The Quality Improvement Practice Gap Assignment Paper
Briefly describe the quality improvement practice gap you identified in your nursing practice or organization.
A significant quality improvement practice gap identified in the organization is high hospital readmission figures. The 30-day all cause hospital readmission figure at the facility is averaged at 15% readmission rate with the average readmission cost being $16,000. Admission for sickle cell anemia/trait accounts for the highest overall readmission rate at 37%, followed by septicemia at 10%, and heart failure at 5%. Highest average readmission cost is reported for complications of transplant tissues and organs at an average cost of $29,000. There is a difference between the reported readmission figures, and the figures that can be potentially obtained on the basis of current professional knowledge. The difference is attributable in part to a deficiency that could be addressed through nursing practice. Some of the causes of hospital readmission are inadequate discussion of care at home, hospital discharge being done early, infection, inadequate nutrition, failure to identify post-acute care needs, lack of timely follow-up care, medication errors, medication non-compliance by the patient, and fall injuries (Vana & Tazbir, 2021).
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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.
Three SMART objectives have been identified for the quality improvement project targeting the hospital readmissions as a nursing practice gap.
First, create a nursing discharge education plan template (specific) that plans out what the discharged patient should watch out for over the next thirty days (measurable, attainable and time-bound) to improve care outcomes and reduce complications (relevant).
Second, adopt a home care management tool (specific) that organizes the home care requests for discharged patients (measurable and attainable) so that the nursing care team can streamline task assignment (relevant) within one day of receipt (time-bound).
Third, adopt a case review tool (specific) that is to be completed within 24 hours before discharge (time-bound) and organizes discharge instructions (measurable and attainable) so that patients are only discharged home when deemed medically appropriate to avoid early discharge (relevant).
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.
Four project management activities will be adopted to address the quality improved practice gap identified. These activities are concrete actions that are well defined and practical, undertaken within the project to achieve the set SMART objectives. First, create and publish a nursing discharge education plan with a copy of the plan available to all nurses. The plan acts as a guide that ensures that the needs of patients after discharge from the hospital are met so that the patients function at an optimal level after they return home. Also, the discharge education plan will guide nurses in enabling patients to understand what is known about their condition, what was done to them in the hospital, the plan for treatment and follow-up while at home, and reasons to return to the hospital within a defined period of time after the discharge (Potter et al., 2022).
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Second, prepare and publish a nurse administered home management care tool with scoring algorithms that is availed to nurses. This is a tool that enables the nurses to generate scores and associated risk levels to identify patients at risk of readmission as well as the care management services that they can benefit from while at home. Patients at high risk of readmission, such as elderly patients susceptible to falls or those who have undergone organ transplant surgery, can then be availed specialty nursing care services while at home to improve recovery and reduce readmission rates (Knapp & Olson, 2020).
Third, prepare and publish a case review tool that is administered by nurses. This is a tool that walks the nurses through details of a patient’s case, facilitates the collection and assessment of safety and quality data, and ensures that the patient is only discharged at the appropriate time after being adequately prepared for home care. This ensures that discharge is done at the appropriate time (not too early and not too late), and systems are in place for timely follow up care (Beauvais, 2018).
References
Beauvais, A. M. (2018). Leadership and Management Competence in Nursing Practice: Competencies, Skills, Decision-Making. Springer Publishing Company.
Knapp. K. R., & Olson, D. M. (2020). The Health Services Executive (HSE): Tools for Leading Long-Term Care and Senior Living Organizations. Springer Publishing Company.
Potter, P. A., Perry, A. G., Stockert, P. A., Hall, A. (2022). Fundamentals of Nursing (11th ed.). Elsevier, Inc.
Vana, P. K., & Tazbir, J. (2021). Kelly Vana’s Nursing Leadership and Management (4th ed.). John Wiley & Sons Ltd.
Pinpointing a quality improvement practice gap in my practice site would be a deliberate act. The quality assurance performance improvement (QAPI) team meets monthly to identify areas for improvement. After identifying an issue, a gap analysis would be performed. There are various trigger or potential areas for quality improvement, including poor patient turning culminating in pressure ulcers, ineffective pain treatment, falls, notably those with multiple injuries, and inappropriate antibiotic use. Upon identification of these issues, further investigations may be indicated, which will result in the discovery of the existing practice gaps. To Prepare: Review the Learning Resources for this week and consider the approaches of project management. Refer to the Week 3 Discussion, and reflect on the quality improvement practice gap you identified. Consider how you might apply the project management approaches examined this week to address the quality improvement practice gap you identified. Think about how you might develop SMART objectives for the planning and execution of a project to address the quality improvement practice gap you identified. Consider any other project management approaches or activities you might recommend using for your project that will address the quality improvement practice gap you identified.
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The Assignment: (2–3 pages) 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. TOOLS TO USE Quality Improvement Essentials Toolkit Institute for Healthcare Improvement Boston, Massachusetts, USA Quality Improvement (QI) Essentials Toolkit IHI’s QI Essentials Toolkit includes the tools and templates you need to launch a successful quality improvement project and manage performance improvement. Each of the ten tools can be used with the Model for Improvement, Lean, or Six Sigma, and includes a short description, instructions, an example, and a blank template. The QI tools include: Cause and Effect Diagram: Also known as the Ishikawa or fishbone diagram, this tool helps you analyze the root causes contributing to an outcome. Failure Modes and Effects Analysis: Also used in Lean management and Six Sigma, FMEA is a systematic, proactive method for identifying potential risks and their impact. Run Charts and Control Charts: These charts help you monitor performance and visualize variation. PDSA Worksheet: Plan-Do-Study-Act rapid-cycle testing helps teams assess whether a change leads to improvement using a methodical learning process. Download the complete toolkit with all ten tools, or download individual tools as you need them to guide your continuous improvement work. *NOTE: Before filling out the templates, first save the PDF files to your computer. Then open and use that version of the tool. Otherwise, your changes will not be saved.
The Quality Improvement Practice Gap Assignment Paper