NURS 8302 Discussion: Quality Improvement Models SOLUTION

NURS 8302 Discussion: Quality Improvement Models SOLUTION

NURS 8302 Discussion: Quality Improvement Models

By Day 3 of Week 8

Post a brief explanation of the quality improvement model you selected, including a description of the components that make up this model. Be specific. Then, explain how this quality improvement model might be implemented in you healthcare organization or nursing practice in response to an adverse event requiring quality improvement. Be specific and provide examples.

Health care delivery is complex and faces numerous challenges. An adequate response to these challenges and ensuring that health care remains optimal requires continuous improvement of processes and outcomes. As a result, quality improvement initiatives to address a performance gap should be part of everyday practice. Quality improvement (QI) models should be applied to ensure that the process is systematic and procedural.

The Root Cause Analysis (RCA) Model

The RCA model is among the commonly applied models when the cause of an adverse problem needs to be explicit. RCA is founded on the premise that issues causing errors must be identified, and health care providers should avoid focusing on individual mistakes (Martin-Delgado et al., 2020). In this case, there is more to errors and other adverse events than what is generally seen. Karkhanis and Thompson (2020) explained that RCA has three main components: data, a multidisciplinary team, and error prevention. When a problem occurs, health care providers should collect relevant data through records’ analysis and participants’ interviews, among other strategies. The multidisciplinary team helps to analyze the problem in-depth from a team approach. Eventually, the identified error is eliminated, and appropriate measures to prevent future harm are implemented (Agency for Healthcare Research and Quality, 2019). The method identifies errors, responds effectively, and guides interventions to prevent future harm.

RCA Implementation in Response to an Adverse Event

The RCA model can be highly effective when responding to a medication error problem. A suitable example would be when a patient receives the wrong prescription. Implementing RCA in this situation would commence with data collection from the health care providers involved in the process. Next, a multidisciplinary team would analyze the problem to examine whether it was individual or administrative. The problem would then be fixed through technology adoption or training health care professionals to prevent recurrence.

Health care organizations should be committed to continuous quality improvement. For better outcomes, they should apply QI models to ensure that QI is systematic and procedural. The RCA model is highly effective in problem identification, analysis, and solution. It can be used in health care organizations and the broader nursing practice to guide quality improvement.




Agency for Healthcare Research and Quality. (2019). Root cause analysis.

Karkhanis, A. J., & Thompson, J. M. (2020). Improving the effectiveness of Root Cause Analysis in hospitals. Hospital Topics99(1), 1-14.

Martin-Delgado, J., Martínez-García, A., Aranaz, J. M., Valencia-Martín, J. L., & Mira, J. J. (2020). How much of Root Cause Analysis translates into improved patient safety: A systematic review. Medical Principles and Practice29(6), 524-531.

A brief explanation of the quality improvement model you selected, including a description of the components that make up this model.

The quality improvement model selected for this assignment is the A3 model.  This model provides a very basic, yet structured approach towards problem-solving. The model was first applied by the Toyota corporation, many years ago, as a model for continuous improvement.  According to UNC Institute for Healthcare Quality Improvement (2021), the model received its name, based on the type/size of the paper, A3.  It is also known as SPS, which is Systematic Problem Solving and is based on the basic principles identified by Edward Demings PDCA (Plan Do Check Act) process (UNC Institute for Healthcare Quality Improvement, 2021). The A3 process involves includes a total of 11 distinct steps, including a step 0, which identifies the problem.  Steps 1 – 8 are planning steps, interestingly enough, embedded in these steps are Deming’s PDCA steps.  Step 9 is the do step and step 10 is the check step (Montana State University, n. d.).  At the end of the cycle, any identified opportunities for improvement are identified and the cycle is initiated again.

Explain how this quality improvement model might be implemented in your healthcare organization or nursing practice in response to an adverse event requiring quality improvement. Be specific and provide examples.

At my current organization, we use the A3 method for quality improvement initiatives.  We have a Lean Six Sigma Blackbelt at our organization and all of the directors and managers are at least certified Green Belts in the Lean Six Sigma training.  The A3 form/format is utilized for patient-related harms reported across the organization. This primarily includes Hospital Acquired Pressure Injuries (HAPI’s), Catheter-Associated Urinary Tract Infections (CAUTI’s), and Venous Thromboembolisms (VTE’s).  Although we follow a similar format previously described in the steps above for the A3, our organization asks specific questions for each step of the A3 process. This is very helpful when ensuring that clinicians do a deep dive into the reasons for the harm, as well as identifying opportunities to improve the quality of patient care and prevent further harm.

The most recent incident that we need to complete an A3 was for a harm on the Palliative Care unit.  A bedridden patient developed a HAPI, a stage 2 pressure injury on their right heel (Step 0). Upon review of the chart/patient flow, staff processes/procedures (Steps 1-8), the patient was not being turned every two hours per organizational policy.  It was further determined that the patient was boarded in the ED for 36 hours, prior to being admitted to the Palliative care unit.  Consequently, the ED had to take responsibility for the harm, considering that the patient had only been on the Palliative care unit for less than 24 hours.  Ultimately, the organization needs to ensure that all departments are following our policies related to turning identified patients, every 2 hours (Step 9).  Ongoing, the Performance Excellence Committee reviews data/patient records, to ensure that there are no additional harms (Step 10).  Once the A3 document is completed, it is reviewed with the harms team, and approval is sought for any changes in practice, protocol, policy, etc.


Montana State University (n. d.). Steps of the A3.  Retrieved from

Tromp, R. (n. d.).  A3 report.  Lean Six Sigma Group.  Retrieved from

UNC Institute for Healthcare Quality Improvement (2021).  Resources: A3.  Retrieved from

The Plan-Do-Study-Act Cycle is the Quality Improvement Model that I have chosen for this discussion.  It has been utilized for continuous improvement as described by Edwards Deming (Nash et al., 2019).   This improvement model assumes that 15 percent of poor quality is due to people and 85 percent of poor quality is due to improper management, systems and processes (Nash et al., 2019).


Under this phase of the quality improvement model, we seek to understand the problem and where a gap in practice exists as well as establish an objective laying out what we are trying to accomplish.  In my clinical arena, we would be collecting and analyzing data to identify where a gap exists based on the data. It is possible that we find what we least expected or that the gap exists in a different place than expected.  From here we can plan how to carry out the cycle.


Under this phase of the cycle, we use the gap that we’ve identified and the plan that we’ve made to educate and train staff to carry out the plan. We can start to make small scale changes and evaluate its effectiveness, challenges, and problems on a small scale to prepare for implementing in a much bigger scale.


In this phase of the quality improvement model, we evaluate the effects of the change and decide if it was successful or not. We evaluate whether and to what degree success was obtained or did the gap get larger. Here we can determine what changes need to be made and what steps should be taken next to achieve the objective that was set during the initial plan phase of the cycle.


This is action phase of the cycle where we make changes based on what we have learned whether that is repeating what was done, making small modifications, or creating an entirely new plan and cycle. It is the ending as well as the beginning. In this phase, new gaps can be identified, or current gaps can be modified until the goal or objective is met (Nash et al., 2019).

Shaw et al. (2019) utilized rapid cycle PDSA quality improvement model to improve hypothermia in term and near-term infants delivered vaginally. After 4 PDSA cycles, the incidence of hypothermia dropped from 50% to zero at 1 hour of life (Shaw et al., 2019). A similar project utilizing the PDSA would be beneficial in my healthcare organization in the population mentioned above but could be expounded on to include premature infants who are also risk complications secondary to hypothermia. Shaw et al. (2019) found that regular feedback regarding success and correction of the previous PDSA cycles was important to continue to move forward with the quality improvement project. This model is ideal because the cycles required to achieve the necessary change will vary from hospital to hospital and can be affected by many variables but if continued the result will eventually be achieved. The expectation is not that the objective will be achieve after the first cycle, but that continuous improvement will be achieved. Healthcare is a dynamic field where change is the only constant and therefore, we must aim to be improving continuously an not stop the cycle once a goal is achieved.


Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press

Shaw, S. C., Devgan, A., Anila, S., Anushree, N., & Debnath, H. (2018). Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room. Medical Journal Armed Forces India74(2), 126–132.

Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS:  NURS 8302 Discussion: Quality Improvement Models SOLUTION

This is insightful Brittany, there are different quality improvement strategies that can be employed to enhance effective patient outcomes. These approaches/strategies ought to adhere to the organizational objectives and the operational standards. The Plan-Do-Study-Act Cycle is considered one of the best quality improvement model used by different healthcare institutions (Nash et al., 2019). The model involves the application of the systematic processes for gaining valuable learning and knowledge for the continual improvement of the clinical processes, service delivery, and the products used in enhancing the treatment processes (Shaw et al., 2018). This model has been successfully used to facilitate processes undertaken by different healthcare providers. Under this phase of the quality improvement model, we seek to understand the problem and where a gap in practice exists as well as establish an objective laying out what we are trying to accomplish (McNicholas et al., 2019). Through the use of The Plan-Do-Study-Act Cycle, healthcare providers have been able to integrate all the elements required in the treatment processes and to determine the possible outcomes before undertaking the actual quality improvement program.


McNicholas, C., Lennox, L., Woodcock, T., Bell, D., & Reed, J. E. (2019). Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study. BMJ quality & safety28(5), 356-365.

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press

Shaw, S. C., Devgan, A., Anila, S., Anushree, N., & Debnath, H. (2018). Use of Plan-Do-Study-Act cycles to decrease incidence of neonatal hypothermia in the labor room. Medical Journal Armed Forces India74(2), 126–132.

Lopes Write Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.


Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource

In addition to the Root Cause Analysis (RCA) model, my colleague can enhance the implementation of the quality improvement process by incorporating a robust educational component. This involves developing targeted training programs and workshops for healthcare professionals involved in the identified adverse events, such as medication errors. The educational component aims to address knowledge gaps, enhance skills, and foster a culture of continuous learning and improvement within the healthcare organization.

To implement this strategy, my colleague can collaborate with educational specialists, clinical educators, and subject matter experts to design tailored training modules. These modules can cover topics such as medication safety protocols, dosage calculations, and best practices in administering medications (Rodziewicz & Hipskind, 2020). The training sessions should be interactive, incorporating case studies and real-life scenarios to engage healthcare professionals actively.

Furthermore, the educational component can extend beyond traditional classroom settings to include online modules and resources, ensuring accessibility for all staff members. Regular updates and refresher courses should be integrated to reinforce learning and keep healthcare professionals informed about the latest evidence-based practices and safety measures.

By incorporating education into the Root Cause Analysis model, this identifies the immediate causes of adverse events and  proactively works towards preventing future occurrences (Jones & Despotou, 2016). This strategy fosters a culture of continuous improvement and empowers healthcare professionals with the knowledge and skills needed to provide safer and higher-quality patient care. Additionally, the monitoring and feedback steps of the RCA model can be utilized to assess the effectiveness of the educational initiatives and make necessary adjustments for ongoing improvement.