Quality of Healthcare Assignment

Quality of Healthcare Assignment

Guidelines with Scoring Rubric

Purpose

The purposes of this assignment are to: (a) propose evidence based interventions using a new nursing care delivery model that will reduce costs and improve the quality and safety of healthcare in the organization (CO 1, CO 3 & CO 4), and (b) engage in scholarly inquiry and communication (CO 5)

Course Outcomes

Through this assignment, the student will demonstrate the ability to do the following.

(CO1) Evaluate and develop organizational strategic plans (SP) in relation to patient safety, economic and quality outcomes of healthcare organizations and systems. (PO1)

 

(CO3) Appraise the effects of strategies to reduce costs and improve the quality and safety of healthcare. (PO1 & PO4)

 

(CO4)  Organize legal and regulatory components of healthcare strategies to promote safety and quality care. (PO1 & PO4)

 

(CO5)  Synthesize and communicate research findings to promote quality improvement and safety in healthcare. (PO1 & PO4)

 

Due Date: Sunday 11:59 p.m. MT at the end of Week 7

Total Points Possible:  225

Preparing the paper

Assignment Situation:

You are the nurse executive of Ocracoke Regional Healthcare System. Due to increasing healthcare costs over the past two years, the board and stakeholders have determined the total-patient-care nursing model is no longer sustainable and must be changed. In addition, Joint Commission has just completed their visit. Ocracoke received two recommendations for improvement in two of most current National Patient Safety Goals found at the link below.

National Patient Safety Goals-The Joint Commission https://www.jointcommission.org/standards/national-patient-safety-goals/

You must address these recommendations using a new nursing care delivery model. Senior leadership expects to see increased cost savings through the use of this new model and improved outcomes related to two patient safety goals (you may choose any two patient safety goals you want to improve on  by the time of the  Joint Commission’s revisit in six(6) months.

Scenario Instructions:

For this assignment you will:

Complete the scenario by selecting and defining two National Patient Safety Goals and their deficiencies noted by The Joint Commission. You will identify the outcome measures used to assess them and the goals for improving these outcomes by implementing the new nursing care delivery model. You will describe the nursing care delivery model proposed, how it impacts the deficiencies in the safety goals chosen, and its economic impact on the organization.

Based on all the information gathered through your exploration you will create the PICOT.question for this evidence-based improvement. This will be included as a statement in the Overview of Issue section of the assignment.

At the Ocracoke Regional Healthcare System(P), will implementing a _____________ nursing care delivery system(I), compared to the current total care nursing care delivery system (C), result is compliance with the Joint Commission’s recommendations(O) at their revisit in 6 months(T).  .

(See example  below for review in writing a PICOT)

 

Requirements:

1. Use the following format and headings to organize your assignment
2. Introduction
   1. Statement of purpose of paper
   2. Overview of components of paper
3. Overview of Issue
   1. Scenario
   2. National Patient Safety Goals identified
   3. New Nursing Care Delivery Model identified
   4. Final PICOT stated
4. National Patient Safety Goals
   1. Safety goals and deficiencies identified
   2. Outcome measures defined
5. New Nursing Model
   1. Description of new nursing care delivery model
   2. Impact of model in addressing the safety goals
   3. Impact of model on reducing organizational costs
6. Conclusion
   1. Recap of paper’s purpose
   2. Summary of what was accomplished

 

2. A minimum of three (3) scholarly sources, no older than 5 years must be used for the paper. These should be relevant to nursing and should represent the majority of evidence provided in the paper. Other sources may be used in addition to these, however, they will not be counted as part of the scholarly source requirement.
3. The paper should contain all elements required under the guidelines and provided by the outline.
4. The outline provided should be followed for organizing the paper. Only level one headings are required. Remember, the introduction does not have a heading.
5. A maximum of four (4) pages, excluding title and reference pages, is required.
6. The paper should be written in third person, active voice. Refer to “Guidelines for Writing Professional Papers in Graduate Programs” found in the Student Resources Central of the course.
7. Refer to rubric for paper mechanics

 

PICOT Writing Review Situation: Sunnybrook Health System has started the process for acquiring Magnet status. They have scheduled multiple planning and process meetings over the next year that require attendance of all staff. Staff must attend at least 70% of the meetings live. After three meetings, live attendance of night shift staff has been about 5%. There is concern that with the small amount of interest shown from this group, the benchmark of 70% for live attendance may be jeopardized. Currently, the meeting schedule is communicated to all staff via email and posted announcements. Suzie thinks an incentive of a free meal for live attendance might improve attendance of the night shift crew. How could a PICOT be developed with this information? P = Population – Describes the group upon which the intervention will have an effect. Ex: night shift staff I = Intervention – What we want to do that is different from what we currently do; the thing that is going to impact the population identified Ex. coupons for a free meal in the cafeteria C = Comparison – Here the comparison is a before and after the intervention (incentive in this case) Ex: communication of scheduled meetings via email and posted announcements O = Outcome – What we want to see happen as a result of the intervention. The outcome should meet three criteria: direction (increase, decrease, etc), a baseline, and a goal. Ex: increased mandatory meeting live attendance from 5% to 50% T = Timing or Timeframe – When we expect to see the outcomes. Ex: over the next 4 meetings Now you can create the PICOT: Among night shift staff(P), will offering a coupon for a free meal in the cafeteria(I), as opposed to only email invitations and posted announcements(C), increase mandatory meeting live attendance from 5% to 50% (O) over the next 4 meetings(T)?

For guidance in writing a PICOT statement refer to the following. There is also an instructional webinar in the course announcement that can offer further guidance if needed.

 

 

 

 

 

 

 

Category	Points	%	Description
Introduction	30	13%	Introduction clearly introduces your quality of healthcare assignment and purpose of the assignment.
Overview of issue	30	13%	Scenario Overview provided and includes National Patient Goals identified (2) New Nursing Care Delivery Model identified Final PICOT correctly stated
National Patient Safety Goals	30	13%	Two goals and their deficiencies described Specific outcome measures (goals) defined
Nursing Care Delivery Model	80	38%	New nursing care model delivery described Impact of model in addressing the selected National Patient Safety goals Impact of model on reducing organizational costs
Conclusion	30	13%	Recap of paper’s purpose Summary of what was accomplished
Scholarly inquiry and communication	15	6%	Minimum of three scholarly, empirical evidence sources to support nursing care delivery model Ideas and information from other sources are cited correctly. Text, title page, and references are consistent with APA format.
Writing Conventions	10	4%	Text, title page, and references are consistent with APA format   Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow
Total	225		A quality assignment will meet or exceed all of the above requirements.

 

Grading Rubric

Assignment Criteria	Exceptional (100%) Outstanding or highest level of performance	Exceeds (88%) Very good or high level of performance	Meets (80%) Competent or satisfactory level of performance	Needs Improvement (38%) Poor or failing level of performance	Developing (0) Unsatisfactory level of performance
Content Possible Points = 200 Points
Introduction	30 Points	26 Points	24 Points	11 Points	0 Points
	All elements present are clearly and accurately stated   ·         Statement of purpose; ·         Overview of components	All elements present with minimal inaccuracies   ·         Statement of purpose; ·         Overview of components	One element clearly and accurately stated;     ·         Statement of purpose; ·         Overview of components	All elements present but generally stated     ·         Statement of purpose; ·         Overview of components	No elements present       ·         Statement of purpose; ·         Overview of components
Overview of Safety Issue	30 Points	26 Points	24 Points	11 Points	0 Points
	All elements present are clearly and accurately stated       ·         Scenario ·         Two National Safety Goals Identified ·         New Nursing Care Delivery Model identified ·         Final PICOT	All elements present with minimal inaccuracies       ·         Scenario ·         Two National Safety Goals Identified; ·         New Nursing Care Delivery Model identified ·         Final PICOT	Two elements clearly and accurately stated         ·         Scenario ·         Two National Safety Goals Identified; ·         New Nursing Care Delivery Model identified ·         Final PICOT	One element clearly and accurately stated; OR all elements generally addressed     ·         Scenario ·         Two National Safety Goals Identified; ·         New Nursing Care Delivery Model identified ·         Final PICOT	No elements present           ·         Scenario ·         Two National Safety Goals Identified; ·         New Nursing Care Delivery Model identified ·         Final PICOT
National Patient Safety Goals	30 Points	26 Points	24 Points	11 Points	0 Points
	All elements present are clearly and accurately stated   ·         Safety Goal and deficiency identified ·         Outcome measures defined	All elements present are clearly stated with minimal inaccuracies   ·         Safety Goal and deficiency identified ·         Outcome measures defined	One element clearly and accurately stated     ·         Safety Goal and deficiency identified ·         Outcome measures defined	All elements present generally stated     ·         Safety Goal and deficiency identified ·         Outcome measures defined	No elements present       ·         Safety Goal and deficiency identified ·         Outcome measures defined
New Nursing Model	80 points	70 points	64 points	30 points	0 points
	All elements present are clearly and accurately stated   ·         New Nursing Care Delivery Model described; ·         Impact of model on National Patient Safety Goals; ·         Impact on reducting organizational costs	All elements present are clearly stated with minimal inaccuracies   ·         New Nursing Care Delivery Model described; ·         Impact of model on National Patient Safety Goals; ·         Impact on reducting organizational costs	One element clearly and accurately stated   ·         New Nursing Care Delivery Model described; ·         Impact of model on National Patient Safety Goals; ·         Impact on reducting organizational costs	All elements present generally stated     ·         New Nursing Care Delivery Model described; ·         Impact of model on National Patient Safety Goals; ·         Impact on reducting organizational costs	No elements present       ·         New Nursing Care Delivery Model described; ·         Impact of model on National Patient Safety Goals; ·         Impact on reducting organizational costs
Conclusion	30 Points	26 Points	24 Points	11 Points	0 Points
	All elements present are clearly and accurately stated   ·         Purpose of paper recap   ·         Summary of what was accomplished	All elements present with minimal inaccuracies   ·         Purpose of paper recap   ·         Summary of what was accomplished	One element clearly and accurately stated     ·         Purpose of paper recap   ·         Summary of what was accomplished	All elements present generally stated     ·         Purpose of paper recap   ·         Summary of what was accomplished	No elements present       ·         Purpose of paper recap   ·         Summary of what was accomplished
Content Subtotal					_____ of 200 points
Assignment Mechanics = 25 points
Scholarly Inquiry and communication	15 points	13 points	12 points	6 points	0 points
	All elements present with no inaccuracies   ·         Minimum of three scholarly, relevant (within 5 years), empirical sources provide support to content   ·         Ideas and information from other sources are cited correctly.	All elements present with up to two errors ·         Minimum of three scholarly, relevant (within 5 years), empirical sources provide to support content   ·         Ideas and information from other sources are cited correctly.	All elements present 3 4 errors ·         Minimum of three scholarly, relevant (within 5 years), empirical sources provide support to content   ·         Ideas and information from other sources are cited correctly.	All elements present with 5 errors ·         Minimum of three scholarly, relevant (within 5 years), empirical sources provide  support to content   ·         Ideas and information from other sources are cited correctly.	All elements present with 6 or more errors ·         Minimum of three scholarly, relevant (within 5 years), empirical sources provide  support to content   ·         Ideas and information from other sources are cited correctly.
Writing Conventions	10 points	9 points	8 points	4 points	0 points
	All elements present with no inaccuracies       ·         Text, title page, and references are consistent with APA format   ·         Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow	All elements present with 2 or less  inaccuracies     ·         Text, title page, and references are consistent with APA format   ·         Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow	All elements present with 3 inaccuracies       ·         Text, title page, and references are consistent with APA format   ·         Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow	All elements present with 4-5 inaccuracies       ·         Text, title page, and references are consistent with APA format   ·         Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow	All elements present with 6 or more errors   ·         Text, title page, and references are consistent with APA format   ·         Rules of grammar, spelling, word usage, and punctuation (standard English), logical flow
Format Subtotal				_____ of 25 points
Total Points					_____ of  225 points

 

 

 

 

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Quality of Healthcare

 The increased attention of any clinic is to improve quality care at a reduced cost. Ocracoke Regional Healthcare is not an exception in the journey toward improving care and reducing the overall cost of healthcare delivery (Elmontsri et al., 2018). One of the main goals of the Affordable Healthcare Act in the US is to reduce healthcare costs and increase the accessibility of healthcare delivery. Ocracoke Regional Healthcare would be joining other healthcare centers in rallying behind the goals of the ACA policy. The purpose of this assignment is to explore a new healthcare delivery system at Ocracoke Regional Healthcare that would be effective in reducing the overall cost of healthcare at the facility.

Overview of Issue

Ocracoke Regional Healthcare has realized that the current total patient care nursing model is no longer sustainable and needs to be changed. The increasing cost of healthcare at the facility is the main sign showing the current model is not effective in meeting the healthcare goals at the facility (Goes et al., 2020). While Ocracoke Regional Healthcare has been keen on reducing the cost of healthcare through its overall operation model, the objective has not been attainable because of the infective nursing model installed at the clinic.

National Patient Safety Goals identified

The first goal identified for this clinic is to reduce the risk of healthcare-associated infections and the second goal is to reduce the risk of patient harm resulting from the falls. These goals have been identified because the main issue that Ocracoke Regional Healthcare has been facing is increased cases of patient readmission rates and increased length of stay of patients at the institution (Goes et al., 2020). These issues are connected to the increased cost of healthcare. For instance, increased hospital stays would reflect the healthcare cost that patients would be spending on the additional days they stay at the facility. These are healthcare issues that the clinic would want to revolve around by changing the nursing model at Ocracoke Regional Healthcare.

The new model identified a functional nursing model for the solution of the current issues facing Ocracoke Regional Healthcare. In this model, healthcare staff is assigned to specific tasks or groups of patients to assume the overall direction of care. The main advantage of this model is that it incorporates the skills of primary nurses and UAPs in maximizing skills and delivering better healthcare outcomes (Fawcett, 2021). This model gives all nurses the responsibility of working within the assigned team to deliver the required healthcare needs. The model also improves sharing of knowledge, leading to offering the desired care to patients.

Final PICOT

At the Ocracoke Regional Healthcare System (P) will implement a functional nursing care delivery system(I), compared to the current total care nursing care delivery system (C), result is compliance with the Joint Commission’s recommendations(O) at their revisit in 6 months(T).

National Patient Safety Goals

The selected safety goals in this clinic are to reduce the risk of healthcare-associated infections and reduce the risk of patient harm resulting from falls. Healthcare-associated infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. The infections might also take place at the surgery sites called the surgical site infections (Asepty et al., 2022). The increase of these infections defines a poor health outcome that hospitals need to attend to. The increase in the HAI levels implies that the hygiene at the clinic is wanting, leading to increased cases of infections. Besides, the increase in HAI level also defines a high healthcare cost at the facility.

On the other hand, reduction of the patient harm resulting from falls is a goal that defines the improved quality of care. Patient falls increase injuries to a patient that further increase the amount of medication. Reducing patient falls would imply that a clinic has stringent measures that limit patients from facing fall injuries (Goes et al., 2020). Besides, the patient fall rate is a safety measure that would define the quality of healthcare delivery within a healthcare institution.

Low readmission rates and increased discharge summaries are outcome measures that would prove that the new model effectively raises the quality of healthcare at the institution. The reduction of these two rates would imply that Ocracoke Regional Healthcare offers improved quality and safe care to its patients, reducing the chances of readmission at the facility (Asepty et al., 2022). The increased discharge summaries also imply that more patients can recover from home, reducing their length of stay at the facility.

New Nursing Model

The functioning nursing model is one of the models applied in many successful health care organizations in the US. This model focus on unity in delivering health. The model advocates for increased information sharing and interrelationships among professionals (Schepel et al., 2019). The initial success within any healthcare institution starts from the coexistence of the employees. The functional model allows nurses to overlap their duties and save emergency healthcare situations.

This model would be imperative in addressing the identified safety goals at Ocracoke Regional Healthcare and directing the clinic towards reducing the current high healthcare cost. For instance, the sharing of nursing skills among professionals would limit Ocracoke Regional Healthcare from hiring additional nurses would come at an additional cost (Goes et al., 2020). The unity among healthcare professionals would be imperative in motivating each other toward reducing HAIs and reducing patient falls. While nurses would be rallying towards meeting the patient’s needs, they would have a joint force in driving quality care within the institution.

The model would be imperative in reducing the cost of healthcare for both patients and the institution. On patients, reducing the readmission rates and shorting hospital stays would reduce the cost of treatment (Fawcett, 2021). The model would advocate for the all-around skills nurses who can offer competent care to patients in the hospital. These skills would reduce the need for the clinic to hire other nurses while the existing nurses can meet the required healthcare needs without straining.

Conclusion

Ocracoke Regional Healthcare is currently facing an increased cost of healthcare caused by a non-functioning nurse model. The total care model is not effective in reducing the current healthcare cost at the facility. The new functional nursing model would be important in addressing the national safety goals (reducing the risk of healthcare-associated infections and reducing the risk of patient harm resulting from falls), which are also agents of healthcare cost reduction.

References

Asepty, M. R. P., Amirah, A., & Jamaluddin, J. (2022). The Effect of Healthcare Infection Control Application Committee in Patients Using Urine Cateters on Cost Containtment. Journal La Medihealtico, 3(2), 136-141. https://doi.org/10.37899/journallamedihealtico.v3i2.565

Elmontsri, M., Banarsee, R., & Majeed, A. (2018). Improving patient safety in developing countries–moving towards an integrated approach. JRSM open, 9(11), 2054270418786112. https://doi.org/10.1080/23288604.2018.1539058

Fawcett, J. (2021). More Thoughts About Models of Nursing Practice Delivery. Nursing Science Quarterly, 34(4), 458-461. https://doi.org/10.1177%2F08943184211031584

Goes, M., Lopes, M. J., Oliveira, H., Fonseca, C., & Marôco, J. (2020). A nursing care intervention model for elderly people to ascertain general profiles of functionality and self care needs. Scientific Reports, 10(1), 1-11. https://doi.org/10.1038/s41598-020-58596-1

Schepel, L., Aronpuro, K., Kvarnström, K., Holmström, A. R., Lehtonen, L., Lapatto-Reiniluoto, O., … & Airaksinen, M. (2019). Strategies for improving medication safety in hospitals: evolution of clinical pharmacy services. Research in Social and Administrative Pharmacy, 15(7), 873-882. https://doi.org/10.1016/j.sapharm.2019.02.004