QUALITY IMPROVEMENT MODELS NURS 8302
Sample Answer for QUALITY IMPROVEMENT MODELS NURS 8302 Included After Question
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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Submission and Grading Information
Grading Criteria
To access your rubric:
Week 8 Discussion Rubric
Post by Day 3 of Week 8 and Respond by Day 6 of Week 8
To Participate in this Discussion:
A Sample Answer For the Assignment: QUALITY IMPROVEMENT MODELS NURS 8302
Title: QUALITY IMPROVEMENT MODELS NURS 8302
Root Cause Analysis (RCA) is a technique employed in quality improvement to pinpoint the fundamental causes of issues or adverse events. It is commonly used in healthcare environments to enhance patient safety and care. RCA’s primary aim is to establish what occurred, why it occurred, and how to prevent its recurrence. Participants should remember that the RCA process uses a system-based approach to address human error and does not focus on blaming individuals. They should view the RCA process as an opportunity to share knowledge and prevent patient harm resulting from the recurrence of the safety or sentinel event (Dudley, 2023). The RCA model has various elements, including problem or event identification, data gathering, analysis of causes, development and implementation of recommendations, and evaluation.
The first step involves precisely defining the problem or event, such as a patient safety incident in healthcare, which might include medication errors or unexpected patient deaths. The next stage is collecting comprehensive data on the incident, including patient records, interviews with staff, and environmental conditions, to understand the events that led to the issue. Then, create a timeline or flowchart to track the sequence of events and identify potential problem points, aiding in the visualization of the process and identifying failures (Institute for Healthcare Improvement, 2019).
The analysis uses collected data to determine the root causes of an event, often involving a series of “why” questions to explore each cause more deeply. The critical aspect of the RCA2 process is recognizing and applying measures to mitigate or remove identified system hazards or weaknesses. The review teams must find solutions that prevent the event’s recurrence or lessen its impact if it happens again (National Patient Safety Foundation, 2015). Developing strategies to prevent future occurrences might include procedural changes, staff training, system improvements, or policy amendments. Post-implementation, the effectiveness of these changes is evaluated to ensure they are working and preventing similar events.
RCA involves specific steps in healthcare implementation, like in a nursing practice addressing an adverse event. For example, an active case at our hospital involved a homeless dialysis patient who intermittently refused treatment and care, deemed competent by a licensed psychiatrist, was allowed to leave the hospital against medical advice (AMA), and 2 hours later returned to the emergency room in critical condition. This incident was classified as a “Never Event,” prompting an RCA. The process included gathering all relevant data about the patient’s hospital stay, reasons for refusing treatment, nurses’ and physicians’ notes, discharge process and efforts made, and readmission. The RCA tools chart the event sequence and ask “why” at each stage, identifying systemic issues such as inadequate resources for homeless patients, communication gaps between healthcare providers and psychiatric services, or insufficient policies for patients refusing treatment.
We are currently in the implementation and evaluation phase. It involves developing new protocols for managing patients who refuse treatment, enhancing inter-departmental communication, and providing staff with additional training for complex cases. These strategies could include collaborations with community groups for homeless patient support, enhanced patient education on dialysis, or revised discharge protocols that include thorough patient readiness assessments and follow-up plans. Implementing these changes, like training staff on new protocols and connecting with community organizations, is crucial. Monitoring outcomes is essential to ensure the effectiveness of these changes. It also involves tracking similar incidents, patient outcomes, or staff feedback.
RCA aids in identifying systemic issues and individual decision-making factors that led to the adverse event. By fully understanding these elements, the healthcare organization can implement targeted improvements to prevent future similar events.
References
Dudley, K. A. (2023). Understanding the Root Cause Analysis Process to Increase Safety Event Reporting. AORN Journal, 117(6), 399–402. https://doi.org/10.1002/aorn.13935Links to an external site..
Patient Safety Essentials Toolkit: Action Hierarchy Tool. Boston: Institute for Healthcare Improvement; 2019. (Available at ihi.org).
RCA2: Improving Root Cause Analyses and Actions to Prevent Harm. Boston: National Patient Safety Foundation; 2015.
A Sample Answer 2 For the Assignment: QUALITY IMPROVEMENT MODELS NURS 8302
Title: QUALITY IMPROVEMENT MODELS NURS 8302
Description of Quality Improvement Model
The Plan, Do, Study, Act (PDSA) model is one of the most used quality improvement tools (Christoff, 2018). The PDSA model is primarily used for continuous improvement and quality management. It is structured for addressing problems, implementing changes, and assessing the impact of those changes. The PDSA model identifies and enhances existing processes to make them more efficient and effective (Chen et al., 2021). Additionally, the model is used to solve problems by addressing specific challenges or issues within an organization by testing solutions in a controlled manner.
Components of the Quality Improvement Model
The PDSA model is a systemic approach to continuous improvement. The planning phase involves defining the objective, identifying the problem or opportunity for improvement, and developing a plan to address it (Vordenberg et al., 2018). This involves setting clear goals, outlining strategies, and considering potential challenges. The second phase is “do.” This is the phase where the plan is executed on a small scale (Chen et al., 2021). The doing phase is considered a pilot or trial phase where you implement the changes. The third phase is called “study.” During this phase, the outcomes of the implemented changes are evaluated (Chen et al., 2021). Collect and analyze data to assess whether the goals were met and understand the impact of the changes. The acting phase is based on the study phase. If the results are positive, then implementation on a larger scale is necessary. However, if the results are unfavorable, refine the plan and go through the phase again.
Implementation of Quality Improvement Model
By applying the PDSA model, nursing practice can become more adaptive and responsive to challenges, fostering a culture of continuous improvement (Coury et al., 2017). The PDSA model can be implemented in an adverse event to enhance patient safety and reduce adverse events. For example, let us consider medication errors in a hospital setting. A series of medication errors leading to patient harm is the identified problem. In addition to identifying the problem, the problem would also need to be defined. Inadequate communication during shift changes contributes to confusion in medication administration. The planning phase would also involve setting objectives. Improve communication and reduce medication errors by implementing a standardized handoff process during shift changes. Implementing the new handoff process in the unit would be the “do” phase. Document the changes and communicate them to all relevant stakeholders. Collecting data on medication errors before and after the implementation is essential during the study phase. Finally, hospital-wide implementation would be necessary if the standardized handoff process effectively reduces medication errors and improves communication in that one unit.
References
Chen, Y., VanderLaan, P. A., & Heher, Y. K. (2021). Using the Model for Improvement and Plan-Do-Study-Act to effect SMART change and advance quality. Cancer Cytopathology, 129(1), 9-14. https://doi.org/10.1002/cncy.22319Links to an external site.
Christoff P. (2018). Running PDSA cycles. Current Problems in Pediatric and Adolescent Health Care, 48(8), 198–201. https://doi.org/10.1016/j.cppeds.2018.08.006Links to an external site.
Coury, J., Schneider, J. L., Rivelli, J. S., Petrik, A. F., Seibel, E., Taplin, S. H., Green, B. B., & Coronado, G. D. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Services Research, 17. https://doi.org/10.1186/s12913-017-2364-3Links to an external site.
Vordenberg, S. E., Smith, M. A., Diez, H. L., Remington, T. L., & Bostwick, J. R. (2018). Using the plan-do-study-act (PDSA) model for continuous quality improvement of an established simulated patient program. Innovations in Pharmacy, 9(2), 1-6. https://doi.org/10.24926/iip.v9i2.989Links to an external site.
A Sample Answer 3 For the Assignment: QUALITY IMPROVEMENT MODELS NURS 8302
Title: QUALITY IMPROVEMENT MODELS NURS 8302
The selected quality improvement model for this discussion is the Plan-Do-Study-Act (PDSA). Walter Shewhart and W. Edwards Deming developed the model in 1939 (Scoville & Little, 2014; Johns Hopkins Nursing, 2022). The PDSA model is made up of four stages or components, representing a problem-solving cycle employed to carry out change or improve a process. The first stage is Plan (P), which means identifying a purpose or goal, formulating a theory, and defining success metrics. This component correlates to the scientific method of making a hypothesis. The second element is Do (D), which means setting a plan in motion after putting it in place. In other words, this stage involves implementing the intervention on a small scale while ensuring data collection and documentation. The third stage is Study (S), which involves studying the results after implementation by looking at the collected data, analyzing the results, and comparing them to the set predictions (Johns Hopkins Nursing, 2022). The last component or phase is Act (A), which entails determining the modifications to be made to the plan (if any), depending on what was learned from the study stage.
My nursing practice or healthcare organization can implement the PDSA quality improvement model in response to an adverse event that needs quality improvement. The healthcare organization can use the cycle to develop, test, and pilot changes under diverse conditions. As a result, this could make the organization confident that the changes will function as anticipated and refine the plan where needed (Scoville & Little, 2014). For example, suppose the healthcare organization encounters medication errors that need quality improvement. In this case, the organization will use the PDSA model to plan for a new medication verification process, implement it with a specific patient group, study the results and error rates, and modify the process where necessary before a more comprehensive implementation.
References
Johns Hopkins Nursing. (2022). Quality Improvement. Johns Hopkins Medicine. Center for Nursing Inquiry. Baltimore, Maryland. https://www.hopkinsmedicine.org/nursing/center-nursing-inquiry/nursing-inquiry/quality-improvement
Scoville, R., & Little, K. (2014). Comparing lean and quality improvement. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_8302_Week8_Discussion_Rubric
- Grid View
- List View
| 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 | |||||
Name: NURS_8302_Week8_Discussion_Rubric