Quality Improvement Practice Gaps in Nursing
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press.
• Chapter 4, ‘Data Collection’ (pp. 107–26)
• Chapter 5, ‘Statistical Tools for Quality Improvement’ (pp. 127–169)
Agency for Healthcare Research and Quality. (2018)). Key driver 2: Implement a data-driven quality improvement process to integrate evidence into practice procedures. https://www.ahrq.gov/evidencenow/tools/keydrivers/implement-qi.html
Question 1: Post a brief explanation of how you would identify a quality improvement practice gap in your practice or organization. Describe a potential quality improvement practice gap that you would like to explore or examine and explain why. Then, explain at least two types of tools and/or methods you might use to address this quality improvement practice gap, and explain why. Be specific and provide examples.
Sample Paper
Quality improvement practice gaps in nursing
Quality improvement is the process of identifying opportunities through a data-driven process to create change in health systems and increase productivity (Agency for Healthcare Research & Quality, 2018). Quality improvement acknowledges the existence of few opportunities in healthcare systems, thus recognizing the possibility of healthcare organizations experiencing gaps in practice, allowing the health practitioners to understand that change is possible. The paper discusses the process I can use to identify quality improvement practice gaps in my practice, the potential quality improvement gap that I would like to examine, two types of tools that I may use to address the gap, and the reasons.
Identification of Quality Improvement Gap
Nursing practice is an evolving profession with constantly changing dynamics due to the aging population, increase in infectious diseases, and chronic illnesses. Therefore, health care organizations are at a constant move of ensuring that the QI practice gaps are considered and changes made. I will identify the quality improvement practice gap through a gap analysis process which identifies the specific areas where the gaps are and the differences in their existence in the organization. The gap analysis system will help my organization modify the current gaps to reach the desired goal of improving quality care and outcomes (Kim & Ji, 2018). The gap analysis process will also help maintain a baseline process of care by collecting data in the four main categories of quality improvement process: clinical quality, financial aspect, patient experience, and functional level (Nash et al., 2019).
Potential Quality Improvement Practice Gap
In this case, I will discuss patient care gaps. This is a major drawback in quality improvement practice that can impact the organization’s productivity. For example, my organization has insufficient tools to train patients to manage their postoperative pain after discharge from surgical situations. Most patients, after discharge, are unlikely to follow the recommendations given due to insufficient knowledge. As a result, they might take pain relievers to ease their pain, causing some complications in their health that will lead to readmission. These gaps can impact the quality improvement process if not dealt with accordingly.
Tools to Address the Quality Improvement Practice Gap
The two tools that I will use to address the patient care gap are Plan-Do-Study-Act (PDSA) and the checklist tool. PDSA and checklist are profound in surgical issues and can help bridge the gap to increase patient safety and satisfaction after discharge. Plan-Do-Study-Act tool focus on three main criteria of solving a quality improvement practice problem. The four main sections of this tool try to accomplish a change through answering such questions; what is being accomplished? What is the strategic plan aligned in knowing that the difference is an improvement? And what can be done differently to enhance change improvement? (Johnson & Barach, 2017). These questions can help implement quality improvement educational programs to help the patients cope with the postoperative pains and reduce readmissions.
The checklist is essential in increasing patient safety. I chose this tool to address the patient care gap because, through the checklist, clinicians can improve their communication with patients at a greater level. Patients are taken through all procedures’ requirements and advised on precautions of continuing with some treatments. The patient has an opportunity to learn and understand their treatment procedures through their daily checklist routine and even make updates. Most studies have suggested using checklist tools in improving patient safety, especially in surgical conditions (Johnson & Barach, 2017). By the time the patient is being discharged, they can continue with the care independently. For example, a patient undergoing a leg amputation surgery can record their details, such as identity. Clinicians involved must document their details and explain to the patient all the procedures to document before the treatment begins. The checklist tool equips patients to understand their care and learn how to care for themselves after discharge.
References
Agency for Healthcare Research and Quality. (2018)). Key driver 2: Implement a data-driven quality improvement process to integrate evidence into practice procedures. https://www.ahrq.gov/evidencenow/tools/keydrivers/implement-qi.html
Johnson, J. K., & Barach, P. (2017). Tools and strategies for continuous quality improvement and patient safety. In Surgical Patient Care (pp. 121-132). Springer, Cham. https://d1wqtxts1xzle7.cloudfront.net/53895875/Tools_and_Strategies_9_for_Continuous_Quality_Improvement_and_Patient_Safety-with-cover-page-v2.pdf?Expires=1647286672&Signature=gD~GPeHxlrTIPstzKbXz1T2Dcf7P0Tc2pYVxzp496wj2dX7fomEY40F0XaWIFwLiGSGPuJAsUJ32hgSxGpF2d0R~pRWHJzRxuLWmYhBPX8J~BOeXwqhtJLXvtW83sUZnWcw7N4K0NRI31N-nmGKcJ-Q2i9cB577jKQ3wSnm0ARWEuY7fjTui6PZLc85SzosZjnuFKDEpEpNJUoW0WoKS4KuwBbWP9dctnNfZ2PRqDJ8NOIghImODdog-y1gKnUiVF0fC~CUuoAowy-fNFc~3D7YlfzCu723ZHKK5KZ1HVtWuM7sU9uy4WTr~wQUP5tpdkQ5B9lffCwssi~V5VkuTEQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA
Kim, S., & Ji, Y. (2018). Gap Analysis. The International Encyclopedia of Strategic Communication, 1-6. http://137.189.172.13/images/content_people/publication/sora-ch-2019-gap.pdf
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press. https://compress-pdf.obar.info/#google_vignette
