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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THIS IS A 2 PART ASSIGNMENT. THE ORGANIZATION THAT I NEED THIS TO BE ON IS : Regional One Health, located in Memphis, TN. The quality improvement issue is RN/nurse Retention.

Project: Promoting Health Care

Section 3: Quality Measurement and Assessment

This week you continue working on Section 3 of your Course Project, which was introduced in Week 6. Through your work in previous weeks of this course, you have likely gained critical insights into the organization that serves as the focus for your quality improvement plan. Integrating this knowledge of the organization into your plan for addressing a quality improvement issue is essential for successfully facilitating change.

As you deepen your analysis of your selected organization, consider how the information presented in this week’s Learning Resources relates to strategic priorities as well as to the uniquely collaborative and competitive dynamic that binds organizations in health care.

To prepare:

• Think about the quality improvement issue that you are addressing and the associated plan that you are developing. Consider the following:
  • What is the overall purpose, or aim, of doing this work?
  • What would you hope to achieve for the organization by undertaking this project? What are the objectives of this initiative?
  • What value would this work add to the organization?
  • How would this work improve practice and create outcomes with impact?
• Review Chapter 7 of the Sadeghi, Barzi, Mikhail, and Shabot course text. Consider how addressing this quality improvement issue would align with the organization’s mission, vision, values, and strategic goals and objectives. How does it relate to regulatory issues, and other matters that are significant for the organization? If you notice a misalignment, use this as an opportunity to refine your focus.
• With this in mind, continue to hone your development of this Assignment, integrating the concepts addressed here into Section 3.

To complete:

Write a 3- to 5-page paper that includes:

• An introduction to your quality improvement plan, including the overarching aim of this initiative and an explanation of how it aligns with the mission, vision, values, and strategic goals and objectives of the organization, as well as regulatory issues and other matters that are significant for the organization
• An overview of the current situation with regard to this quality improvement issue in the organization
• A description of measures and indicators
• A presentation on data related to this issue, including:
  • Actual historical and current data and/or a description of the methods that you would use to collect and analyze the data
  • Methods for collecting and analyzing data in the future, including when you would do this
• A description of realistic, evidence-based targets

Be sure to cite evidence from the literature to justify your selection of the measures and indicators, as well as the performance targets. This section of the Course Project serves as the Portfolio Assignment for this course.

Due by Day 7 of Week 8.

Section 4: Quality Improvement Strategies

Through your work on Section 3 of the Course Project, you have examined the gap between current performance and evidence-based targets and considered how addressing this gap relates to organizational priorities and large-scale aims for quality improvement.

In this section of the Course Project, you begin to think about quality improvement strategies that could help to bridge this gap. As noted in the Sadeghi, Barzi, Mikhail, and Shabot text, this is referred to as performance-driven planning.

Since the publication of the Institute of Medicine’s report “Crossing the Quality Chasm,” a good deal of attention has been paid to the need to examine processes that contribute to outcomes (Ernst, Wooldridge, Conway, Dressman, Weiland, Tucker, and Seid). As the USAID has noted, interventions “will not create the desired outcome to improve the quality of care unless the overall process of care delivery is also improved.” Therefore, attention to process redesign is a central aspect of cultivating strategies for improvement.

To prepare:

• Refer to the modified Donabedian model (access, structure, process, outcome, and patient experience) presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text.
• Recall the performance targets that you identified for Section 3 (in Week 6). What does the recommendation that performance-driven planning should “begin with the end in mind” suggest given your established goals?
• Review the information presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text, and think about how you would assess the organization’s strengths and weaknesses related to the performance gaps you identified in Section 3 (Week 6).
• Based on the above, start to think of specific evidence-based strategies that could be implemented to close/minimize the performance gaps you have identified. Consider both interventions (what) and processes (how). Focus on strategies that are supported by the latest research and could create systems-level change. These may be tentative for now, but be sure to identify at least one that specifically lends itself to a change in process (i.e., practice, protocol, pathway, activity).

Additional instructions for Section 4 are presented next week. To complete this Assignment, you will create a process map and write a paper describing quality improvement strategies. This Assignment is due by Day 7 of Week 8.

PART 2 OF THIS ASSIGNMENT:

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Ask a probing question, substantiated with additional background information or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Validate an idea with your own experience and additional resources.

Submission and Grading Information

Grading Criteria

To access your rubric:
Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:
Week 8 Discussion

Project 1: Promoting Health Care Quality

Section 3: Quality Measurement and Assessment

By Day 7

Review the complete Assignment description presented in Weeks 6 and 7. Submit Section 3.

Submission and Grading Information

To submit your completed Project for review and grading, do the following:

• Please save your Project using the naming convention “WK8Proj1+last name+first initial.(extension)” as the name.
• Click the Week 8 Project Rubric to review the Grading Criteria for the Project.
• Click the Week 8 Project link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Proj+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:
Week 8 Project 1 Rubric

Check Your Project Draft for Authenticity

To check your Assignment draft for authenticity:
Submit your Week 8 Project 1 draft and review the originality report.

Submit Your Project by Day 7

To submit your Project:
Week 8 Project 1

Project 2: Promoting Health Care Quality

Section 4: Quality Improvement Strategies

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

• Review the instructions provided in the Learning Resources for creating a process map.
• With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.
• Create a process map using Microsoft Word or PowerPoint.
• Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

• Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.
• Finalize your process map, which will be submitted along with the paper.

By Day 7

Submit your paper and process map.

Submission and Grading Information

To submit your completed Project for review and grading, do the following:

• Please save your Project using the naming convention “WK8Proj2+last name+first initial.(extension)” as the name.
• Click the Week 8 Project Rubric to review the Grading Criteria for the Project.
• Click the Week 8 Project link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Proj+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:
Week 8 Project 2 Rubric

 

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Section 3: Quality Measurement and Assessment

Pneumonia 30 day readmission is the quality improvement issue

Think about the quality improvement issue that you are addressing and the associated plan that you are developing. Consider the following:

· What is the overall purpose, or aim, of doing this work?

· What would you hope to achieve for the organization by undertaking this project? What are the objectives of this initiative?

· What value would this work add to the organization?

· How would this work improve practice and create outcomes with impact?

Consider how addressing this quality improvement issue would align with the organization’s mission, vision, values, and strategic goals and objectives. How does it relate to regulatory issues, and other matters that are significant for the organization? If you notice a misalignment, use this as an opportunity to refine your focus.

With this in mind, continue to hone your development of this Assignment, integrating the concepts addressed here into Section 3.

To complete:

Write a 3- to 5-page paper that includes:

· An introduction to your quality improvement plan, including the overarching aim of this initiative and an explanation of how it aligns with the mission, vision, values, and strategic goals and objectives of the organization, as well as regulatory issues and other matters that are significant for the organization

· An overview of the current situation with regard to this quality improvement issue in the organization

· A description of measures and indicators

· A presentation on data related to this issue, including:

· Actual historical and current data and/or a description of the methods that you would use to collect and analyze the data

· Methods for collecting and analyzing data in the future, including when you would do this

· A description of realistic, evidence-based targets

Be sure to cite evidence from the literature to justify your selection of the measures and indicators, as well as the performance targets. 

Section 4: Quality Improvement Strategies

Through your work on Section 3 of the Course Project, you have examined the gap between current performance and evidence-based targets and considered how addressing this gap relates to organizational priorities and large-scale aims for quality improvement.

In this section of the Course Project, you begin to think about quality improvement strategies that could help to bridge this gap. As noted in the Sadeghi, Barzi, Mikhail, and Shabot text, this is referred to as performance-driven planning.

Since the publication of the Institute of Medicine’s report “Crossing the Quality Chasm,” a good deal of attention has been paid to the need to examine processes that contribute to outcomes (Ernst, Wooldridge, Conway, Dressman, Weiland, Tucker, and Seid). As the USAID has noted, interventions “will not create the desired outcome to improve the quality of care unless the overall process of care delivery is also improved.” Therefore, attention to process redesign is a central aspect of cultivating strategies for improvement.

To prepare:

· Refer to the modified Donabedian model (access, structure, process, outcome, and patient experience) presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text.

· Recall the performance targets that you identified for Section 3 (in Week 6). What does the recommendation that performance-driven planning should “begin with the end in mind” suggest given your established goals?

· Review the information presented in Chapter 9 of the Sadeghi, Barzi, Mikhail, and Shabot text, and think about how you would assess the organization’s strengths and weaknesses related to the performance gaps you identified in Section 3 (Week 6).

· Based on the above, start to think of specific evidence-based strategies that could be implemented to close/minimize the performance gaps you have identified. Consider both interventions (what) and processes (how). Focus on strategies that are supported by the latest research and could create systems-level change. These may be tentative for now, but be sure to identify at least one that specifically lends itself to a change in process (i.e., practice, protocol, pathway, activity).

Throughout this course you have been considering the relationship between structure, process, and outcomes as it relates to health care quality. Looking at outcomes, alone, may not tell the “whole story.” For instance, if you are concerned with improving fall rates, evaluating the process—related activities or practices—can help you identify factors that contribute to outcomes and develop strategies for improving them.

For this section of your Course Project, you create a process map to examine a current process related to your quality improvement issue. You will use the results of the process mapping to redesign a process to help minimize or close the performance gap(s). As you proceed, keep in mind the importance of maintaining a patient-centered focus so the patient experience is not negatively affected by any changes in process.

To prepare:

· Review the instructions provided in the Learning Resources for creating a process map.

· With your quality improvement issue in mind, as well as the other work you have completed on your Course Project thus far, think about how creating a process map could help you to better understand your quality improvement issue and redesign an associated process.

· Create a process map using Microsoft Word or PowerPoint.

· Refine the strategies for promoting systems-level change to minimize or close the performance gap(s) that you began to think about in Week 7. As part of this, identify a way to redesign at least one process based on your analysis of the process map that you have created.

To complete:

· Write a 2- to 3-page paper in which you describe quality improvement strategies that you selected related to your quality improvement issue.

· Finalize your process map, which will be submitted along with the paper.

Process map help

https://www.isixsigma.com/tools-templates/process-mapping/practical-guide-creating-better-looking-process-maps/

Provides detailed description of how to create a process map

http://www.miltonkeynesccg.nhs.uk/resources/uploads/files/NHS%20III%20Handbook%20serviceimprove.pdf

 

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 A 42-year-old African American female is in the clinic for a routine gynecologic exam. When asked, she admits to noticing bleeding in between her menstrual periods for the past several months. She has been pregnant three times and has three children. She is sexually active with one male sex partner in a monogamous relationship. During her bi-manual exam, you note an irregular intrauterine non-tender mass about 4 cm in diameter. The mass is palpable abdomenally. The remainder of her gynecologic exam was normal. 

 Post an explanation of the differential diagnosis for the patient in the case study you selected. Provide a minimum of three possible diagnoses and list them from highest priority to lowest priority. Explain which is the most likely diagnosis for the patient and why. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder. 

 

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  think about common screenings for women. Explain how screenings differ for younger women and older women, and explain the implications of these differences. 

 

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