NURS 8300: Organizational and Systems Leadership for Quality Improvement | Week 7

In Week 6, you explored quality improvement models as a strategy for identifying health care and patient safety concerns. Once a quality or safety issue is identified, what is the next step to ensure the issue is improved? What internal and external organizational factors will influence the success, or failure, of a quality improvement initiative?

The concepts presented this week relate to how nurse leaders can develop quality improvement initiatives that align with the mission, vision, and values of the organization to engender success and achievement of the goals.

Learning Objectives – NURS 8300 Week 7: Determining Organizational Priorities for Quality Improvement

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

• Assess how the mission, vision, and values of the organization determine improvement priorities
• Apply the SMART criteria to a quality improvement initiative
• Analyze the influence of the external environment on the priorities of the organization

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

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Adminisration Press.

• Chapter 11: “Patient Safety and Medical Errors”

Clarke, C. M., & Persaud, D. D. (2011). Leading clinical handover improvement: a change strategy to implement best practices in the acute care setting. Journal of Patient Safety, 7(1), 11–18. doi:10.1097/PTS.0b013e31820c98a8

Designed for leaders who want to improve quality care, this article focuses on clinical handovers that occur within acute care facilities. It provides a model for improvement and is intended to be a supplemental resource that can be used with the existing research and literature on this topic.

Sennett, C. (2010). Healthcare reform: Quality outcomes measurement and reporting. American Health & Drug Benefits. Retrieved from http://www.ahdbonline.com/article/healthcare-reform-quality-outcomes-measurement-and-reporting

The article on this website discusses features of the Patient Protection and Affordable Care Act (PPACA), focusing on the outcomes and implications for quality outcomes measuring and reporting.

Required Media

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

Note: The approximate length of this media piece is 9 minutes.

This video provides an overview of organizational factors that influence quality. Lillee Gelinas discusses the importance of teamwork and enlisting leadership to help move quality initiatives forward. Other topics addressed include the role of stakeholders in improving patient safety and the responsibility of hospital board members in setting the quality and safety agenda.

Optional Resources

Lazarus, I.R. (2011). What will It take? Exploiting trends in strategic planning to prepare for reform. Journal of Healthcare Management, 56(2), 89–93.

Discussion: Quality Improvement Initiative

When attempting to garner support for a quality improvement initiative, it is important to demonstrate how the initiative supports the organization’s mission, vision, and values, as well as external factors that influence an organization’s priorities. Delivering a proposal for a quality improvement initiative requires clear, concise communication of the plan.

To prepare:

• Choose a QI initiative which has been the subject of focus in any healthcare setting. Explain the rationale that your senior leaders used in selecting this initiative for attention and focus.
• Explain how adverse events are handled in your organization from the public’s perspective and well as internally.
• Find a scholarly article or one from the public press, published within the last 5 years which recounts a serious error. Relate this error to any organization with which you have some familiarity.

By Day 3

Post your response.

Read a selection of your colleagues’ responses.

By Day 7

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

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 7: Determining Organizational Priorities for Quality Improvement

ADDITIONAL INFO 

Determining Organizational Priorities for Quality Improvement

Introduction

Quality improvement is an important part of any organization’s strategy for improving performance. In this article, we’ll look at how the level of performance in a variety of areas can be assessed and what steps you can take to determine which ones are candidates for quality improvement.

An organization can identify areas that are candidates for quality improvement by analyzing data on performance.

Once you have identified the areas where performance is below your desired level, you can then analyze data on those areas. This will enable you to determine what causes the problem and how to fix it.

For example, if a certain department’s sales numbers are consistently below average, they may need more support from their sales team or they may want to see if this trend continues after the summer months when customers are less likely to buy products (and thus make purchases). You could also consider whether there’s been an increase in competitors entering that market or if there’s been an increase in competition overall; perhaps both of these things are at play? And finally—and most importantly—you should consider whether there is any other information available about this particular department compared with others within your organization; could there be differences between them that might explain why one group has consistently lower numbers than another?

Both cost and quality measures should be used to identify quality improvement priorities.

While both cost and quality measures are important, they should be used to identify quality improvement priorities. Cost and quality measures are different types of metrics that measure the same thing—the cost or expense of providing a product or service.

Costs of quality can be measured in terms of dollars and cents, but also include time, effort, resources (people), and other factors (such as safety). This means that there may be more than one way to measure the same thing! In fact, you could have two different costs associated with a particular process improvement project: one from your internal team members’ perspectives who will be working on the project; another from outside stakeholders who need access to information about their expectations before agreeing to support it financially

The organization should set a goal for the level of performance it desires in each area it has selected for attention.

The organization should set a goal for the level of performance it desires in each area it has selected for attention.

This is done by determining what the desired level of performance is, as well as what its current level of performance is. The gap between these two numbers tells you how far away from your ideal organizational objectives you are currently, and can help guide your actions going forward.

In addition to considering possible causes for this gap (which may include factors such as employee morale or training), it’s also important to consider how much time has passed since this problem was first noted—and if there were any attempts at fixing it before now.

An organization can choose from a variety of tools to determine quality improvement priorities.

• You can choose from a variety of tools to determine your quality improvement priorities.

• Choose the right one for your organization and its needs.

• Set goals for quality improvement, including the following: 1) identify problems 2) define tasks 3) develop plans 4) implement the plan 5) evaluate results 6) make adjustments if needed

Conclusion

The process of determining organizational quality improvement priorities is a complex one. It requires a thorough understanding of the organization’s goals, financial resources and performance measures to help guide the selection of tools.