The Outcome Measures, Issues, And Opportunities Assignment

As a healthcare professional, it is important to be able to identify and address quality and safety issues within the organization. One such issue is medication errors, which can have serious consequences for patients and can negatively impact the overall quality and safety of care provided. In order to effectively address this issue, it is important to analyze organizational functions, processes, and behaviors, and to determine how they affect outcome measures associated with medication errors. The purpose of this report is to analyze organizational functions, processes, and behaviors in high-performing healthcare organizations or practice settings, in order to identify performance issues or opportunities associated with medication errors. The report will also outline a strategy, using a selected change model, for ensuring that all aspects of patient care are measured and that knowledge is shared with staff in order to improve the quality and safety of care provided to patients. The Outcome Measures, Issues, And Opportunities Assignment

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Organizational Functions, Processes, and Behaviors in High-Performing Health Care Organizations

High-performing healthcare organizations typically have strong leadership practices, effective communication systems, well-established quality processes, sound financial management, robust safety and risk management systems, interprofessional collaboration, and a focus on using the best available evidence and questioning the status quo on all levels. One key factor that sets high-performing organizations apart from less successful ones is the emphasis they place on continuous improvement. These organizations actively seek out and implement best practices, and continuously monitor and measure their performance to identify areas for improvement (Hill et al., 2020)The Outcome Measures, Issues, And Opportunities Assignment. Additionally, they foster a culture of transparency and accountability, which allows for the identification and rapid resolution of problems.

Effective communication systems also play a vital role in high-performing organizations. These organizations have established channels for communication and feedback, both within the organization and with external stakeholders (Hill et al., 2020). This allows for the sharing of knowledge and ideas, and helps to ensure that everyone is working towards the same goals. Quality processes are another key aspect of high-performing healthcare organizations. These organizations have well-established processes in place to ensure that the care they provide is of the highest quality. They regularly measure and monitor their performance, and use data to drive continuous improvement.

Safety and risk management systems are also critical to the success of high-performing organizations. These organizations have robust systems in place to identify and mitigate potential risks, and to ensure that patient safety is always a top priority. Interprofessional collaboration is another key aspect of high-performing healthcare organizations. These organizations foster a culture of teamwork and collaboration, which allows for the sharing of knowledge and ideas, and helps to ensure that everyone is working towards the same goals.

How Organizational Functions, Processes, and Behaviors Affect Outcome Measures

Organizational functions, processes, and behaviors can have a significant impact on outcome measures in healthcare. Positive effects may include improved patient outcomes, increased efficiency and cost savings, and enhanced patient satisfaction. Negative effects may include increased medication errors, decreased patient outcomes, and increased healthcare costs. The reasons for these effects can be multifaceted and complex. Effective leadership practices, clear and effective communication, quality processes, financial management, safety and risk management, interprofessional collaboration, strategic planning, and the use of best available evidence can all contribute to positive outcomes (Sihag & Rijsdijk, 2018)The Outcome Measures, Issues, And Opportunities Assignment. Conversely, poor leadership, inadequate communication, lack of quality processes, financial mismanagement, lack of safety and risk management, lack of interprofessional collaboration, lack of strategic planning, and lack of use of best available evidence can all contribute to negative outcomes. It is important for healthcare organizations and practice settings to continuously evaluate and improve their functions, processes, and behaviors in order to enhance outcome measures and minimize negative effects such as medication errors. Benchmarking against high-performing organizations and utilizing the latest available evidence can aid in this process.

Quality and Safety Outcomes and Associated Measures

One commonly used outcome measure for medication errors is the rate of adverse drug events (ADEs). ADEs refer to any harm that occurs to a patient as a result of medication use and can include allergic reactions, side effects, and other negative consequences. The rate of ADEs can be calculated by determining the number of ADEs that occur within a certain time period and then dividing that number by the total number of patient days. Another relevant outcome measure is the rate of medication errors, which can be calculated by determining the number of medication errors that occur within a certain time period and then dividing that number by the total number of medication orders. This measure can provide insight into the overall safety of the medication administration process within a healthcare organization (Kuklik et al., 2019)The Outcome Measures, Issues, And Opportunities Assignment. An additional measure associated with medication errors is the rate of preventable adverse drug events (PADEs). PADEs refer to ADEs that could have been avoided by better medication management and can provide insight into areas of the medication administration process that may need improvement.

The following is an example of a spreadsheet that can be used to track and measure the quality and safety outcomes related to medication errors and preventable adverse drug events (PADEs) in a healthcare setting.

Performance Issues

Among the key performance issues relevant to medication errors is a lack of standardization in medication management processes. This can result in confusion and errors in prescribing, dispensing, and administering medications. For example, Rodziewicz et al. (2020) found that at least 1.5 million preventable adverse drug events (PADEs) occur annually in the United States. This is a significant problem as these errors can lead to adverse events and even death.

Another performance issue relevant to medication errors is a lack of communication and collaboration among healthcare professionals. This can lead to missed or delayed diagnosis, incorrect treatment decisions, and medication errors. Communication and teamwork breakdowns are identified as a root cause in nearly 70% of reported medication errors (Rodziewicz et al., 2020).

Lack of education and training also contribute to performance issues related to medication errors. Healthcare professionals may not have the necessary knowledge or skills to correctly prescribe, dispense, and administer medications. This can lead to medication errors and adverse events. A study conducted by the American Nurses Association (ANA) found that nurses who received education and training on medication errors had a lower incidence of medication errors compared to those who did not receive education and training (ANA, 2019)The Outcome Measures, Issues, And Opportunities Assignment.

The potential effects of these performance issues on outcomes are significant. Medication errors can lead to adverse events and even death. They can also result in increased hospital stays, additional medical treatment, and increased healthcare costs. It is essential for healthcare organizations to address these performance issues by implementing standardization in medication management processes, promoting communication and collaboration among healthcare professionals, and providing education and training on medication errors.

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Strategy for Ensuring That All Aspects of Patient Care Are Measured

The key strategy for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff is to implement a comprehensive performance management system. This system should be designed to measure and track key quality and safety outcomes, including those related to medication errors. The first step in implementing this strategy is to conduct a thorough assessment of the current organizational functions, processes, and behaviors that may be contributing to performance issues related to medication errors. This assessment should involve input from all stakeholders, including staff, patients, and leadership (Rodziewicz et al., 2018)The Outcome Measures, Issues, And Opportunities Assignment. The second step is to use the Kurt Lewin change model, which consists of three phases: unfreeze, change, and refreeze. The unfreeze phase involves creating awareness and understanding of the need for change among staff and leadership. The change phase involves developing and implementing new processes and behaviors that address the identified performance issues (Barrow et al., 2017). The refreeze phase involves embedding the new processes and behaviors into the organizational culture and monitoring their effectiveness over time.

To share information, knowledge, and best practices, the organization should establish a mechanism for regularly collecting and analyzing data on performance measures related to medication errors. This data should be used to identify areas for improvement and to develop and implement evidence-based interventions. Additionally, the organization should establish a knowledge management system that enables staff to easily access and share information and best practices related to medication errors. This system should include a centralized repository of relevant literature, guidelines, and tools, as well as regular training and education opportunities. Furthermore, the organization should establish a multidisciplinary team to oversee the implementation and evaluation of the performance management system. The team should include representatives from all relevant departments and disciplines, including pharmacy, nursing, and quality improvement (Rodziewicz et al., 2018)The Outcome Measures, Issues, And Opportunities Assignment. This team should be responsible for monitoring progress, identifying areas for improvement, and recommending changes to the system as needed. Finally, a culture of continuous quality improvement should be fostered through leadership’s active participation, regular communication and recognition of staff’s effort. This can be done through regular staff meetings, town hall meetings, and other forms of communication to keep staff informed about the progress of the performance management system and to solicit their feedback and suggestions for improvement.

Conclusion

It is clear that organizational functions, processes, and behaviors have a significant impact on outcome measures, particularly in the area of medication errors. Quality and safety outcomes, such as preventable adverse drug events (PADEs), are relevant in this context and can be measured through a variety of outcome measures. Performance issues, such as lack of communication and inadequate training, can give rise to medication errors and have potential effects on patient outcomes. To address these issues and improve patient care, a strategy must be implemented to ensure that all aspects of patient care are measured and knowledge is shared with staff. The Kurt Lewin change model can be utilized as a framework for implementing this strategy, which includes key steps such as identifying the problem, creating a sense of urgency, creating a guiding coalition, developing a vision and strategy, communicating the change, and creating short-term wins. Additionally, information, knowledge, and best practices must be shared effectively through various means, such as training programs and sharing of data and metrics. With this approach, organizations can strive to become high-performing in terms of quality and safety outcomes, while also reducing medication errors and improving patient care. The Outcome Measures, Issues, And Opportunities Assignment

References

American Nurses Association. (2019). ANA Standards of Professional Performance. https://www.nursingworld.org/practice-policy/nursing-excellence/standards-of-professional-performance/

Barrow, J. M., Annamaraju, P., & Toney-Butler, T. J. (2017). Change management. https://www.ncbi.nlm.nih.gov/books/NBK459380/

Hill, J. E., Stephani, A., Sapple, P., & Clegg, A. J. (2020). The effectiveness of continuous quality improvement for developing professional practice and improving health care outcomes: A systematic review. Implementation Science, 15(1). https://doi.org/10.1186/s13012-020-0975-2

Kuklik, N., Stausberg, J., Amiri, M., & Jöckel, K. (2019). Improving drug safety in hospitals: A retrospective study on the potential of adverse drug events coded in routine data. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4381-x

Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2018). Medical error reduction and prevention. https://www.ncbi.nlm.nih.gov/books/NBK499956/

Sihag, V., & Rijsdijk, S. A. (2018). Organizational controls and performance outcomes: A meta‐analytic assessment and extension. Journal of Management Studies, 56(1), 91-133. https://doi.org/10.1111/joms.12342 The Outcome Measures, Issues, And Opportunities Assignment

Assessment 3 Instructions: Outcome Measures, Issues, and Opportunities

Top of Form

Bottom of Form

• Draft a 6-page report on outcome measures, issues, and opportunities for the executive leadership team or applicable stakeholder group.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

As a nurse leader, you may be called upon to submit a detailed report to your executive leadership team and key stakeholders that describes a quality or safety problem and its effects on outcomes, fully supported by relevant and credible data.

This assessment provides an opportunity to draft such a report in which you can call attention to quality and safety issues and opportunities, effectively support your position, and lay out a plan for change.

This assessment is based on the executive summary you prepared in the previous assessment.

Preparation

Your executive summary captured the attention and interest of the executive leadership team, who have asked you to provide them with a detailed report addressing outcome measures and performance issues or opportunities, including a strategy for ensuring that all aspects of patient care are measured.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

• • How might you engage stakeholders to help develop, implement, and sustain a vision to actually change and improve patient outcomes?
  • What arguments might be most effective in obtaining agreement and support?
  • What recommendations would you make to implement a proposed plan for change?

The following resources are required to complete the assessment.

• • APA Style Paper Tutorial [DOCX]. Use this for your report.

Requirements

Note: The requirements outlined below correspond to the grading criteria in the Outcome Measures, Issues, and Opportunities Scoring Guide. Be sure that your written analysis addresses each point, at a minimum. You may also want to read the Outcome Measures, Issues, and Opportunities Scoring Guide and Guiding Questions: Outcome Measures, Issues, and Opportunities [DOCX] to better understand how each criterion will be assessed.

Drafting the Report

• • Analyze organizational functions, processes, and behaviors in high-performing health care organizations or practice settings.
  • Determine how organizational functions, processes, and behaviors affect outcome measures associated with the systemic problem identified in your gap analysis.
  • Identify the quality and safety outcomes and associated measures relevant to the performance gap you intend to close. Create a spreadsheet showing the outcome measures.
  • Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.
  • Outline a strategy, using a selected change model, for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff. The Outcome Measures, Issues, And Opportunities Assignment

Writing and Supporting Evidence

• • Write coherently and with purpose, for a specific audience, using correct grammar and mechanics.
  • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.
    

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Additional Requirements

Format your document using APA style.

• • Use the APA Style Paper Tutorial [DOCX]. Be sure to include:

• • • A title page and reference page. An abstract is not required.

• • • A running head on all pages.

• • • Appropriate section headings.

• • • Properly-formatted citations and references.

• • Your report should be 6 pages in length, not including the title page and reference page.
  • Add your Quality and Safety Outcomes spreadsheet to your report as an addendum. The Outcome Measures, Issues, And Opportunities Assignment

Portfolio Prompt: You may choose to save your report to your ePortfolio.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• • Competency 1: Analyze quality and safety outcomes from an administrative and systems perspective.

• • • Identify typical quality and safety outcomes and their associated measures.

• • Competency 3: Determine how specific organizational functions, policies, processes, procedures, norms, and behaviors can be used to build reliability and high-performing organizations.

• • • Analyze organizational functions, processes, and behaviors in high-performing organizations.

• • • Determine how organizational functions, processes, and behaviors support and affect outcome measures for an organization.

• • • Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.

• • Competency 4: Synthesize the various aspects of the nurse leader’s role in developing, promoting, and sustaining a culture of quality and safety.

• • • Outline a strategy for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff.

• • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.

• • • Write coherently and with purpose, for a specific audience, using correct grammar and mechanics.

• • • Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style. The Outcome Measures, Issues, And Opportunities Assignment

Guiding Questions

Outcome Measures, Issues, and Opportunities

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Outcome Measures, Issues, and Opportunities assessment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment. Do not turn in this document as your assessment submission.

Drafting the Report

Analyze organizational functions, processes, and behaviors in high-performing health care organizations or practice settings.

• For example, consider such functions, processes, and behaviors as leadership practices, communications, quality processes, financial management, safety and risk management, interprofessional collaboration, strategic planning, using the best available evidence, and questioning the status quo on all levels.
• What makes these organizations high performers?
• What are these organizations doing that less successful organizations are not?
• How does your organization or practice setting compare to these benchmarks of high-performance?

Determine how organizational functions, processes, and behaviors affect outcome measures.

• What is the extent of the positive and negative effects on the outcome measures?
• What are the reasons for these effects? The Outcome Measures, Issues, And Opportunities Assignment

Identify the quality and safety outcomes and associated measures relevant to the performance gap you intend to close.

• Create a spreadsheet showing the outcome measures.
• Refer to the example outcome measures spreadsheet, linked in the resources, that shows medication reconciliation compliance rates.

Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.

• What issues or opportunities are relevant to the systemic problem that you are addressing?
• What factors give rise to these performance issues or opportunities?
• What are their potential effects on outcomes?

Outline a strategy for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff.

• What are the key steps needed to implement your strategy? You are encouraged to use one of the change models included in the Mitchell (2013) article.
• How will information, knowledge, and best practices be shared?

Writing, Supporting Evidence, and APA Style

As you begin composing your report, consider the purpose of the report, the appropriate tone and style, and the expectations of the executive leaders who will be reading it.

Write coherently and with purpose, for a specific audience, using correct grammar and mechanics.

• Express your main points, arguments, and conclusions clearly and concisely.
• Proofread your writing to minimize errors that could distract readers and make it more difficult to focus on the substance of your report. The Outcome Measures, Issues, And Opportunities Assignment

Integrate relevant and credible sources of evidence to support assertions, correctly formatting citations and references using APA style.

• Integrate relevant evidence from at least 6 scholarly or professional sources.

Submission Reminders

• Has your analysis of organizational functions, processes, and behaviors shown what high-performance organizations are doing that less successful organizations are not?
• Have you determined how and why organizational functions, processes, and behaviors affect outcome measures?
• Have you completed your spreadsheet showing quality and safety outcomes and their associated measures?
• Have you identified performance issues or opportunities arising from particular organizational functions, processes, and behaviors?
• Have you outlined your strategy for outcomes measurement and knowledge sharing?
• Are your claims and conclusions well supported by at least 6 sources of credible evidence?
• Is your analysis properly formatted and 6 pages in length, including the title page and reference page?
• Did you add the outcome measures spreadsheet to your report as an addendum?
• Have you proofread your writing to minimize errors that could distract the audience and make it more difficult to focus on the substance of your presentation? The Outcome Measures, Issues, And Opportunities Assignmentthis assessment follows the previous one already completed for reference order # 246749.
  included are the instructions and the guided questions document to help with paper, as well as scoring guide to aim for distinguished grade.
  be sure to include a spreadsheet or graph to show outcomes measured and performance issues followed with a change theory strategy you would use. IMPLEMENT “LEWINS CHANGE THEORY”