Introduction
The quality of patient care is a significant issue in the healthcare system, and nurses play a crucial role in ensuring that the highest standards of care are achieved. Nurses must be actively involved in quality improvement efforts to ensure that patients receive the best possible care. One primary source of the issue is the insufficient staffing levels in many hospitals, which can lead to an increase in medical errors and adverse patient outcomes. A quality improvement program, supervised by a Master of Science in Nursing (MSN), has trained nurses to reduce the number of practice complaints on the Hospital Compare website. The agency for Healthcare Research and Quality (AHRQ) implementation toolkit, interprofessional cooperation, change theory selection, facility readiness assessment, quality improvement instrument selection, project model selection, cost calculation, and outcome measures will all be discussed.
Purpose of the AHRQ Implementation Tool Kit
The AHRQ Implementation Toolkit is designed to support healthcare organizations in planning, implementing, and evaluating quality improvement initiatives. The toolkit contains materials to help with all stages of the quality improvement process, such as goal planning, executing strategies and interventions, and monitoring outcomes (Ortelli, 2018). Interprofessional collaboration is crucial for effective quality improvement programs because it enables teams to exchange knowledge and resources, identify gaps in care, and develop plans to address them. Interprofessional collaboration is essential for ensuring all stakeholders are included and the best solutions are implemented.
Analysis of Fall Prevention Program at CHRISTUS Health Good Shepherd
The frequency of falls among older patients was noted as a practice concern by the Hospital Compare website for CHRISTUS Health Good Shepherd. CHRISTUS’s older patient fall rate is 6.1% higher than the national average of 5.6%. (Maines & Wojda, 2020). The issue statement clearly emphasizes the need for improvement since the rate of falls exceeds the national standard, which may result in adverse patient outcomes. As a result, a thorough fall prevention program must be established to lower the risk of falls and ensure the safety of older patients. Establishing an interprofessional team-based fall prevention program at CHRISTUS effectively reduces fall rates among elderly patients. The goal of the quality improvement initiative is to minimize the number of falls among older patients at CHRISTUS by 20% over six months (Maines & Wojda, 2020).
A literature review revealed that an interprofessional team approach to fall prevention is a beneficial approach for reducing the risk of falls in older adults. The program includes increased staff training and education, the establishment of protocols and processes to promote safety, and effective patient safety monitoring. As a result, creating an interprofessional team collaboration in fall prevention is an excellent strategy for lowering the rate of falls at CHRISTUS.
Assessing the Facility’s Readiness to Change
Analyzing the organization’s current status is necessary to assess the facility’s preparedness for change. The first step involves reviewing existing fall prevention and safety policies and procedures. Moreover, any gaps in the present system must be identified, as well as the current employee numbers and skill sets (Weiner, 2020). In addition, evaluating current communication and teamwork within departments and among staff is essential.It will light up the various barriers and opportunities while introducing a new program.
Lewin’s change theory would be utilized to design the job. The theory’s approach to change involves three steps: unfreezing, altering, and refreezing. Unfreezing entails determining the organization’s existing situation and its preparedness for change (Weiner, 2020). Changing entails establishing a new program and tracking progress. Refreezing entails evaluating the success of the modification and making any required changes. The methodology provides an organized way to implement and monitor organizational changes.
Steps Taken to Understand the Problem
It is critical to thoroughly review the present system to understand the problem of falls in older patients at CHRISTUS. The initial step is to assess any current fall prevention and safety policies and procedures (Maines et al., 2020). Identifying holes in the present system and reviewing current employee numbers and skill sets is critical. Assessing present communication and collaboration between departments and staff members is critical. It will highlight the various obstacles and possibilities while launching a new program.
A root cause analysis will be utilized further to examine the problem as a quality improvement technique. The tool is a valuable method for identifying underlying issues contributing to the situation. It entails breaking the problem into constituent elements and evaluating each component to uncover probable root causes (Maines et al., 2020). The approach can aid in identifying patterns in data and give insight into potential solutions. A Root Cause Analysis can help you better understand the problem and establish preventative methods.
The examination of the situation will entail gathering data from many sources. It contains information from patient records, incident reports, staff questionnaires, and current fall prevention policies and procedures (Maines et al., 2020). Interviews with staff and patients might be conducted to discover relevant contributing variables.After gathering the data, it may be evaluated with a Root Cause Analysis tool to uncover trends and probable underlying causes of the problem.You may acquire a more profound knowledge of the problem and devise preventative methods by completing the evaluation.
Model for the Quality Improvement Project
The quality improvement initiative will follow the Plan-Do-Study-Act approach (PDSA). PDSA is a cyclical quality improvement technique that consists of four steps: plan, do, study, and act. At the planning stage, the problem is recognized, and the project objectives are developed. The intervention is applied, and data is gathered in the do stage (D’Agostino et al., 2018). The data is examined in the study stage to assess whether the intervention succeeded.Lastly, at the act stage, the outcomes are utilized to judge the intervention and how to improve it.
The AHRQ Falls Prevention box will be used as a practice improvement initiative/intervention. The kit includes evidence-based strategies for reducing falls with injury in seniors (D’Agostino et al., 2018). The box provides resources to help healthcare professionals identify patients at risk of falls, apply strategies to reduce those risks, and assess the effectiveness of interventions. Similarly, the gadgets include recommendations on successfully involving Interprofessional teams in the improvement process.
To implement the AHRQ Falls Prevention toolkit, the following steps should be taken:
- Identify patients at risk of falls through a systematic review of medical records and patient interviews (Mazur, 2020).
- Implement strategies to reduce the risk of falls, such as providing patient education, maintaining a safe environment, and implementing medication management protocols.
- Evaluate the effectiveness of the interventions by monitoring patient outcomes and collecting feedback from patients and healthcare providers.
- Monitor the results of the interventions and make adjustments as needed.
- Share the results of the project with stakeholders and other healthcare providers.
Costs Associated with Implementing the Planned Intervention
There are costs connected with carrying out the proposed operation. The essential costs of implementing the AHRQ Falls Prevention kit are the time and resources necessary to identify patients at risk of falling, implement techniques to minimize the risk of falls, and evaluate the success of the treatments (Iacona et al., 2018). The costs of adopting the box are determined by the specific actions chosen and the available resources.
In addition to the expenses of deploying the box, the project may result in additional savings. Reduced rates of falls with injury among senior adults can result in decreased healthcare expenses since fewer patients will seek medical care due to the falls (Iacona et al., 2018). Furthermore, lowering the rate of falls can lead to better patient outcomes, contributing to higher patient satisfaction and a better patient experience. These savings may be used to cover the expenses of deploying the toolkit, making it a more cost-effective option.
Descriptions Based on Donabedian’s Work
- Structure measures for the quality improvement intervention include the availability of resources and the organization of the healthcare team. They are needed to assess the current environment and identify potential areas for improvement.
- Process measures include implementing strategies and interventions to reduce the rate of falls among elderly patients (Iacona et al., 2018). They also include educating patients, ensuring a safe environment, and introducing medication management protocols.
- Outcome measures include the rate of falls with injury among elderly patients. The rate should be monitored to determine whether the intervention is successful.
- Qualitative and quantitative measures are used to determine the effectiveness of the quality improvement initiative (Maines et al., 2020). They include surveys, focus groups, and interviews to collect feedback from stakeholders and patients.
- Qualitative findings are used to identify areas for improvement and understand stakeholders’ and patients’ attitudes and beliefs (D’Agostino et al., 2018). The information can inform the project plan and ensure the intervention is tailored to the organization’s and patients’ needs.
Visual Displays for Reporting Outcome Data
A histogram and a run chart are visual representations that may be utilized to convey outcome data for the practice issue of falls with injury among the elderly at CHRISTUS. A histogram is a bar graph showing the frequency of data points within a specific range (Guetterman & Fetters, 2018). The graph may be used to visualize the rate of falls with injury among older patients over time.
A run chart is a line graph showing data points over time. The graph may be used to find trends in the data by tracking variations in the rate of falls with injury across time. These two visual displays may be used to monitor the effectiveness of the intervention and make necessary modifications.
Conclusion
Healthcare organizations require quality improvement programs to provide reliable services. The AHRQ Implementation Toolbox addresses goal setting, plan implementation, and outcome monitoring. Best practices for working with interprofessional teams and stakeholders throughout the improvement process are included in the toolkit.
CHRISTUS was rated Excellent by Hospital Compare for senior patient who falls with injury. The quality improvement initiative hopes to reduce senior patient falls in six months. PDSA will be used in a fall prevention program based on an interprofessional team. The AHRQ Falls Prevention Toolkit will identify and prevent falls in at-risk patients. The project costs include time and resources spent identifying persons at risk of falling, implementing remedies, and evaluating the treatments. Histograms and run charts can be used to track the success of interventions and make modifications.
References
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