Write an executive summary (750-1,000 words) to present to the board

NRS 451 Executive Summary

Write an executive summary (750-1,000 words) to present to the board


The issue of nurse staffing has become a global challenge. Healthcare institutions are encountering various complexities in delivering quality patient care due to shortage of staff. For this reason, the number of mortalities, medical errors and nurse burnout continue to increase particularly in institutions with low nurse -to-patient ratios. Nurses are known to play a crucial part in providing quality healthcare. Therefore, it is essence to properly plan staffing in healthcare institutions to avoid nurses getting depressed, overworked and thus feeling neglected. Staffing encourages nurses since it exploits their abilities to provide quality patient care.

Purpose of the Initiative

Recent studies in regards to nurse staffing indicate that enhanced staffing in acute healthcare institutions is linked with minimal hospital deaths and errors (Spetz, 2020). Healthcare institutions with high nurse-to-patient ratios report fewer errors and complications since they get the opportunity to provide quality care to their patients. Nurses are essential in providing excellent care in healthcare institutions (Newman et al., 2017). It is of the essence to maintain an accurate staffing rate to guarantee that nurses can uphold eminence care for their patients. Nursing staffing ratios are a growing concern. According to studies, institutions with insufficient nursing ratios have more indigent patient’s results, increased mortalities; nurse suffers exhaustion, advanced turnovers, frustration among patients, and staffs.

Target population

Increasing the number of nurses in healthcare institutions will enormously transform the healthcare system, particularly the nurses. Nurses’ observation at the bedside is crucial to the ability to ensure patient safety. Increasing the number of nurses in institutions benefits both patients and nurses (Newman et al., 2017). The nurse staffing initiative centers on empowering nurses through restructuring work schedules and employing more skilled staff. Among all the members in a healthcare institution, nurses play a vital role through observing patients, detecting mistakes, understanding care procedures, among other tasks (Spetz, 2020). Nurse staffing will guarantee that nurses have an easy time and get adequate resting time to ensure positive patient care. Shortages of nurses result in different complications in the healthcare system; thus, jeopardizing quality patient care.

Benefits of Nurse Staffing

The countrywide crusade for safe nurse-to-patient staffing ratios is considered a worldwide effort to ensure secure staffing for nurses

Write an executive summary (750-1,000 words) to present to the board
Write an executive summary (750-1,000 words) to present to the board

and patients across the world. Researchers have indicated that proper nurse staffing assists in attaining medical and economic enhancements o patient care (Spetz, 2020). Some of the benefits of staffing include:

  • Improvement of patient contentment and HCAHPSf achieves.
  • Reduction in medicine errors, patient deaths, institutions readmissions, and duration of stay
  • Enhanced safety results through minimizing occurrences of falls, pressure, ulcers, and healthcare connected infections
  • Reduces patient care expenses by evading of unexpected readmissions.
  • Averts nurse fatigue

Additionally, staffing creates an opportunity where nurses themselves are encouraged to develop staffing plans and endorse flexible recruitment schedules. Optimal recruitment is essential to providing the most excellent care possible and achieving the utmost value for nurses (Spetz, 2020).

Inter-professional Collaborative initiatives

Efforts to address the staffing concern started with the American Nurses Association (ANA). According to studies, ANA is the preliminary national nursing excellence report card project. ANA is known to be the mother of six other efforts, which are currently playing a crucial role in ensuring positive patient outcomes.

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California Nursing Outcomes Coalition (CalNOC) is among the first State-based schemes set by ANA, which acted as the foundation for the National Database for Nursing Quality Indicators (NDNQI). Preserving an unofficial collaboration with the NDNQI, CalNOC maintains to serve as the regional database initiative ensuring positive patient outcome and nurse satisfaction (Spetz, 2020). Military Nursing Outcomes Database and VA Nursing Outcomes Database projects have recently implemented the CalNOC staffing approaches to enhance nurse staffing in sensitive healthcare institutions (Gandolfi, Stone & Deno, 2017). Studies indicate that currently, all these initiatives gather and investigate unit-level numbers related to the connection amid nurse staffing and the wellbeing and superiority of patient care. Acting as a team, they have developed an unendorsed collaborative of nursing quality database initiatives.

The most current project in regards to regulating staffing and outcomes measures for quality enhancement was developed by the National Quality Forum (NQF).  The aim of the NQF is to enhance American healthcare by consensus-based values for quality measurements (Spetz, 2020). This initiative ensures healthcare activities are in safe hands, timely, valuable, patient-centered, well-organized, and reasonable.


Budget Justification

The common cause of nurse shortages is the failure to recruit enough staff to attend to the patient. Encouraging teams and planning for appropriate staffing can assist in reducing medical errors and nurse burnout (Cho et al., 2016). However, this costs a minimal amount. Furthermore, this initiative aims at enhancing patient outcomes by recruiting more staff. The nursing shortage is an issue that is currently challenging healthcare institutions across the world. This issue will continue to impact the hospital’s budget for the next years (Spetz, 2020). According to studies, this is as a result of implementing more costly customary contract employment solutions necessary to conduit the gaps in nurse staffing.

Hospital labor takes up a significant share of operating expenses in healthcare budgets, at approximately 50%. An average nurse is paid between $200 and $500 (Gandolfi, Stone & Deno, 2017). According to hospitals’ financial records, nurses make up the largest share within hospital labor (Cho et al., 2016). Thus, an augment in the costs of nurse staffing is a significant factor. However, developing a partnership with nursing schools is one measure to enhance the prospective field (Cho et al., 2016). Healthcare institutions are developing private pools to occupy temporary vacancies without using contract labor.

Project Evaluation

Before the execution of the initiative, nurse staffing assessment is conducted to determine patient care and nurse’s ability in each unit and shift (Cho et al., 2016). A similar technique will be used to assess nurse burnout and patient care after the implementation of the initiative and the difference between them noted statistically (Cho et al., 2016). An evaluation of the initiative can be developed by utilizing the schemes of CalNOC and NQF survey data before and after completion of the initiative.


For healthcare institutions to minimize the number of medical errors and hospital deaths, it is essential to consider proper nurse-to-patient ratios.  Given that there is no apparent number for the integer of nurses in healthcare organizations, it is up to the healthcare institutions and administrations to ensure that staffing is suitable to patients’ needs.  More enormous benefits can be attained from staffing approaches that consider the number of nurses and the nurse-to-patient rates. These ratios can be adjusted to account for all divisions and shift level factors since there will be enough staf



Cho, E., Lee, N. J., Kim, E. Y., Kim, S Lee, K., Park, K. O. & Sung, Y. H. (2016). Nurse staffing levels. International journal of nursing studies. (60) 263-271.

Gandolfi, F., Stone, S., & Deno, F. (2017). Servant leadership: An ancient style with 21st-century relevance. Revista de Management Comparat.

Newman, A., Schwarz, G., Cooper, B., & Sendjaya, S. (2017). How servant leadership influences organizational citizenship behavior: The roles of LMX empowerment, and proactive personality. Journal of Business Ethics (145). 49-62.

Spetz, J. (2020). “Nurse staffing ratios: Policy options.” Policy and Politics in Nursing and Healthcare-Ebook, 452.

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.


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.




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 explorations2(4).

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. Epilepsia62(7), 1617-1628.

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 & research72(2), 283-291.

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 medicine3(1), 1-10.

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 research22(7), e19274.