Ensuring Clinical Quality in Telemedicine

Analyze data to identify a health care issue or area of concern.

DISTINGUISHED

PROFICIENT

BASIC

NON-PERFORMANCE

Basic

Attempts to analyze data, but misses trends or opportunities for quality improvement, or fails to persuasively link data to a health care issue or area of concern.Ensuring Clinical Quality in Telemedicine

Faculty Comments:

“

Thank you for discussion of outcomes at this facility. The missing component is the actual numerical data to support your analysis. Please add and highlight updates for review.

”CRITERION:

Outline a QI initiative proposal based on a selected health issue and supporting data analysis.

DISTINGUISHED

PROFICIENT

BASIC

NON-PERFORMANCE

Basic

Attempts to outline a QI initiative proposal, but proposal is missing benchmarks, is not evidence-based, is impractical, or is not clearly linked to the selected health issue or supporting data analysis.

Faculty Comments:

“While there are some good thoughts here, more detail is needed with a specific plan to address as identified in the numerical data that you will include.

”COMPETENCY:

Integrate inter professional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.

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CRITERION:

Integrate inter professional perspectives to lead quality improvements in patient safety, cost effectiveness, and work-life quality.

DISTINGUISHED

PROFICIENT

BASIC

NON-PERFORMANCE

Basic

Attempts to integrate inter professional perspectives, but misses relevant roles or concepts, or fails to consider key inter professional perspectives related to patient safety, cost effectiveness, or work-life quality.

Faculty Comments:

“Again, a good start to this criterion with introduction of inter professional perspectives but this needs to be more specific in response to the above feedback once numerical data and a subsequent qi initiative is established.

”COMPETENCY:

Apply effective communication strategies to promote quality improvement of inter professional care.Ensuring Clinical Quality in Telemedicine

CRITERION:

Apply effective communication strategies to promote quality improvement of inter professional care.

DISTINGUISHED

PROFICIENT

BASIC

NON-PERFORMANCE

Distinguished

Applies effective communication strategies to promote quality improvement of inter professional care, and identifies assumptions on which the suggestions are based.

Faculty Comments:

“Good discussion of effective communication strategies with integration of the SBAR and SMM models. Good work!

”CRITERION:

Communicate evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.

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PROFICIENT

BASIC

NON-PERFORMANCE

Proficient

Communicates evaluation and analysis in a professional and effective manner, writing content clearly and logically with correct use of grammar, punctuation, and spelling.

Faculty Comments:

“Overall well written with only a few minor identified errors in grammar or mechanics!

”CRITERION:

Integrate relevant sources to support arguments, correctly formatting citations and references using current APA style.

DISTINGUISHED

PROFICIENT

BASIC

NON-PERFORMANCE

Distinguished

Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style. Citations are free from all errors.

Faculty Comments:

“Great use of resources with no identified errors in APA. Overall, good start to this assessment. I look forward to seeing how you build upon it.

Data Analysis and Quality Improvement Initiative Proposal

Health care providers work towards improving the quality and safety of patient care. Therefore, care providers should point out areas that require improvement to enhance the provision of quality care. This data analysis and QI initiative proposal will discuss improvements that should be made in the healthcare organization to resolve the identified issue.Ensuring Clinical Quality in Telemedicine

Data Analysis and Identification of a Health Care Issue

Type of Data being Analyzed

The data being analyzing was obtained from my institution. Some details were accessed from the Hospital’s reports while others were provided by the quality management department.

The Significance of the Data

The obtained matters since it reflects the actual performance of the healthcare organization. In other words, it reflects the quality and safety of patient care and the overall health outcomes. The data indicate the provision of poor quality of healthcare services leading to a pain level of 7-10 in more than 24 hours and inadequate symptom relief in over 24 hours in 2014 and 2015.

The Analysis of Dashboard Metrics

The dashboard metrics contain data about pain level of 7-10 in more than 24 hours and inadequate symptom relief in over 24 hours in 2014 and 2015.

Dashboard Metrics that related to the Selected Issue

            Dashboard metrics related to the provision of poor quality of healthcare services include pain level of 7-10 in more than 24 hours and inadequate symptom relief in over 24 hours in 2014 and 2015. These metrics are associated with the provision of poor quality of healthcare services. The table below indicates dashboard metrics data.

Performance Failures

            Hospital quality metrics refer to the standards, which were developed by CMS to evaluate the various aspects of a hospital, including organizational structures, healthcare processes, and patient outcomes. Hospital quality metrics of the healthcare organization in particular pain level and symptom management are below the set standards. Medical practitioners provide poor quality of healthcare services to patients resulting in 13 and 17 cases of a pain level of 7-10 in more than 24 hours in 2014 and 2015, respectively. Additionally, the poor quality of care is attributed to 13 and 22 cases of inadequate symptom relief in over 24 hours in 2014 and 2015, respectively. These incidents indicate performance failure in the healthcare organization.

The Stability of Processes or Outcomes

            Healthcare processes or outcomes are unstable. Key aspects of health outcomes, including pain level and inadequate symptom management, varies. The hospital reported 13 and 17 cases of a pain level of 7-10 in more than 24 hours in 2014 and 2015, respectively. Additionally, the medical facility recorded 13 and 22 cases of inadequate symptom relief in more than 24 hours in 2014 and 2015, respectively.Ensuring Clinical Quality in Telemedicine

Evaluation of the Quality of the Data

            The data is of high quality and reliable since it was provided by the heads of the various care units.

Details needed to Calculate Specific Rates

            The calculation of specific rates required some trends, outcome measures, and information. For instance, the calculation of pain management rate requires the number of patients with a particular level of pain in a given period. In another example, the calculation of inadequate symptom relief requires the number of patients who reported specific symptoms in a particular period.

Metrics that indicate Opportunities for Quality Improvement

            Two hospital metrics, including pain level of 7-10 in more than 24 hours and inadequate symptom relief in over 24 hours in 2014 and 2015 indicate the need for quality improvement. A high pain level of 7-10 in more than 24 hours indicates that poor-quality care is being provided to the patients. Also, poor care services are reflected by inadequate symptom relief in over 24 hours, which were reported in the hospital in 2014 and 2015.

An Outline of a QI Initiative Proposal based on the Provision Poor Quality of Healthcare Services

Benchmarks Aligned to Existing QI initiatives set by Federal Health Care Policies

            Healthcare policies set by the federal government have played a significant role in supporting the provision of quality healthcare services in the country. The national government has introduced some regulatory strategies over the decades especially ones that are applicable to the government programs, which provide care services to the public through the private sector, including Medicare, the State Children’s Health Insurance Program [SCHIP]), and Medicaid (El-Jardali & Fadlallah, 2017). Quality improvement approaches have been incorporated into these programs, which concentrate on portraying some improvement in care delivery and patient outcomes. For instance, data on particular performance measures are collected by Medicare + Choice (M+C) health plans. Additionally, some improvement must be demonstrated over time (El-Jardali & Fadlallah, 2017). Therefore, regulatory strategies, which concentrate on quality improvement facilitates the quality distribution to shift to the right. Thus, the healthcare organization should strive to meet quality standards set by the existing federal healthcare policies.

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The Insufficiency of the existing QI Initiatives related to Poor Quality of Healthcare Services

            The healthcare organization has adopted various QI initiatives to resolve the provision of poor quality of healthcare services. First, the organization has enhanced the efficiency of hospital financing. Inefficient healthcare financing limits the availability of drugs and reagents among other required supplies. Consequently, efforts have been made to increase income. However, this QI initiative has been insufficient due to failure to adhere to the set budget creating deficiencies. Besides, the embezzlement of funds is evident in the healthcare organization due to poor healthcare monitoring systems. Therefore, it is difficult for the organization to purchase medications that can be used to lower the high pain level (7-10) and improve symptom relief in 24 hours. Secondly, the hospital has embarked on the professional development of its workforce to achieve the personal and professional growth of staff. Nonetheless, this QI initiative is insufficient since the staff is not trained in pain management and symptom relief. Thus, these practitioners are unable to lower the pain level to below 7 and improve symptom relief in 24 hours.Ensuring Clinical Quality in Telemedicine

Target Areas for Improvement

            The first QI initiative, which is enhancing the efficiency of hospital financing can be improved through three key strategies. First, the healthcare organization should ensure that all hospital resources are distributed and used maximumly to avoid wastage (Manyazewal et al., 2016). Also, the procurement department should only order important supplies and facilities to avoid wastage of funds. More so, the management should schedule a training program for finance and administration staff to educate them on how to use the available financial resources efficiently. Consequently, the healthcare organization will get the finances required to purchase medications that can be used to lower the high pain level (7-10) and improve symptom relief in 24 hours. Secondly, the QI initiative of professional development can be improved by reviewing the requirements of the healthcare sector and providing staff with skills that will enable them to lower pain levels to below 7 and improve symptom relief in 24 hours.

Evidence-Based Strategies to Improve Quality.

            The poor quality of care that is provided to the patients can be improved through various evidence-based strategies. First, the quality of care can be boosted by improving working conditions. According to Er and Sökmen (2018), the ability of healthcare practitioners to provide quality care is compromised by unsafe working conditions. Therefore, practitioners will be motivated to work towards lowering pain levels to below 7 and improving symptom relief in 24 hours. Additionally, quality of care can be improved by hiring more practitioners to ensure an appropriate nurse staffing ratio in the healthcare organization. Poor healthcare outcomes are associated with a high nurse to the patient (Griffiths et al., 2020). Nurses are unable to provide quality and safe care services if they are assigned more patients due to a high workload. Thus, nurses will reduce the pain level to below 7 and improve symptom relief in 24 hours if they are assigned an appropriate number of patients.

The Evaluation of QI Initiatives

The existing QI initiatives for addressing the provision of poor quality of healthcare services include enhanced the efficiency of hospital financing and professional development of the workforce. These initiatives do not comply with the existing quality indicators from other healthcare organizations, non-governmental bodies, and government agencies on quality improvement, which advocates for the provision of safe and quality patient care. Therefore, the healthcare organization should adopt evidence-based measures to lower the pain level to below 7 and improve symptom relief in 24 hours.

Challenges associated with Meeting the Prescribed Benchmarks

Meeting the prescribed benchmarks will pose some challenges to the health care organization and the inter professional team. First, the organization will require financial resources either to improve the existing QI initiatives or implement new evidence-based measures. It is difficult for the hospital’s management to acquire the required funds due to the limited sources of income. On the other hand, the inter professional team will be faced with the challenge of mandatory training to improve their skills. Additionally, the practitioners will a high workload when some staff will be away for the training, which might make them work for extra hours. Therefore, lowering the pain level to below 7 and improving symptom relief in 24 hours will cause some challenges to the healthcare organization and the inter professional team.Ensuring Clinical Quality in Telemedicine

The Integration of Inter professional Perspectives to Achieve Quality Improvements in Patient Safety, Cost-Effectiveness, and Work-Life Quality

Inter professional Roles and Responsibilities regarding the Provision of Poor Quality of Healthcare Services

Inter professional team members have various roles and responsibilities to play to improve the poor quality of healthcare services in the hospital. According to Bosch and Mansell (2015), inter professional collaboration accrues a wide range of benefits to a medical facility such as reducing morbidity and mortality rates and decreasing preventable adverse drug reactions. In this case, the inter professional collaboration in lowering pain level to below 7 and improving symptom relief in 24 hours. Consequently, the challenge of a high pain level of 7-10 and inadequate symptom relief in more than 24 hours will be resolved.

Ensuring that all the Relevant Roles are Fully Engaged

I would involve some activities to ensure that all inter professional team members are engaged in resolving the provision of poor quality of healthcare services. The first step would involve identifying healthcare practitioners from various professional backgrounds who will be involved in resolving the issue. These healthcare professionals will work along with patients, their family members or caregivers, and communities to provide the clients with the highest quality of care. Secondly, I would create a platform for social interaction. Healthcare practitioners will utilize those platforms to interact during care delivery, thus lowering pain levels to below 7 and improving symptom relief in 24 hours. Finally, I would encourage open communication among practitioners during the provision of care. Open communication will allow the patients to report their levels of pain and present symptoms to the healthcare professionals for appropriate actions to be taken. Additionally, practitioners will be free to share evidence-based practices for lowering pain levels to below 7 and improving symptom relief in 24 hours.

Non-Nursing Concepts that would be Incorporated into the Initiative

Best practices research is the first non-nursing concept to be incorporated into the initiative. This strategy is a powerful QI approach, which identifies the best way of doing something. It starts by identifying a particular practice then conducts a study to identify the best way of approaching it. In this case, a study would be conducted on the best way of lowering pain levels to below 7 and improving symptom relief in 24 hours. The second non-nursing concept involves the use of the Model for Improvement (MFI). This model starts by identifying the targeted goals and work towards achieving them. In this case, the target goals are lowering the pain level to below 7 and improving symptom relief in 24 hours.

The Impact of the Outcomes used to Measure the Intervention on the Inter professional Team

Outcomes are used to measure the effectiveness of the proposed intervention. The proposed intervention aims at lowering the pain level to below 7 and improving symptom relief in 24 hours. The effectiveness of the intervention is depicted by improvement in the identified concern (Hartl, 2018). In this case, the outcomes include lowering the pain level to below 7 and improving symptom relief in 24 hours. The inter professional team will be satisfied with their work if the pain level is reduced to below 7 and symptom relief is improved in 24 hours. Consequently, they will be motivated to continue working in a healthcare organization.

The Impact of the Proposed Initiative on the Nursing Staff and Inter professional Team’s Work-Life Quality

The proposed initiative for lowering pain levels to below 7 and improving symptom relief in 24 hours has a substantial impact on the work-life quality of the nursing staff and the inter professional team. The QI initiative will enrich the work-life quality of the inter professional team and nurse practitioners. First, improving the work-life quality of inter professional teams and nurse practitioners will boost their happiness and willingness to continue working in the healthcare organization. Additionally, improving work-life quality will enable healthcare professionals to provide high-quality holistic care to their patients, thus boosting health outcomes and patient satisfaction (Kelbiso et al., 2017). Greater patient satisfaction will, in turn, enhance healthcare professionals’ job satisfaction.Ensuring Clinical Quality in Telemedicine

Effective Communication Strategies

Inter professional Communication Strategies

Inter professional communication strategies will play a significant role in enhancing the success of the proposed quality improvement initiative. First, clear writing will enable the interdisciplinary team and nurse practitioners to read and understand the proposed to be able to implement it in the healthcare organization. In addition to writing, other communication models such as the Strategies and Tools to Enhance Performance and Patient Safety tools Situation, Background, Assessment, Recommendation (SBAR), and shared mental model (SMM) will facilitate the collaboration of the interdisciplinary team, thus enhancing the success of the QI initiative. Strategies and Tools to Enhance Performance and Patient Safety tools will provide an evidence-based framework for structuring communication. These tools eliminate any subjectivity and emotional charge from the communication dialogue, thus enabling the participants to collaborate and work effectively as a team. Additionally, these tools allow professionals to resolve conflicts that might arise during collaboration. SBAR is a communication technique, which will facilitate appropriate and prompt communication among the interdisciplinary team (Shahid & Thomas, 2018). Finally, a shared mental model (SMM) will promote communication among healthcare professionals and increase the effectiveness of the interdisciplinary team.

Overall, the analyzed data indicate the provision of poor quality of healthcare services in the healthcare organization. Although the organization is making some efforts to resolve this issue, including enhancing the efficiency of hospital financing and professional development, these measures are not effective in solving the problem. Therefore, a QI initiative is required to improve the quality of healthcare services. Specifically, the implementation of evidence-based practices, including improving working conditions and hiring more practitioners will improve the quality of healthcare services. The success of these initiatives in the healthcare organization will be facilitated by inter professional communication strategies.

References

Bosch, B., & Mansell, H. (2015). Inter professional collaboration in health care: Lessons to be learned from competitive sports. Canadian Pharmacists Journal/Revue des pharmaciens du Canada, 148(4), 176-179.

El-Jardali, F., & Fadlallah, R. (2017). A review of national policies and strategies to improve the quality of health care and patient safety: a case study from Lebanon and Jordan. BMC health services research, 17(1), 568.Ensuring Clinical Quality in Telemedicine

Er, F., & Sökmen, S. (2018). Investigation of the working conditions of nurses in public hospitals based on nurse-friendly hospital criteria. International journal of nursing sciences, 5(2), 206-212.

Griffiths, P., Saville, C., Ball, J., Jones, J., Pattison, N., Monks, T., & Safer Nursing Care Study Group. (2020). Nursing workload, nurse staffing methodologies, and tools: A systematic scoping review and discussion. International journal of nursing studies, 103, 103487.

Hartl, G. (2018). Low-quality healthcare is increasing the burden of illness and health costs globally. World Health Organization. https://www.who.int/news/item/05-07-2018-low-quality-healthcare-is-increasing-the-burden-of-illness-and-health-costs-globally

Kelbiso, L., Belay, A., & Woldie, M. (2017). Determinants of quality of work-life among nurses working in Hawassa town public health facilities, South Ethiopia: A cross-sectional study. Nursing Research and Practice, 2017.

Manyazewal, T., Oosthuizen, M. J., & Matlakala, M. C. (2016). Proposing evidence-based strategies to strengthen the implementation of healthcare reform in resource-limited settings: a summative analysis. BMJ Open, 6(9).

Shahid, S., & Thomas, S. (2018). The situation, Background, Assessment, Recommendation (SBAR) communication tool for handoff in health care–a narrative review. Safety in Health, 4(1), 7.

Ensuring Clinical Quality in Telemedicine