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NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

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Capella University

NURS-FPX 6016 Quality Improvement of Interprofessional Care

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Data Analysis and Quality Improvement Initiative Proposal

[Slide 1] Hi! I am Emma. Today, I will present a plan to improve the standard of hospice care at St. Anthony Medical Centre (SAMC). The proposal provides Quality Improvement (QI) strategies that benefit from the Hospice Care Dashboard’s evaluation and dissemination data feature. The main focus is on analyzing critical areas, including effective communication and the incorporation of advanced tools through interprofessional teamwork. 

[Slide 2] Hospice care is a multidisciplinary strategy that provides holistic care to patients reaching their final stage of life (Wajid et al., 2021). Medical facilities can improve the comfort and well-being of patients with terminal illnesses in their last days of life by offering efficient hospice care. Medical professionals can improve hospice care by assessing trustworthy dashboard information to make rational choices and promote continual enhancement. Effective hospice care can reduce the emotional and physical suffering of people with terminal illnesses in intensive care units and aid them in their last days of life by offering a peaceful and soothing atmosphere (Wang et al., 2022). This proposal intends to implement a QI strategy centered on hospice assistance dashboard data evaluation to improve Vila Healthcare’s patient services and productivity.

Identified Benchmark

[slide 3] The evaluation of data from the SAMC’s dashboard reveals numerous aspects of SAMC’s palliative care program that require QI. By reviewing several areas of issue regarding hospice care and the Agency for Healthcare Research and Quality (AHRQ) reportable standards for 2020 and 2021, we obtain knowledge about caregiver and patient satisfaction levels and highlight significant opportunities for improvement.

  • In 2020, 78% of patients with hospice care  observed effective communication between their medical staff and family caregivers. But in 2021, the percentage decreased to 75%.
  • The hospice care statistics also indicated that, in 2020, a decline from 70% to 68% in 2021, with a focus on the immediate and critical support that hospice staff members deliver to patients and family caregivers (Capella University, n.d.).
  • From 2020, about 65% of patients in hospice were satisfied with their medical team’s support in managing pain, mental distress, respiratory problems, and constipation. In 2021, the rate of satisfaction was raised to 68%.
  • In 2020, about 78% of hospice patients were treated with dignity, respect, and compassion by their care staff. Fortunately, the percentage rose to 80% in 2021 (Capella University, n.d.).

Identified Healthcare Issues

[Slide 4] The percentage of hospice patients who perceive efficient interaction with their family caregivers decreased from 78% to 75% during 2020 and 2021, which is reason for concern. Efficient communication is critical in medical care because it assists care providers in comprehending the patient’s medical condition and the required treatment. A breakdown in communication can risk patient safety, leading to misconceptions or neglected care (Tiwary et al., 2019). Another significant concern is the recorded decrease in immediate assistance from 70% to about 68% in 2020 and 2021.

Prompt aid in hospice care is crucial since delays can exacerbate a patient’s suffering and distress. Evidence suggests that adequate availability and execution of palliative care enhances discomfort and pain management. It also promotes autonomy in decision-making and lowers hospitalizations and medical costs. Lowering this proportion indicates insufficient staffing and a slow response rate. In intensive care, medical professionals must respond swiftly to minimize patients’ protracted suffering (Lalani & Cai, 2022).

Patient satisfaction with treating specific medical requirements such as pain, anxiety, and constipation increased from 65% to 68%. Nevertheless, the fact that a substantial percentage of patients remain unsatisfied is problematic. Insufficient assistance and delays in meeting patients’ medical requirements can result in a decline in their well-being and safety issues (Mao et al., 2022). The improvement in patients’ dignity, respect, and compassion from 78% to 80% is crucial. This still needs improvement. Feeling respected and attended to has an enormous effect on the psychological well-being of a patient. When patients are mistreated and disregarded, it can inhibit open discussion about their health issues, jeopardizing their health and safety (Avestan et al., 2019).

Quality of the Data Evaluation

[Slide 5] The evaluation of trends shows both progress and drop in certain aspects. The data is closely tied to the quality of hospice care, making it beneficial in evaluating care. The data’s association with some elements of care underlines the significance of an organized approach to monitoring patient satisfaction and responses in critical domains (Lalani and Cai, 2022). Furthermore, correlating Vila healthcare data to the AHRQ reportable benchmarks for 2020 and 2021 strengthens the data’s trustworthiness. It ensures an extensive and consistent evaluation of the quality of hospice care.

Thus, the data is an invaluable resource for reviewing and measuring trends, points of concern, and prospective opportunities for change within SAMC’s hospice care structure (Patel et al., 2020). The data trends highlight elements of hospice care that are advancing and those that require targeted attention, necessitating a more extensive examination to analyze the reliability of procedures and recognize performance failures. This analysis emphasizes the necessity for an approach to data evaluation, integrating qualitative and quantitative information to support holistic QI initiatives efficiently (Singh et al., 2019).

Quality Improvement Initiative

 [Slide 6] In SAMC’s hospice care unit, the percentage of patients having positive interactions with their family caregivers has decreased. The medical staff is providing less immediate support, which is a cause for caution. These problems promote significant hurdles to communication and timely response, which directly affect patient safety and fulfillment. The QI initiative can improve communication among hospice care personnel, patients, and their family caregivers, resulting in prompt and immediate reactions to treatment needs (Singh et al., 2019). A decrease in communication with care providers from 78% to 75% by 2021 suggests a breakdown in communication channels.  Furthermore, a drop in prompt assistance from healthcare providers from 70% to 68% during 2020 and 2021 indicates that patients and care providers endure postponed responses and lack effective interaction.

Proposed Strategies

The initial endeavor is to promote communication among hospice care providers and family caregivers. The effort seeks to improve communication quality found between 2020 and 2021 by developing training programs. These programs centered around compassionate communication, attentive listening, and open communication of treatment plans and the needs of patients. This program will include interpersonal skills modules, incorporating simulation and constructive criticism (Cochrane et al., 2019). Furthermore, a hospice care communication helpline will be developed, allowing patients and their caregivers to call out immediately when immediate issues emerge, assuring a rapid response to meet the patient’s immediate requirements (Abbott et al., 2021). The initiatives’ impact will be monitored using caregiver satisfaction questionnaires, with the goal of increasing communication satisfaction levels by 10%.

Another effort is to ensure prompt access to hospice care, allowing patients to obtain extensive end-of-life care immediately. A procedure for early identification and delivery of hospice-eligible patients will be created in partnership with primary care providers and specialists. For this purpose, the Hospice Quality-Reporting Program (HQRP) will be integrated into Vila Healthcare. This approach is consistent with the early identification parameters specified by the Centers for Medicare & Medicaid Services (CMS), with the goal of boosting the average period of hospice treatment per patient (Zheng et al., 2019). Predictive analytics tools, guided by hospice care needs evaluation research, will be incorporated to estimate hospice care demand better. A digital interaction platform, like an encrypted application and online portal, allows patients and caregivers to exchange messages, seek assistance, and book appointments. The platform supports families with timely information on the patient’s health. It will provide immediate support while improving patient safety. This initiative’s success will be monitored by recording the average time from early diagnosis to hospice admission (Mayahara et al., 2023).

Knowledge Gaps and Uncertainties

[Slide 7] Further study is required to customize communication training to the particular requirements of hospice care providers and their connections with family caregivers (Starr et al., 2024). Additional research is required to identify individual impediments to early assistance in the SAMC. Addressing the actual challenges of incorporating novel innovations, like an online platform, into the present hospice care system will be critical regarding employee education and patient accessibility concerns (Ritchey et al., 2020). Furthermore, assigning the required resources, including finance and workforce, for the successful execution of QI efforts can be difficult for the organization due to budget restrictions and conflicts (Bhati et al., 2023).

Integrating Interprofessional Perspectives

[Slide 8] Incorporating perspectives from multiple healthcare professions can result in an evidence-based strategy that improves patient safety, affordability, and productivity (Samardzic et al., 2020). This integration requires collaboration and coordination among various medical professionals, such as doctors, nurses, social service providers, and technological specialists. Healthcare personnel, including physicians and nurses, are critical in providing patient safety and care services. Their knowledge and capabilities enable them to improve patients’ care, including medication and surveillance, resulting in significant decreases in unneeded implications.

Furthermore, the medical team’s expertise allows them to recognize issues and provide feedback on solutions, providing safe and affordable care. They also play a critical role in educating patients about their health condition and involving them in decision-making (Walter et al., 2019). To ensure improved communication and cooperative problem-solving, conventional, systematic interdisciplinary sessions will promote an atmosphere of open communication and joint decision-making (Walter et al., 2019).

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

Patients’ health depends on physical well-being and mental health. Psychotherapists play an essential role in ensuring high-quality care. Their experience enables them to provide specialized therapy services. Their approaches can help patients recover faster and shorten hospital stays. The knowledge and expertise of these specialists are also incredibly beneficial to medical personnel. Educating employees on behavioral therapies can significantly reduce work stress while enhancing their balance between life and work (Johansen & Ervik, 2022). Conducting regular seminars and trainings is critical for improving outcomes. Furthermore, incorporating these therapists into patient care plans can improve outcomes, particularly for rehabilitation patients (Arya et al., 2020).

Hospital management can ensure effective policy execution and adherence to security protocols, which can improve patient safety. Furthermore, by optimizing operational procedures, managers maximize the use of resources, reducing an organization’s financial restrictions (Bhati et al., 2023). To improve the standard of care, the organization must deal with its employees’ administrative concerns by fostering a positive work setting. To increase patient safety and lower care costs, hospitals should perform frequent audits and solve employee issues at team conferences (Bhati et al., 2023).

Assumptions 

These approaches, including enhanced interpersonal and communication training, are expected to improve care services. Furthermore, most patients will benefit from rehabilitation programs following care. Medical professionals lack a comprehensive understanding of managing their stress; thus, more training will be valuable to offer efficient care (Arya et al., 2020).

Effective Collaboration and Communication Strategies 

[Slide 9] To ensure the best possible outcome for patients, medical providers must work together effectively. Shared Decision-Making (DSM) is an essential method for promoting collaboration. An in-depth knowledge of patients’ requirements can be addressed by establishing channels for all professions to discuss patients’ health conditions from different aspects and make shared decisions (Kesonen et al., 2022). Inter-Professional Education (IPE) and regular interdisciplinary training sessions enable specialists to understand the roles and duties of their teammates. This approach promotes 6the culture of mutual respect while offering the medical staff an integrative viewpoint on caring for patients (Mohammed et al., 2021).

SAMC can deploy technological innovations in its framework to improve patient hospice care and streamline operations. For instance, the implementation of Electronic Health Records (EHR) systems with collaborative attributes allows medical professionals to access and modify patient medical data simultaneously. The EHR offers everyone all relevant professionals accessibility to the most recent patient data, mitigating the likelihood of errors (Quinn et al., 2019). Furthermore, multidisciplinary groups can create specialized platforms and channels for addressing hospice patients’ issues. For example, providers can use video conferencing, telehealth services, and other virtual platforms to exchange and debate on patient health. The approach guarantees that all experts engaged have an identical platform to provide timely updates and assist them in patient care (Ignatowicz et al., 2019).

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

 Efficient interaction and communication are vital for carrying out collaborative initiatives. Developing open communication networks is critical to improving teamwork among medical professionals. Effective communication systems can help ensure that critical information is transmitted quickly and securely (Tiwary et al., 2019). Furthermore, an efficient feedback system can be valuable, enabling specialists to give input on the collaborative process and creating an opportunity for improvement. It also ensures that inter-professional assistance remains adaptive to the developing difficulties faced by hospitals like SAMC (Walter et al., 2019).

These collaborative approaches are founded on numerous assumptions. For instance, it is assumed that all specialists can become accustomed to the positive aspects of these collaborative techniques. Moreover, professionals from different fields can adjust their workloads to get involved in collaborative meetings and survey platforms. It is expected that interdisciplinary professionals agree to implement these approaches to improve patient care (Walter et al., 2019).

Conclusion 

Slide 10] SAMC’s dashboard evaluation of data identified significant aspects in hospice care that need urgent changes. For example, changes in communication and interaction with family caregivers and response to patient requirements highlight the significance of continuous QI. Based on the data gathered, SAMC can deliver effective change, improving patients’ hospice care.

References

Abbott, J., Ferraro, K., Johnson, D., Statland, B., Massone, J., Fowler, C., & Cantrill, S. V. (2021). Colorado palliative care and hospice crisis standards: Moving beyond critical care planning. Journal of Pain and Symptom Management61(6), 1287-1296. https://doi.org/10.1016/j.jpainsymman.2020.12.009

Arya, A., Buchman, S., Gagnon, B., & Downar, J. (2020). Pandemic palliative care: Beyond ventilators and saving lives. Canadian Medical Association Journal192(15), E400-E404. https://doi.org/10.1503/cmaj.200465

Avestan, Z., Pakpour, V., Rahmani, A., Mohammadian, R., & Soheili, A. (2019). The correlation between respecting the dignity of cancer patients and the quality of nurse-patient communication. Indian Journal of Palliative Care25(2), 190. https://doi.org/10.4103%2FIJPC.IJPC_46_18

Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: A comprehensive review. Cureus15(10). https://doi.org/10.1016/10.7759/cureus.47731

Capella University. (n.d.). Vila health: Data analysis. capella.edu. https://signon.capella.edu/idp/SSO.saml2 

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

Cochrane, B. S., Ritchie, D., Lockhard, D., Picciano, G., King, J. A., & Nelson, B. (2019). A culture of compassion: How timeless principles of kindness and empathy become powerful tools for confronting today’s most pressing healthcare challenges. In Healthcare Management Forum32(3), 120-127. https://doi.org/10.1177/0840470419836240

Ignatowicz, A., Atherton, H., Bernstein, C. J., Bryce, C., Court, R., Sturt, J., & Griffiths, F. (2019). Internet videoconferencing for patient–clinician consultations in long-term conditions: A review of reviews and applications in line with guidelines and recommendations. Digital Health5, 2055207619845831. https://doi.org/10.1177/2055207619845831

Johansen, M.-L., & Ervik, B. (2022). Talking together in rural palliative care: A qualitative study of interprofessional collaboration in Norway. BioMed Central Health Services Research22(1), 314. https://doi.org/10.1186/s12913-022-07713-z

Kesonen, P., Salminen, L., Kero, J., Aappola, J., & Haavisto, E. (2022). An integrative review of Interprofessional teamwork and required competence in specialized palliative care. OMEGA-Journal of Death and Dying0(0). https://doi.org/10.1177/00302228221085468

Lalani, N., & Cai, Y. (2022). Palliative care for rural growth and wellbeing: Identifying perceived barriers and facilitators in access to palliative care in rural Indiana, USA. BioMed Central Palliative Care21(1). https://doi.org/10.1186/s12904-022-00913-8

Mao, J. J., Pillai, G. G., Andrade, C. J., Ligibel, J. A., Basu, P., Cohen, L., & Salicrup, L. A. (2022). Integrative oncology: Addressing the global challenges of cancer prevention and treatment. CA: A Cancer Journal for Clinicians72(2), 144-164. https://doi.org/10.3322/caac.21706

Mayahara, M., Wilbur, J., Fogg, L., Paice, J. A., & Miller, A. M. (2023). e-pain support: A digital pain management application for home hospice care. American Journal of Hospice and Palliative Medicine0(0). https://doi.org/10.1177/10499091231211493 

Mohammed, C. A., Anand, R., & Ummer, V. S. (2021). Interprofessional Education (IPE): A framework for introducing teamwork and collaboration in health professions curriculum. Medical Journal, Armed Forces India77(Suppl 1), S16. https://doi.org/10.1016%2Fj.mjafi.2021.01.012

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

Patel, M. N., Nicolla, J. M., Friedman, F. A., Ritz, M. R., & Kamal, A. H. (2020). Hospice use among patients with cancer: Trends, barriers, and future directions. JCO Oncology Practice16(12), 803-809. https://doi.org/10.1200/OP.20.00309

Quinn, M., Forman, J., Harrod, M., Winter, S., Fowler, K. E., Krein, S. L., & Chopra, V. (2019). Electronic health records, communication, and data sharing: Challenges and opportunities for improving the diagnostic process. Diagnosis6(3), 241-248. https://doi.org/10.1515/dx-2018-0036

Ritchey, K. C., Foy, A., McArdel, E., & Gruenewald, D. A. (2020). Reinventing palliative care delivery in the era of COVID-19: How telemedicine can support end of life care. American Journal of Hospice and Palliative Medicine®37(11), 992-997. https://doi.org/10.1177/1049909120948235

Samardzic, M., Doekhie, K. D., & van Wijngaarden, J. D. (2020). Interventions to improve team effectiveness within health care: A systematic review of the past decade. Human Resources for Health18, 1-42. https://doi.org/10.1186/s12960-019-0411-3

Singh, J., Sillerud, B., & Omar, M. (2019). Quality improvement in hospice settings: Perceptions of leaders. International Journal of Health Care Quality Assurance32(7), 1098–1112. https://doi.org/10.1108/ijhcqa-04-2019-0084

Starr, L. T., Washington, K., Pitzer, K., Oliver, D. P., & Demiris, G. (2024). Close but not close enough: how distance caregiving is associated with hospice family caregiver hospice communication experiences. Health Communication39(3), 482-492. https://doi.org/10.1080/10410236.2023.2170199

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 Research4, 7. https://doi.org/10.12688%2Fwellcomeopenres.15042.1

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal

Wajid, M., Rajkumar, E., J. Romate, Allen Joshua George, R. Lakshmi, & Srinagesh Simha. (2021). Why is hospice care important? An exploration of its benefits for patients with terminal cancer. BioMed Central Palliative Care20(1). https://doi.org/10.1186/s12904-021-00757-8

Walter, J. K., Schall, T. E., DeWitt, A. G., Faerber, J., Griffis, H., Galligan, M., & Feudtner, C. (2019). Interprofessional team member communication patterns, teamwork, and collaboration in pre–family meeting huddles in a pediatric cardiac intensive care unit. Journal of Pain and Symptom Management58(1), 11-18. https://doi.org/10.1016/j.jpainsymman.2019.04.009

Wang, Q. L., Han, B.-R., & Yue, P. (2022). The efficacy of hospice care for terminally ill emergency patients during the coronavirus 2019 pandemic. Journal of Multidisciplinary Healthcare15, 1667–1676. https://doi.org/10.2147/jmdh.s371915

Zheng, N. T., Mukamel, D. B., Rokoske, F. S., Morley, M., Zepeda, S., & Aldridge, M. D. (2019). Have hospice costs increased after implementation of the hospice quality–reporting program?. Journal of Pain and Symptom Management58(1), 48-55. https://doi.org/10.1016/j.jpainsymman.2019.03.013

 

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