Overview Congratulations! Your quality improvement initiative was approved by your manager. Now you need to communicate and bu

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Healthcare Improvement Initiative

Veronica Horne

Southern New Hampshire University

March 7, 2022

IHP 604

Selection of Healthcare Organizations

St. Jude Children’s Research Hospital is world renowned and has several locations within the United States. The first hospital was open imn1962 and one of its primary focuses was sickle cell disease and leukaemia, as well as other cancers for podiatric patients. St. Jude’s is well known for the care and treatment of children and ensuring that parents of patients are never billed for the services they provide. This also includes meals and housing for the families of patients during treatment. Within the first year of the hospital year of operation, more than thirty research projects have been instituted, with four completed (St. Jude, 2022).

For this project, a team was put together to monitor the quality and risk management as it pertain to St. Jude Children’s Research Hospital. Data has been collected and analysed to determine what healthcare improvement initiatives can be implemented to improve quality and safety for staff, patients, and patients’ families and any other visitors.

Selection of Public Facing Data

Childhood cancer is something that no family wants to go through for their child, yet it happens all the same for far too many families. The Public Access Data Tables that will be used for this project will show the information collected and analysed from the participants in the Childhood Cancer Survivor Study (CCSS). The information found within the tables will be organized by the type pf cancer, gender, age, years since diagnosis, age of diagnosis and what treatments were given. St. Jude Children’s Research Hospital was chosen due to the enormous amount of work and dedication put into increasing survival rates for podiatric cancer patients, and the amount of information available on their research, past and present.

Selection of Area of Improvement

St. Jude Children’s Research hospital’s area of improvement is the cancer services required for children with cancer. There needs to be efficacy in applying the services through information technology to reduce human errors. The public-facing data that will be utilized will include the Public Access Data Tables, which will show the information collected and analyzed from participants in the Childhood Cancer Survivor Study (CCSS).

Selection of Method of Improvement

The method adopted for improving cancer care is implementing and improving electronic order entry with a system to activate order sets (Dobrozsi et al., 2019). The plan would help notify the health providers in St. Jude of fever or related complications before the patient arrives on the hospital premises.

Selection of Framework to Use in Improvement Initiative Recommendations

Program-wide interventions through process maps will be the utilized method of improvement for cancer care in children. There will be an initiation of a PDSA process in each affiliate program (Coury et al., 2017). Specifically, it will improve timely antibiotic administration for children with febrile neutropenia. Besides, it will also help cancer patients with sepsis.

Discuss your Selections

I selected the area of improvement because diagnosing cancer in a child or young adult is an emotionally overwhelming experience (Morgan et al., 2019). Therefore, the kind of care offered at St. Jude hospital must improve the child’s condition without risking health. The selected method of improvement will help the health practitioners determine the patients with additional complications such as Sepsis and those who require prompt administration of antibiotics. The chosen framework will enable the hospital to use rapid small-step change cycles to implement the intervention.

Report Sections

The report sections to be included in my course project to describe my healthcare quality improvement initiative will consist of the background information where I will identify background on the services offered at St. Jude, the state of cancer patient care, the implemented technologies, and other relevant information. The scope of the study section will describe the purpose and objective of the report. The literature review will provide research information on the issue. The methodology section will describe the application of the intervention. The conclusions and recommendations section will be the last segment of the report.

Recommendations

I recommend all procedures and collection of data to be monitored and closely updated at the following intervals. This is at one month, then 3, 6, and 12 months. Ongoing monitoring allows the facility and management to see how information has changed, what areas have improved and at what rate, or have not failed to improve. This would allow management and the healthcare team to allow for modifications as needed, to ensure that it continues to improve, and if some areas do not, as to why. This can be failure of staff following sanitary protocols, such as using PPE equipment, or failing to input all data electronically.

A facility such as St. Jude’s that is world renowned, and relies heavily on donations, cannot afford to make costly errors that potentially can be avoided if all protocols are followed. Additionally, staff need to maintain an impeccable image for not just themselves, but for the entire organization as a whole. It should be considered an honor to work for such an organization, and for their cause, which is to save children with cancer or other life-threatening illness such as leukemia or other blood disorders. Maintaining a constant eye on how to continue to improve healthcare and safety is imperative.

References

Coury, J., Schneider, J., Rivelli, J., Petrik, A., Seibel, E., & D’Agostini, B. et al. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a sizeable pragmatic study involving safety net clinics. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-2364-3

Dobrozsi, S., Tomlinson, K., Chan, S., Belongia, M., Herda, C., & Maloney, K. et al. (2019). Education Milestones for Newly Diagnosed Pediatric, Adolescent, and Young Adult Cancer Patients: A Quality Improvement Initiative. Journal Of Pediatric Oncology Nursing, 36(2), 103-118. https://doi.org/10.1177/1043454218820906

Morgan, J., Deyo, J., Cox, J., Fasipe, F., Mohamed, A., & Russo, C. (2019). Quality Improvement Interventions across a Network of Pediatric Hematology-Oncology Clinics. Pediatric Quality & Safety, 4(2), e149. https://doi.org/10.1097/pq9.0000000000000149

St. Jude Children’s Research Hospital (2022). Timeline: From Dream to Reality. Retrieved from https://www.stjude.org/about-st-jude/history/timeline.html?sc_icid=our-history-timeline

St. Jude Children’s Research Hospital (2022). Public Access Data Tables. Retrieved from https://ccss.stjude.org/content/dam/en_US/shared/ccss/documents/data/data-bk-brief-symptom-inventory-18-basejb.pdf

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6

ABC Surgical Center Report

Veronica Horne

IHP 604

Southern New Hampshire University

January 16, 2022

TO: Director, ABC Surgical Center

FROM: Assistant Director, ABC Surgical Center

DATE: January 16, 2022

SUBJECT: New Quality Improvement Initiatives

Elements of Evidence-Based Literature

Older Adult Falls Data by the CDC – Sarmiento, K., & Lee, R. (2017). STEADI: CDC's approach to make older adult fall prevention part of every primary care practice. Journal of safety research, 63, 105-109.

According to Sarmiento & Lee (2017), health providers play a significant role in protecting older adults from falls. According to their study, falls among older adults aged 65 and older are one of the prime causes of morbidity and death in the world. Furthermore, this leads to direct medical expenses of nearly $35 billion. To avoid these catastrophic falls, the CDC Injury Center forecasted the amount of older adult falls by 2030, as well as the related medical costs, before examining what modifications in clinician practices may be made to prevent such falls.

Preventing Falls in Hospitals by AHRQ – Cunha, L. F. C. D., Baixinho, C. L., & Henriques, M. A. (2019). Preventing falls in hospitalized elderly: design and validation of a team intervention. Revista da Escola de Enfermagem da USP, 53.

In their study, Cunha, Baixinho & Henriques (2019) reflect on AHRQ's data on the number of falls and how team intervention could prevent falls for hospitalized elderly. 25 million older people fall every year, resulting in more than 30,000 fatalities. Every year, an additional 2 million older persons are sent to emergency rooms after falling, with one out of every five of them suffering from broken bones and bruises. According to Cunha, Baixinho & Henriques (2019), falls are not a natural aspect of aging and may be avoided by a systematic approach.

Report Validity

Data Collection

Data from the first article was compiled using the CDC's Reporting System. Meanwhile, data from the second article, which covered the number of falls among older people, were collected from AHRQ's website.

The first article is reliable for many reasons. First, it was published in the NCBI, which promotes research and health by providing access to scientific and genetic information. Second, the study used the CDC's WISQARS cost module to show the size of the overall lifetime medical cost of fatal falls and the CDC's Reporting System. The second report, on the other hand, is also reliable since the research was conducted by competent researchers who used data from AHRQ, a recognized body that produces evidence meant to make healthcare safer, more accessible, affordable, and equitable.

According to the researchers in the first article, these severe falls should be treated as regular in primary care to help mitigate their vastness. A hospital should evaluate the risk of falls, devise medication plans suited to each patient's practical skills (Sarmiento & Lee, 2017). This conclusion is legitimate since research suggests that fatal adult falls might approach 100,000 per year, with a cost of about $100 billion, and that if we do nothing, it would be too dangerous. According to the second research, the predicted 25 million people would decrease to 7 million by 2030, which is in accordance with the previous projection.

Report Applicability

Both studies apply to the ABC Surgical Center since the number of falls at the surgical center has been high, necessitating a change in primary care routine to prevent more falls. Both reports recommended incorporating fall risk screening, evaluating and changing medicines, and prescribing vitamin D supplements to patients as measures to reduce rather than add to the five falls that occurred in the surgical center over a month. Furthermore, the CDC's effort provides a practical strategy to implementing the clinical practice guideline for fall prevention developed by the American and British Geriatrics Societies.

Metric Comparison

Through a study of data, the first report's metrics of data used the CDC and US Census Bureau data that estimated fatal adult falls could reach 100,000 per year with an associated cost of about $100 billion by 2030. The second research indicated that 25 million older adult falls occur yearly, and, like the previous report, the study predicted that this number would rise if a feasible solution is not implemented.

Recommendation

I believe the surgical center should include fall risk evaluations into their usual general care, and fall risk patients should be given particular attention to preventing deadly falls. In addition, an interdisciplinary Implementation team with a strong connection to hospital administration and people with the requisite skills is required, to prevent falls. This group will manage the surgical center's fall prevention program by making important design choices, implementing improvement activities, and tracking the new routine's success. These suggestions should be adopted as quickly as possible since being prepared for change is essential for avoiding further complications.

Organizational Culture Improvements

Once these guidelines are implemented, there would be a team leader who would keep track of the team's progress, which would include:

· Within 24 hours after admission, a fall risk factor evaluation is performed.

· The drugs that patients are taking are evaluated for their potential to cause them to fall.

· Patients who need regular toileting assistance are assisted as soon as possible.

References

Cunha, L. F. C. D., Baixinho, C. L., & Henriques, M. A. (2019). Preventing falls in hospitalized elderly: design and validation of a team intervention. Revista da Escola de Enfermagem da USP, 53.

Sarmiento, K., & Lee, R. (2017). STEADI: CDC's approach to make older adult fall prevention part of every primary care practice. Journal of safety research, 63, 105-109.

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2

Healthcare Improvement Initiative

Veronica Horne

Southern New Hampshire University

February 6, 2022

IHP 604

Selection of Area of Improvement

St. Jude Children’s Research hospital’s area of improvement is the cancer services required for children with cancer. There needs to be efficacy in applying the services through information technology to reduce human errors. The public-facing data that will be utilized will include the Public Access Data Tables, which will show the information collected and analyzed from participants in the Childhood Cancer Survivor Study (CCSS).

Selection of Method of Improvement

The method adopted for improving cancer care is implementing and improving electronic order entry with a system to activate order sets (Dobrozsi et al., 2019). The plan would help notify the health providers in St. Jude of fever or related complications before the patient arrives on the hospital premises.

Selection of Framework to Use in Improvement Initiative

Program-wide interventions through process maps will be the utilized method of improvement for cancer care in children. There will be an initiation of a PDSA process in each affiliate program (Coury et al., 2017). Specifically, it will improve timely antibiotic administration for children with febrile neutropenia. Besides, it will also help cancer patients with sepsis.

Discuss your Selections

I selected the area of improvement because diagnosing cancer in a child or young adult is an emotionally overwhelming experience (Morgan et al., 2019). Therefore, the kind of care offered at St. Jude hospital must improve the child’s condition without risking health. The selected method of improvement will help the health practitioners determine the patients with additional complications such as Sepsis and those who require prompt administration of antibiotics. The chosen framework will enable the hospital to use rapid small-step change cycles to implement the intervention.

Report Sections

The report sections to be included in my course project to describe my healthcare quality improvement initiative will consist of the background information where I will identify background on the services offered at St. Jude, the state of cancer patient care, the implemented technologies, and other relevant information. The scope of the study section will describe the purpose and objective of the report. The literature review will provide research information on the issue. The methodology section will describe the application of the intervention. The conclusions and recommendations section will be the last segment of the report.

References

Coury, J., Schneider, J., Rivelli, J., Petrik, A., Seibel, E., & D’Agostini, B. et al. (2017). Applying the Plan-Do-Study-Act (PDSA) approach to a sizeable pragmatic study involving safety net clinics. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-2364-3

Dobrozsi, S., Tomlinson, K., Chan, S., Belongia, M., Herda, C., & Maloney, K. et al. (2019). Education Milestones for Newly Diagnosed Pediatric, Adolescent, and Young Adult Cancer Patients: A Quality Improvement Initiative. Journal Of Pediatric Oncology Nursing, 36(2), 103-118. https://doi.org/10.1177/1043454218820906

Morgan, J., Deyo, J., Cox, J., Fasipe, F., Mohamed, A., & Russo, C. (2019). Quality Improvement Interventions across a Network of Pediatric Hematology-Oncology Clinics. Pediatric Quality & Safety, 4(2), e149. https://doi.org/10.1097/pq9.0000000000000149

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