Applying Performance Improvement Tools
Read the following scenario:
Imagine that, for about a year, your nursing unit has been involved in an intensive campaign to improve patient satisfaction scores with pain management. You are getting good data from your patients, as the length of stay on this inpatient geriatric medical nursing unit is only about 6 days. Your hospital does 100% survey to inpatients, and the response rate is about 25%, which is higher than it has been. This notwithstanding, the percent of “patient very satisfied” (top box), with a score of 5, has been in the low 70s. The national benchmark for medical surgical units like yours is about 85% very satisfied. Of all the units in your hospital, your unit is the lowest scoring on this HCAPHS survey. But as your unit is the only geriatric medical nursing unit in the hospital, you’d always thought it was the nature of the patient population.
You have been the day shift representative to the QI team, and the scores on your unit are posted monthly. Here are the numerous strategies that have been tried on your unit and the timeframes.
Document: Strategies and Interventions (PDF)
For this Discussion, examine the strategies and interventions tried in your unit and consider the following questions: a) Were the strategies effective in creating a sustainable change on your nursing unit, and b) To what extent can your nurse manager and CNO count on your unit exceeding the national benchmark in the next quarter, the next year? That is, does this run chart have some predictive ability? Does the run chart support the nursing unit’s decision to celebrate? To what extent can the leadership be confident that the trend will continue?
By Day 3
Based on the scenario, explain what was done successfully and where improvement was needed in the quality improvement process. Identify the quality improvement tools and explain how they contributed to the outcome.
Support your response with references from the Resources and professional nursing literature. Your posts need to be written at the capstone level.
Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ? 5 years old).
Required sources
Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Health Administration Press.
- Chapter 4, “Evaluating Performance” (pp. 79-118)
- Chapter 5, “Continuous Improvement” (pp. 119-142)
- Chapter 6, “Performance Improvement Tools” (pp. 143-174)
Note: Although Chapter 4 is previously assigned reading, please review it in preparation for this week’s material.
Yoder-Wise, P. S. (2019). Leading and managing in nursing (7th ed.). Mosby.
- Chapter 19, “Building Effective Teams” (pp. 335-356)
Microsoft. (n.d.). Use charts and graphs in your presentation. https://support.office.com/en-
gb/article/Use-charts-and- graphs-in-your-presentation- c74616f1-a5b2-4a37-8695- fbcc043bf526
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46–51. http://doi.org/10.1136/
bmjqs.2009.037895
Expert Answer and Explanation
Applying Performance Improvement Tools
Successful Implementations
The primary role of the healthcare sector is to ensure that the patients are cared for in an effective manner and that there is proper patient satisfaction. The main symptom that the majority of the patients complain about is the aspect of pain or discomfort. In order to ensure patient satisfaction, there was a need to identify quality improvement measures on how to address the issue of pain. The success of the campaign was attributed to various interventions that were taken to ensure that the patients experienced less pain, were able to identify the source, and could easily tell the magnitude of the pain (Farooq et al., 2016). Within the surgical unit, some of the successful measures taken include nurse education on assessment of pain, collection or posting of pain data, and teaching patients and the staff about overall pain management techniques.
The success of the nurses in ensuring proper pain management techniques is based on whether they are in a position to meet the desired outcome. Nurse education provided the desired skills and expertise to identify, monitor, and intervene when a patient is depicting signs of pain and suffering (Trail-Mahan and Heisler, 2015). The knowledge was critical for the attainment of the desired outcome. Be that as it may, the satisfaction of patients with the pain management measures they receive is dependent on different elements such as the overall patient expectation, severity of the pain, promptness of health care providers, and effectiveness of pain medication. Each of these attributes was put into account during the account and all the stakeholders addressed the importance of ensuring all the elements are put into effect. The identified measures were critical in the creation of nursing sustainability and reliance between the nurse and the patient (Trail-Mahan and Heisler, 2015). Through the implementation of the measure, various areas of nurse-patient interactions were improved significantly. For instance, there was improved communication and feedback between the nurses and the patients in relation to how the interventions were acting on their bodies. Other aspects that improved include overall knowledge of pain management, and how different pain medications work. The improvements have been critical in the success of the campaign.
Quality Improvement Tools
In order to ensure the success of the campaign the use of quality improvement tools was effective and helped maintain the desired outcome. The main tool used was the patient performance tool which helped in recording the overall quality of pain management that the patient had over time (Rice et al., 2019). The tool consisted of areas where the patient could rate their pain levels after being administered the appropriate medication and their overall feeling. The document offered details that would be used to create the run chart showing levels of patient satisfaction over time. The other tool used was the six sigma DMAIC tool which was beneficial for the definition of pain, measurement of severity, analysis of best intervention, and creating of improvement or control strategies to help the patient (Ponsiglione et al., 2021). The use of the DMAIC tool ensures that the success of the pain management aspect among the patients within the facility is maintained. The tools offer a means to ensure constant and accurate patient care and effective guidance towards mitigating the pain felt by the patients. The tools are instrumental in the establishment of the desired outcome and better communication and engagement between the patients and the nurses. The overall outcome would be continued quality improvements and better rates in relation to patient satisfaction.
References
Farooq, F., Khan, R., & Ahmed, A. (2016). Assessment of patient satisfaction with acute pain management service: Monitoring quality of care in clinical setting. Indian Journal of Anesthesia, 60(4), 248-252.
Ponsiglione, A. M., Ricciardi, C., Improta, G., Orabona, G. D. A., Sorrentino, A., Amato, F., & Romano, M. (2021). A Six Sigma DMAIC methodology as a support tool for Health Technology Assessment of two antibiotics. Math. Biosci. Eng, 18(4).
Rice, K., Castex, J., & Redmon, M et al (2019). Bundling interventions to enhance pain care quality (BITE Pain) in Medical Surgical Units. Ochsner Journal, 19, 77-95 Discussion: Applying Performance Improvement Tools Essay.
Trail-Mahan, & Heisler, S. (2015) Quality Improvement Project to Improve Satisfaction with Pain Management: Using Human Centered Design. Journal of Nursing Care Quality, 31(2), 105-112.
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