Discussion: Applying Performance Improvement Tools
Read the following scenario:
Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.
You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.
For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?
- two files are attached with information that is to be used in the scenario
Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the quality improvement tools and explain how they contributed to the outcome.
Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level.
Notes Initial Post: This should be a 3-paragraph (at least 450 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).
Expert Solution Preview
Introduction:
Quality improvement is an essential part of healthcare. Patient satisfaction is a crucial outcome measure used to evaluate the quality of care provided at a healthcare facility. The following discussion deals with the scenario of an inpatient geriatric medical nursing unit, which has been involved in a campaign to improve patient satisfaction scores with pain management. The discussion will focus on the effectiveness of the quality improvement strategies applied and their contribution to the outcome.
Strategies and interventions tried in the unit:
Several strategies and interventions were applied to improve patient satisfaction with pain management on the geriatric medical nursing unit. These included staff education, a pain management kit, hourly rounding, and a pain management task force. While the interventions resulted in short-term improvements in patient satisfaction scores, a sustainable change was not achieved. The reason is that the strategies were implemented as individual projects without any clear direction or overarching structure, resulting in a lack of sustainability of the improvement.
Quality improvement tools and their contribution:
The quality improvement tools used at the geriatric medical nursing unit included Plan-Do-Study-Act (PDSA) cycle, Root Cause Analysis, and Run Charts. The PDSA cycle helped in identifying opportunities for improvement and creating an action plan. Root cause analysis was used to investigate the underlying causes of the problem and design solutions. The Run Chart was used to track outcomes, identify trends, and make data-driven decisions. The use of the Run Chart was particularly helpful in identifying a steady increase in patient satisfaction scores over time, indicating a positive trend.
Predictive ability of the Run Chart:
The Run Chart provided evidence that the quality improvement strategies that were applied at the geriatric medical nursing unit resulted in a sustainable change in patient satisfaction scores. The steady increase in patient satisfaction scores over time indicates that the strategies, particularly the hourly rounding and pain management kit interventions, were effective in improving the quality of care. However, the nursing unit cannot be assured that they will exceed the national benchmark in the next quarter or year. A celebration of the improvement with an assurance for sustainability was the appropriate decision. The nursing unit may need to continue using the quality improvement tools and consider additional interventions to achieve further improvement.
Conclusion:
The quality improvement process is an ongoing effort, and it requires a systematic approach. To achieve a sustainable change, improvement strategies should be implemented systematically, and their effectiveness should be measured regularly using quality improvement tools such as PDSA cycles, Root Cause Analysis, and Run Charts. These tools provide a structured approach to identify areas for improvement and evaluate their effectiveness while allowing for data-driven decision-making. The nursing unit should continue using these tools and consider additional interventions to achieve further improvement in patient satisfaction scores.
