The Organization’s Quality Indicator in a Healthcare Unit Essay

Introduction

The offered paper is devoted to the peculiarities of a specific case in a healthcare unit and its analysis. The pivotal aim of the project is to outline the critical importance of promoting positive change within a hospital following the central ideas of implementation science (IS). Reconsideration of the existing practices and their replacement with new, more effective ones can be a complex and sophisticated process because of the impact of multiple factors, both internal and external (2). For this reason, the creation of a successful model and plan for facilitating alteration and implementing a new approach should be preceded by a comprehensive analysis outlining the main forces that should be considered. The given case study report focuses on the Intensive Care unit’s (ICU) functioning and quality indicators that should be altered to attain better results.

The analysis of the selected issue is performed regarding the current literature devoted to the IS, its use in a healthcare setting, and models that can be used to attain desired outcomes. Moreover, the ICU’s work and current reports of its central problems are also taken into account and used as the basis for the analysis and discussion. The paper also offers recommendations on addressing the problem by applying the RE-AIM model and creating the background for promoting positive change and attaining better results within the selected unit. At the end of the document, the summary and conclusions are given.

Case Description

The selected case revolves around the functioning of the ICU within an internal medicine specialized hospital. The selected indicator is linked to outcomes and is defined as the healthcare-associated infections (HAIs) rate peculiar to the ICU unit’s work. The leading complications include ventilator-associated pneumonia, catheter-associated bloodstream infections, and infections of the urinary tract (1). The existing reports demonstrate the high incidence of such adverse effects and their negative impact on clients’ states, health, and satisfaction (8). Moreover, the need for improvement is evidenced by the fact that about 10% of all patients contact HAI and have a high risk of developing new problematic states or issues (8). Under these conditions, there is an urgent necessity to address this problem and promote positive change.

Further disregard of the problem might precondition the deterioration of outcomes and the emergence of additional complaints. Thus, HAIs might serve as a serious factor in increased mortality rates among patients with complex conditions or belonging to risk groups (8). Moreover, HAIs negatively affect patients’ satisfaction levels and complicate relations between a care provider and a client (9).

If unresolved, the high HAIs rate can result in the critical worsening of treatment outcomes, change in the care unit’s image, and the need for the radical reconsideration of the ICU unit’s work (11). The growing percentage of patients with ventilator-associated pneumonia, catheter-associated bloodstream infections, and urinary tract infections also demand additional costs to manage these conditions and provide care to all clients (1). For this reason, the positive change in addressing this indicator is vital for the hospital’s work.

The selected indicator peculiar to the work of the ICU presupposes several stakeholders impacting outcomes and results. First, my role as a nurse presupposes increased attention to providing care to all patients in ways that guarantee their safety, improved stay, and well-being after treatment (7). For this reason, all specialists should be aware of high HAIs rates and focus on the elimination of possible risks and working with clients in safe and effective ways (8). Second, physicians also remain responsible for monitoring the given indicator and trying to reduce incidence rates by improving the quality of providing care and controlling the procedures associated with the high risk of transmitting infections and deteriorating patients’ states.

The role of healthcare leaders regarding the indicator should also be emphasized. Team leaders should play central roles in managing employees and selecting care delivery strategies (5). At the same time, they are responsible for educating staff members and their knowledge and expertise levels (1). For this reason, the emergence of a critical problem and its future development should become a fundamental concern for leaders and impact their further decision-making. The reorganization of the unit’s work is impossible without their active participation, meaning that this group of stakeholders plays a vital role in addressing the issue and improving care related to the high HAIs rate in the ICU unit.

Analysis

Analyzing the selected problem, it is vital to address the main factors impacting HAIs rates within the selected unit. First, the poor performance of this quality factor can be explained by the inappropriate hygiene among the staff (9).

Little attention to this aspect preconditions the increased risk of infecting a patient and promoting the further deterioration of the given showing. Second, the absence of clear guidelines on how to manage infections within the ICU unit and attain the desired outcomes can be another aspect increasing the topicality of the selected indicator and the need for its improvement. Finally, the lack of basic infection control knowledge and its implementation also serves as the barrier to attaining improved care outcomes and reducing HAIs’ incidence rates within the ICU. It means that there is a need to create a new culture focusing on this problem and its resolution.

Patient satisfaction data also evidences the high importance of the selected indicator and the need for its addressing. HAIs have always served as the central source of growing dissatisfaction among patients with the quality of provided care (11). The reports show that in units with the unresolved problem of health-acquired infections, relations between patients and caregivers might be complex and characterized by a lack of trust (9). Furthermore, the development of complications among patients in ICU is another problem decreasing their satisfaction levels and evidencing the need for interventions aimed at enhancing infection control and creating a safe and secure environment needed for patients to recover.

Health care personnel (HCP) teams’ experience should also be considered the force affecting the selected indicator. At the moment, there are no detailed guidelines or evidence-based interventions aimed at reducing HAIs incidence within the ICU unit. It means that the caregivers’ behaviors mainly focus on providing appropriate care to patients, not considering the high prevalence of various infections associated with clients’ stay in the hospital (11). Moreover, there is no specific culture promoting increased attention to such problems and the need to provide more attention to risks linked to the infections’ spread in the unit. Under these conditions, it is possible to conclude that HCP teams lack an understanding of the importance of the chosen indicator and how it can be addressed to improve outcomes.

Finally, the existing approaches and guidelines rest on the relevant research and practices outlining the best ways to deliver care to patients and improve their states. However, speaking about HAI incidence rates in ICU, there are no clear guidelines supported by research on how to act to minimize risks or attain significant improvement (11). Under these conditions, the research and evidence base existing in the facility should be included in the plan with the primary goal to generate additional knowledge and ensure that the personnel is provided with information about interventions that can help to promote the positive change and ensure patients do not suffer from the high risk of acquiring undesired outcomes within the selected ICU unit (6).

Improvement Plan

The positive change within the selected unit should be promoted by using IS and the RE-AIM model. It presupposes the following elements:

• Reach – how to address the selected group.
• Effectiveness – practical use of intervention.
• Adoption – development of organizational support for intervention.
• Implementation – appropriate delivery of the approach.
• Maintenance – ensure the positive and long-term outcomes of the change (5).

In such a way, the offered intervention should be effective, consider the existing problems, promote sustainability, and be adopted at all levels of the unit’s work. Regarding the analysis results, the improvement presupposes the creation of a safety culture, and additional guidelines on managing HAIs can be offered.

First of all, it is vital to affect the organizational culture and address the stakeholders identified above. It can be performed by explaining tasks to team leaders and ensuring their active participation in the change process (10). The alteration of the current culture should be attained by additional training and seminars explaining the root causes for spreading HAIs, how they can be reduced, and practices, such as observing the introduced guidelines, to address the problem. The effectiveness of these interventions is evidenced by recent research proving the significance of the organizational change affecting HAIs in various units (10).

Second, the recommended intervention should also focus on working with team leaders to ensure active participation in the planned change. Staff resistance or poor understanding of the planned alteration can become a barrier to achieving desired goals. That is why the leadership change should also be facilitated to ensure the adoption of new models (2). Heads of teams or top managers should be explained the necessity to observe new rules to address high HAIs rates and decrease them. They should also be responsible for cooperating with nurses and other specialists to guarantee their better engagement.

Communication between all participants of change is vital for better implementation and sustainability of the process. It can be organized by creating interdisciplinary teams consisting of nurses, physicians, and epidemiologists to outline the central causes of growing HAIs rates within the ICU and guarantee that this information will be shared with other employees to promote their better understanding (3). It can also help to reduce voltage drop when implementing evidence-based practices in real conditions (8). The local hospital’s network can be used to provide specialists with access to data and offer the opportunity to discuss some problems that might emerge during the change to resolve them.

Considering the significance of the problem and its influence on the work of the ICU unit and patients’ satisfaction, it is vital to ensure the hospital’s resources available at the moment are utilized to support the planned change and attain the existing goals. It might presuppose additional equipment for better hygiene (soap, gloves, or electronic hand hygiene monitoring tools) and personnel training to ensure they possess the correct vision of how HAIs rates can be reduced by following the existing guidelines and creating robust security culture within the chosen unit.

Finally, the RE-AIM model presupposes the maintenance phase vital for guaranteeing the long-term effects of the change. It can be achieved by establishing effective monitoring and evaluation tools. First, the results of ICU units should be controlled to observe whether there is a decrease in HAIs’ incidence rate and an increase in patient satisfaction levels (7). Second, the evaluation of how the proposed guidelines and safety culture work can be performed by collecting nurses’ and other stakeholders’ feedback on how the proposed intervention works and possible alterations that can make it more effective.

At the same time, there is a need for champions responsible for observing the progress and how change is implemented. First, one of the HCP team’s leaders should be appointed as a person responsible for monitoring and planning change. Second, a specialist in providing guidelines and explanations regarding the proposed alteration is demanded (4). A champion to ensure that nurses are provided with detailed instructions and possess an improved vision of how to act should also be selected. Finally, a champion responsible for organizational aspects should also be appointed. The cooperation of these specialists will help to promote change and attain desired results.

Conclusion

Altogether, HAIs’ incidence rate in the ICU unit is selected as the indicator that outlines the need for change. The application of the RE-AIM model is viewed as a beneficial option for the chosen setting as it helps to translate the existing evidence-based knowledge into practice and create guidelines on how to improve hygiene and decrease the number of complications among patients. Moreover, the growing patients’ dissatisfaction also shows the necessity of resolving the problem and introducing new approaches using IS major concepts. It is expected that the focus on leadership, the creation of specific culture, and organizational change will help to attain the desired outcomes.

References

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