QI Plan Part I
January 27, 2015
According to a recent survey, the quality of service of Davis Health Care needs improvement. Research suggests that patient safety measures like hourly rounding by nursing personnel positively impacts patient fall rates, call light usage and overall patient satisfaction (Olrich et al., 2012, p. 25). Patients are likely to recover and thrive in an environment where they know that they are being acknowledged, monitored and their concerns are being addressed. Health care facilities that have instituted hourly rounding, where nursing staff (e.g. registered nurses, licensed practical/vocational nurses and nurse aides) ...view middle of the document...
We want to see how we can eliminate the less than satisfactory patient experience at Davis Health Care. The improvement team needs to collect internal data (e.g. incidences of falls, call light usage and level of patient satisfaction in the unit) and compare it with external data that can be found in research on other healthcare facilities. Once we are able to see what other healthcare facilities have done successfully to prevent sentinel events, we are able to complete the second step by creating a link between the improvement goal and solution. The team should participate in multi-voting in order to narrow down the lists of improvement goals. Multi-voting incorporates unstructured and silent brainstorming in order to prioritize the improvement goal (Spath, 135). After the team decides to focus on hourly rounding, we need to get other nurses involved with reviewing quantitative research and critiquing studies. The team can then make critical appraisals on a worksheet. We need to develop a structured approach to teaching the importance of hourly rounding to fellow nursing staff, setting goals as to how much staff should know and achieve regarding hourly rounding as well as ways to evaluate effectiveness of hourly rounding after it has been implemented.
The cause and effect diagram is a structured form of brainstorming (Spath, 137). In this diagram, we develop a graphical representation of the outcomes of our service (e.g. patient level of satisfaction) and the factors that influence them (e.g. how quickly staff respond to the patients’ call bells). Improvement teams usually create a cause and effect diagram at the beginning of an improvement project to clarify the improvement goal (Spath, 138). At times, cause and effect can be difficult to simplify in this diagram, however, if everyone agrees on the improvement goal of focus, then cause and effect can be discussed in further detail. If the change in practice affects the standard of care in an entire facility, performing a pilot demonstration on one or two units this allows practitioners to influence adaptation of the change to fit one’s practice needs (Rosswurm & Larrabee, 1999, p. 321). Once the pilot successful, then we can proceed to the last step the change model. In the final step of change implementation, we integrate and maintain hourly rounds as a standard protocol throughout the healthcare facility.
As healthcare teams at Davis Health Care carry out discussions related to hourly rounds during treatment rounds and staff meetings and nursing staff become accustomed to incorporating hourly rounds during each shift, will need to re-evaluate the level how patients feel regarding their experience at our organization. We need to re-issue surveys to our patients because they serve as feedback regarding our quality of service. We need to provide surveys that are brief in nature, including priority questions that reflect our objective (Spath, 149). Quantitative surveys allow patients...