Introduction
The goal of this project is to add a place on the registration form to list an emergency contact person. Currently, there is no place for this. I work in an urgent care setting and have had two instances where a patient came in alone and went unconscious. The purpose of this paper is to describe a quality improvement initiative that will allow the collection of emergency contact information for patients in urgent care.
Background and Significance
The MNS Essentials for this project are Quality Improvement and Safety and Translating and Integrating Scholarship into Practice Not having an emergency contact has been an issue on several occasions. Two different times patients lost consciousness, and we didn’t know who to notify. According to recent research, many patients frequently believe that when a doctor asks for emergency contact information, they are being asked for the person they’d prefer to make medical choices for them (Saleem et al., 2021; Zare & Jebraeily, 2018). However, that is a function that has to be specified in a legal instrument known as an advance directive. The form that provides a third party with the authority and legal power to make medical decisions in the case when a patient is unable to do this is different and requires medical professionals to explain the purpose of the form and the consequences of it. Hence, there is a clear gap in patient understanding of emergency contact forms.
In some other units of the hospital, healthcare providers are required to collect emergency contact information. According to Mayo Clinic Staff (2020), “When an emergency happens, whether it’s a heart attack or a hurricane, it’s critical that medical service providers have access to health information for anyone who needs assistance” (para. 1). By definition, urgent care implies that a patient may be in a critical condition that threatens their health or even life. Therefore, there is a need to ensure that the medical staff can contact family members or other people significant to the patient who can provide emotional support and help this individual.
I would obtain more internal data by collecting information from the nurses who work in the emergency department and who have faced a situation where a patient lost consciousness and there was no emergency contact information on their file. This would provide quantitative data that would allow comparing the number of cases when patients’ health state worsens. Personal observations show that urgent care patients often need assistance or support from a family member or a friend, but the lack of practice in collecting such data leads to the inability of the medical personnel to provide this help. Moreover, in many cases in emergency care, patients may lose consciousness, and the nurses or physicians cannot obtain emergency contact information. In my current practice, the hospital does not require patients to fill out forms with emergency contacts. Therefore, the personnel is not required to request such information. The change of the protocol can help improve the healthcare process by allowing medical professionals to notify family members about the condition of the patient.
Problem Statement
Geographically, the hospital is located in an urban area, and it is a private practice. The population of the area is approximately 120,000 individuals. Hence, this is a medium-sized healthcare system, with this particular hospital having 200 beds in total. According to AAUCA (n.d.), “urgent Care Medicine is the provision of immediate medical service offering outpatient care for the treatment of acute and chronic illness and injury” (para. 1). In urgent care, there are several physicians and nurses caring for patients. Since urgent care practitioners are on the front lines of medicine, they need to be proficient in evaluating and caring for – at least initially – any patient who walks into an urgent care medical center or urgent care clinic. For this reason, there is some overlap in the scope of practice between Urgent Care Medicine and all existing medical specialties that involve direct patient care.
The particular area of focus for this project is the emergency care unit, where the majority of the employees are nurses tending to the patient’s needs. The target population of this problem is the urgent care department’s patients, which are typically individuals in a critical state with acute conditions. The problem is that patients in the urgent care unit are not required to fill out forms stating their emergency contacts. The solution is to implement a simple form that outlines one or several individuals who should be contacted in case the patient’s health state worsens or they lose consciousness.
Quality Improvement Model
A four-step cycle known as Plan-Do-Check-Act (PDCA) enables you to execute change, address issues, and constantly enhance procedures. Its cyclical structure makes it possible to use it continuously for continuing development. One of the most popular methods for planning an organization’s operations is PDCA. It has become more significant in a variety of professional domains. This strategy is a crucial component of the management system used by the healthcare sector. The PDCA methodology has real advantages for healthcare facilities. PDCA is a feasible model for this project because, in many cases, change initiatives cannot be implemented at once and the initial plan has to be reviewed reevaluated, and the leader of the project has to make changes to ensure that it will allow reaching the necessary objectives. As a result, with this approach, one can collect feedback from the nurses to determine if the form is actually helpful and whether the information on it is sufficient to contact the patient’s family in an emergency situation.
During the Plan state, I will gather data on the project, such as scholarly findings and anecdotal information, to prepare for the design of the form. At the Do stage, I will create the emergency contact form and will offer the department’s management to make it a standard for all patients in this unit. At the Check stage, I will implement the new form and observe the nurses and patients for several months to determine if the collected information has been useful. Next, for the Check stage of the Act stage of the PDCA, I will ensure that this form is used as a standard for the unit for all patients. Thus, PDCA is the ideal model for ensuring that this project is implemented successfully in a hospital environment because it allows the leader of the initiative to make changes based on the actual feedback from nurses and patients who should benefit from this quality improvement initiative.
Implementation Plan
For the implementation of this project, I will have to create a printed form that will be distributed to patients in the unit. The main resource required for the implementation is the paper to print out the forms. Additionally, a small training of the 10-minute duration will be required to explain to the nurses the purpose of the form and how to collect emergency contact information and use it in case of necessity. The nurses will also need a storage space to store the collected information or access an online record where emergency contacts can be cited to store data. Since the forms will be collected in print, the nurses will initially store these with other patient records. However, it is best to ensure that all relevant information is also included in the electronic patient records, as this will allow access to other healthcare providers. This, however, has to be implemented in cooperation with the IT department and can be overly complicated for the purpose of this quality improvement initiative. Thus, the main objective is to use and collected paper forms and store this information with other health records.
The main stakeholders, in this case, will be the nurses who will be working with the form. Additionally, the management of the hospital is another stakeholder group because this initiative will improve the overall quality of services provided at this facility. Finally, the patients are stakeholders because they will be directly influenced by the implementation of this contact form. The barriers may include the unwillingness of the patients to share this information, as some research suggests that individuals believe that emergency contacts can make medical decisions for the patients. The approximate cost of this project is $100, which is primarily the budget for printing out the forms. In terms of long-term sustainability, any change within an organization is likely to face resistance from the personnel.
This is why a proper change management process, such as the three stages of change, must be used to ensure long-term sustainability. Three steps—unfreezing, altering, and refreezing—make up Kurt Lewin’s change model. According to Lewin, the process of change involves first persuading people that a change is necessary, followed by a move toward the intended new level of conduct, and ultimately, establishing the desired new behavior as the norm (Rosenbaum et al., 2018). In case the project’s sustainability is under question in the long-term perspective, there is a need to make adjustments to the form or the way this information is collected and used. After I leave this project, the head of the nursing staff in this urgent care unit should be in charge of ensuring that this information continues to be collected and used by the nurses and physicians. To ensure this, I will talk to the management of the unit and explain the purpose and goal of my quality improvement initiative.
Evaluation Plan
It used to be thought that measuring change management was difficult and elusive. Measurement basics are developing, despite the fact that how change management is measured might differ from project to project (“Metrics for measuring change management,” n.d.). At the outset of a project, it is critical to have stakeholder agreement on the measurements for each category. The specific change expected from this project is the nurses of the urgent care unit possessing and collecting the data for the patient’s emergency contacts.
This objective will be measured by comparing the number of emergency contacts done by nurses before and after the implementation of this project.
Summary
In conclusion, this paper describes a quality improvement project that will target emergency care and will allow the collection of contact information from patients. I will need to produce a printed form that will be given to the unit’s patients. To save the data gathered, the nurses will also want a storage area. The nurses will first keep the forms with other patient records because they will be gathered in print.
References
AAUCM. (n.d.). What is urgent care medicine? Web.
Mayo Clinic Staff. (2020). Emergency health infomation. Web.
Metrics for measuring change management. (n.d.). Web.
Rosenbaum, D., More, E. and Steane, P. (2018). Planned organisational change management: Forward to the past? An exploratory literature review. Journal of Organizational Change Management, 31(2), 286-303. Web.
Saleem, S., Ali, S., Ghouri, N., Maroof, Q., Jamal, M., & Aziz, T. et al. (2021). Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pakistan Journal Of Medical Sciences, 38(ICON-2022), 10-50. Web.
Zare, Z., & Jebraeily, M. (2018). Patients’ perceptions of applying information and communication technology tools in self-care and factors affecting it.Acta Informatica Medica, 26(2), 102. Web.