NURS-FPX6218 Outcome Measures Issues and Opportunities Questions
Assessment 3 Instructions: Outcome Measures, Issues, and Opportunities
Top of Form
Bottom of Form
PRINT
Draft a 6-page report on outcome measures, issues, and opportunities for the executive leadership team or applicable stakeholder group.
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
As a nurse leader, you may be called upon to submit a detailed report to your executive leadership team and key stakeholders that describes a quality or safety problem and its effects on outcomes, fully supported by relevant and credible data.
This assessment provides an opportunity to draft such a report in which you can call attention to quality and safety issues and opportunities, effectively support your position, and lay out a plan for change.
This assessment is based on the executive summary you prepared in the previous assessment.
Preparation
Your executive summary captured the attention and interest of the executive leadership team, who have asked you to provide them with a detailed report addressing outcome measures and performance issues or opportunities, including a strategy for ensuring that all aspects of patient care are measured.
Note: Remember that you can submit all or a portion of your draft report to Smarthinking for feedback before you submit the final version for this assessment. However, be mindful of the turnaround time of 24–48 hours for receiving feedback, if you plan on using this free service.
As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
How might you engage stakeholders to help develop, implement, and sustain a vision to actually change and improve patient outcomes?
What arguments might be most effective in obtaining agreement and support?
What recommendations would you make to implement a proposed plan for change?
The following resources are required to complete the assessment.
APA Style Paper Template [DOCX]. Use this template for your report.
Requirements
Note: The requirements outlined below correspond to the grading criteria in the Outcome Measures, Issues, and Opportunities Scoring Guide. Be sure that your written analysis addresses each point, at a minimum. You may also want to read the Outcome Measures, Issues, and Opportunities Scoring Guide and Guiding Questions: Outcome Measures, Issues, and Opportunities [DOCX] to better understand how each criterion will be assessed.
Drafting the Report
Analyze organizational functions, processes, and behaviors in high-performing health care organizations or practice settings.
Determine how organizational functions, processes, and behaviors affect outcome measures associated with the systemic problem identified in your gap analysis.
Identify the quality and safety outcomes and associated measures relevant to the performance gap you intend to close. Create a spreadsheet showing the outcome measures.
Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.
Outline a strategy, using a selected change model, for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff.
Writing and Supporting Evidence
Write coherently and with purpose, for a specific audience, using correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
Additional Requirements
Format your document using APA style.
Use the APA paper template linked above. Be sure to include:
A title page and reference page. An abstract is not required.
A running head on all pages.
Appropriate section headings.
Properly-formatted citations and references.
Your report should be 6 pages in length, not including the title page and reference page.
Add your Quality and Safety Outcomes spreadsheet to your report as an addendum.
Portfolio Prompt: You may choose to save your report to your ePortfolio.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Analyze quality and safety outcomes from an administrative and systems perspective.
Identify typical quality and safety outcomes and their associated measures.
Competency 3: Determine how specific organizational functions, policies, processes, procedures, norms, and behaviors can be used to build reliability and high-performing organizations.
Analyze organizational functions, processes, and behaviors in high-performing organizations.
Determine how organizational functions, processes, and behaviors support and affect outcome measures for an organization.
Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.
Competency 4: Synthesize the various aspects of the nurse leader’s role in developing, promoting, and sustaining a culture of quality and safety.
Outline a strategy for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write coherently and with purpose, for a specific audience, using correct grammar and mechanics.
Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
Resources: Outcome Measured and Process Improvement
PRINT
The following resources provide context and background information that will help you with this assessment.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice.Journal of Professional Nursing, 33(1), 51-55. doi:http://dx.doi.org/10.1016/j.profnurs.2016.05.009
In this article, the authors discuss how one group developed and then tested relevant quality measures.
Ismail, A., Ansell, G., & Barnard, H. (2020). Fitting in, standing out, and doing both: Supporting the development of a scholarly voice.Journal of Management Education, 44(4), 474-489. doi:https://doi-org.library.capella.edu/10.1177/1052562920903419
Tsironis, L. K., & Psychogios, A. G. (2016). Road towards Lean Six Sigma in service industry: A multi-factor integrated framework.Business Process Management Journal, 22(4), 812-834. doi:http://dx.doi.org.library.capella.edu/10.1108/BPMJ-08-2015-0118
In this article, the authors present a framework that describes the behaviors and beliefs of high-performing organizations.
NewsCAP: Joint Commission revises National Patient Safety Goal for suicide prevention.(2019, March). American Journal of Nursing, 119(3), 13.doi:10.1097/01.NAJ.0000554020.75227.67
National Database of Nursing Quality Indicators (NDNQI). (n.d.). JCAHO core measures.http://nursingandndnqi.weebly.com/index.html
Explore this resource and examine the indicators related to the effects of nursing on safety, quality, and outcomes.
Vila Health: Quality and Safety Gap Analysis.
The following interactive exercise suggests an approach to drafting a detailed report for executive leaders addressing outcome measures and performance issues or opportunities, which may help you with the assessment.
Resources: Change Theory
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1), 32-37.
This article may help you in outlining a strategy for change.
Resources: Risk Management
Risk Management and Patient Safety Drag and Drop.
In this interactive exercise, you will examine the fundamental differences between risk management and patient safety.
Executive Summary
Patient falls during hospitalization in the clinical setting are the most serious adverse safety incidents in the United States. The rate of falls that result in moderate to severe injuries inpatient population at Washington Hospital is high to the point that it is impacting its financial performance and reputation as a Magnet Status facility. While the organization has implemented several fall prevention measures to mitigate the effect of this problem on its systems and procedures for care, these measures have yielded minimal results. Also, the strategic importance of addressing the problem informed the conduct of the quality and safety gap analysis that identified the multiple factors that made the problem pervasive and difficult to address. Similarly, the root cause analysis contributed to the solutions that were integrated into the organization’s strategic plan to improve the quality and safety of patient care in the respective units where falls rate are highest. Therefore, this executive summary describes the outcomes of the patient falls prevention initiative, their strategic value, the influence of quality and safety culture, and the role of the leadership team during implementation and efforts to sustain these outcomes.
Key Quality and Safety Outcomes
The systemic problem that informed the implementation of the quality improvement initiative is the high falls rate at the post-operative care and telemetry units. According to the report from the patient safety group of this hospital, the falls rate is 10.5 and the rate of severe injuries that result from them is 50%. In this regard, the resolution of the systemic problem is critical to the continuous delivery of acute and surgical care at Washington Hospital because it would reduce the burden of healthcare cost on patients and increase their utilization of the facility in the future due to their high satisfaction rates. Also, the reduction of the patient falls rate is needed by the hospital to avoid the extended hospital stay that is estimated at 12 days and 61% increase in the cost of normal care (Gu, Balcaen, Ni, Ampe, & Goffin, 2016). As a result of the negative consequences of patient falls at this healthcare facility, the quality, and safety improvement initiatives that were implemented by the patient safety group resulted in reduced cost of care for patients and the organization, reduced cases of medical malpractice fines and litigations, and increased financial performance due to higher bed utilization rates.
Strategic Values of Outcomes
The practice changes that were introduced as part of the quality improvement program at Washington Hospital generated outcomes that are aligned with the organization’s strategic value. As a healthcare facility that is committed to maintaining its Magnet Status as the leading accident and trauma care in the region, the reduction of the falls rate is vital for achieving this goal and preventing the negative consequences of low patient satisfaction and higher cost of care. Also, the reduction in the rate of falls among hospitalized patients in the post-operative and telemetry units would eliminate the extended hospital stay and its contribution to higher workloads on the clinical staff. The evidence that increased nurse workload results in several adverse and near-miss events and their associated legal, financial, and reputational implications from the study by LeLaurin and Shorr (2019) provide the additional rationale of the strategic values of the outcomes that would be generated from the implementation of this quality improvement initiative. Similarly, the outcomes of this program would strengthen the hospital’s capacity to allocate financial, human, and material resources to other initiatives that contribute to its strategic corporate goals. Therefore, the reduction of patient falls rate at the respective units of this hospital are critical to the attainment and sustenance of the strategic initiatives of this healthcare organization.
Relationship between Patient Falls Rate and Quality Outcomes
Patient falls rate is a quality and safety indicator of nursing care and one that reflects the type of work culture and environment that exists in a healthcare organization. At Washington Hospital, the care approach is the consistent use of the evidence-based practice to deliver care to patients across the lifespan. One of the critical quality and safety outcomes that are directly linked to patient falls at this facility is the length of stay of hospitalized patients. In this regard, the right of the length of stay for the care and management of the non-hospital acquired conditions of patients is representative of the quality of the care. However, the injuries that result from preventable falls at the facility increase the length of stay for patients and represent non-attainment of quality and safety goals. Similarly, the hospital’s total non-reimbursable cost of care per hospitalized patient is another quality outcome that is linked to patient falls during hospitalization. According to Fehlberg et al. (2017), the Center for Medicaid and Medicare Services (CMS) non-reimbursement of inpatient falls provides the indicator that the hospital can use to measure the effectiveness of falls prevention initiatives. As a result, the relationship between patient falls and quality outcomes are very strong and provide assessment tools for hospitals to achieve their strategic patient safety goals or outcomes.
Strategic Initiatives and Quality and Safety Culture
The framework that was used to develop and implement the strategic initiatives are appropriate for using its outcomes to promote Washington Hospital’s quality and safety culture. First, the practice changes were based on the evidence-based Tailoring Interventions for Patient Safety (TIPS) for patient fall prevention toolkit. Second, the strategic initiatives include staff education and training on the multidisciplinary protocols that are effective for fall prevention in critical and surgical care hospitals. In this regard, the training focused on equipping the participants with the skills and competencies to avoid the cause of patient falls and monitoring adherence to protocols by their colleagues. As Turner et al. (2022) stated, this approach for implementing the practice changes at the hospital is effective for fostering safety and quality culture after the implementation of improvement initiatives in the units. For example, the practice changes illustrated how the nurses can fulfill their patient care duties without experiencing burnouts and the result of failure on their job satisfaction levels. Therefore, the use of the evidence-based falls prevention protocols and training of staff on them are evidence of how this
Leadership Team and Implementation and Sustenance of Changes
Finally, the support of the leadership team at Washington Hospital is critical to the successful implementation of the practice changes in the quality improvement initiatives. In this regard, the leadership team is required to provide the resources for procuring and installing the notification systems in the high-risk patients’ rooms and wards to help the nurses implement the right protocols to prevent falls. Also, the support of the leadership is needed for the approval of the policy changes on fall prevention that covers incident reporting and handling to encourage feedback from frontline care workers and supervisors. According to Titler et al. (2016), these measures are essential for entrenching the new safety culture in the organization and illustrating the importance of the practice changes to all employees. Similarly, leadership support results in the perception that quality and safety are the shared responsibility of all stakeholders and not restricted to only the care teams in the respective units. Additionally, leadership support for the recommendations of the patient safety group after the project’s implementation is vital for sustaining the positive impacts of the practice changes. Therefore, the leadership team at Washington Hospital would play a major role in resource provision, policy introduction, and implementation of recommended improvement initiatives to achieve the expected outcomes from the strategic initiative and sustain them for the organization.
References
Fehlberg, E. A., Lucero, R. J., Weaver, M. T., McDaniel, A. M., Chandler, A. M., Richey, P. A., Mion, L. C., & Shorr, R. I. (2017). Impact of the CMS No-Pay Policy on Hospital-Acquired Fall Prevention Related Practice Patterns. Innovation in aging, 1(3), igx036. https://doi.org/10.1093/geroni/igx036
Gu, Y. Y., Balcaen, K., Ni, Y., Ampe, J., & Goffin, J. (2016). Review on prevention of falls in hospital settings. Chinese nursing research, 3(1), 7-10. https://doi.org/10.1016/j.cnre.2015.11.002
LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283. doi: 10.1016/j.cger.2019.01.007
Titler, M. G., Conlon, P., Reynolds, M. A., Ripley, R., Tsodikov, A., Wilson, D. S., & Montie, M. (2016). The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre–post implementation study in the US. Applied nursing research, 31, 52-59. DOI: 10.1016/j.apnr.2015.12.004
Turner, K., Staggs, V. S., Potter, C., Cramer, E., Shorr, R. I., & Mion, L. C. (2022). Fall Prevention Practices and Implementation Strategies: Examining Consistency Across Hospital Units. Journal of patient safety, 18(1), e236–e242. https://doi.org/10.1097/PTS.0000000000000758
**Guiding Questions: Outcome Measures, Issues, and Opportunities**
**Introduction:**
**Executive Summary Impact:**
– How has the executive summary influenced the request for a detailed report?
– What specific aspects of the summary prompted the need for further analysis?
**Preparation:**
**Engaging Stakeholders:**
– How might stakeholders be involved in developing, implementing, and sustaining a vision for change?
– What strategies could be employed to garner stakeholder support and agreement?
**Effective Arguments:**
– What arguments are likely to be most compelling in obtaining agreement and support?
– How can these arguments be tailored to address the concerns of different stakeholders?
**Recommendations for Implementation:**
– What actionable recommendations would facilitate the implementation of the proposed plan for change?
**Drafting the Report:**
**Analysis of Organizational Functions:**
– What functions, processes, and behaviors characterize high-performing health care organizations?
– How do these organizational aspects impact outcome measures?
**Quality and Safety Outcomes:**
– What specific quality and safety outcomes are relevant to the identified performance gap?
– How do these outcomes align with the organization’s goals and objectives?
**Performance Issues and Opportunities:**
– What performance issues or opportunities are associated with organizational functions, processes, and behaviors?
– How do these issues or opportunities impact quality and safety outcomes?
**Strategy for Measurement and Knowledge Sharing:**
– What change model will be used to guide the strategy for ensuring all aspects of patient care are measured?
– How will knowledge be effectively shared with staff to facilitate improvement initiatives?
**Writing and Supporting Evidence:**
**Coherent Writing for Specific Audience:**
– How effectively does the report communicate its message to the intended audience?
– Is the writing clear, purposeful, and grammatically correct?
**Integration of Relevant Evidence:**
– Are assertions supported by relevant and credible sources of evidence?
– Have citations and references been formatted correctly according to APA style?
**Additional Requirements:**
**Document Formatting:**
– Does the report adhere to APA style guidelines, including appropriate formatting of headings, citations, and references?
– Are the title page, running head, and reference page included as required?
**Length and Content:**
– Does the report meet the specified length requirement of 6 pages, excluding the title page and reference page?
– Is the content comprehensive, addressing all aspects of outcome measures, issues, and opportunities?
**Overall Reflection:**
**Reflection on Preparedness:**
– How well does the completed report reflect your understanding and analysis of outcome measures, issues, and opportunities?
– What areas of improvement or further exploration have you identified through this process?
The post NURS-FPX6218 Outcome Measures Issues and Opportunities Questions appeared first on Destiny Papers.
