REDUCTION AND PREVENTION OF FALLS AMONG PATIENTS WITH DEMENTIA AT KINDRED HOSPITAL
TASK 1: ASSESSMENT
Stakeholder Identification
Stakeholders refer to individuals or organizations likely to be affected by the change, decision, or project outcome. They have an interest or are affected by the project or an initiative. Stakeholder identification is vital in project management, as it facilitates efficiency and enhanced realization of the project objectives (Slabá et al., 2019).
The identification of stakeholders for the project was to utilize interventions that included brainstorming and interviewing influential individuals in the organization. There was brainstorming with team members as well as experts in nursing.
The brainstorming aimed to identify individuals who were most likely to be affected or benefit from the project (Gregory et al., 2020).
The brainstorming sessions aimed to answer questions related to individuals, directly and indirectly, involved and affected by the project, losers and gainers from the project, individuals to facilitate the successful implementation of the project, and individuals that may cause the project failure. (Gregory et al., 2020)
The second strategy utilized to identify the stakeholders was interviewing influential people. They included Nurse Leaders, Managers, and Team Leaders. The interview provided critical information about individuals who were likely to benefit and be disadvantaged with the project implementation.
The interview also provided insights into the success strategies needed for the project’s success.
The next step after stakeholder identification was stakeholder prioritization. Stakeholder prioritization was done based on the power and interest towards the project. The power-interest grid was adopted where stakeholders with high power and high interest in the selection process (Slabá et al., 2019).
Stakeholders with high power, low interest, and low power were not selected, as they could drag the successful realization of the desired project objectives.
Stakeholder identification and prioritization led to selecting three individuals, including the Nurse Manager, Nurse Leader, and Unit Preceptor. The individuals to have high interest and high power, which meant that they could contribute significantly to the project’s success. They also had extensive experience in project implementation and initiating change in healthcare settings.
The Nurse Manager has extensive experience and skills in managing change projects in the organization. For the last five years, she has been a Nurse Manager and has received awards for her ability to drive excellence in the organization.
She also has an adept understanding of the systems and processes needed for the successful implementation of the project.
The Nurse Leader is highly influential in the organization. She knows how to lead and motivate the employees to embrace the desired actions and behaviors for organizational success.
The Preceptor has extensive experience in leading interprofessional teams in implementing best practices in healthcare. As a result, he is well-positioned to lead the implementation of the project.
Roles of the Consulted Individuals
The identified stakeholders will play critical roles in supporting the proposed healthcare improvement project.
For example, the Nurse Manager will coordinate the entire project activities. She will utilize her experience in project management to ensure the realization of the project deliverables as planned in the proposal.
The Nurse Leader will use her influential power to motivate the staff to adopt the proposed change. The leader will also guide the implementation the best practices needed for the project’s success.
The Preceptor will lead the inter-professional teams in implementing the project (Boaz et al., 2018). He will also provide assessment data on the strategies needed to ensure enhanced outcomes in the healthcare improvement project.
Needs Assessment Using Affinity Analysis
The need for the healthcare improvement project was determined using affinity analysis. Affinity analysis refers to a method of determining the co-occurrence of relationships in ideas and activities undertaken by groups or individuals.
Affinity analysis represents the output from brainstorming ideas by groups of individuals. The process generates, organizes, and consolidates information related to the interest issue. Some processes were utilized in the affinity analysis approach to determine the need for the healthcare improvement project.
One of the processes was brainstorming ideas of the stakeholders on issues affecting dementia patients in the setting. The stakeholders wrote their ideas on stick notes to analyze their perceived critical issues affecting dementia patients in the institution (Stern, 2020). The stakeholders posted their ideas on the chart pack randomly for team analysis.
The second step in the process was examining the ideas by the stakeholders to identify interrelated ideas. The stakeholders examined and grouped ideas closely related to preventing falls among dementia patients in the setting. The grouping process also led to identifying lone ideas that did not share any similarities.
The third step entailed the discussion of the grouped ideas with the stakeholders. The discussion focused on defining categories of ideas and creating summaries for each group of ideas (Mizuno & Bodek, 2020). The stakeholders also reached a consensus on eliminating any controversial ideas and making changes or improvements when deemed necessary.
Sub-themes represent the grouped ideas to capture the meaning of the entire group. The purpose of developing the sub-themes was to identify best practice interventions adopted to address patients with dementia in the setting.
The last step was combining the sub-themes into main themes. Combining the sub-themes ensured that the stakeholders agreed on the best approach to guide the healthcare improvement project (Stern, 2020).
The stakeholders reached a consensus by discussing the developed ideas, subthemes, and themes. They discussed the relevance, similarities, and differences that brainstormed ideas, sub-themes and themes had.
They also discussed the overall implications of the adopted themes on understanding the clinical issue. They agreed on the best practice intervention relevant to the healthcare improvement project.
Feasibility Assessment
Feasibility of the Healthcare Improvement Project
The feasibility assessment of the healthcare improvement project showed that the project could be in the practice site. The project will benefit patients with dementia due to enhanced care safety and improved efficiency in inpatient care.
It is also an improvement n care safety as it reduces the risk and rates of falls among patients with dementia. The reduction in the rate and risks of falls translates into enhanced quality and safety of care.
It strengthens the adoption of models of care that promote patient-centeredness. Patient-centeredness promotes safety in the care and patient empowerment and satisfaction with their care.
The feasibility analysis revealed low impact risks that may arise due to project implementation. Some of the identified low-impact risks include an increase in the provider workload, reluctance, costs incurred by the organization, and the possibility of project failure.
However, the risks pose minimal threat to the healthcare improvement project since a positive impact on calculating the impact ratio. An impact ratio of three translates into the enhanced possibility of the healthcare improvement project with positive outcomes for patients and healthcare organizations.
Therefore, the project should drive excellent inpatient provision in the setting.
Organizational Readiness and SWOT Analysis
SWOT analysis is a tool utilized to determine the factors that are likely to affect the success of the healthcare improvement project. The analysis assesses the readiness of the organization to support change.
Identify ways of optimizing their strengths and opportunities in their environment to minimize the potential impact of threats and organizational weaknesses on the successful implementation of the project.
There was serious discussion among the stakeholder in the SWOT Analysis. The stakeholder tabled various criteria that may impact the implementation of the HIP into two criteria: internal and external criteria.
The stakeholders enumerated the following internal criteria: participation norms, defined roles, resources, funding, commitment, collective capabilities, people, experience, knowledge, data, innovative aspects, collaboration stools, processes systems, IT, and communication; include the development of knowledge, dissemination of knowledge or best practices, political, legislative, economic environment technology development, and innovation as the external criteria.
After serious brainstorming by the stakeholders about the criteria, weaknesses, and strengths, by unanimous decisions of the stakeholders agreed that the below table of SWOT Analysis is approved.
SWOT Analysis
Please refer to appendix C to review the SWOT analysis.
The Internal and External criteria were a consensus among the stakeholders.
The approach to SWOT analysis by Stern (2020) in this project, SWOT analysis begins with the examination of the strengths of the organization.
The strengths focus on the positive internal factors that provide the organization a competitive advantage in the industry. In this step, the team members explored collective capabilities, commitment, service quality and efficiency, morale, leadership, governance, culture, customer goodwill, participation norms, and financial resources.
Stern (2020) also asserts that the SWOT analysis process examines organizational weaknesses.
The weaknesses are internal and are negative organizational factors. The factors place the organization at a disadvantage compared to other healthcare organizations.
They also hinder its ability to influence its performance and achieve its desired core goal of growth. Also, the weaknesses are continuous staff turnover due to overwork and low staff morale due to improper motivation.
The team members utilized knowledge from their experience with the organization to identify weaknesses by focusing on market image, costs of care, resource distribution, management, leadership styles, and the competency level of the employees.
The third step in undertaking the SWOT analysis process, as stated by Stern (2020), was examining the organizational opportunities. Opportunities refer to the factors that will enhance the organization’s market prosperity.
The factors comprise the organizational existence in its markets. The team members explored external opportunities from their research and experience, including changes in consumer preferences, innovation, technologies, government regulations, and complacence of competitors.
The last step in the process entailed the examination of threats to the hospital. Threats refer to external damaging factors that are likely to affect the organization’s performance.
They are beyond the control of the organization. The team members explored external threats to an organization, such as competitiveness, technology changes, government regulations, and how they likely affect organizational performance (Mizuno & Bodek, 2020).
The team members ranked the factors to determine the severity of their effect to guide the implementation of responsive interventions to address them.
The SWOT analysis performed on the organization revealed some strengths, weaknesses, threats, and opportunities.
One of the strengths identified from the SWOT analysis is a supportive, committed, and devoted management team. The organization’s leaders are ready to implement change initiatives that would contribute to safety, efficiency, and quality of patient care.
The support can achieve the outcomes of the project. The other identified strength is productivity, scientific and guidance used in inpatient care.
The healthcare providers have the competencies of using different technologies, which would enhance the project’s outcomes.
The SWOT analysis also showed several weaknesses in the organization.
One of the weaknesses is the continuous staff turnover due to overwork. Covid19 pandemic has placed immense pressure on the organization’s workforce. The healthcare providers are inadequate to meet the high care needs of the large influx of patients to the organization.
The other weakness is poor staffing; they do not feel leadership understands their work demands, working much overtime, and having a poor work-life balance.
The SWOT analysis revealed the minimal involvement of the employees in making critical organizational decisions, lack of open communication, and inefficient use of reward mechanisms to enhance the performance and motivation of the staff.
The SWOT analysis also revealed several threats to the organization.
One of them is the high costs associated with acquiring new technologies. New technologies are expensive to acquire, maintain, and equip healthcare providers with the knowledge and skills needed to operate the systems.
The other threat is competition from the leading providers of care in the region that has embraced health information technologies to prevent and reduce patient falls.
The other threats include changing trends in healthcare and the emergence of new health problems that affect the sustainability of the adopted organizational interventions.
The organization can overcome the above issues and challenges by focusing on its opportunities. They include adopting novel technologies for sustained performance in terms of quality, safety, and efficiency, training its staff on technologies in healthcare, and encouraging evidence-based interventions.
It can also tap into the highly informed consumer base by providing solutions such as remote care using digital technologies in healthcare.
One of the regulations that will facilitate the implementation of the healthcare improvement project is the Health Insurance Portability and Accountability Act (HIPAA).
HIPAA is a regulation adopted to promote the safe use of health information technologies. The regulation requires healthcare organizations to ensure data integrity in health information technologies.
It also protects patients from the adverse effects of data breaches in healthcare organizations.
HIPAA provisions also require healthcare organizations to develop strict policies that will guide access and use of private and confidential data of the patients.
HIPAA will facilitate the implementation of the proposed healthcare improvement project by ensuring that safe and efficient systems are adopted to prevent patient falls in the organization (Shuaib et al., 2021).
It will also guide the development of processes to implement health information technologies to prevent and minimize patient falls in healthcare.
SMART+C Goal and Outcome Statement
The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.
The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.
Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.
The proposed project is highly feasible in the organization. It entails using best practice interventions to reduce and prevent patient falls. It also entails using relevant practices to nursing that would enhance the safety and quality of patient care.
The project is relevant to the organization because of the recent increase in inpatient falls. The relevance can also be from the organization’s focus on achieving care outcomes such as safety, quality, and efficiency.
Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.
The project will start in October and end in July next year. Some of the anticipated challenges to the project may include getting adequate institutional and provider support, sustaining the project interventions, and effective implementation of health information systems to prevent and reduce the risk of falls in the organization.
SMART + C Goal
Please refer to appendix D to view the SMART + C Goal Questionnaire. This project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program. Please refer to the appendix.
Goal Outcome
The project’s outcome is the reduction in the rate of falls among patients with dementia.
The secondary outcomes include the reduction in the costs incurred by patients with dementia, hospital stay, and improvement in the overall efficiency in the institution.
The project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program.
The staff has significant roles to play to fulfill all the set goals.
TASK 2: INTRODUCTION FOR HEALTH IMPROVEMENT PROJECT.
- INTRODUCTION
- Problem Background
Promoting safety, quality, and efficiency in patient care is essential for their health and wellbeing. However, patient falls adversely affect the safety and quality of care that patients receive. Patients of a specific category, such as those with dementia, have an increased risk of falls.
Patients who have dementia have an increased risk of falls due to factors such as impaired judgment, visual-spatial perception, gait, and the ability to identify and avoid hazards that relate to falls (Peek et al., 2018).
The risk for falls in patients with dementia in the US is twice higher than those without the disorder (Fernando et al., 2017). Dementia is associated with adverse effects on the patients’ health and their careers. As a result, falls in these patients predispose them to worse health outcomes and poorer quality of life (Wheatley et al., 2019).
Falls in patients with dementia cause adverse effects, including injuries, increased care costs, and mortality (Peek et al., 2018). Nurses and other healthcare providers have a critical role in preventing falls in patients with dementia.
They utilize evidence-based interventions in inpatient care to optimize the care outcomes in patients with dementia (Oki et al., 2021). In addition, they explore inter-professional interventions that can be adopted to reduce and prevent falls in patients with dementia (Rajagopalan et al., 2017).
Health information technologies such as wearable sensors and motion detectors effectively reduce the risk and prevent falls in patients with dementia. The technologies enhance the ability of healthcare providers to respond promptly to patients’ vulnerability to falls in their settings, thereby promoting the patients’ health (Baig et al., 2019).
Despite the efficacy of the systems, the practice site has not implemented its use, leading to a high rate of falls among patients with dementia. Therefore, the project’s focus is on using health information technologies such as wearable sensors to predict, prevent and reduce the rates of falls among patients with dementia.
The project is significant as it enhances the safety and quality of care. The reduction in the risk and prevention of falls promote safety and quality in care by preventing the predisposition of patients with dementia to outcomes such as injuries, prolonged hospital stays, and mortality (Wheatley et al., 2019).
The project also promotes cost-efficiency in care. Falls increase the costs incurred by patients due to prolonged hospital stays, and complex care needs to manage the effects of falls. The reduction in the risks and rates of falls in patients with dementia promotes cost-efficiency inpatient care (Fernando et al., 2017).
The project also informs evidence-based practice in nursing. It guides the introduction of evidence-based interventions that can be adopted to prevent falls in dementia patients and acute care settings.
Through the project, nurses know about efficient and effective ways of incorporating technology into dementia care to promote safety and quality in their settings (Peek et al., 2018).
- Description of the Problem
Dementia is one of the global health problems with adverse effects on the affected populations. Dementia is a term that encompasses a range of conditions associated with alteration in multiple high functions such as cognition, memory, communication, behavior, and the ability to perform the activities of daily living.
Patients with dementia are highly predisposed to falls compared to those without it. The risk and rate of falls annually are almost twice in patients with dementia compared to those without (Peek et al., 2018).
People with dementia have a history of falls five times and an increased risk of falls than those without any history of falls. Falls have adverse health effects on patients. Accordingly, it predisposes patients to fall-related injuries that include hip fractures.
It also increases mortality risk due to its complications (Fernando et al., 2017). Falls also predispose patients with dementia to health problems that include long-term disability, premature institutionalization, functional dependence, and traumatic brain injury.
Patients with a history of falls also develop a fear of falling, leading to anxiety and a decline in the quality of their lives (Stark et al., 2021).
Patients with dementia are increasingly predisposed to falls due to risk factors such as cognitive impairment and altered gait, balance, vision, and functional health status (Oki et al., 2021).
The medications that patients with dementia use also predispose them to falls due to their side effects, such as hypotension, confusion, and increased irritability (Wheatley et al., 2019).
Falls are associated with adverse economic effects to patients with dementia, healthcare institutions, and the state. For example, statistics estimates from the US show that about $30 billion is used annually for treating falls among elderly adults (Stark et al., 2021).
The costs incurred in the state for managing fatal falls in the US are estimated to be US $637.1 million and the US $31.3 billion for non-fatal falls. Due to the increased risk of falls in patients with dementia, its related hospitalizations to be 26% of all the hospitalizations in the US (Bayen et al., 2017).
The costs of treating dementia alone are significantly high for patients and their families. For example, Jutkowitz et al. (2017) found in their study that the cost of care for a person with dementia is $321,780 from the time of diagnosis until its optimum management or death due to its associated complications.
Families and patients incur 70% of the total cost burden from the above amount, while Medicaid and Medicare account for 14% and 15% of the costs, respectively.
The costs incurred by a family with a patient with dementia in healthcare are 86% higher than those without a dementia case (Jutkowitz et al., 2017).
Considering the above economic burden of dementia alone, a patient fall worsens the economic status of the patients and their families significantly, hence, the need for responsive interventions to address the problem.
Early detection and prevention of falls among patients with dementia are critical to promoting their health and wellbeing.
Early detection and prevention have the potential of reducing the morbidity as well as mortality associated with falls. Most of the elderly fallers (50-75%) experience recurrent falls in their lives irrespective of their disease states, making it imperative to take preventive measures to reduce fall-related injuries and fall risks at large (Bayen et al., 2017).
The implementation of rapid fall detection and prevention systems limits the risk of ling-lie, a predictor of worse health outcomes, reduced walking capacity, and prolonged hospital stay (Rajagopalan et al., 2017).
Rapid detection and prevention of falls also enhance the accuracy of care directed to injuries related to patient falls.
It also lowers the short-term indirect effects of falls such as hypothermia, phlebitis, and pressure sores alongside long-term fall-related effects such as fear of subsequent falls, loss of autonomy, and social isolation (Baig et al., 2019; Bayen et al., 2017).
Consequently, healthcare providers and institutions should embrace responsive interventions that promote early detection and prevention of falls among patients with dementia to enhance their health and wellbeing.
- Purpose Statement
This healthcare improvement project aims to examine the effectiveness of healthcare technologies such as wearable devices in reducing and preventing falls among patients with dementia.
Through its implementation, the cost, safety, and quality of care given to patients with dementia will improve significantly.
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- (a) Project Management Lifecycle
Project management lifecycle is a model that organizations use to guide the implementation of their projects. The lifecycle comprises steps for optimum outcomes to be achieved in project implementation.
The steps include initiation, planning, execution, and closure. Initiation is the first step in the cycle where the project stakeholders identify an organizational need, problem, or opportunity for enhanced performance and productivity.
The stakeholders also develop the objectives of the project and its feasibility. They also develop deliverables that will guide the project implementation process.
The activity in this phase of the cycle in the proposed project will be the development of project objectives and deliverables (Clegg et al., 2020). The objectives and deliverables will guide the implementation process of the project.
The second step to be noted in the project management lifecycle is planning. Planning is when the stakeholders break down the more significant project deliverables into smaller, achievable tasks.
The stakeholders also develop an inter-professional team that will be held responsible for overseeing the implementation of the project.
They also develop timelines for completing the project tasks. At this phase, the project stakeholders must develop smaller goals that will underpin the project’s main objective, vision, and mission.
During the implementation of the healthcare improvement project, the activity in this step is creating a project plan (Clegg et al., 2020). A project plan comprising project timelines, phases, tasks, resources, and budget will guide the implementation of the process.
The third step in the project management lifecycle is execution. Execution is when the developed strategies in the planning phase are in practice. The stakeholders turn the project plan into action.
The project management leaders ensure that the project activities are on track in this phase. They organize the team members, assign roles and responsibilities, manage the project timelines, and ensure the implementation according to the developed plan.
One of the activities that will occur in this phase during the implementation of the healthcare improvement project will be creating tasks for teams and organizing workflows. The project leaders will assign tasks to the appropriate team members and ensure efficiency in the project’s implementation (Clegg et al., 2020).
The leaders will also coordinate project activities to ensure execution aligns with the developed plan.
The last step in the project management lifecycle is closure. The closure is when the project stakeholders provide the end deliverables of the project, release resources of the project and evaluate the success of the project in achieving its outcomes.
The closure provides an opportunity to reflect on the project successes, weaknesses, and opportunities that should achieve optimum outcomes in similar projects in the future.
One of the activities undertaken in this phase during the closure of the healthcare improvement project will be evaluating the project’s effectiveness. Process and outcome measures will determine whether the desired objectives of the project were achieved or not (Clegg et al., 2020).
In addition, feedback to the team members involved in the project to inform their practice.
4 (b). Project Guidance Initiation to Closure
The project management lifecycle will guide the project from its initiation to closure. It will provide the stakeholders with insights into the project objectives and deliverables.
It will also guide the development of an inter-professional team to implement the project.
The lifecycle will also guide the development of project strategies that would achieve the expected outcomes.
The project management lifecycle will also provide the desired structure for delivering the project.
It will provide a framework for enhancing project activities such as scheduling, communication, and collaboration.
The cycle will also guide the progressive evaluation of the project at different stages of its implementation.
The evaluation will inform the implementation of interventions that improve the project outcomes.
Lastly, the model will guide progress throughout the project implementation, evaluation, and termination processes (Institute, 2019). The tracking will eliminate potential issues such as task duplication and infective use of resources for the desired result to be achieved in the organization.
- Review of Relevant Scholarly Sources.
- Scholarly Review Purpose
A scholarly review of sources on the selected healthcare improvement project with some aims was to determine the credibility and reliability of evidence supporting the use of the intervention in addressing the clinical issue.
The sources of evidence should have valid, reliable, and credible evidence to inform the clinical practice in nursing.
The other purpose of the scholarly source review was to identify gaps in practice. Identifying gaps in practice informed the need for the healthcare improvement project. It also strengthened its relevance to the organization and its ability to address its needs.
The third aim of the scholarly review in the healthcare improvement project was to learn about the project’s practical ways. Accordingly, the sources of scholarly evidence inform the strategies utilized in the translation of evidence into practice (Dingwall & Staniland, 2020). Therefore, a scholarly review of sources of evidence must inform the need and relevance of healthcare improvement projects
- Table of Scholarly Sources
First Author and (Publication Year) | Scholarly Source Title | Type of Scholarly Source | Relevance |
1. Behera et al. (2021) | State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review | Peer-reviewed journal | This article is relevant to the proposed project, as it explores the benefits of using health information technologies in promoting safe inpatient care. It explores the benefits of technology use in detecting and preventing patient falls. It also provides insights into the factors for the effective use of health information systems of patients with dementia. |
2. Bezold et al. (2021) | Sensor-based fall risk assessment in older and aged adults with or without cognitive impairment: A systematic review | Peer-reviewed journal | This article is relevant to the proposed project as it shows the efficiency associated with technologies used in detecting, preventing, and reducing falls among elderly patients. The article shows that sensor technologies have a high level of accuracy in fall detection. The results also show that the technology reduces the workload for healthcare providers. It also shows that the use of sensor technologies for fall prevention is a feasible project in acute care settings, including those involved in the care of patients with dementia.
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3. Boutella et al. (2019) | Covariance matrix-based fall detection from multiple wearable sensors | Peer-reviewed journal | This article is relevant to the proposed project, as it shows that health information technologies are effective in fall detection and prevention. The article shows that automatic fall detection systems are easy to use and provide highly accurate data that can aid the promotion of safety in healthcare by preventing falls.
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4. Gettel et al. (2021) | Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review | Peer-reviewed journal | This article relates to the healthcare improvement project by showing the effectiveness of healthcare technologies in fall prevention in elderly patients with dementia. The article shows that the technologies improve function, cognitive status, psychosocial status, caregiver burden, and home safety.
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5 Potter et al. (2017) | Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care. | Peer-reviewed journal | This article relates to the project, as it explored the effectiveness of sensor technologies in preventing falls in acute care settings. The article shows that sensor technologies have enhanced efficiency over fall alert systems. It also shows that healthcare technologies in fall prevention are viable in healthcare settings. |
6 Subermaniam et al. (2017) | The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients. | Peer-reviewed journal | The article relates to the project by examining healthcare technologies in fall prevention among elderly patients. The article shows that technologies have enhanced effectiveness in accurately detecting bed absence episodes. The technologies also reduced workload scores. The rate of acceptability of the technologies is high among nurses.
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7 Sun & Sosnoff (2018) | Novel sensing technology in fall risk assessment in older adults: A systematic review | Peer-reviewed journal | The article relates to the project by showing that healthcare technologies such as sensors effectively reduce the risk of falls among older adults. The technologies provide accurate, inexpensive, and easy methods to prevent falls.
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- Scholarly Source Synthesis
All the selected articles for the synthesis recognize that falls in elderly patients and those with dementia are critical health concerns with adverse health effects.
The sources further identify that falls and related injuries are preventable and predictable. Falls can be detected and prevented using interventions that aim at modifiable risk factors that predispose patients to falls, such as mobility, balance, and muscle strength (Sun & Sosnoff, 2018).
Effective adoption of fall prevention programs promotes cost efficiency in healthcare and maximizes the quality of life of patients with dementia.
Most of the selected articles agree that healthcare technologies such as sensors, pressure sensors, ambient motion sensors, and low-cost depth cameras and videos are effective in fall detection and prevention.
For example, Sun and Sosnoff (2018) assert that technologies provide accurate data to determine fall’ risk assessment and alert nurses about the need for responsive actions to prevent falls.
Despite evidence about the effectiveness of technologies in fall prevention, minimal interventions have to examine their use in the acute care of elderly patients.
In addition, limited evidence exists on the use of the technologies in undertaking fall risk assessment (Sun & Sosnoff, 2018). Subermaniam et al. (2017) provide similar assertions in their study that wireless modular bed absence sensor devices accurately detected bed absence episodes in geriatric inpatients and alerted nurses accordingly.
The authors found that the technology had 100% sensitivity and a 68% positive predictive value.
The technology further reduced the workload score by the end of the intervention, with 83% of the nurses considering it an effective tool for fall prevention.
However, the difference between the study by Subermaniam et al. (2017) and Sun & Sosnoff (2018) lies in the methodologies where the former used a two-part, uncontrolled study design while the latter was a systematic review.
The study by Potter et al. (2017) evaluated the effectiveness of sensory technology in detecting a risk of falls and preventing falls in acute care.
The study showed themes that included reducing fall rates and total patient-bed days.
The study also revealed the theme of enhanced efficacy of the sensory systems over the standard fall alert systems in fall detection and prevention in acute care settings.
As a result, the researchers recommended adopting fall prevention systems, as they are viable in healthcare organizations.
The systematic review by Bezold et al. (2021) also revealed a similar theme. The use of healthcare technologies in fall detection and prevention was to have a high level of accuracy and feasibility in elderly adults, irrespective of their cognitive status.
Unlike Potter et al. (2017), Bezold et al. (2021) identified factors such as the location of the sensors, type, and attachment to affect the accuracy of detection and alerts by the adopted healthcare technologies.
Gettel et al. (2021) investigated the effectiveness of ambient-assisted living, fall detection, and dementia care technologies in promoting safety in dementia care.
The study revealed themes that included improved function, cognitive and psychosocial status, caregiver burden, and home safety using the technologies.
The others, however, noted the need to consider barriers to the use of technologies in fall detection and prevention, such as privacy concerns, willingness to accept assistance, and suboptimal user experience (Gettel et al., 2021).
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D157 IZM 1MANAGNG RESOURCES IN THE ERA OF DISRUPTION
Human Resource Management
The design and implementation of a health improvement project require a careful plan formulation that considers several aspects, such as management of the whole project. The implication is that a well-crafted document should be a guiding light (Scott et al., 2020).
In the previous weeks, a potential project to help decrease the incidents of patient falls among elderly individuals in the medical-surgical unit.
Therefore, this current write-up explores various aspects of this project, such as human resource management, project team member engagement, financial resource management, and project charter.
The human resource is an integral part of any project, and therefore appropriate staffing requirements should timeously be considered and addressed to ensure that the project is a success (Zaid et al., 2018).
- Staffing:
Therefore, this section discusses the staff requirements and strategies of allocating and assigning the human resource. This project is to be implemented among elderly patients with dementia to prevent them from falling or reduce the incidences of falls.
Therefore, various staff with specific specialization will be needed. The required staff includes a unit preceptor, nurse leader, and nurse manager. These staffs are chosen since they have a higher leadership power and high interest, implying that they can substantially contribute to the project’s success.
By their experience, these staffs have extensive experience in change initiation and project implementation in healthcare settings.
The chosen staff have various roles and expectations. The nurse manager uses the extensive skills and experience acquired in managing various change projects in nursing and the obtained understanding of the system to fulfill the responsibilities (Caramanica & Spiva, 2018).
The nurse manager has various roles, such as coordinating the whole project. The implication is that the nurse manager will ensure that the expected deliverables are within the projected time frame achieved by the team.
The nurse leader uses the influence held in the organization to motivate and lead the organization’s employees to accept and embrace the targeted behaviors and actions for the project’s success (Harvey et al., 2020).
Therefore, the primary responsibility of the nurse leader is to motivate every organization’s staff to adopt the desired change and lead everyone in implementing the necessary best practices that are key to the success of the project.
By their experience, preceptors have extensive knowledge in working with interprofessional teams in various healthcare initiatives, such as implementing best practices (Spiva et al., 2017).
The preceptor plays a vital role in the project’s implementation phase. The key responsibility of the preceptor is to lead the inter-professional teams during the project implementation.
In addition, the preceptor will avail the strategies assessment data to ensure that the team achieves the expected outcomes.
- Costs:
For the project’s success, there are costs associated with the health improvement project related to the roles, personnel, projected hours, and salaries. The project’s duration is to take six months for full implementation. The projected salary for the staff is $10,000 monthly, resulting in a total of $60000 for the whole duration.
Project Team Member Engagement
- Recruitment Strategies
The engagement of the project team member is vital for the successful implementation of the project. Therefore, it is essential to timeously identify the project team members and develop appropriate strategies to engage them (Fischer et al., 2017).
Various strategies in recruiting additional project team members are as follows; One of the strategies is holding a consultative meeting with the current team members to identify roles that need the project’s success effectively.
Such meetings can be vital in ensuring that role overlap is eliminated and specialization for better outcomes is actualized. It is vital to undertake team building with the team members in place. Therefore, various strategies for team building, such as coaching, entails using the expertise of a professional or a senior person in a particular role to train the staff on how to accomplish particular tasks (Shirley, 2020).
It is also essential to establish trust among the team members to ensure that everyone fulfills their roles accordingly. Collaboration is critical, and therefore, as part of team building, the staff will be encouraged and empowered to collaborate and accomplish tasks within the defined time frame.
As part of the project team member engagement, various team guidelines will be used and will form part of the project. For instance, decision-making will guide the team into making the right choices during the project implementation process.
Conflict management will also form part of the guidelines. For example, a clear channel of managing any potential conflict during the project implementation will be made clear and form part of the team guidelines (Sipes, 2019).
For example, the nurse manager will only be involved in conflict management if the nurse leader has tried, and apparently, the conflicts remain unsolved. Again, it will be critical to keep communication channels active and open.
The staff will know how to channel their communication and the steps they should take when communicating issues dealing with the organization and the project implementation.
D(i). Support for Team Members
The success of the project depends on various aspects. One of such aspects is ensuring that the work environment is healthy and that the members achieve a work-life balance.
Thus, it is necessary to support the project team members and staff during the implementation using evidence-based strategies.
One of the strategies includes asking for their views and implementing them if necessary. Their views into the project’s day-to-day running feel appreciated and experience a better work-life balance (Soomro et al., 2018).
Another strategy is a regular review of the workload as this will prevent various negative distractions such as burnout which can hinder the project’s progress.
In addition, it gives a chance to redistribute workloads and potentially hire a new member for better implementation.
They were encouraging the team members to take a break where necessary is another crucial aspect of ensuring that they have a better work-life balance. Creating and making open communication channels can also be critical in this regard.
The team member will effectively air out their concerns, thoughts, and grievances, which could be vital in implementing the whole project. The Health Improvement Project RACI chart is an essential document for this project as it shows the detailed roles and responsibilities of various team members; the chart is in the appendices.
D(ii). RACI Chart (Please see Appendix E)
Financial Resource Management
- Budget Methods and Requirements (F and F1)
It is essential to manage financial resources appropriately. The financial resource management section documents the financial methods applied in formulating the operating budget to plan the HIP’s control and implementation phases and the input from various project team members who helped influence the budgeting process.
The financial method used in creating the pro forma invoice is activity-based budgeting. This financial method entails a top-down approach where the team analyzes activities and uses the analysis to predict the future costs and operating budget (Jones et al., 2018).
So, it takes place in three different phases: identifying, determining, and estimating. One team member who dramatically influences the budgeting process is the nurse manager.
Nurse Managers have vast experience in project management and implementation and all the financial aspects involved. So, the nurse manager was vital in helping identify the key areas to spend the money and the line-item financial estimates to the pro forma budget.
The process used in the financial estimates was through thorough research on the current market prices of various items and services. There was also a collaboration with various staff and team members. The nurse preceptor was particularly crucial in this aspect, drawing from a vast experience of the market and the overall costs.
The project Pro Forma operating budget has been included as part of the appendix and explains various parts such as the budget items, amount for each item, and the description of each item.
Budget Variances
Budget variance can come with anxiety and threaten the successful completion of a project as it can either be unfavorable due to high cost or favorable, implying more revenue. Therefore, it is essential to track and manage such variance.
One way of tracking and managing the variance is regularly running a budget to report (Jones et al., 2018). Ensures that the team keeps updated on the variance to spot trends and possible trouble sports timeously.
It will ensure that variance does not occur. Budget adjustment can also be essential. The implication is that the budget can be adjusted mid-way to ensure that the variance does not occur.
Project Charter
The project charter section focuses on various aspects such as justification for the project, the project summary, the project’s objectives and constraints, the high risks, budget overview, and the schedule of milestones summary (Sipes, 2019).
STRIDE Early Mobility program entails using a walking program among the patients at risk of falling. This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital. The project charter is in Appendix H.
Healthcare Improvement Project Charter (Appendix G)
Justification
This project STRIDE, Early Mobility program help, reduce the rates of falls among patients with dementia. Older individuals living with dementia are always at risk of fallings and ensuring consequences.
In addition, these patients with dementia experience twice the rates of falls experienced by cognitively intact individuals, and they have more injurious falls.
This patient falls among patients with dementia can lead to enhanced institutionalization rates, mortality, and morbidity. Therefore, there is always a need to develop various strategies to prevent the incidences of such falls.
While some interventions have been successful to a degree, there is a need to develop better methods of controlling these falls. Therefore, this project will focus on lowering the rates of falls among patients with dementia.
The targeted intervention is the STRIDE Early Mobility program.
STRIDE Early Mobility program entails using a walking program among the patients identified to be at risk of falling.
This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital.
Project Goal and Outcome Statement
The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.
The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.
Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.
The proposed project is highly feasible in the organization. It entails using best practice interventions to reduce and prevent patient falls. It also entails using relevant practices to nursing that would enhance the safety and quality of patient care.
The project is relevant to the organization because of the recent increase in inpatient falls. The relevance can also be from the organization’s focus on achieving care outcomes such as safety, quality, and efficiency.
Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.
The project will start in December and end in November next year. Some of the anticipated challenges to the project may include getting adequate institutional and provider support, sustaining the project interventions, and effective implementation of health information systems to prevent and reduce the risk of falls in the organization.
Project Milestones
The project is to start on October 2, 2021, and end by graduation date after May 31, 2022
Project Budget
For successful completion of the project, finance will be critical, hence formulating a budget with the main project expenses and the total anticipated expenses, as such, various budget items in this section.
One of the necessary budget items includes Research sources and preparation of interview questions and questionnaires, projected to cost $1000.
The other item is telephone expenses and transport allowance, which cost $700. It will ensure effective communication and collaboration between the stakeholders and the team members. The next item covered in the budget is teaching and educating staff on the STRIDE Early Mobility program. There will be a need to hire experts who can train the staff.
Therefore, the expected cost is $3000. Another $800 on dinner and allowance for stakeholders who work overtime during the project implementation process and another $900 for snacks and allowances for individuals attending meetings for more efficient processes and the total cost will be $6400.
Significant Risks
Risks While the project can give better outcomes among the participants, there are also possible risks; one of the possible risks is a possible injury to the participants caused by the STRIDE program as the participants will have to participate in the daily walks program. Such a walking requirement may prove challenging to individuals with dementia and are already frail.
Conclusion
In conclusion, the success of a health improvement project largely depends on the implementation plan put in place.
Therefore, a good plan is critical. Phase two of the project has mainly dealt with planning. Various aspects have been addressed and discussed, such as human resource management, project team member engagement, financial resource management, and project charter.
DJ158 JAM 1 Task 1
The most vital step in a project cycle is the implementation phase since it ensures that every conceptualized idea is translated into reality to achieve the goals and objectives. Central to the implementation is a strategic plan for executing the proposed health improvement project (Leeman et al., 2017).
While the primary focus is on successfully implementing the project, various aspects have to be considered, such as the socioeconomic data on the selected population that the proposed health improvement project will impact. Such a step helps in comprehensive analysis to determine opportunities and risks.
Analysis forces for and against the project is critical in determining the strategies to overcome the points against the project for success. Therefore, the purpose of this assignment is to explore a strategic plan for the execution of the STRIDE Early Mobility program.
Meetings and Organizational Policies
Having meetings are an essential part of any project implementation and management efforts. Therefore, it is prudent to have a timely plan describing how the project meetings would be organized and led (Radujković & Sjekavica, 2017).
It is vital to organize and lead meetings, so the leader is more than a moderator or a time monitor and avoids the pitfalls of wanting to make everyone see things from the leader’s point of view, dictating outcomes or direction (Radujković & Sjekavica, 2017). So the meetings will be organized by following various strategies such as formulating relevant objectives for each meeting and translating them into a practical plan through agenda formulation.
The other strategy is to communicate timeously to the team and encourage them to participate when the time comes and create an enabling environment that encourages everyone to participate (Lock, 2017) fully and actively. Again, it is essential to communicate the meeting results and accept and incorporate feedback from members to enhance the meeting process.
The following are some best practices in building consensus.
- In building consensus for an idea, collaborate early and often.
- Collaborate with others, make the idea a collage formed from the ideas of others.
- Pre-syndicate for alignment.
- Give and take.
- Let ideas go.
- Open discussion
One of the methods to reach consensus during the meetings is facilitating an open discussion and ensuring that every team member participates (Straus, 2017). This step will ensure that everyone’s input is brought on board regarding a particular agenda, quickly reaching the consensus. When members feel consulted and involved, they are more likely to welcome and accept the decision made regarding the agenda.
It is vital to find out if the organization has some existing policies that can affect the implementation of the project. Some of such policies can create a considerable hindrance; hence, it is vital to find more about them to make informed decisions. One of the methods I will use is to request the organization’s policy document from the nurse manager. We would then read the document with a legal expert to help in understanding every clause that could impact the implementation process of the proposed project.
Action Plan Development
The action plan is one of the critical documents in project management and implementation as it gives a clear roadmap on the actions to undertake and strategies to use to ensure that the implementation process is a success and that the goals are achieved (Teixeira & Junior, 2019).
An action plan is in the appendix section (Appendix H).
The action plan contains various items such as action items, owner role, five action items, the phases, and the target due date.
Gathering the input related to the development of the action plan is critical in ensuring that the correct input forms part of the action plan.
One of the strategies I plan to use is a survey (Zwikael et al., 2018). The survey will have a self-administered questionnaire with questions dealing with various aspects of the forming part of the survey. Through the survey, there will be meaningful and relevant input from the members who will attend to the survey questions. The survey is easy to administer and saves time. It is essential to use the right strategy in describing the key steps. A detailed literature search on relevant project implementation and management identified the owner’s role and the title. In addition, the five high action items, identification of the action phase, and the target date through a collaboration with the nurse manager and nurse leader, both of whom have vast experience in implementing quality improvement and evidence-based practice projects.
SDOH and Target Population
World Health Organization defines SDOH as how people are born to the world, how they grow, live, work and age. These circumstances are controlled by the distribution of money, power, and resources globally, nationally, and locally. It is primarily responsible for health inequities like the unfair and avoidable differences in health status seen within and between countries.
The resources that enhance the quality of life can significantly influence population health outcomes. Examples of these resources include access to education, safe and affordable housing, public safety, an environment free of life-threatening toxins, availability of healthy foods, and local emergency/health services.
Healthy People 2030 highlights the necessity of looking at SDOH by including “social and physical environments which promote good health for all and sundry as one of the four goals for the decade.
It is a known fact that poverty limits access to safe neighborhoods and healthy foods, and education is a predictor of better health. The differences in health are significant in communities with poor SDOH, such as low income, unstable housing, substandard education, or unsafe neighborhoods. Applying what we know about SDOH can improve individual and population health and advance health equity.
The social determinant of health is as follows:
- Healthcare access and quality: The connection between people’s access to and understanding of health services and their health.
This domain includes critical issues such as access to healthcare, primary care, health insurance coverage, and health literacy.
- Education access and quality: The connection of education to health and wellbeing. This domain includes critical issues such as finishing from high school, admission to higher education, educational attainment in general, literacy and language, and early childhood education and development.
- Social and community context: The connection between the characteristics of the contexts within which people are living, learning, working, and playing and their health and wellbeing. It includes topics like cohesion within a community, civic participation, discrimination, conditions in the workplace, and incarceration.
- Economic stability: The connection between the financial resources people have, income, cost of living, and socioeconomic status and their health. This area includes vital issues such as poverty, employment, food security, and housing stability.
- Neighborhood and built environment: The connection between where a person lives, housing neighborhood, environment, and their health and wellbeing.
It includes topics like the quality of housing, access to transportation, availability of healthy foods, air and water quality, and neighborhood crime and violence.
Knowing and describing the target population is critical in further aligning the proposed intervention for the health improvement project. Therefore, this section describes the target population’s sociodemographic characteristics and social determinants of health and how the proposed project would affect them.
The program targets older individuals living with dementia. This group of people usually faces an enhanced risk of falling. Indeed, persons living with dementia have a twice chance and rates of falling when compared with individuals with the proper cognitive functionality (Peek et al., 2020). Due to their condition, these individuals need much social support to have better outcomes and ensure that they come with the incapacitating nature of the condition.
There are various social determinants of health for elderly individuals living with dementia. One of them is a social support network. These individuals experience the adverse impact of this chronic condition and therefore need social support from different networks.
Belonging to social support groups leads to better health outcomes for this population. Socioeconomic status is another determinant of health (Young et al. 2020). Better economic wellbeing is associated with better health outcomes as the patients can afford care and related services.
Most of the patients have excellent social support through their immediate families, churches, other elderly support groups, and senior citizen groups. They have support group meetings held weekly, which allows them to interact and socialize.
Neighborhood and physical environment is another social determinant of health for this group. A supportive neighborhood ensures that they have better health outcomes. When the physical environment is modified to reduce falls, these patients have higher chances of better patient outcomes.
Most patients live in a perfectly conducive neighborhood, some live in old nursing homes, while some stay with their children. The crime rate is relatively low.
The physical environment favors the elderly as sidewalks, parks, and public transportation are cheap, accessible, and affordable. The homes they live in are very safe as the community looks after each other.
Education is another determinant. Individuals with low levels of education tend to have limited knowledge on various aspects such as appropriate access to care, self-care activities, and relatively less finance to seek medical attention and payment of bills. Therefore, such individuals could have worse health outcomes.
The other social determinant related to health and healthcare is health coverage. Some of these patients lack health insurance, and when a patient lacks health insurance, they have considerably lower chances of having a primary care provider, hence impacting negatively on their health outcomes (Northwood et al., 2018).
On access to healthcare, my target population has access to first-tier hospitals like the University of New Mexico Hospital, Presbyterian Hospitals, Lovelace Hospitals, and Veteran Affairs Hospital. They all have qualified primary care practitioners in all the listed hospitals, and each County has standard primary health care facilities spread across the town.
Specialists in various medical fields, especially as it relates to geriatric medicine, they are all available; le and accessible. The average distance to see a specialist cannot be more than 2 to 4 miles to their residences.
On medical insurance, most of the targeted elderly patients have Medicare which assists them tremendously, also coupled with the fact that some of them have secondary health insurance.
The other determinant is quality of care. Patients living with dementia need a high quality of care for better health outcomes as the condition is disabling mentally. As such, when patients lack access to high-quality care, then they have poorer outcomes. Health coverage and quality of care are two of the most important SDOH that address health and healthcare-related to patients with dementia. As earlier indicated, these patients are also susceptible to falls due to their condition, however, if they have a higher quality of care and better health coverage, then their chances of falling are greatly reduced.
The proposed intervention entails a physical activity program. The program entails the initiative of a walking program among patients living with dementia who risk falling. The STRIDE Early Mobility program can improve the health outcomes among the identified target population by reducing falls. When the incidences of falls, these patients have a reduced risk of overstaying in the hospitals. The implication is reduced healthcare spending and decreased exposure to healthcare-acquired infections.
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Force Field Analysis
The force field analysis allows identifying the forces which are likely to drive the implementation of the proposed intervention forward and the possible forces that are likely to oppose the implementation process (Rosenbaum et al., 2018).
A detailed force field analysis table has been included in appendix I.
In analyzing the force field table, three positive or driving forces and three hostile or restraining forces are to be considered. The positive or driving forces identified include positive organizational support, effective communication, and a strong commitment from the leadership team.
On the other hand, the three identified hostile or restraining forces include possible resistance to the change implementation, inadequate resources, and lack of stakeholder engagement. The positive forces will help plan for the implementation of the proposed project.
Positive organizational support means that the implementation process is likely smoother since the organization supports the project (Rosenbaum et al., 2018). Therefore, the focus will lead to other organizational factors likely to hinder the implementation process.
Effective communication as a driving force means that the implementation process is tabled for the consideration of the team members as they will pass vital information related to the project more effectively to support the implementation process.
The leadership team is also committed to the change hence such a force will be critical in the implementation process. The implication is that little or no supervision will be needed while implementing the project.
The existence of the opposing forces is also likely to influence the implementation phase. For example, change resistance can derail the whole implementation process (Rosenbaum et al., 2018).
So as part of the implementation plan, strategies will be used to overcome possible resistance, such as increased involvement of every member and to send out communications in time (Hodgson, N., & Gitlin, 2021). The possible existence of inadequate resources means appropriate plans to procure the needed resources in time. On the other hand, lack of stakeholder engagement implies that strategies will as part of the plan to increase stakeholder engagement.
The force field theory shows that the desired change occurs after the positive forces override the opposing forces (Rosenbaum et al., 2018). Therefore, it is essential to use relevant and appropriate strategies to overcome the restraining forces. The possible resistance to change can be overcome by undertaking a clear communication initiative and making every member understand why the change is necessary (Bel et al., 2018).
This step will ensure that they buy into the idea and effectively support the initiative. If possible, opinions and thoughts should be part of the process; this will make them feel a sense of belonging and feel part of the project, hence lowering the chances of resistance. Inadequate resources can derail the implementation process (Fadlallah et al., 2018).
Therefore, a funding request to the relevant entities supporting the initiative and ensuring that the needed resources are procured and made available in time. The opposing force of lack of stakeholder engagement will be overcome by timely communication with the stakeholders and promptly addressing their concerns. They will also be encouraged to participate actively and contribute to ensure that they feel part of the project.
Gantt Chart Information
A Gantt chart is a powerful tool that helps visualize the significant tasks of activities performed in a health improvement project by indicating the start dates, end dates, the progress, and who is assigned to do what (Astafeva, A., & Gazizulina, 2021). In support of the Gantt chart, the start and end dates of the significant activities are below.
Task | Start Date | End Date |
Planning | 25-Jan-22 | 01-Feb-22 |
Literature Search | 28-Jan-22 | 02-Mar-22 |
Project Design | 30-Jan-22 | 03-Apr-22 |
Implementation | 04-Apr | 02-Jun-22 |
Follow up | 03-Jun-22 | 25-Jul-22 |
The approach used in creating the Gantt chart was through the Microsoft Excel software. This software enables a smooth creation of the Gantt chart with possible modifications added to customize the output. The information to formulate the Gantt chart through a comprehensive literature search on the significant activities in the health improvement implementation plan.
The literature search was therefore vital in offering the possible activities to include. Consultation with the nurse manager was also crucial since they have engaged in many health improvements projects. Therefore, the advice was used to modify the information obtained from the literature search to make it more relevant. The five high action items, identification of the action phase, and the start and end date through collaboration with the nurse manager and nurse leader have vast experience in implementing quality improvement and evidence-based practice projects.
A complete Gantt chart is in Appendix J.
Scope Statement
The project’s justification is that patients living with dementia are more prone to falls, and therefore there is a need to design programs that can prevent these fall events (Modarresi et al., 2019). Even though various programs for fall prevention exist, these programs are still inadequate; as shown in the increased cases of patient falls, it needs more robust programs.
The goals of this project entail using health information technologies to prevent and reduce the rate of falls among patients with dementia. The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients. Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.
The project deliverables include a well-tested, acceptable, and usable walking program for preventing falls among patients living with dementia. Another deliverable is acceptable levels of adherence to the use of the walking program.
The key performance indicators include reduced rates of falls among patients living with dementia, reduced costs incurred by patients living with dementia, and reduced duration of hospital stay.
The project’s outcome is reducing the rate of falls among patients with dementia.
The secondary outcomes include the reduction in the costs incurred by patients with dementia, hospital stay, and improvement in the overall efficiency in the institution. The project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2021, to July 30, 2022, through the implementation of the STRIDE Early Mobility program.
Communication Management Plan
A communication management plan ensures effective communication throughout the project phases. Therefore, correct information should be communicated promptly to the right people (Samáková et al.,2018). Therefore, the intended receivers of the communication are the implementation team, the stakeholders, and policymakers.
The context of the communication will be from the pre-implementation period, during the implementation period, and the post-implementation period. Expected communication outcomes include improved processes and activities during the implementation face, increased by in and reduced resistance to the proposed change.
While the key messages will depend on the phase of the project, the underlying theme will be rallying the efforts of everyone to support the project. The message medium will majorly be through email as it is official and can send multiple and bulk messages simultaneously. The Covid-19 protocols and restrictions will be the barest minimum for face-to-face messages conveyance meetings.
D159 JIM 1 TASK 1
Like any other project, health improvement projects have a cycle composed of various steps. One of the most critical phases of a project cycle is the evaluation phase. The evaluation phase offers the project management a chance to assess the continuing project and when the project is complete (Kerzner, 2019).
The primary goal is to explore the extent of achieving the project’s set objectives, sustainability, impact, efficiency, and development effectiveness. Eventually, the results obtained are fundamental for the stakeholders when making critical decisions regarding the project. Various aspects must test for a project’s practical evaluation, including key performance indicators and data elements (Kerzner, 2019).
Therefore, this latest face of the health improvement project aims to explore the project’s evaluation and closure plan and explore various aspects, including project reports, data management plan, results in dissemination plan, and project closure plan.
Project Reports
A project report is essential in tracking and monitoring the project’s progress. Project reports are a crucial part of the evaluation as it enables the implementers to communicate what is to track and monitor the progress, demonstrate impact, and document lessons learned. It is essential to timeously identify the data elements that determine the project’s success (Crawford, 2021).
Bringing collaborators on board is critical. This collaboration will be among the project team members. Emails will be a strategy of communication to let the team members know that their input is vital. A face-to-face meeting will integrate everyone’s thoughts and views to develop the required data elements.
Effective communication will be the pillar of this collaborative effort. The project report also contains various data elements (Crawford, 2021).
Data elements are vital in designing project reports or dashboards (Luciano et al., 2019). The data elements include patient fall history, patient sex, and patient age. The patient fall history is critical in determining the project’s impact; it will allow a comparison between the fall rates before and after implementing the health improvement project.
The patient sex will also be important in determining if sex has a relationship with the program and outcomes. The patient’s age will also be important in determining whether the results are due to the STRIDE project by age or not.
REPORT PERIOD | DATE PREPARED | PREPARED BY |
Start on October 2, 2021, and end by graduation date after May 31, 2022 | February 24, 2021 | Program Director |
REPORT PARTICIPANTS |
Unit Preceptor, Nurse Leader, Nurse Manager, and the Program Director |
REPORT PURPOSE |
To decrease elderly patient falls on the Medical-Surgical Unit by 30% beginning October 2, 2021, to July 30, 2022, through the implementation of the STRIDE early mobility program |
PROJECT DETAILS
PROJECT NAME | PROJECT NUMBER |
Reduction and prevention of falls among patients with Dementia at Kindred Hospital | None |
PROJECT SPONSOR | PROJECT OWNER |
Kindred Hospital | Kindred Hospital |
PROGRAM DIRECTOR | PROJECT OWNER |
Nursing Director | None |
Key Performance Indicators
Quantitative KPI results with narratives | Date of analysis | Responsible Party |
Reduced rates of falls among patients living with Dementia | 02/23/2022 | Nurse Leader |
Reduced costs incurred by patients living with Dementia | 02/24/2022 | Nurse Manager |
Reduced duration of Hospital Stay | 02/25/2022 | Nurse Manager |
PROJECT BENCHMARK | Date of analysis | Responsible party |
A reduction of falls by 40% | 02/26/2022 | Nurse Leader/Nurse Manager |
PROJECT OUTCOME |
Reducing the rate of falls among patients with Dementia |
SECONDARY PROJECT OUTCOME |
Reduction in the costs incurred by patients with Dementia |
Reduction in-hospital stay for patients with dementia |
Improvement in the overall efficiency of the institution. |
OUTCOME |
None |
Data Management Plan
A data management plan is also a vital and essential part of project management as it helps in describing the nature of data to be generated or acquired how the data is to be managed, described, analyzed, and stored (Meyke, 2019). Therefore, it is critical to identify the data source to obtain data for measuring the project’s success.
Various data types will be collected. Quantitative data will be collected, such as the demographic data on the patients. The data fields include list (both numeric and text values) and date. The specific data to be collected includes age, sex, and ethnicity.
One of the processes for identifying the necessary data is reviewing the project goals and noting down the data needed to fulfill the goals. This strategy will help identify the correct data and data sources to use.
One of the data sources will be electronic health records (Sylvia, 2018). This data source will offer accurate patient history information, such as the number of falls before and during the project.
Measuring the project’s success helps determine how effective the project is and the project goals at the end. The key performance indicators are central to such measurement (Attia, 2018).
Since the project is about fall prevention among older patients with dementia, various key performance indicators can measure the STRIDE program’s success.
One of them is the % completion of elderly patients with dementia. Will be regarded as successful when done within 24 hrs. of patient admission.
The next one is the % reduction of falls among the patients with dementia. The reduction rates in falls will be determined and compared with current fall rates in the facility to get the percentage reduction in falls. A benchmark established for the % reduction of falls is a reduction in falls by 40%. The established national benchmark for patient falls is 28% (CDC, 2020). So, it is key reduce these rates to below the benchmark.
Data collection methods are an integral part of the project; therefore, the quantitative data uses various strategies. For example, questionnaires will be vital in collecting relevant quantitative data (Quinlan et al., 2019).
Designed questions to extract relevant data from the patients will be used, and data from the hospital system will be used, for example, the trends in inpatient fall in the facility from the health records. In addition, data to determine the rates of falls upon implementing the STRIDE program by recording the cases of falls.
Various parameters will be critical when collecting the data. For example, dates will help determine when the falls occurred to correctly calculate the rates of falls within a specified period. The collection frequency will be daily as the patient can be experienced any day and any time.
Data analysis will also help understand the project’s impact.
So, the high priority like percentages, averages, and counts will be analyzed using suitable software such as SPSS (George& Mallery, 2018). Using this software will be easy to analyze the counts, averages, and percentages.
Analyzing these data is not the end, as they are needed to assist in decision-making. So, the interpretation of data will be through the help of a statistician who has a deep understanding of data analysis to help understand the meaning of various coefficients and values obtained.
One of the contextual issues that may potentially affect the proposed project result is the nature of the targeted population (Li et al., 2018). Patients living with dementia are known to have high chances of falling due to the disabling nature of the condition (Sharma et al., 2018), so this could be a factor that may impact the results obtained on the rates of falls even upon the implementation of the fall prevention program.
Results Dissemination Plan
Dissemination of project results is essential as it allows the stakeholders to consider the results and make further decisions. Therefore, it is essential to have a dissemination plan (LoBiondo-Wood et al., 2018).
So, the professional setting for presenting the result will be a workshop organized at the facility where various healthcare professionals will be present. The results will also be in organized conferences.
These media will give a chance for other individuals to have an idea of the impact of the STRIDE early mobility program in preventing patient falls. The primary method used in the professional delivery of the results is a PowerPoint presentation and a poster.
Project Closure Plan
Upon evaluating the project, it is essential to wrap up the session. The project closure entails various activities. One of such activities is acknowledging the organization for its support and time (Shirley, 2020).
This acknowledgment will be in various ways. One of them is acknowledging the organization by the end of the professional presentation of the workshop or conference results. An official letter will also be addressed to the organization to show gratitude for the support offered.
The project team members will also for their time and effort and personal and customized emails to the team members with well-drafted content thanking them for their support and roles (Meredith et al., 2020). If the results are for official publication, the team members’ names will also as a show of acknowledgment.
The project team wrap-up session will also discuss any next steps. During the session, the team members will offer their views regarding the whole project cycle and challenges faced, new lessons learned, and improvement.
A round table discussion will then talk about the next steps, such as rolling out the project on a large scale depending on the effectiveness and what to do to make it more effective.
Conclusion
In conclusion, this latest part of the health improvement project has focused on the evaluation phase. The evaluation phase is vital as it helps determine the project’s effectiveness and the methods used during the implementation of the project. The data management plan, reports, dissemination of the results, and project closure plan have all been explored and discussed.
References.
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Appendix “A”
Individuals Consulted
Nurse Manager
Nurse Leader Unit Preceptor |
v
Appendix” B”:
Impact Analysis
Benefits:
Category | Improvement Project Benefits | Rating |
Patient Safety | 1. Reduction in adverse events due to falls among patients with dementia.
2. Provision of patient-centered care that minimizes the risk of falls and other safety events in dementia care |
3
3 |
Healthcare efficiency | 3. Reduction in costs incurred by patients and healthcare institutions due to patient falls.
4. Reduction in resource utilization due to decreased hospital stay and demand for specialized care by dementia patients |
3
3 |
Total Benefits Score | 12 |
Risks:
Category | Improvement Project Risks | Rating |
Patient safety | 1. The project may increase the workload for healthcare providers due to the increased need for additional care | 1 |
2. The project may cause reluctance among healthcare providers due to an increase in false-alarm rates for potential circumstances related to falls | 1 | |
Healthcare efficiency | 3. The project may cause increased costs incurred by the hospital due to the need for additional purchases and hiring more staff.
4. The organization may incur losses should the project fail to achieve its objectives. |
1
1 |
Total Risk Score 4
Impact Ratio
Impact Ratio = __3___ [Benefits Rating total score divided by Risks Rating]
|
Appendix “C”
SWOT Analysis
Factors to Maintain | Factors to Address | |
Internal Criteria | Strengths | Weaknesses |
I. Morale, Commitment, Leadership
II. Experience, Knowledge, and Data |
(i) Effective clinical and educational training/support.
(ii) Dedicated, Collaborative, and devoted Leadership/Management team.
(i) Evidenced-based research to support system processes.
(ii) Mandatory in-service and continuous training to maintain staff competency |
(i) Leadership appears not to address this with the staff worsening the problem. Communication from leadership needs to improve.
(ii) Poor staffing: staff does not feel leadership understands their work demands, works much overtime, and has a poor work-life balance.
(i) Inconsistency of all team players to consistently follow the bundle as taught.
(ii) The staff are not aligning and complying with the training policy. |
External Criteria | Opportunities | Threats |
I. Stakeholder Involvement”
II. Innovation and Development of Knowledge. |
(i) Introduction of modern technology improve patient care, which encourages the Stakeholders (patients)
(ii) Inputs from diverse stakeholders can provide data for continual improvement.
(i) Variety of best practice suggestions from multiple stakeholders.
(ii) Positive input of innovation in modern healthcare management |
(i) The Stakeholders (patients) may be discouraged if the entire project fails.
(ii) Monitoring agencies can sanction improper conduct, undermining patient trust and decreasing patronage.
(i) Multiple stakeholders may lead to consistent disagreement on the data due to multiple studies that may conflict. (ii) Tasks/care may be delayed due to needed new equipment and training. |
Appendix “D”
SMART+C Goal and Outcome Statement
SMART+C Criteria
Questions |
SMART+C Criteria
Answers |
Specific: What is the specific project? | Prevention and reduction of falls among patients with dementia through the implementation of the STRIDE program. |
Measurable: What are the indicators or parameters that will be measured? | Rates of falls among patients with dementia
Costs of care incurred by patients with dementia Average hospital stays by patients with dementia The medical-surgical fall rate is 12 per year, with a monthly average fall rate of 1 per month. The number of falls will be tracked and trended monthly after implementing the STRIDE program, hoping to reduce the falls by 30%. |
Achievable: How feasible or realistic is the project? | Evidence-based data on the possible interventions for use exists. The interventions apply to any clinical setting.
Yes, when connected to the Impact Analysis with an impact ratio of 1:50, this healthcare improvement project is good because the benefits outweigh the risks. The SWOT analysis supported the implementation of the project after comparing the strengths and opportunities that were advantageous towards the project. The need analysis highlighted that the number of falls continues to be a costly problem within the organization that needs addressing to reduce costs to the company and improve patient outcomes. |
Relevant: How worthwhile is the project to the organization? | The project is worthwhile for the organization.
It will reduce the rate of falls among patients with dementia It will also reduce the cost of care for patients with dementia It will also improve the safety, quality, and efficiency of care It will also heighten its market visibility |
Time-Bound: What are the start and end dates of the project? | The project is expected to start on October 2, 2021, with the implementation occurring after my graduation date, which is after May 31, 2022. The end date will be July 30, 2022. |
Challenging: What is challenging about the project? | To decrease elderly patient falls by 30% on the medical-surgical unit over the six months of data collection.
Getting support from the healthcare providers Getting adequate support from the hospital Sustaining the use of the project interventions in the organization Implementation of health information systems to be used in detecting and preventing falls among hospitalized patients
|
SMART+C Project Goal: | |
This project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to JULY 30, 2022, through the implementation of the STRIDE Early Mobility program. | |
Goal Outcome Statement: | |
The project’s outcome is the reduction in the rate of falls among patients with dementia.
The secondary outcomes include the reduction in the costs incurred by patients with dementia, hospital stay, and improvement in the overall efficiency in the institution. The project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program. |
Appendix E
- Table of Scholarly Sources
First Author and (Publication Year) | Scholarly Source Title | Type of Scholarly Source | Relevance |
1. Behera et al. (2021) | State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review | Peer-reviewed journal | This article is relevant to the proposed project, as it explores the benefits of using health information technologies in promoting safe inpatient care. It explores the benefits of technology use in detecting and preventing patient falls. It also provides insights into the factors for the effective use of health information systems of patients with dementia. |
2. Bezold et al. (2021) | Sensor-based fall risk assessment in older and aged adults with or without cognitive impairment: A systematic review | Peer-reviewed journal | This article is relevant to the proposed project as it shows the efficiency associated with technologies used in detecting, preventing, and reducing falls among elderly patients. The article shows that sensor technologies have a high level of accuracy in fall detection. The results also show that the technology reduces the workload for healthcare providers. It also shows that the use of sensor technologies for fall prevention is a feasible project in acute care settings, including those involved in the care of patients with dementia.
|
3. Boutella et al. (2019) | Covariance matrix-based fall detection from multiple wearable sensors | Peer-reviewed journal | This article is relevant to the proposed project, as it shows that health information technologies are effective in fall detection and prevention. The article shows that automatic fall detection systems are easy to use and provide highly accurate data that can aid the promotion of safety in healthcare by preventing falls.
|
4. Gettel et al. (2021) | Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review | Peer-reviewed journal | This article relates to the healthcare improvement project by showing the effectiveness of healthcare technologies in fall prevention in elderly patients with dementia. The article shows that the technologies improve function, cognitive status, psychosocial status, caregiver burden, and home safety.
|
5 Potter et al. (2017) | Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care. | Peer-reviewed journal | This article relates to the project, as it explored the effectiveness of sensor technologies in preventing falls in acute care settings. The article shows that sensor technologies have enhanced efficiency over fall alert systems. It also shows that healthcare technologies in fall prevention are viable in healthcare settings. |
6 Subermaniam et al. (2017) | The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients. | Peer-reviewed journal | The article relates to the project by examining healthcare technologies in fall prevention among elderly patients. The article shows that technologies have enhanced effectiveness in accurately detecting bed absence episodes. The technologies also reduced workload scores. The rate of acceptability of the technologies is high among nurses.
|
Appendix F
Healthcare Improvement Project
RACI Chart
HIP Roles & Responsibilities Matrix | ROLES | ||||
Nurse Manager, DS | Nurse leader, GC | Unit Preceptor, BA | Nurse Educator, SA | Nurse, HF | |
Coordination of the whole project | AI | R | C | C | I |
Review of research | AI | R | C | C | C |
Presentation development | AI | R | C | C | C |
Approval of the intervention plan | A | RA | C | C | CI |
Reviewing of the information provided | R | R | A | I | C |
Project implementation | RA | R | C | C | I |
Presenting the health improvement project to the staff | A | R | R | R | R |
Requesting of the feedback from staff | A | R | C | I | I |
Verification of staff compliance | I | RA | I | C | I |
Data review | R | R | R | I | I |
In the empty boxes above, enter the appropriate letter for the role that will be responsible, Accountable, Consulted, or Informed for each deliverable/task using the letters below: | |||||
R = Responsible for completion of task or deliverable | |||||
A = Accountable for completion and approval of the task | |||||
C = Consulted by those responsible for advice and expertise | |||||
I = Kept updated on progress and notified when tasks are completed |
Appendix G
Healthcare Improvement Project
Pro Forma Operating Budget
Budget Item | Budget Amount | Description | Comments | |||||
Research sources and preparation of interview questions and questionnaires
|
$1000 |
This budget item covers valuable literature research materials that need to be purchased. It will also help prepare interview questions and questionnaires to be applied in project evaluation and assessment.
|
The sources will be valuable in offering evidence and using the STRIDE Early Mobility program. The questionnaires and interview questions will also offer valuable information regarding the study.
|
|||||
Telephone expenses and transport allowance
|
$700 | This budget covers the travel and telephone costs for all the team members as they will need to travel to the practice site, meet each other, and conduct interviews.
|
Constant and frequent conversation and connection between the team members is critical for the project’s success, hence the transport and telephone call allowance.
|
|||||
Dinner and allowance for stakeholders working overtime
|
$800 |
This budget will cover the costs for working extra time or up to late hours. They will need to get an allowance for fuel and motivation.
|
This item is vital as it will show that these individuals are appreciated, enhancing motivation.
|
|||||
Snacks and allowances | $ 900 | The budget will cover the snacks needed by the team members and stakeholders during the meetings. The program will pay an allowance to those who participate in the project.
|
The token of appreciation is vital in improving motivation and cooperation.
. |
|||||
Teaching and educating staff on the STRIDE Early Mobility program
|
$3000 |
This item will cover the training of the staff taking care of the dementia patients prone to falls for successful implementation of the program. |
Training and education are essential as it ensures that the staff are knowledgeable about the program and makes them embrace it and feel confident using and following the program. |
|||||
ORDER A PLAGIARISM-FREE PAPER HERE
Healthcare Improvement Project Charter (Appendix G)
Justification
This project STRIDE, Early Mobility program help, reduce the rates of falls among patients with dementia. Older individuals living with dementia are always at risk of fallings and ensuring consequences.
In addition, these patients with dementia experience twice the rates of falls experienced by cognitively intact individuals, and they have more injurious falls.
This patient falls among patients with dementia can lead to enhanced institutionalization rates, mortality, and morbidity. Therefore, there is always a need to develop various strategies to prevent the incidences of such falls.
While some interventions have been successful to a degree, there is a need to develop better methods of controlling these falls. Therefore, this project will focus on lowering the rates of falls among patients with dementia.
The targeted intervention is the STRIDE Early Mobility program.
STRIDE Early Mobility program entails using a walking program among the patients identified to be at risk of falling.
This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital.
Project Goal and Outcome Statement
The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.
The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.
Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.
The proposed project is highly feasible in the organization. It entails using best practice interventions to reduce and prevent patient falls. It also entails using relevant practices to nursing that would enhance the safety and quality of patient care.
The project is relevant to the organization because of the recent increase in inpatient falls. The relevance can also be from the organization’s focus on achieving care outcomes such as safety, quality, and efficiency.
Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.
The project will start in December and end in November next year. Some of the anticipated challenges to the project may include getting adequate institutional and provider support, sustaining the project interventions, and effective implementation of health information systems to prevent and reduce the risk of falls in the organization.
Project Milestones
The project is to start on October 2, 2021, and end by graduation date after May 31, 2022
Project Budget
For successful completion of the project, finance will be critical, hence formulating a budget with the main project expenses and the total anticipated expenses, as such, various budget items in this section.
One of the necessary budget items includes Research sources and preparation of interview questions and questionnaires, projected to cost $1000.
The other item is telephone expenses and transport allowance, which cost $700. It will ensure effective communication and collaboration between the stakeholders and the team members. The next item covered in the budget is teaching and educating staff on the STRIDE Early Mobility program. There will be a need to hire experts who can train the staff.
Therefore, the expected cost is $3000. Another $800 on dinner and allowance for stakeholders who work overtime during the project implementation process and another $900 for snacks and allowances for individuals attending meetings for more efficient processes and the total cost will be $6400.
Significant Risks
Risks
While the project can give better outcomes among the participants, there are also possible risks; one of the possible risks is a possible injury to the participants caused by the STRIDE program as the participants will have to participate in the daily walks program. Such a walking requirement may prove challenging to individuals with dementia and are already frail.
Action Plan (Appendix H)
|
Appendix I
Healthcare Improvement Project
Force Field Analysis Template
Force Field Analysis | |
A force field analysis will assist you in identifying the driving and restraining forces for implementing your healthcare improvement project. In the table below, list three positive forces that will drive the implementation of your project and three negative forces that will restrain it. | |
3 Positive (Driving) Forces | 3 Negative (Restraining) Forces |
1. Positive organizational support | 1. Possible resistance to change |
2. Effective communication | 2. Inadequate resources
|
3. Strong commitment from the leadership team | 3. Lack of stakeholder engagement |
APPENDIX J
GANTT CHART
MARIAN ADENIKE AKINOLA
JIM1 — JIM1 TASK 1: HEALTHCARE IMPROVEMENT PROJECT PHASE 2—PROJECT EVALUATION AND CLOSURE PLAN
EVIDENCE-BASED MEASURES FOR EVALUATING HEALTHCARE IMPROVEMENTS — D159
PRFA — JIM1
TASK OVERVIEWSUBMISSIONSEVALUATION REPORT
COMPETENCIES
7073.5.1 : Success Indicators
The graduate collaborates with internal and external stakeholders to identify key success indicators for evaluating the effectiveness of a healthcare improvement project.
7073.5.2 : Data Sources
The graduate determines the most effective technology and data sources for capturing data that will measure the key performance indicators (KPIs) for a health improvement project (HIP).
7073.5.3 : Data Management
The graduate creates a data collection plan that includes the data fields and types, frequency of collection, data collector, and the data sources for retrieving and entering data.
7073.5.4 : Evaluation Plan
The graduate initiates the process of collaboratively developing a healthcare improvement evaluation plan that addresses stakeholder questions and high-priority areas to measure progress over time and describes contextual issues that may impact the results.
INTRODUCTION
IMPORTANT: Please note that you must have completed and passed the performance assessment and clinical practice experience (CPE) for D158: Strategically Planning the Execution of a Healthcare Improvement Project prior to beginning this performance assessment.
After your first course, the remaining specialty courses through your capstone will each have a summative assessment that consists of an authentic performance assessment that scaffolds the tasks of a healthcare improvement project (HIP) through the project management phases of project initiation, planning, implementation, and evaluation. Each performance assessment will focus on aspects of the project you will implement or the project you will propose for a healthcare improvement project using a real-world approach to improving healthcare. Each phase will be described in different sections of a Healthcare Improvement Project (HIP) paper.
Evidence-based measures for evaluating healthcare improvements are essential components of the planning phase of a HIP. Another important component is learning to identify key performance indicators and metrics used to determine the success of a HIP.
In this performance assessment, you will describe the collaborative process you would use to identify the data elements needed for project reports and for determining the success of your proposed implementation project. You will also describe the collaborative process you would use to create the project data management plan. You will have the opportunity to develop a project results dissemination plan that will allow you to effectively share your project findings, as well as the opportunity to develop a project closure plan that will allow you to properly wrap up your proposed project.
This task requires the submission of your entire HIP paper template, including the “Healthcare Improvement Project Evaluation and Closure Plan†section of your HIP paper, which you will be developing in this performance assessment and consists of the following subsections:
• “Project Reportsâ€
• “Data Management Planâ€
• “Results Dissemination Planâ€
• “Project Closure Planâ€
While you must submit your entire HIP paper, you will only be evaluated on the “Healthcare Improvement Project Evaluation and Closure Plan†section.
During your clinical practice experience (CPE), you will be evaluated on whether the “Project Reports†and “Data Management Plan†elements are completed. In this task, these elements will be evaluated on content and quality of completion. CPE provides you an opportunity to practice and improve these items before including them in your performance assessment.
REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.
You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.
Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).
Complete the “Healthcare Improvement Project Evaluation and Closure Plan†section of your healthcare improvement project (HIP) paper by doing the following:
ORDER A PLAGIARISM-FREE PAPER HERE
Project Reports
A. Explain how you would collaborate with project team members to identify data elements that would be necessary for determining the success of your proposed project.
B. Describe three data elements that you and your project team members may identify as being essential for designing project reports or dashboards, and explain why each of these data elements would be essential.
Data Management Plan
C. Describe the process you would use to identify the data source needed to measure the success of your proposed project in collaboration with your project team, and explain why you would use that data source.
D. Describe the measures you would use to determine the success of your proposed project by doing the following:
1. Describe 1–2 key performance indicators (KPIs) that you would use to determine the success of your proposed project.
2. Describe one benchmark you would establish for each KPI you described in part D1.
E. Evaluate the process you would use to collect your quantitative data by doing the following:
1. Explain the method you would use to collect your quantitative data (e.g., downloaded data from a system, data gathered from a survey).
2. Justify the parameters you would use to collect your quantitative data (e.g., dates, data elements, calculated fields, frequency of collection).
F. Evaluate the process you would use to analyze and interpret your data by doing the following:
1. Describe a method you would use to analyze high-priority data (e.g., descriptive statistics such as counts, averages, percentages).
2. Discuss the process you would use to interpret initial results.
3. Analyze a contextual issue that may potentially affect your proposed project results.
Results Dissemination Plan
G. Describe your plan to disseminate your proposed project results, including the following components:
• the professional setting where you would present your results
• the method you would use to professionally deliver your results
Project Closure Plan
H. Create your plan for the project team wrap-up session by doing the following:
1. Describe the method you would use to acknowledge the organization for its time and support.
2. Describe the method you would use to acknowledge the project team members for their time and effort.
3. Explain how you would use the project team wrap-up session to discuss any next steps.
I. Incorporate the following components of APA style and formatting into your HIP paper:
• bias-free language
• objectivity, credibility of sources, and evidence-based approach
• APA-specific rules regarding verb tense, voice, and perspective
• a title page and headers
• APA-specific formatting rules for in-text citations and references, margins, spacing, numbering, and indentation for the title page, main body, and appendices of your HIP paper, including headers, bulleted and numbered lists, and tables and figures
J. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A:COLLABORATION WITH PROJECT TEAM MEMBERS
NOT EVIDENT
The submission does not explain how the candidate would collaborate with project team members to identify data elements that would be necessary for determining the success of the proposed project.
APPROACHING COMPETENCE
The submission explains the process of collaborating with project team members to identify data elements that would be necessary for determining the success of the proposed project, but the process explained is not logical or not appropriate for collaborating with project team members.
COMPETENT
The submission explains a logical and appropriate process of collaborating with project team members to identify data elements that would be necessary for determining the success of the proposed project.
B:DATA ELEMENTS
NOT EVIDENT
A description of 3 data elements or an explanation of why each of the data elements would be essential is not provided. Or neither are provided.
APPROACHING COMPETENCE
The description of 3 data elements that may be identified by project team members as essential for designing project reports or dashboards is not logical. Or the explanation of why each of the data elements would be essential is not logical.
COMPETENT
The description of 3 data elements that may be identified by project team members as essential for designing project reports or dashboards is logical, and the explanation of why each of the data elements would be essential is logical.
C:DATA SOURCE
NOT EVIDENT
A description of the process that would be used to identify the data source needed to measure the success of the proposed project is not provided or an explanation of why the data source would be used is not provided. Or neither are provided.
APPROACHING COMPETENCE
The description of the process that would be used to identify the data source needed to measure the success of the proposed project is not logical. Or the explanation of why that data source would be used to measure the success of the proposed project is not logical.
COMPETENT
The description of the process that would be used to identify the data source needed to measure the success of the proposed project is logical, and the explanation of why that data source would be used to measure the success of the proposed project is logical.
D1:KEY PERFORMANCE INDICATOR(S)
NOT EVIDENT
The submission does not describe 1–2 KPIs that would be used to determine the success of the proposed project.
APPROACHING COMPETENCE
The submission describes 1–2 KPIs that would be used to determine the success of the proposed project, but 1 or both of the KPIs are not logical, or 1 or both of the KPIs are not feasible for determining success.
COMPETENT
The submission describes 1–2 logical and feasible KPIs that would be used to determine the success of the proposed project.
D2:BENCHMARKS
NOT EVIDENT
The submission does not describe 1 benchmark for each of the KPIs identified in part D1.
APPROACHING COMPETENCE
The submission describes 1 benchmark for each of the KPIs identified in part D1, but 1 or more of the benchmarks are not appropriate for the KPI.
COMPETENT
The submission describes 1 appropriate benchmark for each KPI identified in part D1.
E1:DATA COLLECTION METHOD
NOT EVIDENT
An explanation of the method that would be used to collect quantitative data is not provided.
APPROACHING COMPETENCE
The explanation of the method that would be used to collect data is not logical, or the data collection method is not feasible or not appropriate for the collection of quantitative data.
COMPETENT
The explanation of the method that would be used to collect data is logical, and the data collection method is feasible and appropriate for the collection of quantitative data.
E2:DATA COLLECTION PARAMETERS
NOT EVIDENT
A justification of the parameters that would be used to collect quantitative data is not provided.
APPROACHING COMPETENCE
The justification of the parameters that would be used to collect data is not logical, or the parameters that would be used to collect the data are not feasible or not appropriate for collecting quantitative data.
COMPETENT
The justification of the parameters that would be used to collect data is logical, and the parameters that would be used to collect the data are feasible and appropriate for collecting quantitative data.
F1:DATA ANALYSIS METHOD
NOT EVIDENT
A description of a method that would be used to analyze high-priority data is not provided.
APPROACHING COMPETENCE
The description of the method that would be used to analyze high-priority data is not logical, or the method that would be used is not appropriate for analyzing the high-priority data.
COMPETENT
The description of the method that would be used to analyze high-priority data is logical, and the method that would be used is appropriate for analyzing the high-priority data.
F2:INTERPRETATION OF INITIAL RESULTS
NOT EVIDENT
A discussion of the process that would be used to interpret initial results is not provided.
APPROACHING COMPETENCE
The discussion of the process that would be used to interpret initial results is not logical, or the process that would be used is not appropriate for interpreting initial results.
COMPETENT
The discussion of the process that would be used to interpret initial results is logical, and the process that would be used is appropriate for interpreting initial results.
F3:CONTEXTUAL ISSUE
NOT EVIDENT
The submission does not analyze a contextual issue that may potentially affect the proposed project results.
APPROACHING COMPETENCE
The submission analyzes a contextual issue that may potentially affect the proposed project results, but the analysis is not logical or not relevant to the results.
COMPETENT
The submission analyzes a contextual issue that may potentially affect the proposed project results, and the analysis is logical and relevant to the results.
G:PLAN TO DISSEMINATE RESULTS
NOT EVIDENT
The submission does not describe a plan to disseminate the proposed project results.
APPROACHING COMPETENCE
The submission describes a plan to disseminate the proposed project results, but the plan is not feasible or illogical. Or the description is missing 1 or both of the given components.
COMPETENT
The submission describes a feasible and logical plan to disseminate the proposed project results, and the description addresses both of the given components.
H1:ORGANIZATION ACKNOWLEDGEMENT
NOT EVIDENT
The submission does not describe a method that would be used to acknowledge the organization for its time and support.
APPROACHING COMPETENCE
The submission describes a method that would be used to acknowledge the organization for its time and support, but the method described is not feasible, not professional, or not appropriate for acknowledgement.
COMPETENT
The submission describes a feasible, professional, and appropriate method that would be used to acknowledge the organization for its time and support.
H2:TEAM ACKNOWLEDGEMENT
NOT EVIDENT
The submission does not describe a method that would be used to acknowledge the project team members for their time and effort.
APPROACHING COMPETENCE
The submission describes a method that would be used to acknowledge the project team members for their time and effort, but the method described is not feasible, not professional, or not appropriate for acknowledgement.
COMPETENT
The submission describes a feasible, professional, and appropriate method that would be used to acknowledge the project team members for their time and effort.
H3:DISCUSSION OF NEXT STEPS
NOT EVIDENT
The submission does not explain how the project team wrap-up session would be used to discuss any next steps.
APPROACHING COMPETENCE
The submission explains how the project team wrap-up session would be used to discuss any next steps, but the approach is not logical or appropriate for a project team wrap-up session.
COMPETENT
The submission explains a logical and appropriate approach for how the project team wrap-up session would be used to discuss any next steps.
I:APA STYLE AND FORMAT
NOT EVIDENT
The submission does not incorporate the given APA style and format components as described in the current APA manual.
APPROACHING COMPETENCE
The submission does not accurately or consistently incorporate 1 or more of the given APA style and format components as described in the current APA manual.
COMPETENT
The submission accurately and consistently incorporates all of the given APA style and format components as described in the current APA manual.
J:PROFESSIONAL COMMUNICATION
NOT EVIDENT
Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.
APPROACHING COMPETENCE
Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.
COMPETENT
Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.
SUPPORTING DOCUMENTS
HIP Paper Template – Implementation Version.docx
HIP Paper Template – MCA Version.docx