Hello and welcome to your team collaboration site for the Team Quality and Safety Case Study in NUR 687. This project is not a night-before project! DO NOT put it off! Follow the timeline below. Complete all your work within Office 365; faculty will be following your progress here. Once your team is completed with all sections you will then upload the final document to BlueLine for grading.
NOTE: Some groups assign a color for each team member and provide a legend for faculty to identify which team member is responsible for each section.
The purpose of this assignment is to critically analyze quality improvement and its relationship to service, patient safety, and improved outcomes and analyze local, regional, and national nursing practices for benchmarking outcomes with national quality indicators.
This is a TEAM project. Every team member must participate in progress postings and zoom meetings. Your team will be posting your progress on the assignment and Zoom meetings via Office 365 through your collaborative BlueLine site.
The table below is a modified version of strategies and factors which appear to contribute to performance improvement on core measures. These measures are associated with quality and safety in healthcare organizations as reported by the Commonwealth Fund (2020).
Part 1: Team Case Study Review (25pts); See Case Study Rubric
Your team has been provided with six case studies to read and review in the course modules for Weeks 8 -11. Collaborate with your team members, and from your team’s analysis of the case studies, identify which Organization best exemplified the quality and safety strategy. Provide 3-4 bullet points in the table below illustrating how quality and safety strategies were met.
Part 2: Team Case Study (75pts); See Team Quality and Safety Case Study Rubric
Now you have a better understanding of strategies and factors which contribute to performance improvement core measures with quality and safety. As a team, develop your own case study. You may use an experience from an organization in which one of you work, you can use parts of an experience from an organization in which one of you work, or you can “make up” a case study. Throughout the case study, provide evidence to support the case study. Your case study should include the organizational description, identification of the quality or safety concern, data analytics and benchmarking, quality and safety strategies utilized for success and results. This follows the methods used to present the case studies you read and reviewed.
Case Study Team Timeline
Initial Draft of Case Study Developed in Collaboration Site Initial Draft of Case Study April 6, 2022
Second Zoom meeting; all team members required to attend
As a team review case study for structure, grammar, sentences, review TurnItIn score, APA, etc. Record and provide link for Zoom meeting Have meeting by April 13, 2022
Submit Draft Case Study to TurnItIn for Score: Green is good, Yellow is okay, Red suggests work needed on proper citing of sources TurnItIn Practice Submission April 13, 2022
Finalize Case Study April 13, 2022
Resources/ References Provide a list of resources and references using APA 7th Edition
Ongoing
Submit Final Paper to Blueline Submit document from Office 365 to BlueLine TEAM Quality and Safety Case Study Due April 20, 2022
PART I
Case Study Review Table – As a team, complete columns 3 & 4 of table here.
Activity Quality and Safety Strategy From the Case Study 3-4 bullet points on how this strategy was exemplified by the organization you picked
Management & Culture
Leadership
Dedicate staff time to quality improvement
Example:
20% of staff time is protected from other responsibilities to develop and test new ideas, supporting a culture of experimentation Luther Midelfort Mayo Health System Staff members are given time apart from their daily responsibilities to test new ideas.
Some physicians spend 10 to 30 percent of their time on safety or quality improvement activities
Hospital leaders have participated in training and improvement activities for the past 15 years and have learned the best techniques in system improvement.
Conduct Strategic Planning
Example:
Strategic
planning takes place every 180 days, supported by ongoing data collection, monitoring progress toward goals, and adoption of plans that support the goals Luther Midelfort Mayo Health System
Luther Midelfort engages in strategic planning every 180 days to identify what will be done in the next six months.
It collects data and monitors progress
measures have been a focus of improvement and therefore at the forefront of the organization’s plans and resources
Derive momentum from national campaigns
Example:
Participate in a national improvement collaborative, such as those sponsored by the Institute for Healthcare Improvement and the Centers for Medicare and Medicaid Services Gaston?
Physician Engagement
Establish peer-to peer counseling
Example:
Physicians discuss quality data and performance with peers whose performance does not meet standards St. Mary’s
Review variances at a high level
Example:
Medical staff has a peer review committee to review variation from practice standards and present findings to all providers Luther Midelfort Mayo Health System
The first team defines the clinical standard, what should be done for each patient presenting with a particular condition. The team is typically led by a physician and includes physicians, nurses, pharmacists, and others with expertise in a particular clinical area.
Luther Midelfort’s Quality Resources Department offers resources including advice on quality improvement techniques such as PDCA cycles and manual data checking systems
The Quality Resources Department also uses case managers to monitor achievement of standards in real time. If they discover a deficiency, they can alert medical leadership, who can contact a physician while a patient is still in the hospital and address it.
Urge adoption of practice standards
Example:
The president and the board provide direction to the entire medical staff about the importance of adopting standards of practice related to core measures St. Mary’s
Clinical Staff Engagement
Designate case managers to attend to discharge measures.
Example:
Designated discharge care managers focus on getting each patient the correct discharge instructions and follow-up appointments Flowers
Establish pharmacist review of drug related protocols
Example:
Pharmacists review prescribing decisions throughout patients’ hospitalizations to address problems or deviations from standards directly with doctors Northshore
Create interdisciplinary teams of caregivers
Example:
With doctors, nurses, pharmacists, and others involved in the care process at the table, it is possible to avoid surprises or slips late Gaston
Appoint process improvement team to coordinate changes
Example:
A designated process improvement team can provide the expertise in process redesign, complementing the work of the clinical performance improvement team Northshore
Provide quality improvement education to clinical staff
Example:
Nurses, doctors, and pharmacists are trained in ways to improve care OK Heart
Support favorable nurse/patient ratios
Example:
Most hospitals agree adequate staffing is important to quality care
OK Heart
Motivating Staff
System and regional benchmarking
Example:
Hospitals compare their performance with other hospitals in their system, region, or peer group to instigate competition and motivate improvement St. Mary’s
Discuss performance data
Example:
Display and discuss data throughout the hospital to create transparency and accountability. Discuss and display data weekly, even for a small number of patients, to focus staff attention Northshore
Celebrate successes
Example:
Use newsletters, meetings, and positive feedback to recognize good results Gaston/Flowers?
Monitoring and Measurement Perform a daily audit or concurrent review of care
Example:
a method of auditing the achievement of care standards on a daily basis Flowers
System and regional benchmarking
Example:
Compare performance with other hospitals in their system, region or peer group to instigate competition and motivate improvement Luther Midelfort Mayo Health System
Process measures are collected weekly, even if only for a small number of patients. Once the care processes repeatedly produce the right results, monitoring becomes biweekly.
Local data are joined with reports from across all Mayo sites to inspire competition.
Luther Midelfort compares their hospital performance average with Minnesota average and national average
Discuss performance data
Example:
Display and discuss date throughout the hospital St. Mary’s
Problem Identification and Solving Support staff with a central quality department
Example:
Have staff with expertise in quality measurement and improvement OK Heart
Use the Plan-Do-Check-Act cycle Gaston
Practice Improvements Have providers create care maps
Example:
Provider involvement in the design of care maps ensures buy in and clinical relevance Luther Midelfort Mayo Health System
Teams led by physicians use care flow diagrams for pneumonia treatment.
Physician by-in is extremely high of care processes.
Order sheets are designed so that the right way to provide the care is also the easiest way to order it.
Explore the evidence base
Example:
Showing medical evidence to support care map increases buy-in Northshore
Use Care map to define what data are collected
Example:
Measures should be closely aligned with processes in order to affect the outcomes desired Luther Midelfort Mayo Health System
Tracking sheet for the pneumonia care process, illustrating how measures and process are connected throughout the patient’s stay.
At each point in the process of the care flow diagram, there is an opportunity to measure compliance.
Hospital Implementation Team (HIT) redesigns the care processes and determines the best way to translate that standard into a highly reliable system.
Use Web-based decision tools
Example:
Nurses respond to a series of questions to guide them toward a decision about whether to order a vaccination Flowers
Build electronic checklists
Example:
An electronic checklist can generate a flowchart to guide care decisions OK Heart
Part II
As a Team complete your Team’s Own Case Study using the criteria from the rubric.
Team Quality and Safety Case Study Rubric
Criteria Description Total Points
Case Study Review Table
Case studies reviewed and identification of quality and safety strategies (in table) From case study review; correct organizations are identified that best exemplify quality and safety strategies as outlined in the assignment table. Team provides 3-4 bullet points that correctly identify how the Quality and Safety Strategy was met in the case study. 20
Team Case Study Organizational Description The organization description includes location, type, beds, and a general description of the organization. 10
Team Case Study
Identification of the Quality and/or Safety Concern Clearly and succinctly describes the quality and/or safety concern at the organization. 10
Team Case Study
Data analytics and benchmarking used Identifies benchmarking data and or data analytics used to indicate a quality concern at the organization. Identifies how data will be used to monitor improvement and how data will be collected, by whom, how often, and used as a motivator. 10
Team Case Study
Quality and Safety Strategies utilized for success Clearly and succinctly explain strategies that will be implemented to improve performance on core measures in quality and safety. Explains how strategies will be implemented and by whom. Provides evidence to support the strategy and implementation process. 20
Team Case Study
Results Clearly identifies the results of the team’s case study, what improvements in quality and safety have been achieved and how achievement is measured. 10
APA for writing
Limit 10 pages not including case study review table, title page, reference page, and appendix. Uses APA format for professional papers correctly. Clear and succinct writing. Grammar, spelling and sentence structure and paragraphs clear and understandable to the reader. 10
Participation Participated in team Zoom meetings and progress posted on collaboration site every time. 10
Part II Working section: (continue to color code your word in this section)