Data Analysis and Quality Improvement Initiative Proposal Paper

Data Analysis and Quality Improvement Initiative Proposal 

Introduction

Healthcare organizations strive to enhance patient safety and improve patient outcomes leading to patient satisfaction and increased reputation in the organization. Healthcare providers should deliver services that are safe by preventing harm caused by falls, medical errors, and other health hazards. Healthcare organizations, policymakers, and governmental agencies should strive to develop procedures and implement policies that promote patient safety. To successfully enhance patient safety and provide quality care, there is a need for effective leadership that contributes to an appropriate work environment, effective communication, collaboration, evidence-based practices, and interpersonal skills. The healthcare industry is significantly increasing safety to improve the value of care. The paper serves to discuss the proposal on data analysis and quality improvement initiatives based on patient falls and safety. The internal and external benchmark data and EBP recommendations to improve healthcare safety and quality are explored. The communication strategies used to gain acceptance from interpersonal stakeholders who implements the initiative are discussed Data Analysis and Quality Improvement Initiative Proposal .

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Needs and Problems

Patient falls have multifactorial risk factors and cause that further increase hospital stay and increase morbidity and mortality. The frequency of patient fall increases with age with more cases reported among elderly patients, especially for people aged 65 years and above. The incorporation of evidence-based research and practice to prevent patient falls and enhance the quality of care is on the rise (Gilbert et al., 2020). Quality improvement initiatives through research and other innovation are appropriate strategies that effectively decrease the incidence of patient falls in skilled nursing institutions and hospitals. Healthcare leaders and policymakers are at the forefront of ensuring the development of quality improvement strategies that target problem areas in patient falls at Miami Nursing Home. The nurse informatics and educators analyzed data on patient falls in the fiscal year 2019 at the facility. The analysis report on patient falls’ inference data on causes of patient falls, the prevalence of patient falls, and periods when falls are likely to occur. According to reports from Villa Health, patient falls cause about $14,000 for management of every patient who sustains patient falls due to prolonged hospital stay and management of secondary problems (Hemler et al., 2022)Data Analysis and Quality Improvement Initiative Proposal . According to CDC, the direct and indirect cost used for the management of injuries related to patient falls in 2020 was about $67.7 billion in the United States. The estimated cost of managing patient falls at Miami Nursing Home was about 4 million in 2020.

The number of patient falls in healthcare facilities in the United States has been increasing with about 700,000 to 1,000,000 individuals affected yearly. The patient falls cause detrimental consequences such as lacerations, fractures, or internal bleeding that increases hospital stay and high cost of healthcare utilization. The interventions to prevent patient falls include managing the underlying risk factors as well as optimizing the environment and physical design of healthcare facilities. The interventions used in preventing patient falls need the adoption of a multidisciplinary approach in the creation of safe environments through utilizing appropriate healthcare programs and educating healthcare providers on appropriate care (Dykes et al., 2020). The number of patient falls in healthcare facilities in the United States has been increasing with about 700,000 to 1,000,000 individuals affected yearly. The patient falls cause detrimental consequences such as lacerations, fractures, or internal bleeding that increases hospital stay and high cost of healthcare utilization. The interventions to prevent patient falls include managing the underlying risk factors as well as optimizing the environment and physical design of healthcare facilities. The interventions used in preventing patient falls need the adoption of a multidisciplinary approach in the creation of safe environments through utilizing appropriate healthcare programs and educating healthcare providers on appropriate care Data Analysis and Quality Improvement Initiative Proposal .

Proposed Solution

The proposed solutions are represented in tables and graphs with figures one to three displaying the age, cause of fall, and time when falls are common. The graph in figure four shows the downward pattern that has a maximum peak and then a steady decline. The demonstration discusses the patterns and links between the above factors related to patient safety to propose effective strategies in Miami Nursing Home. The focus of the paper is to determine premises that govern healthcare quality and appropriate interventions in nursing to enhance safety. Cunha, Baixinho, & Henriques, (2019) emphasize that the use of effective strategies such as hourly rounding, use of bed alarms, proper lighting, and wearing suitable shoes are some examples of strategies to reduce patient falls. The paper also explores the strategies that address the causes of patient falls such as errors to enhance quality and recommends the framework to promote quality outcomes in patient care in the facility. Healthcare providers should strive to improve the quality of care and patient safety through enhancing care-measured healthcare outcomes. The measured data should be validated on information support to ensure performance improvement. The incorporation of health informatics and improved procedures and technology are core to quality improvement initiatives (Cunha, Baixinho, & Henriques, 2019)Data Analysis and Quality Improvement Initiative Proposal . The data analysis methods proper documentation, EBP models, and research based on a quality benchmark to boost patient outcomes.

Analysis of Dashboard Metrics to Identify Quality Issues

Nurse Managers in the healthcare facility are positioned to influence policies and practices which will shape current care practices to improve service delivery and patient safety. All patients regardless of their age, cases of patient falls, and impacts of falls including injuries secondary to the falls such as bruises, minor cuts, concussions, and fractures. The inpatient falls in the facility are a major cause of patient safety concerns which contribute to distress, injuries, or even deaths (Carthon et al, 2019). The occurrence of patient falls at Miami Nursing Home in the inpatient setting results in harm to extent of being referred to as adverse events. The hospital acquired infections are preventable causes of patient harm that endanger patient safety in the instructions. These problems affect patient outcomes by causing safety concerns that negatively impact on quality of their lives due to associated morbidity and mortality.

Figure 4 demonstrates the rate of patient falls declining from 2017 to 2019. Miami Nursing Home has implemented approaches to decrease patient falls since 2017 leading to a significant decrease in the incidence of patient falls displayed. The financial implications associated with causes of patient safety such as falls and hospital-acquired infections including the cost of treating the infections, management of fractures, and increased cost of service due to prolonged length of hospital stay further impede access to healthcare services (Hemler et al., 2022)Data Analysis and Quality Improvement Initiative Proposal . Thus, there is a need to implement strategies that improve the quality of services offered in the facility to reduce patient safety concerns such as falls. The likelihood of experiencing patient falls increases with age with more occurrences commonly seen in elderly patients over the age of 65 years. According to statistics gathered from internal databases such as system reports in the Miami Nursing Home, over 70% of cases of harm were patient falls among elderly patients followed by medical errors (Hemler et al., 2022). Other contributing factors that increase the rates of patient falls are underlying medical problems such as dementia, stroke, and Alzheimer’s disease.

Currently, the incidence of patient falls has declined to lead to reduced cases of injuries related to falls. The initiatives such as the use of bed alarms, hourly rounding, replacement of slippery floors, and wearing of appropriate footwear have prevented patient falls within the facility. However, patient falls remains a global safety concern in healthcare facilities. Other approaches such as encouraging patients to ambulate are useful in enhancing mobility, and muscle strength, and improving the overall health status of hospitalized patients (Gilbert et al., 2020)Data Analysis and Quality Improvement Initiative Proposal . The failure to incorporate routine patient assessment such as daily monitoring for risk of patient falls is attributed to higher rates of falls and injuries related to falls. The training of patients on the attainment of activities of daily living to improve their independence is crucial as independent patients can walk alone as they strive to attain daily chores such as hygiene and elimination needs. The reduced incidence of patient falls at Miami Nursing Home has been attributed to efforts implemented in the facility through leadership efforts such as training of personnel on effective mechanisms for reducing falls.

The Proposed Quality Improvement Initiative

The interventions to prevent patient falls are essential since the problem has remained debilitating and frequent in hospitals worldwide. The hospitals should implement strategies to prevent patient falls prevention that is focused on environmental modifications, clinician education, medication reviews, and the use of assistive devices (Gilbert et al., 2020). The healthcare teams should provide quality education to create awareness of the hospital environment and the utilization of equipment to prevent patient falls. Also, hourly rounding is critical in addressing the various patient needs to promote quality care in pain assessment, position changes, and drug administration. The closeness of healthcare providers enables patients to be in touch with providers hence getting their necessities promptly and expressing their concerns without disrupting other work schedules (Gilbert et al., 2020)Data Analysis and Quality Improvement Initiative Proposal . Finally, medical reviews enable pharmacists to collaborate with other healthcare providers in various drug dynamics such as inappropriately prescribed and medication reactions that would have increased the risk of drug reactions.

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Quality Improvement Evaluation

The effective evaluation of quality healthcare services by Miami Nursing Home is done through the use of nursing frameworks and models. The appropriate framework for the evaluation of quality improvement initiatives measures the availability and use of resources to implement change initiatives. For instance, resources such as available supplies, beds, staff, and communication devices should be determined. Additionally, an evaluation of processes parameters should be done to determine the effectiveness of processes in discharging duties. The adoption of manual tracking and EHR data reported by healthcare providers can be used in the monitoring process (Cunha, Baixinho, & Henriques, 2019). The quality improvement initiatives to attain appropriate solutions for the problem, particularly reducing the frequency, impact, and severity of patient falls and medication errors are explored below. The quality improvement initiatives entail the interventions which are designed to reduce potential risk factors and causes which endanger patient safety as discussed in the model below.

The Plan Do Study Act (PDSA) model is the strategy that is commonly used to effectively monitor quality improvement strategies in sectors such as healthcare settings. The model is used in the planning and implementation of quality improvement initiatives to improve healthcare outcomes. Gilbert et al., (2020) explain that the model offers structured methods to plan and implement change strategies in the healthcare sector. The model can be used in Miami Nursing Home to test patient falls prevention plans that can be used to decrease patient falls. On plan, the nurse leaders identify the area of concern or problem and then gather information for identification of causes of patient falls through a review of the incidence reports. The communication of findings is done to foster collaboration with other healthcare staff and leaders through the development of a suitable plan. Secondly, the Do step is launched with a specific focus on the implementation of the identified strategies to attain desired goals with proper communication of the goals to foster guidance, training, and support among stakeholders (Gilbert et al., 2020)Data Analysis and Quality Improvement Initiative Proposal . Thirdly, the study phase follows with an analysis and review of data to evaluate the implementations to determine improvements or need for modifications. Finally, Act entails the results that guide the termination or continuation of the interventions based on progress.

Integrating Interprofessional Perspectives in Quality Improvements Strategies

Although nurse leaders are major components of quality improvement initiatives, all stakeholders in the health sector are integral in ensuring the implementation of quality improvement initiatives at Miami Nursing Home. Nurses and other healthcare providers are at the forefront to implement evidence-based approaches to prevent patient falls (Dykes et al., 2020). The main interventions that can be utilized in fall prevention are appropriate patient education, hourly rounding, and medical reviews. Health education on patient falls is essential to create awareness of risk factors for falls and ways that could be utilized in fall prevention. The healthcare teams should utilize posters and lecture presentations to sensitize patients and service providers’ risk factors related to patient falls or the impact of polypharmacy among patients especially the elderly (Dykes et al., 2020)Data Analysis and Quality Improvement Initiative Proposal . The availability of nurses at the bedside should be improved by encouraging hourly rounding to promote routine patient assessment and enable them to feel less apprehensive and safer. Additionally, medication reviews are important since polypharmacy is commonly associated with patient falls. The problems linked to polypharmacy such as frequent urination, impaired balance dizziness, and confusion often increase the chances of patient falls. Thus, clinicians and pharmacists should review and modify the use of various medications to minimize instances of patient falls.

Effective Communication Strategies to Promote Quality Improvement

The use of effective communication skills is necessary for a healthcare organization during the implementation of change strategies to effectively impact positive change in the facility. The healthcare leadership should foster effective communication with feedback and respectful interactions among personnel to ensure the delivery of safe and high-quality care (Kampstra et al., 2018). The importance of appropriate interaction among personnel is necessary through face-to-face interactions and the use of technologies such as smartphone messaging and video calling. The above effective strategies foster positive communication to enhance the quality of care thus boosting patient satisfaction. Kampstra et al., (2018) discuss that effective communication modes support collaboration among personnel leading to the prevention of falls and medication errors that endanger patient safety. Therefore, the healthcare facility should train personnel on effective communication between patients and staff to boost the assessment of needs and implementation of appropriate strategies Data Analysis and Quality Improvement Initiative Proposal .

Conclusion

In summary, substandard service delivery is not the sole fault of healthcare providers but failures in healthcare systems such as inadequate equipment, faulty alarms, and staff shortages. The frequency of patient fall increases with age with more cases reported among elderly patients, especially for people aged 65 years and above. According to CDC, the direct and indirect cost used for the management of injuries related to patient falls in 2020 was about $67.7 billion in the United States. The use of effective strategies such as hourly rounding, use of bed alarms, proper lighting, and wearing suitable shoes are some examples of strategies to reduce patient falls. The PDSA model is used in the planning and implementation of quality improvement initiatives to improve healthcare outcomes. The use of effective communication skills is necessary for a healthcare organization during the implementation of change strategies to effectively impact positive change in the facility Data Analysis and Quality Improvement Initiative Proposal .

References

Carthon, J. M. B., Davis, L., Dierkes, A., Hatfield, L., Hedgeland, T., Holland, S., … & Aiken, L. H. (2019). Association of nurse engagement and nurse staffing on patient safety. Journal of nursing care quality, 34(1), 40. DOI: 10.1097/NCQ.0000000000000334

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. https://doi.org/10.1590/S1980-220X2018031803479

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. doi:10.1001/jamanetworkopen.2020.25889 Data Analysis and Quality Improvement Initiative Proposal

Gilbert, A. W., Billany, J. C., Adam, R., Martin, L., Tobin, R., Bagdai, S., … & Bateson, J. (2020). Rapid implementation of virtual clinics due to COVID-19: report and early evaluation of a quality improvement initiative. BMJ open quality, 9(2), e000985. http://dx.doi.org/10.1136/bmjoq-2020-000985

Hemler, J. R., Edwards, S. T., Valenzuela, S., Baron, A., Hall, J. D., Perry, C. K., … & Cohen, D. J. (2022). The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative. The Journal of the American Board of Family Medicine, 35(1), 124-139. https://doi.org/10.3122/jabfm.2022.01.210205

Kampstra, N. A., Zipfel, N., van der Nat, P. B., Westert, G. P., van der Wees, P. J., & Groenewoud, A. S. (2018). Health outcomes measurement and organizational readiness support quality improvement: a systematic review. BMC health services research, 18(1), 1-14. https://doi.org/10.1186/s12913-018-3828-9

Prepare an 8-10 page data analysis and quality improvement initiative proposal based on a health issue of interest. Include internal and external benchmark data, evidence-based recommendations to improve health care quality and safety, and communication strategies to gain buy-in from all interprofessional team members responsible for implementing the initiative.

Introduction
Health care providers are perpetually striving to improve care quality and patient safety. To accomplish enhanced care, outcomes need to be measured. Next, data measures must be validated. Measurement and validation of information support performance improvement. Health care providers must focus attention on evidence-based best practices to improve patient outcomes Data Analysis and Quality Improvement Initiative Proposal .

Health informatics, along with new and improved technologies and procedures, are at the core of all quality improvement initiatives. Data analysis begins with provider documentation, researched process improvement models, and recognized quality benchmarks. All of these items work together to improve patient outcomes. Professional nurses must be able to interpret and communicate dashboard information that displays critical care metrics and outcomes along with data collected from the care delivery process.

For this assessment, use your current role or assume a role you hope to have. You will develop a quality improvement (QI) initiative proposal based on a health issue of professional interest. To create this proposal, analyze a health care facility’s dashboard metrics and external benchmark data. Include evidence-based recommendations to improve health care quality and safety relating to your selected issue. Successful QI initiatives depend on the support of nursing staff and other members of the interprofessional team. As a result, a key aspect of your proposal will be the communication strategies you plan to use to get buy-in from these team members Data Analysis and Quality Improvement Initiative Proposal .

Preparation
To develop the QI initiative proposal required for this assessment, you must analyze a health care facility’s dashboard metrics. Choose Option 1 or 2 according to your ability to access dashboard metrics for a QI initiative proposal.

Option 1
If you have access to dashboard metrics related to a QI initiative proposal of interest to you, complete the following:

Analyze data from the health care facility to identify a health care issue or area of concern. You will need access to reports and data related to care quality and patient safety. For example, in a hospital setting, you would contact the quality management department to obtain the needed data. It is your responsibility to determine the appropriate resource to provide the necessary data in your chosen health care setting. If you need help determining how to obtain the needed information, consult your faculty member for guidance.
Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic. Please abide by Health Insurance Portability and Accountability Act (HIPAA) compliance standards Data Analysis and Quality Improvement Initiative Proposal .
Option 2
If you do not have access to a dashboard or metrics related to a QI initiative proposal:

Use the hospital data set provided in Vila Health: Data Analysis. You will analyze data to identify a health care issue or area of concern.
Include in your proposal basic information about the health care setting, size, and specific type of care delivery related to the identified topic.
Instructions
Use your current role or assume a role you would like to have. Choose a quality improvement initiative of professional interest to you. Your current organization is probably working on quality improvement initiatives that can be evaluated, so consider starting there.

To develop your proposal you will:

Gather internal and external benchmark data on the subject of your quality improvement initiative proposal.
Analyze data you have collected.
Make evidence-based recommendations about how to improve health care quality and safety relating to your chosen issue.
Remember, your initiative’s success depends on the interprofessional team’s commitment to the QI initiative. Think carefully about these stakeholders and how you plan to include them in the process, as they will help you develop and implement ideas and sustain outcomes. Also, remember how important external stakeholders, such as patients and other health care delivery organizations, are to the process. As you are preparing this assessment, consider carefully the communication strategies you will employ to include the perspectives of all internal and external stakeholders in your proposal Data Analysis and Quality Improvement Initiative Proposal .

The following numbered points correspond to grading criteria in the scoring guide. The bullets below each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your proposal addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels related to each grading criterion.

Analyze data to identify a health care issue or area of concern.
Identify the type of data you are analyzing from your institution or from the Vila Health activity.
Explain why data matters. What does data show related to outcomes?
Analyze the dashboard metrics. What else could the organization measure to enhance knowledge?
Present dashboard metrics related to the selected issue that are critical to evaluating outcomes.
Assess the institutional ability to sustain processes or outcomes.
Evaluate data quality and its implications for outcomes.&
Determine whether any adverse event or near-miss data needs to be factored in to outcomes and recommendations.
Examine the nursing process for variations or performance failures that could lead to an adverse event or near miss.
Identify trends, measures, and information needed to critically analyze specific outcomes.
Specify desired outcomes related to prevention of adverse events and near misses.
Analyze which metrics indicate future quality improvement opportunities.
Develop a QI initiative proposal based on a selected health issue and supporting data analysis.
Determine benchmarks aligned to existing QI initiatives set by local, state, or federal health care policies or laws.
Identify any internal existing QI initiatives in your practice setting or organization related to the selected issue. Explain why they are insufficient.
Evaluate external national or international QI initiatives on the selected health issue with existing quality indicators from other facilities, government agencies, and nongovernmental bodies on quality improvement.
Define target areas for improvement and the processes to be modified to improve outcomes.
Propose evidence-based strategies to improve quality.
Analyze challenges that meeting prescribed benchmarks can pose for a health care organization and the interprofessional team. Data Analysis and Quality Improvement Initiative Proposal
Communicate QI initiative proposal based on interdisciplinary team input to improve patient safety and quality outcomes and work-life quality.
Define interprofessional roles and responsibilities relating to data and the QI initiative.
Explain how to ensure all relevant interprofessional roles are fully engaged in this effort.
Identify how outcomes will be measured and data used to inform interprofessional team performance related to specific tasks.
Reflect on the impact of the proposed initiative on work-life quality of the interprofessional team.
Describe how the initiative enhances work-life quality due to improved strategies supporting efficiency.
Determine communication strategies to promote quality improvement of interprofessional care.
Identify interprofessional communication strategies that will help to promote and ensure the success of the QI initiative.
Identify communication models, such as SBAR and CUS, to include in your proposal.
SBAR stands for Situation, Background, Assessment, Recommendation.
CUS stands for “I am Concerned about my resident’s condition; I am Uncomfortable with my resident’s condition; I believe the Safety of the resident is at risk.”
Consult this resource for additional information about these fundamental evidence-based tools to improve interprofessional team communication for patient handoffs:
Agency for Healthcare Research and Quality (AHRQ). (n.d.). Module 2: Communicating change in a resident’s condition. https://www.ahrq.gov/professionals/systems/long-term-care/resources/facilities/ptsafety/ltcmod2ap.html
Communicate QI initiative proposal in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
Example Assessment: Refer to QI Initiative Proposal Exemplar [PDF] for an idea of what an assessment given a proficient or higher rating on the scoring guide would look like. Data Analysis and Quality Improvement Initiative Proposal

Additional Requirements
Submission length: 8-10 typed, double-spaced pages of content plus title and reference pages.
Font: Times New Roman, 12 point.
Number of references: Cite a minimum of five current scholarly and/or authoritative sources to support your QI initiative proposal. Current means no older than 5 years unless a seminal work.
APA formatting: Citations and references need to adhere to APA style and formatting guidelines. Consult these resources for an APA refresher:
Evidence and APA.
APA Module.
American Psychological Association. (n.d.). APA style. https://www.apastyle.org/
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses.
Determine whether any adverse event or near-miss data must be factored in to outcomes and recommendations.
Competency 2: Plan quality improvement initiatives in response to routine data surveillance.
Develop a QI initiative proposal based on a selected health issue and supporting data analysis.
Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
Analyze data to identify a health care issue or area of concern.
Competency 4: Integrate interprofessional perspectives to lead quality improvements in patient safety, cost effectiveness, and work life quality.

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Communicate QI initiative proposal, based on interdisciplinary team input, to improve patient safety and quality outcomes and work-life quality.
Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
Determine evidence-based communication strategies to promote quality improvement of interprofessional care.
Communicate QI initiative proposal in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling Data Analysis and Quality Improvement Initiative Proposal