NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

Sample Answer for Included After Question

The Assignment: (2–3 pages)

  • Briefly describe the quality improvement practice gap you identified in your nursing practice or organization. Be specific.
  • Develop at least two SMART objectives you might apply in the project planning phase or execution phase to address the quality improvement practice gap you identified.
  • Recommend at least two project management activities you would use for your project, addressing the quality improvement practice gap you identified. Explain your justification for why these activities would provide the best support. Be specific and provide examples.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

A Sample Answer For the Assignment: NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

Title: NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

Health care organizations should be continually involved in practice outcomes’ improvement. In this case, they need to make practice gaps identification a norm and respond effectively. Regardless of the situation, the approach chosen to address practice gaps affects outcomes considerably. Project management principles and activities can be integrated into practice improvement projects to guide planning, execution, and implementation. This paper describes the quality improvement practice gap, SMART objectives, and project management activities suitable for the project.

Quality Improvement Practice Gap

Medication errors are common in practice settings, and their rates depend on the experience of the workforce, the technology used, and health conditions, among other factors. The causes of medication errors in practice settings vary, with diagnosis and prescription inefficiencies and ineffective drug distribution practices among the leading causes (AMCP, 2019). Human-based issues and team inefficiencies are other major causes. Such issues include communication gaps and an uninformed patient population (Tiwary et al., 2019). Medication errors impact health outcomes adversely, necessitating up-to-date and evidence-based interventions. They are sources of new health conditions, injuries, and even death (Wondmieneh et al., 2020). Medication errors also cause patient dissatisfaction by reducing the quality of overall care.

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Health care organizations can apply different strategies in medication errors control. These strategies can be the basis for using project management activities in practice improvement. Modern technology integration into health care practices is highly recommended in reducing and preventing medication errors. For instance, as Godshall and Riehl (2018) proposed, barcode scanning can prevent and mitigate drug prescription and administration problems. The other strategy is creating an informed nursing staff through nursing education. Doing so can help nurses follow institutional policies on medication transcription, such as the five rights of medication (Hanson & Haddad, 2021). Individually or jointly, these strategies can effectively address the practice gap.

NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap
NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

SMART Goals

Medication errors cannot be effectively addressed without setting goals to guide practice improvement. Suitable goals in the planning phase or execution phase include:

  1. Adopting appropriate technologies in the practice setting to prevent medication errors within six months.
  2. Educating the nursing staff to equip it with knowledge on medication errors prevention and control in three months.

As required in goal setting, these goals are specific, measurable, and time-bound. They outline the measures necessary to achieve a particular outcome.

Project Management Activities to Apply in the Project

Project management is a broad topic with different phases and activities. A suitable project management activity for the project is a project strategy and business case. In project management, project strategy and the business case involve defining all the project’s requirements and proposing an appropriate methodology to achieve the desired goals (Schmidt, 2021). In medication errors’ prevention, project strategy and business case would involve identifying the technologies needed to prevent errors and proposing an approach to acquire them. For instance, the practice setting can rely on internal resources or donations.

The other crucial activity is preparation. It is a critical activity before the project starts. Here, the project leader ensures that all the necessary resources are in place and timelines and roles are defined through work breakdown structure and Gantt charts, among other tools. Both activities are crucial to prevent working on a project without a definite end and specific goals.

Conclusion

Quality improvement requires high-level thinking and applying appropriate approaches. A project approach is justified when addressing quality improvement practice gaps such as medication errors. Preparation is vital before starting the project, among other activities like developing a project strategy and business case. Addressing medication errors requires a similar approach due to the complexity of the task and the need to work on specific, measurable, and time-bound goals.

References

AMCP. (2019). Medication errors. https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/medication-errors

Godshall, M., & Riehl, M. (2018). Preventing medication errors in the information age. Nursing2020, 48(9), 56-58. doi: 10.1097/01.NURSE.0000544230.51598.38

Hanson, A., & Haddad, L. M. (2021). Nursing rights of medication administration. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560654/

Schmidt, T. (2021). Strategic project management made simple: Solution tools for leaders and teams. New Jersey Wiley.

Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: Examples from two case reports. Wellcome Open Research, 4. https://doi.org/10.12688/wellcomeopenres.15042.1

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: A cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing19(1), 1-9. https://doi.org/10.1186/s12912-020-0397-0

A Sample Answer 2 For the Assignment: NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

Title: NURS 8302 Applying Project Management Approaches for a Quality Improvement Practice Gap

Chronic heart failure annually impacts approximately 5.7 million individuals in the United States, resulting in a financial burden of over $30.7 billion due to healthcare expenses and treatment costs (Taklalsingh et al., 2020). According to Driscoll et al. (2020), the annual survival rate for hospital admissions is only 30-40%, suggesting a potential impact on morale. The projected readmission rate within 30 days is 23% for patients. The Hospital Readmissions Reduction Program was initiated by the Centers for Medicare & Medicaid Services (CMS) in 2012. It aims to reduce avoidable readmissions for heart failure patients by imposing financial penalties on institutions with higher readmission rates following heart failure hospitalizations. These penalties result in lower monthly payments or reimbursements for these institutions. This paper aims to elucidate the identified gap in quality improvement practice.

Identification of the Gap for Quality Improvement

During this practicum, I observed a deficiency in my practice regarding the 30-day hospitalization rates for congestive cardiac failure. The inclusion of the 30-day readmission rate as a metric for evaluating hospital quality aims to reduce healthcare expenses and prevent inadequate treatment for individuals with heart failure. This study utilized multiple communities to evaluate various metrics, including hospital rating and payment rate, to promote improved care for individuals with congestive heart failure. Healthcare institutions have recognized the importance of maintaining a low 30-day readmission rate to achieve high-quality assessments and receive high reimbursement rates.

As a result, they have enhanced their ability to monitor and provide appropriate treatment to patients with congestive heart failure (Roshanghalb et al., 2019). This research investigates how project execution and root-cause analysis can improve outcomes for individuals with congestive heart failure. This research seeks to utilize the Johns Hopkins Nursing Evidence-Based Practice and the Johns Hopkins Nursing Evidence-Based Practice Translation Tool to identify effective measures or strategies for significantly reducing the 30-day readmission rate among patients with heart problems. Lewin’s theory of managing change is a component of the change management process.

SMART Objectives for Quality Improvement

This research evaluates interventions hospitals and healthcare providers can implement to reduce the 30-day readmission rate for cardiac conditions. The proposed intervention seeks to achieve two main objectives.

  1. This study aims to evaluate the quality of available information regarding effective strategies and interventions for reducing the 30-day readmission rate for heart-related issues in hospitals within a 12-month.
  2. The objective is to reduce the hospital’s 30-day readmission rate for heart conditions to be lower than the national average or to be ranked within the top five hospitals in the country.

To meet these goals, the hospital should conduct a root-cause analysis to determine the primary risk factors associated with heart failure readmission rates. Subsequently, intervention recommendations can be made based on this data (Delgado et al., 2019). The objectives of reducing the rate of heart disease readmissions are SMART (specific, measurable, attainable, realistic, and timely), making them feasible to implement within a medical setting.

Recommended Project Management Activities

To fulfill its goals, the facility has to consider two main tactics. Finding the best evidence-based therapies is crucial to lowering the hospital’s readmission rate for heart disease. To accomplish these changes further, change management techniques must be implemented. Project management strategies are needed for both processes (Taklalsingh et al., 2020). Comprehensive home healthcare programs that include round-the-clock phone support for up to 25–30 days after discharge, personalized education on self-care techniques during hospitalization, frequent check-in visits, and encouragement of in-home follow-up are beneficial to patients with heart failure (Cholack et al., 2021).

Through root-cause analysis, a team may use project management tools to evaluate hospitals’ readiness and current procedures to reduce 30-day hospitalization rates linked to cardiac problems. According to the National Patient Safety Foundation (NPSF), root-cause analysis is a valuable method employed by interdisciplinary development teams to identify the underlying causes and explanations for readmissions (Blumer et al., 2021). To reduce cardiovascular disease readmissions, the development team will incorporate change management strategies to implement evidence-based practice improvements (Khan et al., 2021).

Conclusion

One month post-hospital discharge. Engaging in these activities can reduce the readmission rate for heart failure by providing a meaningful approach to identifying and addressing underlying issues or causes and linking them to appropriate therapeutic interventions. Applying change management principles can be advantageous for organizations as it reduces employee resistance, enhances internal support, and optimizes the effectiveness of proposed policy changes. Therefore, by implementing project management, organizational transformation, and evidence-based practice methods, an organization may lower its 30-day readmission rate for cardiac issues.

References

Blumer, V., Mentz, R. J., Sun, J., Butler, J., Metra, M., Voors, A. A., Hernandez, A. F., O’Connor, C. M., & Greene, S. J. (2021). Prognostic role of prior heart failure hospitalization among patients hospitalized for worsening chronic heart failure. Circulation: Heart Failure, 14(4). https://doi.org/10.1161/circheartfailure.120.007871

Bonilla-Palomas, J. L., Anguita‐Sánchez, M., Elola-Somoza, F. J., Bernal, J. L., Fernández-Pérez, C., Ruiz‐Ortiz, M., Jiménez‐Navarro, M., Bueno, H., Cequier, Á., & Marín-Ortuño, F. (2021). Thirteen‐year trends in hospitalization and outcomes of patients with heart failure in Spain. European Journal of Clinical Investigation, 51(11). https://doi.org/10.1111/eci.13606

Cholack, G., Garfein, J., Errickson, J., Krallman, R., Montgomery, D., Kline–Rogers, E., Eagle, K. A., Rubenfire, M., Bumpus, S. M., & Barnes, G. D. (2021). Early (0-7 days) and late (8-30 days) readmission predictors in acute coronary syndrome, atrial fibrillation, and congestive heart failure patients. Hospital Practice, 49(5), 364–370. https://doi.org/10.1080/21548331.2021.1976558

Delgado, J., Gregori, A. F., Fernández, L. N., Claret, R. B., Sepúlveda, A. G., Fernández‐Avilés, F., González-Juanatey, J. R., García, R. V., Otero, M. R., Cubero, J. S., Figal, D. P., Crespo-Leiro, M. G., Álvarez‐García, J., Cinca, J., & Ynsaurriaga, F. A. (2019). Patient-associated predictors of 15- and 30-day readmission after hospitalization for acute heart failure. Current Heart Failure Reports, 16(6), 304–314. https://doi.org/10.1007/s11897-019-00442-1

Driscoll, A., Dinh, D., Prior, D., Kaye, D. M., Hare, D. L., Neil, C., Lockwood, S., Brennan, A., Lefkovits, J., Carruthers, H., Amerena, J., Cooke, J., Vaddadi, G., Nadurata, V., & Reid, C. M. (2020). The effect of transitional care on 30-day outcomes in patients hospitalized with acute heart failure. Heart, Lung and Circulation, 29(9), 1347–1355. https://doi.org/10.1016/j.hlc.2020.03.004

Khan, M. S., Sreenivasan, J., Lateef, N., Abougergi, M. S., Greene, S. J., Ahmad, T., Anker, S. D., Fonarow, G. C., & Butler, J. (2021). Trends in 30- and 90-day readmission rates for heart failure. Circulation: Heart Failure, 14(4). https://doi.org/10.1161/circheartfailure.121.008335

Roshanghalb, A., Mazzali, C., & Lettieri, E. (2019). Multi-level models for heart failure patients’ 30-day mortality and readmission rates: the relation between patient and hospital factors in administrative data. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4818-2

Taklalsingh, N., Wengrofsky, P., & Levitt, H. (2020). The Heart Failure Clinic: Improving 30-Day All-Cause Hospital Readmissions. Journal for Healthcare Quality, 42(4), 215–223. https://doi.org/10.1097/jhq.0000000000000221