NRS-451 Executive Summary GCU
Executive Summary Assignment: Hand Washing
Human hands touch a lot of surfaces in the course of daily life. The premise makes them perfect vehicles in transporting germs which then gets into the body. Thorough hand washing is crucial in reducing the spread of germs. At the care facility, proper hand washing protocol must be defined to significantly control the spread of infections (Pittet, Boyce, & Allegranzi, 2017). Often, hand washing using water and soap is one of the safest ways to minimize the spread of Hospital Acquired Infection (HAI) in a hospital setting. On the contrary, not all healthcare workers have the time to conduct an effective hand washing procedure. Nonetheless, patients lack adequate information on the procedures for hand washing (Butenko, Lockwood, & McArthur, 2017). Since healthcare personnel have busy schedules and patients are in need of quality care, there is a need to introduce hand washing education for sen
sitization with an aim to minimize the spread of HIA.
The Purpose of the Project
At the Brooklyn Hospital Center in Brooklyn, New York, a hand washing project that targets both the health workers and patients is to be instituted. The program comes handy after the latest concerns of improper hand washing especially for hospitalized patients in the facility. The purpose of the project is to recommend a hand washing protocol that guarantees safety to workers and patients (Haverstick et al., 2017). This will be achieved through education which will take place at the hospital boardrooms for health workers and at the outpatient units or at the bedside for patients.
The Target Nurses and Patients
The initiative targets patients and healthcare workers especially nurses. Patients are the recipients of care in a health facility. Safety in quality outcomes depends on the effectiveness of hand washing protocols in a care facility. On the other hand, the project targets the nurses at the Brooklyn Hospital Center since the professionals spend the longest time with the patients and are likely to spread infection if safe hand washing procedures are not followed. Moreover, nurses need to understand the basic techniques necessary for effective hand washing not only to provide care to patients but also to educate them on proper techniques that guarantee their safety.
Benefits of the Project
The hand washing project is important to the Brooklyn Hospital Center, nurses, and patients (Pittet, Boyce & Allegranzi, 2017). To the nurses, the project aims to inform them of the basic procedures that are essential to minimize the spread of infections to their patients. Nurses will acquire knowledge on the basic techniques to identify sources of hand contamination in the hospital and how to deter the spread of such infection. Additionally, the implementation of the project will ensure that nurses limit the spread of HAIs by 30%. To the patients, hand washing projects serve to inform them about the effective procedures to ensure hand hygiene (Butenko, Lockwood, & McArthur, 2017). The project will reduce potential exposures to contaminants and germs that might cause hospital-acquired infections. In overall, the project will ensure the quality of health outcomes since the patients will only be treated for illnesses that they had been admitted for and not newly acquired infections at the care facility. This, in turn, leads to reduced length of stay in the care facility and saves the patients additional financial expenditures. To the hospital, the project will ensure that the costs of care are reduced. In general, the reputation of the hospital will be enhanced as one of the top health centers providing quality care in New York. In a study by Haverstick et al (2017), hand hygiene compliance reduces the rates of hospital-acquired infection by 75%. This means that the implementation of the program will guarantee improved quality outcomes since compliance ensures that patients and health workers do not contract or spread infections.
Budget Justification
In order to implement hand washing project at the Brooklyn Health Center, 20 missing hand rubs will be availed. Awareness training program will be conducted to sensitize nurses on the effectiveness of hand washing. Missing sinks in the hospital wards will be installed. In total, 10 sinks will be provided to ensure patients have access to clean and safe water for hand washing. The initiative will also require the distribution of educational papers to patients and nurses. It is estimated that about 1000 handouts and brochures will be availed to ensure that participants acquire education necessary for hand washing practice (Pittet, Boyce, & Allegranzi, 2017). A handprint culture will also be procured to identify the type of germs that are predominant in the care facility. Moreover, financial resources will also be allocated for the regular monitoring of the feedback to assess the effectiveness of the project. This also involves awarding complaint nursing staff and patients to motivate other players in achieving effective hand washing technique at the facility. The overall cost of the entire projected is estimated to be $3,906 per year.
Basis of Project Evaluation
In order to assess the effectiveness of the project, monitoring and evaluation will be conducted. This will be based on the frequency of patient and nurse visits to the sink as they implement hand washing (GH, 2014). The rates of hospital-acquired infections will also be recorded during the pilot project and compared with outcomes from earlier data on the same. Patients and nurses will also be asked to demonstrate hand washing procedures monthly to ascertain that the knowledge acquired is implemented effectively. Nonetheless, the effectiveness of the program will also be evaluated based on the number of refills made to the hand rub gels used by both patients and nurses.
References
Butenko, S., Lockwood, C., & McArthur, A. (2017). Patient experiences of partnering with healthcare professionals for hand hygiene compliance: a systematic review. JBI database of systematic reviews and implementation reports, 15(6), 1645-1670.
GH, R. (2014). Comparison of disinfectant effect of Decosept and Betadine-ethanol on hand bacterial flora. Medical-Surgical Nursing Journal, 3(3), 148-142.
Haverstick, S., Goodrich, C., Freeman, R., James, S., Kullar, R., & Ahrens, M. (2017). Patients’ hand washing and reducing hospital-acquired infection. Critical care nurse, 37(3), e1-e8.
Pittet, D., Boyce, J. M., & Allegranzi, B. (Eds.). (2017). Hand hygiene: a handbook for medical professionals (Vol. 9). Hoboken, NJ: John Wiley & Sons.
The fundamental target of this proposal is to provide an answer to a contemporary medical challenge whose negative impact to the nation is huge and very costly. There is critical need of executing precautionary measures to avert the issue and inability to this, its unfavorable impacts will end up uncontrolled. The primary target population of this program is the obese that are have low socioeconomic status and prone to obesity or over weight. This program will address healthcare disproportion in the community. The individuals in the community will learn through the program the significance of healthy eating, abstaining from excessive food intake and routine physical activities and thus, this healthy way of living will help in limiting instances of lifestyle diseases such as heart disease, stroke, osteoporosis and obesity which is centered on in this program. There are different qualities that make this program worthy and essential to execute. Obese patients are consistently victimized; however, this program will help to teach the individuals in this community about how to grant help and support to the victims affected rather that despising them therefore, it will raise their self-confidence and be encouraged to accept the program and cut excessive weight.
The program has a well-organized spending plan and plans to get the required money to run it. At the point when the advantages and the expenses of the projects are evaluated, it is clear that this program is within means and worth carrying out. Additionally, there is minimization of expenses and its advantages are significant, thus, the target group can be impacted, and the goals achieved.
There are specific organized areas where the program will be held. Participating members will likewise get an opportunity to learn from healthcare providers about issues concerning health and thus, their health education will improve.
Proper measurements have been used to assess the adequacy of the program and this clarifies the program is successful in drawing attention to obesity and bringing down the instances of obesity in the population served.
In such programs, there are numerous advantages that it would yield, and they are contacting the health facility and accordingly, there is high likelihood that the facilities will support the program and its execution will be fruitful.
There are many quality improvement initiatives in healthcare. Some of the most common ones include Six Sigma, Lean, and Total Quality Management (TQM). Six Sigma is a data-driven methodology that aims to improve the quality of products and services. It uses a set of tools and techniques to measure defects and identify ways to reduce them. Lean is a process improvement approach that aims to eliminate waste and increase efficiency. It focuses on eliminating steps or activities that do not add value to a product or service. TQM is a management philosophy that promotes the pursuit of excellence in all areas of business operations. It emphasizes continuous improvement, customer satisfaction, and teamwork. The purpose of this assignment is to analyze a quality improvement initiative involving improved electronic medical record documentation, including target population, benefits, cost, and the basis upon which the quality improvement initiative will be evaluated.
Main Problem
In my healthcare settings, incomplete or illegible documentation continues to be a major problem that requires improvement. One potential solution is improved electronic medical record documentation. Incomplete physician notes are the leading cause of malpractice claims, and account for almost half of all paid malpractice claims. In my healthcare organization, incomplete or illegible documentation lead to miscommunication and errors. For example, if a doctor’s notes are incomplete or illegible, another doctor may not be able to understand them and could end up prescribing the wrong medication or performing the wrong procedure.
Solution to the Problem
Improved electronic medical record documentation is one way to help mitigate the problems caused by incomplete or illegible documentation. With accurate and complete patient information, clinicians can deliver consistent healthcare services to patients. Electronic health records (EHRs) can help improve the accuracy and completeness of patient information. EHRs can also help reduce the amount of time clinicians spend on documentation, which can free up time to provide more patient care. Improved electronic medical record documentation is a quality improvement initiative that will ensure proper and accurate information.
Purpose of the Quality Improvement Initiative
The purpose of the quality improvement initiative is to improve electronic medical record documentation by reducing the number of incomplete or illegible documentation. The goal of this initiative is to improve patient care by ensuring that all information pertinent to the patient’s care is documented in the electronic medical record (Fazio et al., 2020). Incomplete or illegible documentation can lead to errors in treatment, which can potentially have adverse impacts on patients. By improving electronic medical record documentation, we can ensure that all information pertinent to a patient’s care is available when it is needed most (Gandrup et al., 2020). This will help us provide the highest level of care possible for our patients.
Target Population or Audience
The target population for a quality improvement initiative involving improved electronic medical record documentation would be healthcare professionals who are responsible for providing patient care. This would include physicians, nurses, and other clinical staff. The goal of the initiative would be to improve the accuracy and completeness of medical records documentation (Fitzgerald et al., 2021). This would ultimately improve patient care by ensuring that all relevant information is available to healthcare professionals when making decisions about treatment plans. It would also help to ensure that patients receive appropriate care based on the most current information available.
Benefits of the Quality Improvement Initiative
The benefits of the quality improvement initiative involving improved electronic medical record documentation include: A reduction in medical errors and adverse drug events, improved patient care and safety, efficient and accurate communication between providers, time savings for clinicians, and reduced costs for healthcare providers. Improved EMR can help to ensure that all members of the healthcare team have accurate and up-to-date information about a patient’s medical history, medications, and allergies. This can help to reduce the risk of medical errors, which can potentially lead to serious injury or even death. EMR also makes it easier for healthcare professionals to track patients’ progress over time and to identify any potential problems early on. This can lead to more timely and effective treatment plans, which in turn results in improved patient care.
The Cost or Budget Justification
A recent study published in the Journal of the American Medical Association found that improved electronic medical record documentation, or “EHR use”, can result in significant cost savings for healthcare organizations. The study was conducted over a two-year period and found that EHR use led to a 11.8% reduction in hospital admissions and a 13.6% reduction in total hospital costs. The study also found that increased EHR use was associated with reductions in both length of stay and costs for patients who were admitted to the hospital.
The overall cost of this project will be $36,000,000 on the lower side and $49,500,000 on the higher side. The breakdown is as follows:
| Cost Category for EMR Improvement | Start-up Costs per bed-low ($) | Start-up Costs per bed-high ($) |
| External IT Consulting | 26,000 | 30,000 |
| Hardware | 14,000 | 25,000 |
| Clinical Software Licenses | 15,000 | 20,000 |
| External Training Services | 10,000 | 12,000 |
| Other Software Licenses | 5,000 | 7,000 |
| Internal IT Support | 2,000 | 5,000 |
| Total | 72,000 | 99,000 |
| Total Bed Capacity | 500 | |
| Grand Total | 36,000,000 | 49,500,000 |
Interprofessional Collaboration Required For the Quality Improvement Initiative
Interprofessional collaboration is key for the success of any quality improvement initiative. In order to improve electronic medical record documentation, all healthcare professionals involved in the patient’s care will work together to create and implement a plan that meets the specific needs of each individual patient (Tajirian et al., 2020). There is also the need for collaboration with external organizations and partners to ensure the implementation of all the processes required. By involving all members of the healthcare team, one can ensure that everyone has a shared understanding of the patient’s care plan and are able to properly document all interventions and treatments in the EMR (Sutton et al., 2020). This improved documentation will help to improve patient care overall and ensure that all members of the healthcare team are working towards the same goal.
The Basis for Evaluating a Quality Improvement Initiative
There are a few key factors that will be considered when evaluating the quality of an electronic medical record documentation improvement initiative. First, it will be important to look at how the new system is being used by clinicians – is it making their lives easier or more difficult? If it is making their lives more difficult, then the initiative is not likely to be successful in the long run. Second, the implementation team will look at how well the system is capturing patient data (Sutton et al., 2020) and to determine whether sufficient information in the records are available to support clinical decision-making. Other question that will be asked when evaluating the quality improvement initiative will be: Are all of the necessary fields being completed, and are they populated with accurate data? If not, then there will be problems downstream when the data is analyzed for quality improvement purposes.
Conclusion
A quality improvement initiative involving improved electronic medical record documentation can have a number of benefits, including: improved patient care, increased efficiency and accuracy in data entry, reduced administrative costs, and enhanced overall quality of care. Anytime a change is introduced to a given process, it is important to evaluate the impact of those changes. In this case, you’re talking about introducing an electronic medical record documentation system. There are a number of factors to consider when evaluating the impact of such a change.
References
Fazio, S., Doroy, A., Da Marto, N., Taylor, S., Anderson, N., Young, H. M., & Adams, J. Y. (2020). Quantifying mobility in the ICU: Comparison of electronic health record documentation and accelerometer-based sensors to clinician-annotated video. Critical care explorations, 2(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188433/
Fitzgerald, M. P., Kaufman, M. C., Massey, S. L., Fridinger, S., Prelack, M., Ellis, C., … & Hagopian, S. (2021). Assessing seizure burden in pediatric epilepsy using an electronic medical record–based tool through a common data element approach. Epilepsia, 62(7), 1617-1628. https://doi.org/10.1111/epi.16934
Gandrup, J., Li, J., Izadi, Z., Gianfrancesco, M., Ellingsen, T., Yazdany, J., & Schmajuk, G. (2020). Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study. Arthritis care & research, 72(2), 283-291. https://doi.org/10.1002/acr.23848
Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. https://www.nature.com/articles/s41746-020-0221-y
Tajirian, T., Stergiopoulos, V., Strudwick, G., Sequeira, L., Sanches, M., Kemp, J., … & Jankowicz, D. (2020). The influence of electronic health record use on physician burnout: cross-sectional survey. Journal of medical Internet research, 22(7), e19274. https://www.jmir.org/2020/7/e19274/PDF
Quality improvement initiatives allow healthcare organizations and providers to implement new programs aimed to enhancing overall care delivery and patient outcomes. The main electronic system in hospital is the electronic health records (EHRs) that function as the main database or repository for all patients’ files and information. Nurses can leverage these systems, including equipment management software to track and schedule their shifts as part of the revolutionized EHRs and other technology components (Dempsey & Assi, 2018). The purpose of this executive summary paper is to discuss the intended quality improvement idea, the benefits of the proposed idea to the organization, the selected population as well as the expected costs.
Purpose of the Quality Improvement Initiative
The quality improvement initiative is about increasing the use of electronic systems in the facility beginning with the electronic health records system and equipment management software to enhance care delivery. The quality initiative seeks to improve the implementation of these systems and offer nurses sufficient knowledge to improve their competencies and skills to attain the expected patient outcomes (Hedderson et al., 2019). The quality improvement focuses on enhancing the ability of nurses to use medical equipment software for optimal service delivery and reduce the susceptibility of patients to risks emanating from incorrect patient information and data provided by the system.
Target Audience or Population
The target population for this quality improvement initiative are mainly nurses and informatics nurses that use different electronic and technology systems to deliver patient care to diverse populations and patients in their settings. The use of electronic systems has revolutionized healthcare provision and nurses need the important competencies to improve care delivery and patient safety.
Benefits of the Quality Improvement Initiative
Quality improvement projects or initiatives in organizations focus on enhancing overall care delivery, improving patient care quality and accessibility. The proposed initiative will lead to better patient care experiences and efficiencies. Studies show that electronic health systems (EHRs) have great significant in enhancing health care services offered to patients (Dempsey & Assi, 2018). Imperatively, many healthcare organizations continue to shift their focus to using EHRs to improve care provision as the systems offer repository for patient data and files. Nurses also leverage these systems to track and schedule shifts among them in different care units. further, the medical equipment software allows physicians to monitor their patients in critical care, including the intensive care unit (ICU).
Healthcare continues to experience significant improvements in service delivery using electronic systems. These improvements include reduction of medication errors and ascertaining advanced health management. Further, these systems have improved administration efficacy and workflows as providers can deliberate the best approach to implementing new interventions based on the seamless sharing and flow of information and ideas (Mitchell & Kan, 2019). For instance, hospitals and providers use EHRs system to collect data about patients, and enables them to integrate care across different health care units or areas. Again, nurses and physicians use the medical database software to document and share patient’s information and data on various digital platforms. The implication is that this initiative will offer immense benefits to the organization.
Inter-professional Collaboration
The implementation of this project will require an inter-professional team based on collaboration to attain its set goals and objectives. Inter-professional collaboration is a core component of effective project implementation as it provides professionals and practitioners from various specialties in the organization to deliver the intended healthcare goals (Ngiam & Khor, 2019). In this case, the inter-professional collaboration would be required include having nurses, chief nurse officer, nurse leaders and nurse managers, informatics nurse and health information systems administrators or directors. The project will also entail the participation of the management through appointing a project sponsor to oversee effective implementation and continuous evaluation to ascertain that it meets its goals and objectives. The execution of this project will require the involvement of different players who shall provide expert knowledge and skills to its inception and completion.
Cost or Budget Justification
Quality improvement initiatives aim at enhancing the overall environment in an organization and assist different providers meet set goals and quality metrics. The cost of implementing this project will be significant because it will entail different components; from electronic health records (EHRs) system to other components like the software applications that will be integrated into the overall system (Ngiam & Khor, 2019). Further, the development will also entail training nurses to understand how to use the system as well as the associated software. As such, the cost justification is that despite the resources required to implement the program, it will have immense benefits for the organization and the providers (Menear et al., 2019). These include easy access to patient data as well as effective sharing. Therefore, the overall cost will vary based on the components of the integrated system that the facility will implement.
Evaluation of the Initiative
Evaluation or assessment is a core aspect of determining if a quality proposal meets the organizational goals and its purpose. The evaluation will also reveal areas that need improvement to increase effectiveness and efficacy of the initiative (Sherwood & Barnsteiner, 2021). In this case, the evaluation will be based on the outcomes emanating from improved patient care due to a reduction in number of medication errors and improved efficiency in the process and workflow. The evaluation will be conducted each month with data on the different aspects collected and analyzed to inform the kind of interventions required.
Conclusion
Electronic systems, especially EHRs, have changed the healthcare landscape and the provision of services to patients. Quality improvement initiatives focusing on electronic systems are beneficial to organizations because of the benefits associated with their implementation. This quality improvement initiative will be fundamental in lowering adverse events, enhancing patient experience, and raising the quality of care offered to patients.
References
Dempsey, C., & Assi, M. J. (2018). The impact of nurse engagement on quality, safety, and the
experience of care: what nurse leaders should know. Nursing administration quarterly, 42(3), 278-283. DOI: 10.1097/NAQ.0000000000000305.
Hedderson, M., Lee, D., Hunt, E., Lee, K., Xu, F., Mustille, A., … & Liu, V. (2019). Enhanced
recovery after surgery to change process measures and reduce opioid use after cesarean delivery: a quality improvement initiative. Obstetrics and gynecology, 134(3), 511.
DOI: 10.1097/AOG.0000000000003406.
Menear, M., Blanchette, M. A., Demers-Payette, O., & Roy, D. (2019). A framework for value-
creating learning health systems. Health research policy and systems, 17(1), 1-13. DOI:https://doi.org/10.1186/s12961-019-0477-3
Mitchell, M., & Kan, L. (2019). Digital technology and the future of health systems. Health
Systems & Reform, 5(2), 113-120. DOI: 10.1080/23288604.2019.1583040.
Ngiam, K. Y., & Khor, W. (2019). Big data and machine learning algorithms for health-care
delivery. The Lancet Oncology, 20(5), e262-e273.
https://doi.org/10.1016/S1470-2045(19)30149-4
Sherwood, G., & Barnsteiner, J. (Eds.). (2021). Quality and safety in nursing: A competency
approach to improving outcomes. John Wiley & Sons.