In this course, you develop a comprehensive Course Project: Promoting Health Care

Quality. To initiate this project, this week you examine the systems and structures of an

organization with which you are familiar.

Organizational Systems and Structures, Part 1

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an

inclination to focus on a specific event rather than to examine the larger context

surrounding it. Analyzing the systems and structures within an organization provides a

foundation for generating a fuller understanding of how and why the event occurred and

for developing strategies to address the underlying issues. Perhaps more importantly,

such an analysis can be used to proactively identify potential challenges and improve

organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a

health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be

able to sufficiently analyze to complete the full scope of the Course Project. (Refer to

the Course Project Overview as needed.)

Select two or more of the following frameworks:

· Learning organizations

· Complex adaptive systems (CAS)

· Clinical microsystems

· Good to great

· The 5 Ps

With these frameworks in mind, analyze the systems and structures of the

organization. Be sure to research and consider:

· Mission, vision, and values

· Strategic plan, goals, and objectives, if possible

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

Week 4: Organizational Systems and Structures, Part 2

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay

attention to culture. Organizational culture provides the context in which all interactions

and processes occur and is therefore central to any effort to enact change.

To prepare:

Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of

the Course Project).

Continue to analyze essential elements of organizational culture and evaluate the

influence of culture on the ability to achieve goals within your selected organization.

To complete:

Write a 3- to 5-page paper in which you:

· Provide a description of the organization that you selected

· Present your analysis of the organization with attention to:

· Its mission, vision, values

· Strategic plan, goals, and objectives

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

· The essential elements of the organization’s culture

· The influence of culture on meeting organizational goals

Section 2: Quality Improvement Issue

To help you move forward with your Course Project, this week you identify a quality

issue that you would like to address and submit a description of this issue for Instructor

feedback.

Your proposed issue should reflect a genuine need for improvement within your

selected health care organization. Through your Course Project, you will analyze this 

issue and propose strategies to improve outcome(s), including the redesign of a related

process.

To prepare:

· Review the six quality improvement aims from the Institute of Medicine (IOM)

· Safe: Avoiding harm to patients from the care that is intended to help them.

· Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

· Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

· Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

· Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

· Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

· Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement.

· Consider what you have surmised thus far through your analysis of the organization

that you selected. What have you noticed that could help you identify a quality related need for improvement? For instance:

· What has captured your attention in meetings, reports, and/or daily activities?

· Have you noticed discrepancies between activities in the organization and

recommendations in the research literature, quality standards, and/or the

organization’s stated policies and procedures?

· If so, what do you think could be the reason(s) for variations or gaps between

what you have observed and what is recommended?

Identify a quality improvement issue that you would like to investigate for this project.

Note: Review the Course Project Overview/full instructions, located in the Week 3

Learning Resources, as needed to identify a quality improvement issue that is viable for

completing the full scope of this project. Once you receive a response from your

Instructor on the quality improvement issue that you submit, be sure to integrate his or

her feedback before moving forward with Section 3 of your Course Project.

To complete:

Write a brief description of the quality improvement issue that you would like to address

for your Course Project.

 

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This is the second part to the first question I posted. ( Below is the information for the proposed change)

      

Creating a balanced scorecard for the new stroke nurse position is critical. The balanced scorecard will track improvements to the quality of patient outcomes and financial outcomes (Jeffs, Merkley, Richardson, Eli, & McAllister, 2011). With the balanced scorecard allows for leadership to see where and how to grow the new stroke nurse position. 

Collecting data is how you can justify if the new change is working “Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives,” 2014). Data collection is mandated by the joint commission to maintain comprehensive stroke certification. The stroke nurse will collect and monitor patients progress during admission and give follow-up calls around up to 90 days after discharge from the hospital. This will allow for leadership to see an improvement in the outcome of stroke patients. After six months the collected data from before stroke nurse and after stroke nurse can be compared. The hospital is expected to have an increase in a stroke patient with the new comprehensive stroke certification. This will create an increase in revenue which will help offset the cost of the stroke nurse program. 

References

Create a Balanced Scorecard of Robust Measures, Meaningful Targets, and Strategic Initiatives. (2014). Balanced Scorecard Evolution, 221-267. doi:10.1002/9781118915011.ch6

Jeffs, L., Merkley, J., Richardson, S., Eli, J., & McAllister, M. (2011). Using a nursing balanced scorecard approach to measure and optimize nursing performance. Nursing Leadership, 24(1), 47-58. doi:10.12927/cjnl.2011.22334

Section 4: Budgeting and Timeline Tools

As you have been examining this week, budgeting and timeline tools are vital for determining necessary resources and planning for a proposed change. For your Course Project, you use these types of tools to assess resources that may be required for the successful implementation of your strategic plan.

To prepare:

• Review the information on budgeting in this week’s Learning Resources. Which tools (e.g., Revenue Projection Model, Capital Budgeting Analysis, Depreciation Calculator, Profit and Loss Projection) would be most useful for developing your strategic plan? 
• Use one or more budgeting tools to outline the financial resources for your proposed change. Reflect on any challenges that arise as you evaluate the financial resources required for this change now and in the future.
• Review the information on PERT and other timeline tools in this week’s Learning Resources, including Dr. Huston’s presentation in the media program.
• Use PERT or another tool to analyze and represent the activities that need to be completed to successfully plan and implement your proposed change. Be sure to note dependencies (e.g., a task/milestone that must be completed in order to trigger the next step) and realistically assess the minimum time needed to complete the entire project.  

To complete:

• Outline the financial resources for your proposed change. Describe the budgeting tool(s) you used to arrive at these determinations. Explain what challenges, if any, you encountered through the budgeting process. Provide documentation (e.g., Excel worksheets) to support your analysis.
• Outline the timeline for the implementation of your proposed change using PERT or another timeline tool. Consider how your timeline can allow leeway for variance.

By Day 7

Submit:

• Section 3: Balanced Scorecard
• Section 4: Budgeting and Timeline Tools (which includes an outline of financial resources and a timeline)

 

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 Case Study #5 NURS 6541: Trina is a 9-year-old female who weighs 110 pounds. Vital signs are as follows: BP 122/79, P 98, R 20. Her mother reports she is a picky eater and refuses to eat fruits and vegetables. Her physical activity includes soccer practice for 1 hour a week with one game each weekend from September through November. Family history is negative for myocardial infarction, but both parents take medication for dyslipidemia. 

 Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the respiratory, cardiovascular, and/or genetic disorder. 

Due: 7/9/18 at 6am

 

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Select a patient that you examined during the last three weeks. With this patient in mind, address the following in a SOAP Note:

• Subjective: What details did the patient provide regarding her personal and medical history?
• Objective: What observations did you make during the physical assessment?
• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
• Reflection notes: What would you do differently in a similar patient evaluation?

 

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Assignment 1: Application – Best Practices

For over 20 years, the Women’s Health Initiative (WHI) study has conducted research trials to examine factors that impact risks and development of conditions that impact women such as heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. Health care providers use results from these trials to develop guidelines for delivering care to patients. In your role in clinical settings, you must be familiar with these guidelines, and you must be aware that through clinical practice, guidelines frequently evolve and change. Often, what is considered a best practice today might not be a best practice in the future. For this Assignment, you compare guidelines outlined in the WHI study to current best practices for assessing and managing conditions.

By Day 7 of Week 11

To Prepare:

• Review the Women’s Health Initiative website in this week’s Learning Resources. Select one disorder presented in this study.
• Locate a research article focused on women’s health issue that you have learned about on the Women’s Health Initiative project. Be sure that the research article you select is from a reputable source.
• Discuss the best practices presented in the article about the health issue. Explain if there are any differences in the literature about best practices about health issue.
• Explain whether you think the current best practices in the article you selected should be used in clinical practice. Support your position with evidence-based research.

To Complete:

Write a 2- to 3-page paper that addresses the following:

• Describe the disorder you selected from the Women’s Health Initiative study.
• Explain the current best practices for assessing and managing this disorder as suggested in the research article you selected.
• Compare the best practices presented in the WHI study to the current best practices presented in the article. Explain how the differences in best practices might impact women’s health.
• Explain whether you think the current best practices in the article you selected should be used in clinical practice. Support your position with evidence-based research.

 

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