NURS 8302 Discussion Quality improvement processes

Quality improvement processes are essential in different organizations. For example, in the healthcare system, quality improvement is often regarded as one of the best approaches to enhancing the quality of services delivered. Quality improvement processes often involve the application of different strategies, resources, and tools. The choice of the strategies and tools to employ often depends on the number of resources available. Quality improvement usually targets different operational processes, the workforce, or the general performance of the organization. While undertaking quality improvement processes, there is always the need to involve the management and the entire workforce. There are different quality improvement models that can be used to facilitate quality improvement processes.

Quality improvement models are essential in providing the guidelines that ought to be followed to achieve the desired outcomes in the quality improvement processes. They can be used to determine and prioritize the potential areas to make changes (Fukey et al., 2019). Through these models, the management is able to identify and understand different approaches that can be undertaken to improve general outcomes. Quality improvement models enhance the visualization of the systems employed in the quality improvement processes. Models also provide templates that guide the change agents in constructing the system. Also, models enhance the documentation of the decision that has been made during the quality improvement processes.

The quality improvement processes can greatly benefit from modeling, which allows the development team to better visualize the plans of the whole system and enhance rapid development and implementation of policies required for successful outcomes (Hamilton et al., 2020). There are always complexities associated with the quality improvement processes; these complexities can be simplified through the application of models.

One of the main examples where quality improvement models can be used is in the establishment of new processes in reducing the rate of healthcare-acquired infections in the healthcare settings. In these cases, quality improvement models will ensure that all the aspects of the project are implemented and that the right procedure is followed to the end. In the above case, the Six Sigma model can be applied in achieving the best outcomes.

References

Fukey, L. N., Issac, S. S., Balasubramanian, K., & Jaykumar, V. (2019). Service delivery quality improvement models: a review. Procedia-Social and Behavioral Sciences, 144, 343-359. https://www.sciencedirect.com/science/article/pii/S1877042814042323

Hamilton, S., Jennings, A., & Forster, A. J. (2020). Development and evaluation of a quality improvement framework for healthcare. International Journal for Quality in Health Care, 32(7), 456-463. https://academic.oup.com/intqhc/article/32/7/456/5874332?login=true

What is the best way to implement quality improvement? What particular strategies and/or models should be used when developing a plan? Throughout the past 7 weeks, you have explored quality improvement in healthcare and nursing practice, and you will continue this exploration by analyzing specific quality improvement models. What models might work best in your nursing practice or healthcare organization?

Healthcare is complex and varied; therefore, quality improvement cannot be a one-sized fits all approach. To fit the complex and varied needs of an organization, there are multiple strategies and methods to implement quality improvement.

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For this Discussion, select one quality improvement model to explore and analyze. Using the selected model, consider how this model might be implemented in your healthcare organization or nursing practice. Examine the effectiveness of this model and consider how this model might be applied to address impacts to adverse events for nursing practice.

To Prepare:

Review the Learning Resources for this week, and reflect on the different quality improvement models presented.
Select one quality improvement model from the following to focus on for this Discussion:
- Root Cause Analysis (RCA)
- A3
- Lean
- Plan, Do, Study, Act (PDSA)
Reflect on the quality improvement model you selected, and consider how it might be implemented in your healthcare organization or nursing practice.

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.

By Day 6 of Week 8

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different quality improvement model than you. Suggest an additional strategy on how your colleague may implement the quality improvement model they selected in their healthcare organization or nursing practice.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

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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).

Plan

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.

Study/Check

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.

Act

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.

References

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 India, 74(2), 126–132. https://doi-org.ezp.waldenulibrary.org/10.1016/j.mjafi.2017.05.005

Content

Name: NURS_8302_Week8_Discussion_Rubric

	Excellent 90–100	Good 80–89	Fair 70–79	Poor : 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.	Points Range: 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	Points Range: 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	Points Range: 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Cited with fewer than two credible references.	Points Range: 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing	Points Range: 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation	Points Range: 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	Points Range: 8 (8%) – 8 (8%) Meets requirements for full participation. Posts main Discussion by due date.	Points Range: 7 (7%) – 7 (7%) Posts main Discussion by due date.	Points Range: 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic and may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
First Response: Writing	Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic and may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic and lacks depth.
Second Response: Writing	Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in standard, edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in standard, edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Excellent

90–100

Good

80–89

Fair

70–79

Poor

: 0–69

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

Points Range: 35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

Points Range: 31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Cited with fewer than two credible references.

Points Range: 0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

Main Posting:

Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

Points Range: 9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

Points Range: 8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

Points Range: 7 (7%) – 7 (7%)

Posts main Discussion by due date.

Points Range: 0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic and may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic and may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

Second Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100