Background and Current State
In the analyzed medical organization, the main population of patients is people with low income and education, as well as people addicted to various substances. The primary issue with the transition of care is that the institution lacks an established process for communication and interaction. This leads to patients not receiving the necessary information to access the required medical services.
The importance of this problem lies in the fact that it leads to stagnation in the community’s health status. The inability to determine the necessary information about the patient’s medical history leads to the fact that they receive incorrect or incomplete treatment. Accordingly, this significantly burdens this medical institution, as there is no progress in solving problems and improving patients’ health.
Regarding more detailed information, it is essential to highlight the issue with the transfer of information from patients themselves. They are often unable to determine their medical history, as well as their previous healthcare providers. Accordingly, the whole process of interaction becomes more complicated, which can lead to ambiguous consequences for both patients and the medical institution. Thus, the main impact of this problem is patient safety.
Therefore, a medical history plays a crucial role in providing competent medical treatment. Considering that patients are not asked the necessary questions when registering, there is a significant lack of unity and potential for misinformation. Consequently, the medical staff involved in providing treatment services does not have a complete picture. This leads to the wrong decisions being made, and the condition of patients does not improve significantly.
Literature Review
The process of literature review involves studying relevant articles devoted to the topic of transition of care. Scientific studies were selected that contained information about conducting experiments on this topic. Each of them aimed to obtain results that would enable researchers to identify the most effective forms of communication in medical institutions. The transfer of a patient is one of the vulnerable or critical stages in treatment; at this stage, continuity between medical professionals is necessary.
Obtaining such information is especially important when contacting the emergency department of a hospital for complex patients in emergencies, particularly when the patient is unable to provide the necessary medical information independently (Parry et al., 2021). The exchange of information reduces the likelihood of errors in diagnosis and treatment due to insufficient information (Naylor et al., 2018). Thus, it will contribute to making more accurate and correct clinical decisions quickly.
Evidence-Based Practice
Several important evidence-based practice strategies are highlighted in the literature devoted to addressing this problem. They aim to address the communication issues between patients and medical professionals, as well as between departments (Li et al., 2021). In this case, it should be noted that “Hospital-Based Trust, Plain Language and Coordination” and “Patient Communication and Care Management” are specified in the article by Li et al. (2021). These strategies enable medical staff to significantly simplify interactions by providing more accessible information and communication systems.
Gaps
Based on the existing evidence-based practice, various errors and inaccuracies in the organization of a medical organization’s activities can be identified. Firstly, this is due to the lack of a unified system in which information about patients and their backgrounds is structured, as they may not know it or refuse to report it. Secondly, it is essential to consider that when registering patients, they do not provide the necessary information to ensure quality treatment. Therefore, it is essential to address these two issues.
Goals
The primary task is to reorganize the workflow within the medical institution. Accordingly, this process aims to improve coordination and communication between medical professionals and departments. This will be achieved through specially designed training programs, after which employees will be able to enhance their knowledge and skills, enabling them to better understand the importance of receiving information from patients. A more fundamental goal is to improve the indicators, which will indicate a reduction in repeated patient visits and an improvement in the quality of services provided.
Quality Method
The quality improvement method is the Model for Improvement (MFI), and the QI Initiative is the PDSA (Plan-Do-Study-Act) cycle. At the planning stage, it is necessary to formulate a goal, make assumptions, and develop theories. The primary existing issue is the lack of a well-established communication system between patients and medical professionals, which complicates the transition of care. Thus, the proposal involves introducing an approach that entails the development of special checklists and a program map. This will enable medical professionals to identify what needs to be learned and documented regarding the patient’s medical history and transfer this information to the relevant department or employee.
At the “Do” stage, conditions are created, and the necessary training or additional support is provided to implement the plan. It is essential that healthcare professionals fully understand the goals and the plan and agree on the procedures necessary to implement the plan. It is crucial to implement changes in iterations, observing how hypotheses are confirmed or refuted. Therefore, it is necessary to gradually introduce additional working materials and questionnaires of various types to assess their effectiveness and convenience.
In managing the implementation of changes at the “Study” stage of the cycle, the main analytical actions are carried out: the collected patient complaints statistics are analyzed, the results are evaluated, and a forecast is made. Therefore, it is necessary to use additional tools to assess the implemented changes qualitatively. In this case, the Pareto Diagram is used as a tool to help distribute efforts in resolving emerging problems and identify the main reasons to start acting (Alkiayat, 2021). Thus, the use of protocols is evaluated, and barriers to successful implementation are detected. It is essential to identify the measurable indicators that will be used to evaluate the effectiveness of the process. For example, it may involve the registration of errors during patient transfer, as well as interviews with employees directly involved in the process.
At the “Act” stage, the recommended changes are implemented simultaneously with the elimination of the detected shortcomings. Therefore, it is necessary to consolidate the knowledge acquired from regulations, standards, specifications, and instructions. When developing the checklist contents, it is helpful to interview the participants in the process and ask them what information they need. To group the interview content into a checklist, it needs to be broken down into sections and subcategories. It is essential to note that the checklist should include a common section for all departments, such as the patient’s full name and medical history number, as well as sections specific to each department.
Analysis
On the Pareto diagram, the causes of problems are listed along the abscissa axis in descending order of the problems they cause. The problems themselves are numerically quantified on the ordinate axis and in accumulated percentage terms. The Pareto analysis ranks individual areas by significance or importance, identifying and eliminating those causes that contribute to the most significant number of problems (Alkiayat, 2021). The primary data will be selected based on existing practices in the medical institution.
First, it is necessary to determine which actions, or their absence, led to the current situation. It is necessary to assess the interest of the medical staff themselves, as well as to evaluate patients’ opinions regarding the quality of services provided. The evaluation will be based on a comparison and identification of patterns that show how the implemented changes have affected the work organization’s practice. Quantitative data will be recorded in aspects such as the number of errors that occur, the overall speed of providing medical services, the frequency of negative incidents, and the emotional and physical well-being of patients and employees.
Based on the data obtained, it will be possible to determine the aspects in which problems often arise. To implement the quality assessment of the project, it is necessary to attract leaders who will strive to use new recommendations and instructions in daily nursing practice. One way to involve leaders in the process is to engage them in developing the document and staff training. It is also important to conduct interviews with the staff after implementation and gather feedback.
At this stage, they will be allowed to implement their ideas, which will impact the entire process of organizing the work of a medical institution. The leading cause of errors is inefficient communication between medical professionals participating in this process. Therefore, it is necessary to encourage nurses’ leadership qualities, and competencies should give effective feedback (Parry et al., 2021). When implementing the project, it will be helpful to make the necessary changes, as well as adjust the forms, checklists, and other recommendations. Thus, nursing leadership plays a key role in this process, as it simplifies and accelerates the integration of changes.
References
Alkiayat, M. (2021). A practical guide to creating a pareto chart as a quality improvement tool. Global Journal on Quality and Safety in Healthcare, 4(2), 83–84.
Li, J., Du, G., Clouser, J. M., Stromberg, A., Mays, G., Sorra, J., Brock, J., Davis, T., Mitchell, S., Nguyen, H. Q., & Williams, M. V. (2021). Improving evidence-based grouping of transitional care strategies in hospital implementation using statistical tools and expert review. BMC Health Services Research, 21(1).
Naylor, M. D., Hirschman, K. B., Toles, M. P., Jarrín, O. F., Shaid, E., & Pauly, M. V. (2018). Adaptations of the evidence-based transitional care model in the U.S. Social Science &Amp; Medicine, 213, 28–36.
Parry, C., Johnston-Fleece, M., Johnson, M. C., Shifreen, A., & Clauser, S. B. (2021). Patient-centered approaches to transitional care research and implementation. Medical Care, 59(Suppl 4), 330–335.