NURS 8302 Assignment 1: Applying Project Management Approaches for a Quality Improvement Practice Gap ANSWER

• Briefly describe the quality improvement practice gap you identified in your nursing practice or organization. Be specific.
• Develop at least two SMART objectives you might apply in the project planning phase or execution phase to address the quality improvement practice gap you identified.
• Recommend at least two project management activities you would use for your project, addressing the quality improvement practice gap you identified. Explain your justification for why these activities would provide the best support. Be specific and provide examples.

Applying Project Management Approaches for a Quality Improvement Practice Gap

Healthcare organizations should always be committed to delivering care that meets all the outcome standards. As a result, progressive assessment of performance gaps is necessary to identify areas that need attention and quality improvement. Due to their critical role in primary care provision, nurses engage in evidence-based practice projects within their healthcare settings or other appropriate settings. Generally, these health projects follow the typical phases of project management, including initiation, planning, execution, evaluation, and controlling. Nurses also need to set SMART goals when implementing EBP projects, showing the application of project management principles in healthcare delivery. The purpose of this paper is to describe the quality improvement practice gap, SMART objectives, and project management activities relevant to the project.

Quality Improvement Practice Gap

I chose readmissions for my nursing practice quality improvement gaps. According to Hekkert et al. (2019), hospital readmissions hamper the quality of care since they are associated with unfavorable patient outcomes. Readmissions indicate that patients do not receive the deserved care and are at risk of health complications. Upadhyay et al. (2019) further mentioned that readmissions have substantial financial implications since more resources are used to address the same problem. Resources used towards readmissions can be used for quality improvement initiatives. Due to the profound implications of readmissions, process improvement and the use of data are essential. Process improvement includes interventions such as preventing hospital-acquired infections and improving handoff communication. Data-driven care includes utilizing technology to enhance accuracy and communication outcomes. Data for at-risk patients can be used to make special arrangements for their care to reduce delays.

SMART Objectives to Apply in the Project Planning Phase

1. Identifying three causes of readmissions in healthcare settings as the basis for appropriate interventions
2. To identify and apply two quality improvement interventions to reduce readmission rates

As a critical phase in project management, project planning involves laying out the project’s roadmap. In this case, the requirements of the project to facilitate easy implementation are identified. For instance, tasks and technical requirements are identified during the planning phase. Goals and deliverables are also set during the project planning phase (Moran, 2019). As a result, the two SMART objectives indicate the goals and deliverables to be achieved through the project.

Project Management Activities

Like projects in other fields, DNP projects are tiring and time-consuming. Whether using the agile approach or other methods, it is important to outline the necessary project management activities to guide decision-making and resources allocation. Tasks are also distributed according to the project’s activities (Moran, 2019). A suitable project management activity suiting my project is outlining the scope of the project. Here, the implication is that specific project goals, tasks, deliverables, costs, and deadlines should be outlined. For instance, an education program to increase healthcare providers’ knowledge of reducing readmission rates should be complete in six months. The other activity suiting my project is identifying appropriate stakeholders. Quanbeck (2019) defined stakeholders as influencers in practice change projects since the outcomes directly affect them. Appropriate stakeholders should be identified, including their roles and expectations. The two activities are critical since outlining the scope facilitates efficient resource allocation while stakeholders provide huge support. For instance, organizations’ management prepares the organization for change and provides venues for organizing meetings.

Conclusion

The project management approach can be used in addressing quality improvement practice gaps. In this case, nursing projects can apply similar project management phases and guidelines. SMART objectives ensure that the nurse looks forward to achieving specific and measurable outcomes. Ambiguity should be avoided by all means. As described above, appropriate project management activities for my project including defining the scope and identifying the stakeholders.

References

Hekkert, K., Borghans, I., Cihangir, S., Westert, G. P., & Kool, R. B. (2019). What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study. BMJ Open, 9(4), e025740. http://dx.doi.org/10.1136/bmjopen-2018-025740

Moran, K. J. (2019). Doctor of nursing practice project: A framework for success. Burlington, MA: Jones & Bartlett Learning.

Quanbeck, A. (2019). Using stakeholder values to promote implementation of an evidence-based mobile health intervention for addiction treatment in primary care settings. JMIR mHealth and uHealth, 7(6), e13301.  doi: 10.2196/13301

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. Inquiry : A Journal of Medical Care Organization, Provision and Financing, 56, 46958019860386. https://doi.org/10.1177/0046958019860386

 

Health care organizations should be continually involved in practice outcomes’ improvement. In this case, they need to make practice gaps identification a norm and respond effectively. Regardless of the situation, the approach chosen to address practice gaps affects outcomes considerably. Project management principles and activities can be integrated into practice improvement projects to guide planning, execution, and implementation. This paper describes the quality improvement practice gap, SMART objectives, and project management activities suitable for the project.

Quality Improvement Practice Gap

Medication errors are common in practice settings, and their rates depend on the experience of the workforce, the technology used, and health conditions, among other factors. The causes of medication errors in practice settings vary, with diagnosis and prescription inefficiencies and ineffective drug distribution practices among the leading causes (AMCP, 2019). Human-based issues and team inefficiencies are other major causes. Such issues include communication gaps and an uninformed patient population (Tiwary et al., 2019). Medication errors impact health outcomes adversely, necessitating up-to-date and evidence-based interventions. They are sources of new health conditions, injuries, and even death (Wondmieneh et al., 2020). Medication errors also cause patient dissatisfaction by reducing the quality of overall care.

Health care organizations can apply different strategies in medication errors control. These strategies can be the basis for using project management activities in practice improvement. Modern technology integration into health care practices is highly recommended in reducing and preventing medication errors. For instance, as Godshall and Riehl (2018) proposed, barcode scanning can prevent and mitigate drug prescription and administration problems. The other strategy is creating an informed nursing staff through nursing education. Doing so can help nurses follow institutional policies on medication transcription, such as the five rights of medication (Hanson & Haddad, 2021). Individually or jointly, these strategies can effectively address the practice gap.

SMART Goals

Medication errors cannot be effectively addressed without setting goals to guide practice improvement. Suitable goals in the planning phase or execution phase include:

1. Adopting appropriate technologies in the practice setting to prevent medication errors within six months.
2. Educating the nursing staff to equip it with knowledge on medication errors prevention and control in three months.

As required in goal setting, these goals are specific, measurable, and time-bound. They outline the measures necessary to achieve a particular outcome.

Project Management Activities to Apply in the Project

Project management is a broad topic with different phases and activities. A suitable project management activity for the project is a project strategy and business case. In project management, project strategy and the business case involve defining all the project’s requirements and proposing an appropriate methodology to achieve the desired goals (Schmidt, 2021). In medication errors’ prevention, project strategy and business case would involve identifying the technologies needed to prevent errors and proposing an approach to acquire them. For instance, the practice setting can rely on internal resources or donations. The other crucial activity is preparation. It is a critical activity before the project starts. Here, the project leader ensures that all the necessary resources are in place and timelines and roles are defined through work breakdown structure and Gantt charts, among other tools. Both activities are crucial to prevent working on a project without a definite end and specific goals.

Conclusion

Quality improvement requires high-level thinking and applying appropriate approaches. A project approach is justified when addressing quality improvement practice gaps such as medication errors. Preparation is vital before starting the project, among other activities like developing a project strategy and business case. Addressing medication errors requires a similar approach due to the complexity of the task and the need to work on specific, measurable, and time-bound goals.

 

 

References

AMCP. (2019). Medication errors. https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors

Godshall, M., & Riehl, M. (2018). Preventing medication errors in the information age. Nursing2020, 48(9), 56-58. doi: 10.1097/01.NURSE.0000544230.51598.38

Hanson, A., & Haddad, L. M. (2021). Nursing rights of medication administration. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560654/

Schmidt, T. (2021). Strategic project management made simple: Solution tools for leaders and teams. New Jersey Wiley.

Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: Examples from two case reports. Wellcome Open Research, 4. https://doi.org/10.12688/wellcomeopenres.15042.1

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(1), 1-9. https://doi.org/10.1186/s12912-020-0397-0

SMART Objectives to Address Medication Non-adherence

1. To reduce the incidence of antipsychotic medication non-adherence due to the knowledge gap among patients with schizophrenia by 50% within the next 12 months.
2. To reduce the number of relapses of schizophrenic episodes and associated hospital readmission rates by 20% within the next 12 months.

Project Management Activities Recommendations

Project management activities follow a systematic approach throughout the project process. These activities are dependent on the phases of project management which include initiation, planning, execution, monitoring and control, and analysis and reporting (McCaskell et al., 2019). Adequate communication and proactive engagement of all stakeholders are integral at every stage of project management. The two recommended project management activities to address medication non-adherence among schizophrenia patients will be as follows:

1. Establishment of the specific objectives and course of action that integrates best evidence-based practices and interventions to minimize medication non-adherence among schizophrenia patients. This will ensure a systematic project process free of confusion. Continuous evaluation of the intended outcomes should be done to enable scale-ups and improvement strategies.
2. Implementation of the quality improvement program through strategies such as adequate education of patients with schizophrenia and their caregivers about medication adherence and monitoring any changes in the incidence of drug non-adherence. Quality improvement measures through indicators such as non-adherence-associated readmissions will identify any practice gaps among schizophrenic patients and enable targeted mitigation measures.

 Conclusion

Quality improvement measures lead to transformative and innovative changes in the healthcare system. This is due to the application of evidence-based best practices and interventions to address quality gaps and complex health-related issues. This allows for performance measurement with tailored improvement interventions for identified practice gaps. Medication non-adherence due to a knowledge gap among patients with schizophrenia is an example of a preventable quality improvement practice gap. An improvement program to address this issue can be developed by formulating specific objectives and courses of action that will guide the project management process.