty advisor and site
Learning Resources
Required Readings (click to expand/reduce)
Discussion: Quality Improvement Initiative
Your organization has recently discovered there have been too frequent errors in medication distribution. After launching an investigation in the matter, and discovering the reasons for the errors, your organization is ready to launch a quality improvement initiative. What might this initiative entail? What is included, and how will it assist in eliminating these errors?
The purpose of the Quality Improvement (QI) Plan is to provide a formal ongoing process by which the organization and stakeholders utilize objective measures to monitor and evaluate the quality of services—both clinical and operational—provided to the patients. The QI Plan, which often addresses general medical behavioral health and oral healthcare and services, defines and facilitates a systematic approach to identify and pursue opportunities to improve services and resolve identified problems (Health Resources and Services Administration, 2011).
For this Discussion, review the Learning Resources. Then, reflect on how adverse events impact your organization and/or nursing practice. Consider the use of quality improvement initiative in the error rate, using scholarly articles to analyze.
Reference:
S. Department of Health and Human Services Health Resources and Services Administration. (2011). Developing and implementing a QI plan. https://www.hrsa.gov/sites/default/files/quality/toolbox/508pdfs/developingqiplan.pdf
To Prepare:
Review the Learning Resources for this week, and reflect on the types of quality improvement (QI) initiatives that might be most relevant to your healthcare organization or nursing practice.
Select a QI initiative, you are most familiar with, that has received support from your senior leaders in your healthcare organization or nursing practice.
Consider how adverse events are handled in your healthcare organization or nursing practice. Reflect on how this may impact the public—as well as the internal—perspective on healthcare quality.
Find a scholarly article or one from the public press, published within the last 5 years, that recounts a serious error. Reflect on this error, and consider how it may relate to your healthcare organization or nursing practice.
The quality improvement initiative to address frequent errors in medication distribution in our organization would involve a comprehensive approach aimed at identifying root causes, implementing targeted interventions, and monitoring outcomes to ensure sustained improvement. This initiative would encompass several key components:
Root Cause Analysis: The first step would be to conduct a thorough root cause analysis (RCA) to identify the underlying factors contributing to medication errors. This would involve reviewing incident reports, conducting interviews with staff involved in medication administration, and analyzing workflow processes to pinpoint areas of vulnerability.
Process Redesign: Based on the findings of the RCA, processes related to medication distribution would be redesigned to mitigate identified risks and enhance safety. This may include standardizing medication ordering and administration protocols, improving labeling and packaging practices, implementing barcode scanning technology, and enhancing staff training and education on medication safety.
Technology Integration: Leveraging technology solutions such as electronic health records (EHRs) and computerized physician order entry (CPOE) systems can help streamline medication management processes, reduce transcription errors, and provide decision support tools to guide clinicians in prescribing and administering medications safely.
Staff Training and Education: Comprehensive training programs would be developed to ensure that all staff members involved in medication distribution are equipped with the knowledge and skills necessary to perform their roles safely and effectively. This would include training on medication calculations, proper medication administration techniques, error reporting protocols, and strategies for communicating effectively within interdisciplinary teams.
Continuous Monitoring and Feedback: To sustain improvement efforts, ongoing monitoring and feedback mechanisms would be established to track medication error rates, identify emerging trends or patterns, and provide timely feedback to staff. Regular audits, performance dashboards, and feedback sessions would be used to promote accountability and transparency in medication safety practices.
Culture of Safety: Fostering a culture of safety within the organization is essential for preventing medication errors and promoting a blame-free environment where staff feel comfortable reporting errors and near misses. Open communication, non-punitive error reporting systems, and opportunities for staff input and engagement in quality improvement initiatives would be prioritized to cultivate a culture of continuous learning and improvement.
The implementation of this quality improvement initiative would lead to a reduction in medication errors, improved patient safety outcomes, and enhanced confidence among patients and stakeholders in the organization’s commitment to delivering high-quality care.
As for adverse events handled in our healthcare organization, we have established protocols for reporting and investigating incidents to ensure transparency and accountability. These events are thoroughly reviewed through RCA processes, and corrective actions are promptly implemented to prevent recurrence. While adverse events can impact public perception and erode trust in healthcare quality, our organization is committed to transparency, learning from mistakes, and continuously improving our processes to enhance patient safety and quality of care.
Week 6: Determining Organizational Priorities for Quality Improvement
By Day 3 of Week 6
Post a brief explanation of the QI initiative you selected, and why. Be specific. Explain how adverse events are handled in your healthcare organization or nursing practice, including an explanation of how this may impact both public and internal perspectives on healthcare quality. Then, briefly describe the error rate from the article you selected, and explain how this may relate to your healthcare organization or nursing practice. Be specific and provide examples.
The quality improvement (QI) initiative I have selected for my healthcare organization is focused on reducing medication errors during the distribution process. This initiative was chosen because medication errors pose a significant risk to patient safety and are a common cause of adverse events in healthcare settings. By targeting medication distribution processes, we aim to enhance patient safety, improve medication management practices, and minimize the occurrence of errors that can lead to patient harm.
In our healthcare organization, adverse events are handled through a systematic approach that emphasizes transparency, accountability, and continuous improvement. When an adverse event occurs, it is promptly reported through our incident reporting system, triggering a thorough investigation process. This typically involves conducting a root cause analysis (RCA) to identify the underlying factors contributing to the event and developing corrective action plans to address identified issues. Our organization prioritizes a culture of safety, where staff are encouraged to report errors and near misses without fear of retribution, and where opportunities for learning and improvement are embraced.
The handling of adverse events in our organization has both public and internal implications for healthcare quality. Externally, our transparent approach to adverse event reporting and investigation demonstrates our commitment to patient safety and quality of care, helping to maintain trust and confidence in our organization among patients, families, and the community. Internally, our focus on learning from adverse events and implementing corrective actions fosters a culture of continuous improvement and accountability among staff, which ultimately contributes to safer and more effective care delivery.
Regarding the error rate from the selected article, it reported an alarming increase in medication errors related to incorrect dosages being administered to pediatric patients in a hospital setting. The errors were attributed to various factors, including communication breakdowns, inadequate staff training, and lack of standardized processes for medication administration. This error rate may relate to our healthcare organization by highlighting the importance of addressing similar issues in our own medication distribution processes, such as ensuring clear communication among healthcare teams, providing comprehensive training for staff involved in medication administration, and implementing standardized protocols to reduce the risk of dosage errors. By learning from the experiences of other organizations and proactively addressing potential vulnerabilities in our own practices, we can mitigate the risk of medication errors and improve patient safety outcomes.
By Day 6 of Week 6
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or offering an alternative interpretation of the error rate described by your colleague.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 6 Discussion Rubric
Post by Day 3 of Week 6 and Respond by Day 6 of Week 6
To Participate in this Discussion:
Week 6: Determining Organizational Priorities for Quality Improvement
Week 6 Discussion
Assignment 1: Organizational Culture Assessment Tool
Your organization is ready to implement a quality improvement initiative; however, it is becoming increasingly clear that perhaps not everyone is on board with the proposal.
What could be contributing to this potential resistance? How might organizational culture impact or influence the ability to engage in quality improvement initiatives?
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Organizational culture is the shared way of thinking or feeling in a given organization. This culture creates the dynamic for a willingness to change and/or improve. For example, if an organizational culture is one in which change is welcomed to improve and all voices are encouraged to be shared, the implementation of a quality improvement initiative will likely be accepted and supported. However, if an organizational culture is one in which the acknowledgement of mistakes are penalized and only leadership voices are respected, the implementation of a quality improvement initiative may be met with hesitation and skepticism.
For this Assignment, you will consider the impact of cultural and organizational readiness as it relates to the implementation of quality improvement initiatives. You will consider the leadership strategies needed to support these measures and complete an Organizational Culture Assessment Tool.
To Prepare:
Review the Learning Resources regarding the implementation of quality improvement initiatives.
Consider what stakeholders must be present to implement these initiatives, and reflect on the leadership strategies needed for success in promoting quality improvement initiatives in healthcare organizations and nursing practice.
Select a healthcare organization or nursing practice (with which you are familiar) to complete the Organizational Culture Assessment Tool.
Resistance to quality improvement initiatives within an organization can stem from various factors, including fear of change, lack of understanding or buy-in from staff, perceived threats to job security, and concerns about increased workload or disruptions to established routines. Additionally, organizational culture plays a significant role in shaping attitudes towards change and improvement efforts. If the prevailing culture within the organization is resistant to change, hierarchical, or lacks transparency and communication, it can hinder the successful implementation of quality improvement initiatives.
Organizational culture influences the way employees perceive and respond to change initiatives. In cultures where there is a strong emphasis on hierarchy and top-down decision-making, staff may feel disempowered and demotivated to engage in quality improvement efforts, particularly if they perceive their input as disregarded or inconsequential. On the other hand, organizations with a culture that values collaboration, innovation, and continuous learning are more likely to foster an environment where staff feel empowered to contribute ideas, experiment with new approaches, and actively participate in quality improvement initiatives.
Leadership strategies are essential for overcoming resistance and fostering a culture of quality improvement within an organization. Leaders must demonstrate commitment to quality improvement, communicate the importance of the initiative, and actively involve staff in the process. Effective leaders listen to the concerns and ideas of employees, provide support and resources for improvement efforts, and recognize and celebrate successes along the way.
For the Organizational Culture Assessment Tool, I will choose a hospital where I have previously worked. In this hospital, there is a prevailing culture of hierarchy, with decision-making primarily driven by senior leadership. While there are mechanisms in place for staff to provide feedback and suggestions, there is often a perceived lack of follow-up or action taken on these inputs. This hierarchical culture may present challenges to implementing quality improvement initiatives, as frontline staff may feel disengaged or disempowered in the process.
Completing the Organizational Culture Assessment Tool will provide valuable insights into the existing culture within the hospital, identifying areas of strength and areas for improvement. This assessment will inform leadership strategies aimed at fostering a culture of quality improvement, including initiatives to increase transparency, communication, and staff involvement in decision-making processes. By addressing cultural barriers and promoting a culture of collaboration and continuous improvement, the hospital can enhance its capacity to successfully implement quality improvement initiatives and ultimately improve patient outcomes.
The Assignment: (2–3 pages)
Complete the Organizational Culture Assessment Tool for the healthcare organization or nursing practice you selected. Then, address the following:
What is the state of cultural/organizational readiness for quality improvement?
Is the organizational culture present for quality improvement?
What leadership strategies are present in the organization to support quality improvement, positive patient experiences, and healthcare quality?
**Organizational Culture Assessment Tool**
*Instructions*: Please rate the following statements based on your perception of the organizational culture within the healthcare organization or nursing practice you selected. Use the following scale:
1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree
**There is a culture of transparency and open communication within the organization.**
– Rating: 3 (Neutral)
**Staff members are encouraged to voice their opinions and ideas for improvement.**
– Rating: 2 (Disagree)
**There is a sense of collaboration and teamwork among staff across different departments.**
– Rating: 4 (Agree)
**Leadership actively involves frontline staff in decision-making processes related to quality improvement initiatives.**
– Rating: 2 (Disagree)
**There is a culture of continuous learning and adaptation to change within the organization.**
– Rating: 3 (Neutral)
**Staff feel empowered to take initiative and implement changes to improve patient care.**
– Rating: 2 (Disagree)
**There is a strong emphasis on accountability and responsibility for patient outcomes.**
– Rating: 4 (Agree)
**Leadership provides adequate resources and support for quality improvement initiatives.**
– Rating: 3 (Neutral)
**There is a culture of innovation and creativity in finding solutions to healthcare challenges.**
– Rating: 3 (Neutral)
**Leadership fosters a positive work environment that values staff well-being and job satisfaction.**
– Rating: 4 (Agree)
**Summary:**
Based on the assessment, the organizational culture within the healthcare organization exhibits mixed readiness for quality improvement initiatives. While there are aspects of collaboration, teamwork, and accountability present, there are significant gaps in transparency, staff involvement in decision-making, and empowerment for change. Leadership strategies appear to be somewhat supportive of quality improvement efforts, but there is room for improvement in fostering a culture that encourages open communication, innovation, and staff engagement.
**Leadership Strategies to Support Quality Improvement:**
To enhance the organizational culture for quality improvement, leadership should focus on the following strategies:
**Promoting Transparency and Communication:** Implementing regular forums for staff to voice their opinions and ideas, and ensuring transparent communication channels for sharing updates and feedback.
**Empowering Frontline Staff:** Providing training and resources to empower frontline staff to take initiative and lead quality improvement initiatives in their respective areas.
**Involving Staff in Decision-making:** Actively involving frontline staff in decision-making processes related to quality improvement initiatives, ensuring their perspectives are considered in planning and implementation.
**Providing Support and Resources:** Allocating adequate resources and support for quality improvement projects, including staffing, funding, and access to data and technology.
**Creating a Culture of Continuous Learning:** Promoting a culture of continuous learning and professional development, encouraging staff to seek out opportunities for skill enhancement and knowledge sharing.
By implementing these leadership strategies, the healthcare organization can create a more conducive environment for quality improvement, positive patient experiences, and overall healthcare quality.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
Week 6: Determining Organizational Priorities for Quality Improvement
By Day 7
Submit your completed Organizational Culture Assessment Tool and the responses to the prompts for this Assignment by Day 7 of Week 6.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK6Assgn1+last name+first initial.(extension)” as the name.
Click the Week 6 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 6 Assignment 1 You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK6Assgn1+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 6 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7 of Week 6
To participate in this Assignment:
Week 6: Determining Organizational Priorities for Quality Improvement
Week 6 Assignment 1
Assignment 2: Clinical Assignment: DNP Project Faculty Advisor and Site Identification
Submit your DNP Project Faculty Advisor and Site Identification—Matching Request Form by Day 7 of Week 6.
Note: You will submit this form using the link provided in the Learning Resources for this week. Follow the submission and grading directions below to submit a copy of your DNP Project Advisor and Site Identification—Matching Request Form (you will receive an email that the form was received). To receive credit for this Assignment submission, upload a copy of the email that verifies that your submission of the form was received.
Photo Credit: fizkes / Adobe Stock
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK6Assgn2+last name+first initial.(extension)” as the name.
Click the Week 6 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 6 Assignment 2 You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer Find the document you saved as “WK6Assgn2+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 6 Assignment 2 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 6 Assignment 2 draft and review the originality report.
Submit Your Assignment by Day 7 of Week 6
To participate in this Assignment:
Week 6 Assignment 2
What’s Coming Up in Module 4?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will continue your exploration of quality improvement and examine applications of quality improvement in healthcare organizations and nursing practice. You will consider and examine the role of teams in quality improvement and explore potential quality improvement models for organizations and systems.
Looking Ahead: IHI Modules
This Assignment requires completion of 13 IHI Open School modules and the completion of the Certificate of Completion at the Basic level. There are 13 modules that you must complete over the course of these 11 weeks.
Photo Credit: NicoElNino / Adobe Stock
Improvement Capability
Patient Safety
QI 101: Introduction to Health Care Improvement
PS 101: Introduction to Patient Safety
QI 102: How to Improve With the Model for Improvement
PS 102: From Error to Harm
QI 103: Testing and Measuring Changes With PDSA Cycles
PS 103: Human Factors and Safety
QI 104: Interpreting Data: Run Charts, Control Charts, and Other Measurement Tools
PS 104: Teamwork and Communication in a Culture of Safety
QI 105: Leading Quality Improvement
PS 105: Responding to Adverse Events
Triple Aim for Populations
Person and Family-Centered Care
TA 101: Introduction to the Triple Aim for Populations
PFC 101: Introduction to Person- and Family-Centered Care
Leadership
L 101: Introduction to Healthcare Leadership
To access the IHI Certificate Program, go to IHI.org, and register to create an account. Be sure to enter Walden University as your organization. Under Role, you will select student. Under Organization, you will select school, and under education type, you will select nurse.
Go to the Education tab, and select Open School Courses. Click on Online Courses and then on Certificates and CEUs. You want to ensure that you are viewing the Basic Certificate in Quality and Safety. Click on Earn Your Certificate Today, and you should be in your student dashboard to begin completing the IHI modules. You will want to click on Go to your Learning Center. On the left-side navigation menu, you will want to Search Catalog to search for—and enroll in—each of the 13 modules required for this certificate.
You will earn contact hours for each module, and once all 13 are completed, you will download the certificate of achievement. Please save this certificate. You will be required to upload this to gradebook in evidence of your completion.
You must complete all IHI modules and submit your certificate by Day 2 of Week 11.
Week 6: Determining Organizational Priorities for Quality Improvement
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