Quality Improvement Plan Nursing Leadership and Management Essay
Quality Improvement Plan Nursing Leadership and Management Essay
NRS-451 Executive Summary Sample
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.
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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 (Fazio et al., 2020). 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 an 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 project 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.
Conclusion
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, it is introducing an electronic medical record documentation system. There are a number of factors to consider when evaluating the impact of such a change.
References
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 Explorations, 2(4). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188433/
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. Epilepsia, 62(7), 1617-1628. https://doi.org/10.1111/epi.16934
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 & Research, 72(2), 283-291. https://doi.org/10.1002/acr.23848
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 Medicine, 3(1), 1-10. https://www.nature.com/articles/s41746-020-0221-y
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 Research, 22(7), e19274. https://www.jmir.org/2020/7/e19274/PDF
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Assessment Description
In this assignment, you will propose a quality improvement initiative from your place of employment that could easily be implemented if approved. Assume you are presenting this program to the board for approval of funding. Write an executive summary (750-1,000 words) to present to the board, from which the board will make its decision to fund your program or project. Include the following:
The purpose of the quality improvement initiative.
The target population or audience.
The benefits of the quality improvement initiative.
The interprofessional collaboration that would be required to implement the quality improvement initiative.
The cost or budget justification.
The basis upon which the quality improvement initiative will be evaluated.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Executive Summary – Rubric
Rubric Criteria
Total
140 points
Criterion
1. Unsatisfactory
2. Less Than Satisfactory
3. Satisfactory
4. Good
5. Excellent
Interprofessional Collaboration Required to Implement the Quality Improvement Initiative
Interprofessional Collaboration Required to Implement the Quality Improvement Initiative
0 points
The interprofessional collaboration that would be required to implement the quality improvement initiative is not discussed.
13.65 points
The interprofessional collaboration that would be required to implement the quality improvement initiative is incomplete, missing relevant information.
14.38 points
The interprofessional collaboration that would be required to implement the quality improvement is discussed and meets the basic criteria for the assignment as indicated in the assignment instructions
16.2 points
The interprofessional collaboration that would be required to implement the quality improvement is discussed and meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail.
18.2 points
The interprofessional collaboration that would be required to implement the quality improvement initiative is clearly discussed and meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
Paragraph Development and Transitions
Paragraph Development and Transitions
0 points
Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.
5.25 points
Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.
5.53 points
Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.
6.23 points
A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.
7 points
There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
Basis Upon Which the Program or Project Will Be Evaluated
Basis Upon Which the Program or Project Will Be Evaluated
0 points
The basis upon which the quality improvement initiative will be evaluated is not provided.
13.65 points
The basis upon which the quality improvement initiative will be evaluated is incomplete, missing relevant information.
14.38 points
The basis upon which the quality improvement initiative will be evaluated meets the basic criteria for the assignment as indicated in the assignment instructions.
16.2 points
The basis upon which the quality improvement initiative will be evaluated is provided in detail.
18.2 points
The basis, upon which the quality improvement initiative will be evaluated as indicated by the assignment instructions, is provided in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
Documentation of Sources
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
0 points
Sources are not documented.
3.15 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
3.32 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
3.74 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
4.2 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Target Population or Audience
Target Population or Audience
0 points
The target population or audience is not addressed.
13.65 points
The target population or audience is incomplete, missing relevant information.
14.38 points
The target population or audience is provided and meet the basic criteria for the assignment as indicated in the assignment instructions.
16.2 points
The target population or audience meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail.
18.2 points
The target population or audience meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
5.25 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
5.53 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
6.23 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
7 points
Writer is clearly in command of standard, written, academic English.
Purpose of the Quality Improvement Initiative
Purpose of the Quality Improvement Initiative
0 points
The purpose of the quality improvement initiative is not provided.
15.75 points
The purpose of the quality improvement initiative is incomplete, missing relevant information.
16.59 points
The purpose of the quality improvement initiative is provided and meets the basic criteria for the assignment as indicated in the assignment instructions.
18.69 points
The purpose of the quality improvement initiative meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail.
21 points
The purpose of the quality improvement initiative meets all criteria for the assignment, as indicated in the assignment instructions, is provided in detail, and demonstrates higher level thinking by incorporating prior learning or reflective thought.
Benefits of Quality Improvement Initiative
Benefits of Quality Improvement Initiative
0 points
The benefits of the quality improvement initiative are not provided.
13.65 points
The benefits of the quality improvement initiative are incomplete, missing relevant information.
14.38 points
The benefits of the quality improvement initiative are provided and meet the basic criteria for the assignment as indicated in the assignment instructions.
16.2 points
The benefit of the quality improvement initiative meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail.
18.2 points
The benefit of the quality improvement initiative meet all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
Thesis Development and Purpose
Thesis Development and Purpose
0 points
Paper lacks any discernible overall purpose or organizing claim.
5.25 points
Thesis is insufficiently developed or vague. Purpose is not clear.
5.53 points
Thesis is apparent and appropriate to purpose.
6.23 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
7 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Cost or Budget Justification
Cost or Budget Justification
0 points
The cost or budget justification is not provided.
13.65 points
The cost or budget justification is incomplete, missing relevant information.
14.38 points
The cost or budget justification is provided and meets the basic criteria for the assignment as indicated in the assignment instructions.
16.2 points
The cost or budget justification issue meets all criteria for the assignment, as indicated in the assignment instructions, and is provided in detail.
18.2 points
The cost or budget justification issue meets all criteria for the assignment, as indicated by the assignment instructions, and is provided in detail, while demonstrating higher level thinking by incorporating prior learning or reflective thought.
Paper Format (use of appropriate style for the major and assignment)
Paper Format (use of appropriate style for the major and assignment)
0 points
Template is not used appropriately, or documentation format is rarely followed correctly.
2.1 points
Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.
2.21 points
Appropriate template is used. Formatting is correct, although some minor errors may be present.
2.49 points
Appropriate template is fully used. There are virtually no errors in formatting style.
2.8 points
All format elements are correct.
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