Factors Influencing Quality Improvement
Read:
Shea, C.M., Tunrer, K., Albritton, J., & Reiter, K.L. (2018). Contextual factors that influence quality improvement implementation in primary care: The role of organizations, teams, and individuals. Health Care Management Review, 4394), 261-269. doi: 10.1097/HMR.0000000000000194.
Implementing a QI project can often be met with many challenges both in the primary care and acute care settings. Reflect on your on your population of interest and the theory you have chosen. Discuss the factors that may influence a quality improvement project focused on addressing the phenomenon of interest you have identified? What are the theoretical concepts? What outcomes could you measure to evaluate effectiveness of the intervention?
Sample Answer
Factors Influencing Quality Improvement
Readmission rate is a quality improvement (QI) measure that assesses how often previous patients are readmitted to a healthcare facility for a recurrence or continuation of care. The target population would comprise adults between 18 and 65 years without a history of chronic diseases. The success of a QI project addressing this phenomenon would depend on various factors. For instance, if the organization has a poor attitude towards change, it will be difficult to implement it. The theory on resistance to change encompasses the reasons for rigidity, the impact on the organization, and the existing remedies (DuBose & Maya, 2020). Sometimes, caregivers may be unwilling to undertake QI projects since they do not have adequate information. They may also believe in misconceptions that skew their mindsets away from the change initiatives. Hence, the change leader should address such issues before embarking on reducing readmission rates.
Competency levels, at the team and individual levels, also influence QI projects. The team should have the right combination of skills and knowledge to perform all the necessary tasks (Shea et al., 2018). Furthermore, individuals should be confident in their abilities, especially when working with minimal supervision. Hence, a highly competent team will deliver more positive outcomes in the QI initiative.
One can evaluate clinical outcomes. In this case, the tangible result is the change in readmission rates before and after implementation. Additionally, a change leader can evaluate staffing outcomes. One can assess how the initiative impacts staffing paradigms such as satisfaction and turnover rates. Hence, they can determine if their undertaking was beneficial to the care setting. Finally, one can measure organizational metrics. For instance, one can analyze if a change causes better resource utilization, care coordination, and enhanced communication. Successful lowering of readmission rates should be measurable using all three criteria.
References
- DuBose, B. M., & Mayo, A. M. (2020). Resistance to change: A concept analysis. Nursing Forum, 55(4), 631-636. https://doi.org/10.1111/nuf.12479
- Shea, C. M., Turner, K., Albritton, J., & Reiter, K. L. (2018). Contextual factors that influence quality improvement implementation in primary care: The role of organizations, teams, and individuals. Health care management review, 43(3), 261–269. https://doi.org/10.1097/HMR.0000000000000194
