Quality Improvement Proposal

Develop a strategic plan that establishes top priorities for a department or division, aligned with the organization’s strategic plan, which you appraised in Assessment 3.

Quality Improvement Proposal

Propose a high-level quality improvement initiative for a selected departmental strategic priority, and choose an effective method of presenting your proposal to executive leaders and other stakeholders in the organization and community. Quality Improvement Proposal.

This is based on the STRATEGIC PLAN APPRAISAL and STRATEGIC PLAN DEVELOPMENT completed last week.

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Introduction

Quality improvement and management in health care has its roots in the business world and the teachings of quality gurus such as W. Edwards Deming, Joseph Juran, Phillip B. Crosby, and Avedis Donabedian. As health care costs rose in the late 1960s, payers wanted assurance that their investments resulted in improved health. More importantly, patients and health care professionals wanted assurance that their participation resulted in safe, effective care with positive long-term benefits. Quality Improvement Proposal.

As 21st century health care organizations strive for high reliability, executive leadership is tasked with keeping the organization focused on quality and safety. Quality Improvement Proposal. In the previous assessments, you identified an organization’s strategic priorities and provided a comprehensive assessment of stakeholder and leadership influence. High-reliability organizations align quality and safety with strategic goals. Your work in previous assessments will help you identify one strategic priority for improvement.

From the nursing unit level to the executive office, quality equates with attention to the processes and functions that drive and support safety, efficiency, effectiveness, and satisfaction. Quality Improvement Proposal. The DNP-prepared nurse is in a unique position to blend knowledge of systems theory with an understanding of quality management. Quality Improvement Proposal. Added to this mixture is the DNP-prepared nurse’s exquisite appreciation for the holistic needs of individuals and groups.

This assessment provides an opportunity for you to propose a quality improvement initiative that supports a departmental strategic priority.

Preparation

Choose one strategic priority from the departmental strategic plan you developed in Assessment 3 as the focus of a proposed quality improvement initiative.

Note: The assessments in this course must be completed in the order presented; subsequent assessments should be built on both your earlier work and your instructor’s feedback on earlier assessments. If you choose to submit assessments prematurely, without considering and integrating your instructor’s feedback, your assessment may be returned ungraded, resulting in your loss of an assessment attempt.

Instructions

Develop a presentation of your proposed high-level quality improvement initiative for executive leaders and other stakeholders in the organization and community.

Be creative in showcasing your proposal. Choose a presentation method you consider to be both engaging and likely to garner the necessary support and buy-in. For example, you might consider any of the following methods, or something different.

Marketing brochure.
Newsletter.
Video.
Audio or video slide presentation.
Executive summary.

Whichever method you choose, consider the information needs of your intended audience, their communication preferences, and possible time constraints on processing your proposal.

Video Recording

If you choose video as your preferred presentation method, Kaltura is the recommended tool for video recording. Refer to Using Kaltura for more information about this courseroom tool. You are also free to use any other technology of your choice (such as a video camera or smart phone) to record your video; however, please inform the faculty facilitator of your decision not to use Kaltura to avoid potential technical problems associated with file formats.

To record your video, you will need a built-in or external microphone and/or video camera (webcam or other device). Check that your recording equipment and software is working properly and that you know how to record and submit your video. Be sure to set up and test your equipment ahead of time.

Note: If you use assistive technology or any alternative communication methods to access course content, please contact [email protected] with any access-related questions or to request accommodations.

Evaluation

The following tasks correspond to the grading criteria in the scoring guide, so be sure to address each point in the presentation of your proposed quality improvement initiative. Read the performance-level descriptions for each criterion to see how your work will be assessed.

Explain the rationale for establishing a strategic priority.

- Describe the overarching aim and focus of your proposed quality improvement initiative.
- Use the evidence-based literature to provide broad rationale for establishing this priority.
Present the key points from a SWOT analysis of a chosen strategic priority.

- Consider the organization’s political landscape and strategic priorities.
Identify key performance indicators for measuring the success of a quality improvement initiative.

- For example: infection rates, customer satisfaction, financial performance indicators, productivity, nurse satisfaction, or other internal metric.
- These indicators could align with those identified on the departmental balanced scorecard.
Explain the value of stakeholder feedback and the process for collaborating with stakeholders on the proposed quality improvement initiative.

- Identify key stakeholders and explain why their support for this initiative is crucial to its success.
- Explain how you will leverage stakeholder feedback.
Explain how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.
Make policy recommendations to support the proposed quality improvement initiative.

- Your recommendations could entail developing a new policy, revising a current policy, or retiring a current policy.
- Describe the policy implications of this initiative and their impact on the organization.
- Justify your recommendations.
Communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.

- Consider the needs of your audience.
- Be succinct and mindful of communication best practices.
- Carefully review your media and materials to avoid errors that could distract the audience and make it more difficult for them to focus on the substance of your proposed initiative.

Portfolio Prompt: You are encouraged to save your quality improvement proposal presentation to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 3: Propose a strategic plan that integrates feedback from other disciplines and aligns with organizational priorities.

- Explain the rationale for establishing a strategic priority.
- Present the key points from a SWOT analysis of a chosen strategic priority.
- Identify key performance indicators for measuring the success of a quality improvement initiative.
- Explain the value of stakeholder feedback and the process for collaborating with stakeholders on a proposed quality improvement initiative.
- Explain how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.
Competency 4: Recommend policy changes that support a strategic plan.

- Make policy recommendations to support a proposed quality improvement initiative.
Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards.

- Communicate clearly and concisely in a form and style appropriate for the audience and the substance, purpose, and context of the message being conveyed.

Quality Improvement Proposal Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Explain the rationale for establishing a strategic priority.	Does not explain the rationale for establishing a strategic priority.	The rationale for establishing a strategic priority is ambiguous or unconvincing.	Explains the rationale for establishing a strategic priority.	Provides a concise and articulate explanation of the rationale for establishing a strategic priority. The rationale is well supported in the evidence-based literature and reflective of keen insight into the logical implications and consequences of the stated priority.
Present the key points from a SWOT analysis of a chosen strategic priority.	Does not present the key points from a SWOT analysis of a chosen strategic priority.	Presents a brief summary from a SWOT analysis that misrepresents the significance or viability of the chosen strategic priority.	Presents the key points from a SWOT analysis of a chosen strategic priority.	Presents the key points from a SWOT analysis of a chosen strategic priority. Key points indicate a perceptive analysis that reflects awareness and due consideration of organizational politics and strategic goals.
Identify key performance indicators for measuring the success of a quality improvement initiative.	Does not identify performance indicators for measuring the success of a quality improvement initiative.	Identifies performance indicators for measuring the success of a quality improvement initiative.	Identifies key performance indicators for measuring the success of a quality improvement initiative.	Identifies precise key performance indicators, clearly aligned with strategic priorities, for measuring the success of a quality improvement initiative.
Explain the value of stakeholder feedback and the process for collaborating with stakeholders on a proposed quality improvement initiative.	Does not outline a process for collaborating with stakeholders on a proposed quality improvement initiative.	Outlines a process for collaborating with stakeholders on a proposed quality improvement initiative.	Explains the value of stakeholder feedback and the process for collaborating with stakeholders on a proposed quality improvement initiative.	Provides a concise, articulate explanation of the value of stakeholder feedback and the process for collaborating with stakeholders on a proposed quality improvement initiative. Presents an effective strategy for collaborating and draws well-reasoned conclusions about the value of stakeholder support.
Explain how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.	Does not describe a contemporary change theory that could be used to facilitate changes inherent in implementing a quality improvement initiative.	Describes a contemporary change theory that could be used to facilitate changes inherent in implementing a quality improvement initiative.	Explains how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative.	Explains how one contemporary change theory could be used to facilitate changes inherent in implementing a quality improvement initiative. Applies an insightful interpretation of applicable theory to best practices in change leadership.
Make policy recommendations to support a proposed quality improvement initiative.	Does not make policy recommendations to support a proposed quality improvement initiative.	Makes policy recommendations that overlook important political or cultural factors that would influence a quality improvement initiative.	Makes policy recommendations to support a proposed quality improvement initiative.	Makes astute policy recommendations to support a proposed quality improvement initiative. Identifies significant and relevant policy implications and provides compelling justification for policy changes.
Communicate clearly and concisely in a form and style appropriate for the audience and the substance, purpose, and context of the message being conveyed.	Does not communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.	Communication lacks clarity, conciseness, or effectiveness at conveying the intended message.	Communicates clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed.	Communicates clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed. Content, form, and style are congruous, engaging, and facilitate audience comprehension. Adheres to all applicable professional, disciplinary, and scholarly communication and design standards.

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Solution

Quality Improvement Proposal

Introduction

The healthcare sector is under continuous transformations, hence the need for appropriate changes to adapt to the various changes. Besides, the patient needs constantly change, emphasizing the need to make appropriate changes that will enable the healthcare sector to address these changes effectively. Various changes also affect the delivery of high-quality and safe care to patients. This emphasizes the need to continuously evaluate either departmental or the entire organization’s performance, identify existing gaps, determine the contributing factors to such gaps, and develop strategic plans and quality improvement initiatives aimed at addressing those problems and improving the quality of care delivery (Niñerola et al., 2020). The departmental strategic priorities at Elsie Owens Health Center, located in Coram, New York, focus on improving patients’ quality of care. This aligns with the organization’s strategic plan and vision, which is to create relevant advancement, collaborative partnerships, and capacity building to achieve the organization’s vision and ensure a healthy and sustainable community. This paper presents a proposal for a high-level quality improvement initiative for providing high-quality and safe care for the patients as the selected departmental strategic priority. The proposed quality improvement initiative is the provision of a favorable working environment for the caregivers to improve the provision of high-quality and safe care to patients.

The rationale for Establishing the Strategic Priority

Patient safety and the quality of care they receive significantly impact their health outcomes. Ensuring patient safety and improving the quality of care is critical in increasing patient satisfaction by improving their health outcomes, reducing healthcare costs, and building the facility’s reputation, which is an essential determinant of its ability to run its various operations smoothly. Therefore, the quality improvement initiative aims to provide a favorable working environment that facilitates improved care delivery. Some of the measures to provide a favorable working environment as required by the initiative include; adequate staffing, effective leadership, management styles, and proper caregivers’ motivation in terms of salaries and allowances (Mannion & Davies, 2018). Adequate staffing will help reduce workload, which is associated with fatigue and burnout among caregivers, which may compromise the quality of care and patient safety.

Effective leadership styles, for instance, servant leadership, enable the leaders to address various concerns affecting the caregivers, which, when left unaddressed, could also affect care delivery. Effective leadership also enhances collaboration among different stakeholders to ensure adequate resources to drive specific initiatives to improve the quality of care. The excellent motivation of the caregivers also enables them to be committed to their work, hence improving the care quality. Quality Improvement Proposal.

The initiative will help create a conducive working environment for the healthcare providers through these measures. A favorable working environment enables the caregivers to provide high quality and effective care for the patients, thus improving their health outcomes, satisfaction, and experience (Randhawa & Ahuja, 2017). Quality Improvement Proposal.

Failure to provide high-quality and safe care to patients, which could be due to various reasons, including an unfavorable working environment for the caregivers, could result in adverse impacts. Quality Improvement Proposal. These include poor patient health outcomes, low levels of satisfaction and bad experience, and a damaged facility’s reputation that may eventually affect the facility’s reputation.

Key Points from A SWOT Analysis of the Chosen Strategic Priority

The strategic priority chosen has its associated strengths and weaknesses. It also presents opportunities and threats which must be addressed adequately. The primary strength of this strategic priority is that with enhanced quality and safety of care, improved patient health outcomes will also benefit the facility. However, the significant weakness is that other factors can also affect the quality of care and patient safety, thereby making it difficult to determine the effectiveness of the initiative developed to improve patient safety and care quality. The strategic priority also presents opportunities in that the department and the facility can continuously evaluate performance and determine other appropriate ways of improving patient safety and the quality of care they receive. Lastly, the main threat to this strategic priority is where various stakeholders fail to provide adequate support required to achieve the set objectives. This could be due to poor management and the inability to incorporate all the stakeholders in the process, hence the resistance from a section or all stakeholders who may feel left out.

Key Performance Indicators for Measuring the Success of the Quality Improvement Initiative

Following the implementation of the quality improvement initiative, it is essential to conduct regular assessments to determine if the initiative succeeds in achieving set objectives. Quality Improvement Proposal.This also provides the opportunity for determining the factors that may hinder the initiative’s success, which can then be addressed through the development of measures to address such obstacles.

The quality improvement initiative, in this case, aims at providing a favorable working environment for the caregivers, which will, in turn, enhance their work efficiency, thereby promoting quality care delivery to patients (Braithwaite, 2018). Quality Improvement Proposal.

Various key performance indicators can therefore be evaluated to determine the initiative’s success. These include; job satisfaction and confidence among the caregivers, and patient health outcomes, which can be assessed by assessing the recovery rates, duration of hospital stay, patient satisfaction, and experience. Other indicators include evaluating the incidences of medication errors and nurse turnover rates, which affect an unfavorable working environment (Braithwaite, 2018). Lastly, the facility’s reputation can also be assessed since it is also influenced by the productivity of caregivers and work efficiency within the facility.

Value of Stakeholder Feedback and the Process for Collaborating With Stakeholders on a Proposed Quality Improvement Initiative

Successful implementation of the proposed quality improvement initiative requires collaboration among various stakeholders. They include; the facility’s management, the healthcare providers, policymakers, and the funding organizations. Each of them has a critical role required to achieve the necessary outcomes successfully. Therefore, collaboration among the various stakeholders is essential in ensuring proper strategies are put in place to drive the initiative to succeed. All stakeholders must thus be incorporated in the entire process so that they are made aware of the need for the quality improvement initiative, the consequences of not implementing the initiative, their role in the initiative’s success, and why their support is key for successful implementation (Niñerola et al., 2020). Collaborating with various stakeholders also enhances shared decision-making. Quality Improvement Proposal. Different stakeholders may present their opinions, concerns, and needs, which can be used to make necessary adjustments critical to ensuring the initiative’s success.

Contemporary Change Theory

Various change theories and models are applicable in this quality improvement initiative. The most appropriate is the Prosci’s ADKAR Model of change, which consists of 5 stages which are; awareness of the need for change, desire to support the change, knowledge of how to change, ability to demonstrate skills and behavior, and lastly, reinforcement to enhance sustenance of the change (Wong et al., 2019). It is applicable in this initiative because there is first the need to inform various stakeholders on the need for change, how to go about it, and the measures that will be put in place to enhance sustenance and ensure the set objectives are continuously met.

Policy Recommendations

The quality improvement initiative emphasizes establishing a culture of safety and high-quality care. Therefore, a quality care policy is recommended to ensure proper measures are put in place to provide a sustained provision of high-quality care to patients. This policy will advocate for the regular evaluations and assessments of performance to determine gaps in the provision of quality care. Once such gaps are identified, the policy should advocate for measures necessary to address the gaps identified so that patients’ quality of care is not compromised.

Conclusion

The quality improvement initiative developed will ensure that caregivers have a favorable working environment. Quality Improvement Proposal. This will enhance their productivity and achieve set outcomes that focus on enhanced patient safety and the quality of care. Quality Improvement Proposal. The involvement of various stakeholders is crucial in driving the successful implementation of the initiative, which requires regular evaluation by assessing various key performance indicators to determine its success.

References

Braithwaite, J. (2018). Changing how we think about healthcare improvement. BMJ, 361. https://www.bmj.com/content/361/bmj.k2014.abstract

Mannion, R., & Davies, H. (2018). Understanding organizational culture for healthcare quality improvement. BMJ, 363. https://www.bmj.com/content/363/bmj.k4907.long

Niñerola, A., Sánchez-Rebull, M. V., & Hernández-Lara, A. B. (2020). Quality improvement in healthcare: Six Sigma systematic review. Health Policy, 124(4), 438-445. https://www.sciencedirect.com/science/article/pii/S016885102030004X

Randhawa, J. S., & Ahuja, I. S. (2017). 5S–a quality improvement tool for sustainable performance: literature review and directions. International Journal of Quality & Reliability Management. https://www.emerald.com/insight/content/doi/10.1108/IJQRM-03-2015-0045/full/html?casa_token=nMsbU2RacQAAAAAA:BAqTBaLkzrvn3mW0r4h2Si_aVbTDIsPc_c0cHVo7gKu3UlIeWXQskADb2HPdVofwV9sc7neGDAaDAvUvmK8gtjBNau8YAzdvF1iR2zWetR5qg88Az30d

Wong, Q., Lacombe, M., Keller, R., Joyce, T., & O’Malley, K. (2019). Leading change with ADKAR. Nursing Management, 50(4), 28-35. https://journals.lww.com/nursingmanagement/FullText/2019/04000/Leading_change_with_ADKAR.8.aspx

Quality Improvement Proposal.