NURS 8300: Organizational and Systems Leadership for Quality Improvement | Week 11

How do quality improvement teams measure a project’s success? What measurement mechanisms can be applied to evaluate the impact of a practice change? To be an effective change agent, and to be able to sustain change, you must be able to measure the progress and outcomes of implementing new practices or procedures. Many measurement tools can be utilized for this purpose: quantitative frequency distribution charts, line graphs, qualitative data analysis, patient surveys, etc. In order to measure success, however, you need to be familiar with evaluation techniques. To that end, this week you appraise measurement mechanisms to evaluate change in organizations and systems, and evaluate the success of quality improvement initiatives in terms of sustainability. Additionally, this week, you will engage in self-assessment and reflection to evaluate your own leadership skills and preferences.

Learning Objectives NURS 8300:Week 11: Measuring Change in Nursing Essay

By the end of this week, you will be able to:

• Evaluate the extent to which improvement is sustained through leadership and improvement teams
• Determine measurement mechanisms to evaluate the impact of an action plan and quality improvement initiative recommendations
• Interpret the results of a self-assessment to gain insights into leadership preferences within the framework of leadership and management
• Formulate recommendations for leadership development

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Richardson, A., & Storr, J. (2010). Patient safety: A literative review on the impact of nursing empowerment, leadership and collaboration [corrected] [published erratum appears in INT NURS REV 2010 Mar;57(1):158]. International Nursing Review, 57(1), 12–21. doi:10.1111/j.1466-7657.2009.00757.x

This article analyzes how nurses can improve patient safety. It identifies certain knowledge gaps that inhibit nurses’ ability to improve patient safety that must be addressed before they can effectively make contributions.

Bigelow, L., Wolkowski, C., Baskin, L., & Gorko, M. (2010). Lean Six Sigma: Sustaining the gains in a hospital laboratory. Clinical Leadership & Management Review, 24(3), 1–14.

In this article, a health care organization uses Lean Six Sigma to improve performance, but it does not initially achieve the desired results. It then utilizes an Operational Performance Improvement office from within the organization to receive better training in Lean Six Sigma and it is finally able to improve performance.

Murphree, P., Vath, R. R., & Daigle, L. (2011). Sustaining Lean Six Sigma projects in health care. Physician Executive, 37(1), 44–48.

The authors of this article consider ways to keep Lean Six Sigma projects operating instead of closing them. They distinguish between closing and controlling, the latter being the last phase in Lean Six Sigma. According to the authors, many organizations close Lean Six Sigma projects when they should be controlling them.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Organizational change. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

This video examines factors that enhance and impede organizational change. Dr. Wooden and Dr. Freshman discuss change models that can be used to manage the change process and to assist individuals through the transition period.

Optional Resources

Reh, F. J. (2011). Key performance indicators (KPI): How an organization defines and measures progress toward its goals. Retrieved from http://management.about.com/cs/generalmanagement/a/keyperfindic.htm

Discussion: Evaluating and Sustaining Improvement

The downfall of many quality improvement initiatives is the inability to sustain improvements. Last week, you considered the use of evidence-based practice models as a method for sustaining practice changes to improve quality. This week’s Discussion builds on those concepts of sustainability. You evaluate measurement mechanisms and explore strategies that leadership and improvement teams can use to sustain improvement efforts.

To prepare:

• Review the evaluation tools presented in the Learning Resources and how the tools can be used to promote sustainability.
• Select a measurement mechanism that can be used to evaluate your quality improvement initiative. You may wish to conduct additional research on the use of measurement mechanisms to sustain outcomes of improvement initiatives.
• Consider the influence of leadership and improvement teams in sustaining improvement efforts. Ask yourself: What specific strategies can leaders and my improvement team use to sustain our improvement initiative?

By Day 3

Post a cohesive scholarly response that addresses the following:

• Evaluate the influence of leadership and improvement teams in sustaining improvement efforts. Present a succinct analysis of three or more strategies leaders and teams can use in your response.

Read a selection of your colleagues’ responses.

By Day 7 NURS 8300:Week 11: Measuring Change in Nursing Essay

Respond to two of your colleagues in one or more of the following ways:

• Ask a probing question, substantiated with additional background information, evidence, or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues.

Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources. NURS 8300:Week 11: Measuring Change in Nursing Essay

ADDITIONAL INFO 

Measuring Change in Nursing

Introduction

Nursing is a profession that has to be measured. Nurses measure patient progress on a daily basis and use this information to help guide their care. If you’re new to nursing, it can be hard to understand the importance of measuring change in your practice. In this article, we’ll explore why it’s important for nurses (and other healthcare professionals) to measure their work and what metrics they should be looking at when making decisions about their patients’ care

Goals are the foundation of nursing care.

Goals are the foundation of nursing care. Goals are specific, measurable and achievable. They reflect the patient’s condition and preferences, as well as your own values. Goals should be reviewed regularly so that they can be adjusted to reflect changes in the patient’s condition or preferences.

For example: A goal might be “to improve my ability to get around easily by having a walker available at all times.” If you have difficulty walking long distances because of arthritis in your spine or legs (or both), this would not be an appropriate goal for you because it does not take into account how much help getting around will require from others (and why). Your new goal might be instead “to begin using a cane whenever possible.” This allows for more flexibility when deciding whether or not it is appropriate for someone else to help with walking outside their home environment; however, this also means that there may need to come up with other ways of making sure those who live nearby know what services are available if/when needed!

Nurses monitor and evaluate patient status by comparing the observed data to goals.

A goal is a target that nurses use to measure their patients’ status. Goals are the foundation of nursing care, and they’re also one of the most important tools for measuring change in nursing.

Goals are specific, measurable objectives that can be used in evaluating patient status and nursing care. For example, if you want your patient’s temperature to be below 100°F before they leave your room at night (a common goal), then you’ll need to measure their temperature every hour until it reaches 100°F or lower. You then compare this data with what’s expected based on current guidelines so that any deviations from those expectations are noted for improvement or correction later on down the line!

When a patient’s status is improved, goals can be changed to more challenging outcomes.

When a patient’s status is improved, goals can be changed to more challenging outcomes.

It is important to keep in mind that goals should be set at a level that is achievable. If you are going to do something like go home from the hospital and walk 10 minutes without holding onto anything, then this may not be achievable for your patient.

If a goal isn’t feasible, it should be reviewed regularly with the patient’s care team so that they know what their expectations are and whether or not they have been met. In addition, if there are changes made in regards to medications or other treatments prescribed by doctors or nurses during this time period (such as changing from intravenous fluids), these changes will affect how long it takes you achieve each goal individually as well as group-wise

Takeaway:

The takeaway is the most important idea in this article. It summarizes what you learned and makes sure that you remember it for later use.

The takeaway should be a statement of fact, not an opinion. If you can’t summarize your main points into three or four sentences, then you probably need to go back and look at them again!

Conclusion

We’ve covered a lot of ground, and we hope you now feel like you have a solid grasp on how to measure change in nursing. Remember that the goal of any change effort is to improve patient outcomes and satisfaction, so the key is to keep your patients happy!