NURS 8302 Assignment 1: Organizational Culture Assessment Tool ANSWER

Improvement work invariably involves work across multiple systems and disciplines within a practice.  The quality improvement (QI) team or committee (QIC) is the group of individuals within a practice charged with carrying out improvement efforts (AHRQ.gov).  The QI initiative I’ve selected focuses on the medication reconciliation.  Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking including drug names, dosage, frequency and route (IHI.org).  Indications of use should also be reviewed during the medication reconciliation.  Adverse events related to incomplete or inaccurate medication reconciliation in my facility are usually handled through having a root cause analysis with all involved.   This will allow the team to see where the error occured, how it could have been prevented  and how they can move forward to prevent it from happening again. This method deals with the problem at the source and focuses on preventing further incidents.  More than 40% of medication errors are believed to result from inadequate reconciliation in handoffs during admission, transfer and discharge of patients.  Of these errors, about 20% are believed to result in harm (Barnsteiner, 2008).   Often negative outcomes such as death from medication errors could often become headline news, causing the public to sometimes loose trust in the health care systems.

The article I chose is as follows.

A 71-year-old female accidentally received thiothixene ( Navane ), an antipsychotic, instead of her anti-hypertensive medication amlodipine ( Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms (DaSilva, 2016).  This incident is a perfect example of just how important the medication reconciliation is.   Reviewing the outside pharmacy records or simply calling this patient’s pharmacy, could have picked up on this error, before it had such serious effects on the patient.  Medication errors can across throughout all aspects of a patient’s care.  when we think of medication errors the first thing that usually come to mind is a nurse administering the wrong medication or the wrong dose.  Though this is probably the most common type of medication error, other health care professionals can make medication errors as well.

References:

Barnsteiner, JH (2008).  Patient safety and qualtiy:  an evidence-based handbook for nurses.

DaSilva, B.  Krisshnamurthy, M. (2016).  The alarming reality of medication error:  A patient case and review of Pennsylvania and national data.

www.ihi.org

Module 14. Creating Quality Improvement Teams and QI Plans | Agency for Healthcare Research and Quality (ahrq.gov)

Quality improvement is critical for a healthcare organization’s efforts to offer safe and better patient care services. Therefore, a quality improvement initiative has to be formulated and implemented. However, the success of such an implementation effort heavily depends on the organizational culture (Mannion & Davies, 2018). The implication is that there is a need to assess the organization’s culture to evaluate the readiness for quality improvement initiative implementation. The purpose of this week’s assignment is to complete the organizational culture assessment tool for a healthcare organization and explore the state of the organizational readiness for quality improvement. In addition, the write-up will explore the leadership strategies present in the organization to support quality improvement, positive patient experiences, and healthcare quality.

The State of the Organizational Readiness for Quality Improvement

As earlier highlighted, the success of implementing a quality improvement initiative heavily hinges on an organization’s culture, which affects its readiness for a quality improvement initiative implementation (Fulop & Ramsay, 2019). As such, an organizational culture assessment tool (Appendix 1) was completed by responding to sixteen questions reflecting on various aspects of the organization’s readiness for quality improvement. In general, the organization looks ready for quality improvement; this is indicated in the answers to some prompts in the assessment tools. For instance, a strongly agree response was given for the prompt, “If a process, procedure, approach is not working, we can correct it with ease.” The response indicates that the organization is always ready to change a process or a procedure in a case where it is not working. This is where the quality improvement initiative comes in, where the organization will readily accept the proposed quality improvement initiative to improve the organization.

The organizational culture is also present for quality improvement. Quality improvement initiatives require the involvement of every staff. The organization’s assessment revealed that the organization uses tools and platforms internally to help collaborate and communicate more effectively. This is an indication that the culture is present for quality improvement. Collaboration and communication between various staff members will be key for successfully implementing the quality improvement initiative (Busse et al., 2019). Therefore, the organizational culture is likely to support the prosed quality improvement initiative fully.

Leadership Strategies Present in the Organization

The organization’s assessment also revealed various leadership strategies present in the organization that can support quality improvement, positive patient experience, and healthcare quality. One of such strategies is effective communication. The leadership has established well-defined communication channels and kept the channels open. The implication is that every staff and patient can communicate to the right person what bothers them so that action can be taken as appropriate. Such effective communication will foster quality improvement and positive patient experiences (Asif et al., 2019).

Another strategy present in the organization’s leadership is the willingness to delegate duty. Duty delegation and responsibility assignment make the staff feel valued and part of the organization. This ensures that the implementation of the quality improvement initiative will be successful since everyone will be involved. The organization leadership also fully supports various organizational administrators in proposals to improve patient care services. Such support will be key in improving patient satisfaction and healthcare quality (Asif et al., 2019). When various administrators receive the full support of the top leadership, they will accomplish the patient service quality improvement initiatives improving the patient experience and healthcare quality in the process.

Conclusion

The implementation of a quality improvement initiative substantially depends on the organizational culture. Therefore, it is imperative to embark on the organizational culture assessment to ascertain the organization’s readiness for the quality improvement initiative implementation. This write-up has presented an assessment of organizational culture and a discussion of the readiness to implement the quality improvement initiative.

References

Asif, M., Jameel, A., Sahito, N., Hwang, J., Hussain, A., & Manzoor, F. (2019). Can leadership enhance patient satisfaction? Assessing the role of administrative and medical quality. International journal of environmental research and public health, 16(17), 3212. https://dx.doi.org/10.3390%2Fijerph16173212

Busse, R., Klazinga, N., Panteli, D., Quentin, W., & World Health Organization. (2019). Improving healthcare quality in Europe: characteristics, effectiveness, and implementation of different strategies. World Health Organization. Regional Office for Europe.

Fulop, N. J., & Ramsay, A. I. (2019). How organizations contribute to improving the quality of healthcare. BMJ, 365. https://doi.org/10.1136/bmj.l1773

Mannion, R., & Davies, H. (2018). Understanding organizational culture for healthcare quality improvement. Bmj, 363. https://doi.org/10.1136/bmj.k4907