NURS-FPX6016: Quality Improvement of Interprofessional Care Instructor’s Name October 2024

Quality Improvement Initiative Evaluation

Healthcare is a major factor in today’s world with the increasing rate of diseases due to various factors including environmental, educational, and so on. This increase in health issues indicates the need for quality improvement initiatives necessary to ensure that the patient’s health is the priority of the healthcare organization and proper measures and strategies are implemented to ensure that the patients are getting effective care coordination and health safety for the improvement in the health of the patients and increasing positive patient outcomes (Bhati et al., 2023). Medication errors occur at a large scale in the clinical setting due to the ineffectiveness of the staff members and the inefficiency of the technological devices integrated into the clinical system. The QI initiatives are implemented to identify and effectively address the areas of concern regarding the standard of treatment provided to the patients and how these areas can be effectively adjusted according to the requirements of the patients for improved results.

Rationale for Quality Improvement (QI) Initiative 

In a Vila Health Care facility, the current QI initiative is based on the integration of an advanced Electronic health record (EHR) system in the medical facility to enhance the generation of medication error alerts for the prevention of harmful events earlier thus reducing the rate of health disparities and increasing the positive patient satisfaction with the strong trust on the treatment of the healthcare providers. The evaluation of this quality improvement initiative can be done through the analysis of its effectiveness in reducing errors and improving patient well-being (Hill et al., 2020). The involvement and collaboration of interprofessional team members are necessary to ensure that the QI initiative is based on the collected knowledge and opinions of all the team members thus reducing the knowledge gaps and areas of uncertainty. However, additional policies can be implemented to ensure the effectiveness of the QI in the improvement of patient outcomes and increasing staff satisfaction without any burden.

Analysis of the Current Quality Improvement Initiative

The patient was admitted to the Vila health setting having health issues and identified allergies with specific antibiotics. Certain reasons including the negligence of staff members, ineffective communication and collaboration between the team members and the nursing staff, and an outdated EHR system resulted in the near-miss event regarding the administration of allergenic antibiotics to the patient (Tiwary et al., 2019). This near-miss event identifies the need for integration of the QI initiative in Vila Health to ensure the prevention of health damages and any adverse events. This current QI initiative is based on the enhancement of the EHR system to generate alerts for the wrong medications and timely prevent the adversity of the events. Moreover, this initiative ensures that proper training should be provided to the staff members and the nursing staff to ensure that they perform well and responsibly while providing patient treatment and administering medications.

Knowledge Gaps

There is no complete information on the usability of the EHR in the Vila health setting by the nursing staff and other healthcare providers. They might miss the features necessary to integrate into the treatment due to a lack of knowledge and understanding about the user experience of the EHR (Tsai et al., 2020). There is incomplete knowledge on the integration of technology in Vila Health by considering the factors including staff education, staff efficiency in operating the systems, reducing the burden on the staff, and increasing the positivity of the patient outcomes. There is a lack of knowledge about the long-term impact of the EHR in clinical settings and how it can be maintained for a better cause.

Areas of Uncertainty

The lack of effective communication between interdisciplinary teams is the major reason behind the implementation of QI initiatives in the clinical setting however, there is uncertainty regarding how this communication can be made effective between the team members to ensure the proficiency of the results. It is still unidentified how the transfer of patient information between the interdisciplinary teams can be improved. The uncertainty about the technology intervention ensuring the safety of the patient information still exists.

Evaluation of Success of Current Quality Improvement Initiative

The evaluation of the success of any implemented practice change can be determined through the factors for which the QI initiative is integrated into the healthcare setting (Hamilton et al., 2020). In the case of Vila Health, the success of the QI initiative will be identified by the reduced rate of medication errors and increased efficiency of the staff members in generating quality outcomes for the patients by providing timely and accurate care coordination based on the specified standards and guidelines provided by the national, state or accreditation bodies. The alignment of the healthcare practices with the guidelines ensures that the staff members are accountable for their acts and are responsible for their duties. The benchmarks help in the identification of the areas of lack and provide an effective approach to the nursing staff and healthcare providers in managing the positive environment of the healthcare setting by providing quality treatment to the patients (Flaubert, 2021). A few benchmarks provided by national, state, and accrediting bodies are given below;

Benchmarks

The Centers for Medicare and Medicaid Services (CMS) focused on the security and safety of patients by tracking the rate of errors of medications and adverse drug events (ADE) in hospitals and providing benchmarks regarding the “Meaningful Use” of EHR in the clinical setting (Syrowatka et al., 2023). The increase in the positive outcomes of the patients and reduction in medication errors is necessary to identify the success of the QI initiative. The state-level organization also focuses on patient safety and provides proper statistics-based reports for the improvement of the health outcomes of the patients.

The Joint Commission (TJC)

The Joint Commission (TJC) also focuses on ensuring the safety of the patients by the reduction of medication errors. The Joint Commission (2024), provides National Patient Safety Goals (NPSG) which ensure that any kind of harm that occurs due to allergies or medications must be prevented for the safety of the patient. Moreover, the nursing practice must comply with the guidelines and goals indicated by NPSG for the effective use of technology to improve the health of the patients. The success of the implementation of the QI initiative can be determined by assessing the adherence of nursing staff in generating quality outcomes for the patient and efficiently operating EHR for the enhancement of the satisfaction level of the patients.

Outcome Measures

The outcomes of the implementation of the QI initiative using the benchmarks provided by the regulatory bodies have certain means to evaluate their effectiveness in improving the health of the patients and ensuring the safety of the treatment provided to the patients. A few outcome measures are given below;

• The reduction in the damages that occur due to the administering of wrong medications indicates the effectiveness of the QI initiative and the proficiency of the nursing staff.
• The improved communication between the interdisciplinary teams for the improvement of the health situation of the patient.
• The effective engagement of all the stakeholders in identifying the effectiveness of the healthcare practice.
• The improved patient satisfaction level and enhanced outcomes of the patients regarding the care quality provided to them.

Assumptions Identification

It has been assumed that the staff members are effectively using EHR and barcoding technology for the improvement of health outcomes. It is the assumption that staff members are honestly reporting the medication errors and the improvement in the health outcome is solely due to the QI initiatives. It has been assumed that the outcomes are strictly associated with the guidelines provided by the regulatory bodies without any other intervention.

Incorporation of Interprofessional Perspectives and Actions

The involvement of the stakeholders and all the interprofessional team members is necessary to ensure that the QI initiatives regarding the upgrading of EHR in Vila health and training the staff members about the effective use of EHR or the improvement in the health of the patients. The team members together can provide different opinions, highlight different areas of concern, and suggest unified solutions to different problems for the effectiveness of the QI initiative (ElAwaisi et al., 2021). The nurses are always at the front line and can provide a deep insight into the monitoring of patient health and administering the medications. They can identify the areas of concern about the implementation of EHR in the clinical setting by considering the workflow and task urgency. Pharmacists also play an effective role in identifying errors in medications by comparing the suggested medicine with the prescribed medicines and cross-checking the EHR for any kind of necessary information like patient allergies. The physician’s role is to determine the allergies and other healthcare needs of the patients and effectively integrate them into the treatment plan for the satisfactory treatment of the patient. Technology experts and administrators play a significant role in defining the resources needed to implement the EHR upgrading process effectively in the clinical facility.

Areas of Uncertainty

Uncertainty about the alert systems exists which creates ambiguity about the important and unimportant alerts thus generating many alerts that will be difficult for the staff members to prioritize. The meetings between the interprofessionals regarding the alerts are unidentified as to how often they will communicate and collaborate about which specific alert. There will be cultural hindrances in the reporting of the near-miss events.

Recommendation of Additional Indicators and Protocols

The recommendations are made to improve the QI initiatives and ensure the sustainability of the quality outcome of the patients and the satisfaction of the staff members (Endalamaw et al., 2024). The recommendations needed to enhance patient outcomes include the upgrading of the tracking system based on real-time identification of errors and properly documenting the reports. A proper standard strategy needs to be used to report near-miss events so that the proper quality measures can be implemented. Including patient feedback regarding the intervention of upgraded EHR systems in their treatment process and identifying the level of patient well-being. Provide training to the team members and nursing staff for the prevention of medication errors and improve the efficiency in operating the EHR system. A few pros and cons of the recommendations are given below;

Pros of Recommendations

The pros of the recommendation regarding the enhancement of the QI initiates for the improvement in the health outcome of the patients are given below;

• Real-time monitoring and documenting of medication errors helps in the timely intervention of healthcare professionals.
• The reporting of near-miss events ensures the prevention of medication errors and the enhanced learning of the interprofessional team members and nurses.
• The patient feedback will provide opportunities for the implementation of patient-centered care technologies.
• The collaboration of interprofessional teams effectively trains the staff by providing simulation opportunities to prevent errors.

Cons of Recommendations

The cons of the recommendations are necessary to be identified so that the necessary adjustments must be made for the prevention of large-scale health disparities. A few are given below;

• The cost of the implementation of the real-time monitoring systems will be high thus creating a burden on the healthcare facility.
• The overloading of the data and the staff overburdening will occur due to the constant reporting of missed events.
• The patient’s feedback can be conflicting due to major personal reasons including knowledge, experience, and cultural preferences.
• The increase in staff meetings will require time and resources which will have a bad impact on the healthcare setting.

NURS FPX 6016 Assessment 2 Conclusion

The implementation of the QI initiatives is necessary to ensure that quality treatment is provided to the patient by identifying the needs of the patients and understanding the various reasons behind the prevailing health issues. In the case of Vila Health, the medication errors are generating near-miss health events which can have adverse impacts on the health and safety of the patient and reduce the credibility of the staff members in generating positive outcomes for the patients. The integration and upgrading of the EHR systems to generate alerts for medication errors is one of the major reasons for the implementation of the QI in the clinical facility (Hamad & Bah, 2022). The effectiveness of the QI initiative implemented can be identified by the decrease in the rate of medication errors and the increase in the level of patient satisfaction. However, with the collaboration of the interprofessional team members, major advancements can be recommended in the QI by considering the pros and cons of the recommendations.

NURS FPX 6016 Assessment 2 References

Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: A comprehensive review. Cureus, 15(10). https://doi.org/10.7759/cureus.47731 ElAwaisi, A., Awaisu, A., Aboelbaha, S., Abedini, Z., Johnson, J., & AlAbdulla, S. A. (2021). Perspectives of healthcare professionals toward interprofessional collaboration in primary care settings in a Middle Eastern country. Journal of Multidisciplinary Healthcare, Volume 14, 363–379. https://doi.org/10.2147/jmdh.s286960 Endalamaw, A., Khatri, R. B., Mengistu, T. S., Erku, D., Wolka, E., Zewdie, A., & Assefa, Y. (2024). A scoping review of continuous quality improvement in the healthcare system: Conceptualization, models and tools, barriers and facilitators, and impact. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-10828-0