Student Name
Capella University
NURS-FPX 6016 Quality Improvement of Interprofessional Care
Prof. Name
Date
Data Analysis and Quality Improvement Initiative Proposal
Slide 1: Hello everyone. I am __________, your quality assurance analyst at St. Anthony Medical Center (SAMC). Thank you for joining me today as we explore the critical role of quality improvement in hospice care.
Slide 2: At hospice, we provide essential care to patients and families as they approach the end of life. However, some form of active quality improvement is relevant for adoption to sustain and improve the quality of care. This presentation will primarily be based on Quality Improvement (QI) regarding patients and families receiving hospice care. In this paper, based on data obtained from the St. Anthony Medical Center (SAMC) dashboard, the current issues will be described, satisfaction measures will be discussed, and best practices for improvement will be recommended. The agenda offers general information regarding important QI principles, data analysis, and useful tips that will allow hospice services to comfort the sick and offer dignity and peace.
Dashboard Data Analysis
Slide 3: Hospice care focuses on providing comfort, dignity, and holistic support to patients and their families during the final stages of life. It is a crucial time as there is no treatment for the disease but support in the form of physical and psychological aspects. Patients prefer having their last days be less complicated, spending time with their loved ones without burdening them. Most Americans strongly desire end-of-life care that prioritizes respect, clear communication, timely assistance, and effective symptom management (Bhatnagar et al., 2023). According to the AHRQ benchmarks referenced in the Vila Health data dashboard, these priorities are essential quality measures in hospice care because they promote patient-centeredness.
Consistent and sporadic care quality is evident from Vila Health’s hospice metrics from 2020-2021. Dignity and respect gained 2% percent and were found at par with national scores; however, further breakdown of facilitators is required at 78% and 80%, respectively. Tackling of symptoms also showed slight improvement from 65 percent to 68 percent, showing that efforts were still lagging benchmark levels. Yet, the rating dropped from 78 to 75% concerning communication with caregivers and from 70 to 68% regarding timely help, which points to problems such as potential patient discomfort and dissatisfaction with the essential score scores for passing the accreditation.
To address these, there is a need for better quality qualitative analysis and process evaluation to improve the results and achieve the target. Moreover, concerns arising from these gaps pertain to communication and care quality because the interview links reduced communication with caregivers due to staff shortages, inconsistent communication standards, and timely help due to late referrals, high patient load, and inadequate resources. There is a need to cut down on time, integrate systems for tracking response times, and assess the schedules used in staffing.
Quality Improvement Initiative Proposal
Slide 4: An exploratory study on data from St. Anthony Medical Center (SAMC) suggests that problems with hospice care lower patient and family satisfaction. Such issues include reduced communication with caregivers and delays in seeking timely help, borne out by the downward performance indicators on dashboards. These areas of concern were identified to show room for growth to satisfy accreditation requirements and patient expectations.
The proposed Quality Improvement (QI) initiative model is the PDSA (Plan, Do, Study, and Act) cycle. For the planning phase, the initiative focuses on addressing two key areas of concern: interaction with the caregivers to make care patient-centered and quick intervention in the case of patients’ needs. A study by Jeong and Han (2023) highlights that the subjectivity of the nurses’ perceptions regarding end-of-life discussions shapes how they communicate with patients. Regarding communication with caregivers, the Do stage of the initiative is to establish a system for periodically checking how good the communication is and which obstacles are present through a feedback mechanism.
NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal
It also includes offering hospice personnel training on listening actively and considering the emotions of the people they communicate with. Research data regarding the staff’s communication skills with the patients points towards caregiver satisfaction, which benefits from staff training in active listening. besides, they are likely to minimize misunderstandings, thereby providing better care (Drossman et al., 2021).
To enhance timely assistance to the patients, the initiative recommends incorporating a response time tracking system for the timely identification of and response to the patient’s needs. Some works have established that identifying responses and other measures can help cut back on wait time and enhance patients’ satisfaction, which is part of the Study phase of the initiative. For instance, evidence from Mayahara and Fogg (2020) shows that hospice care is a 24/7 service, and knowing the type of calls received, and their frequency can help promptly address concerns via support on-call or setting up an appointment as soon as possible. In this way, SAMC can act upon the data, improve patient referrals, and adapt staffing levels to patient needs to improve the time patients’ needs can be met.
Knowledge Gaps and Areas of Uncertainties
Slide 5: The following are the key gaps of knowledge and uncertainties that need to be considered when trying to enhance quality improvement at SAMC. Although the dashboard provides quantitative data to support the analysis, qualitative assessment with caregivers and patients is needed to identify more definite constraints to effective communication. For instance, understanding the patients regarding Hospice care, their cultural or religious beliefs, and accessibility issues (Ko et al., 2020). More research is required to pinpoint specific training deficiencies with staff, for example, in communication and time response, and work towards creating enhanced training programs based on the reasons for the staff’s unwillingness. Further, assessing the existing systems to evaluate and monitor patients’ needs and responses to these is fundamental to identifying inadequacies and delays in service provision.
Interprofessional Perspectives on Various Factors
Slide 6: Interprofessional practice is essential to manage improvements in patient safety, cost containment, and work-life satisfaction. In this case, coordinated duties must be established for the nursing staff, hospice social workers, physicians, quality improvement personnel, and administrative staff. Registered nurses and nurse practitioners will be responsible for ensuring that care is implemented and responding to problems noted by the patient. They will also participate in health communication training to help improve their communication with consumers and caregivers.
Hospice social workers will assist with coordinating care teams and families and address Psychosocial issues that may impact care delivery in this health facility (Burokas et al., 2022). Their participation in scheduling caregivers’ calls and feedback on the quality of communication and service satisfaction will be useful. Hospital physicians will take charge of clinical affairs, including the referral mechanisms and timeframes, to fashion out the best approaches and mechanisms to enhance timely and efficient treatments.
NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal
Actual tracking of quality improvement and evaluation against the benchmark established by AHRQ will be conducted by the quality improvement specialists, who will also identify gaps that need to be addressed. Care communication is vital in nursing in order to monitor and regularly improve the interactions between staff and caregivers and patient care. The administrative and scheduling staff will ensure staffing schedules coincide with patients’ needs, reducing delays and providing quick responses.
They will, for instance, minimize and balance shifts in the best manner that would allow them to meet both the caregiver visits and timely intercession, usually in the evenings and weekends (Mayahara & Fogg, 2020). The premise of success for this scheme is anchored by the belief that better communication, staffing, and feature coordination will lead to improved patient experiences, more satisfied hospice caregivers, and better work-life quality for hospice personnel (Wermuth & Tadi, 2022).
Assumptions
Slide 7: The following is a list of assumptions for the proposed quality improvement initiative. First, it had been hypothesized that increased interactions between the hospice staff and caregiver will lead to increased caregiver satisfaction levels and, thus, improved patient care (Hoff et al., 2023). Second, the initiative assumes that any variance in service delivery will be greatly reduced if not eradicated by clear communication structures, resulting in the alignment of all team members in their communication with patients and families.
Third, it is assumed that improving the processes of patients’ referrals and adjusting the working hours based on the number of patients will decrease the time necessary to deliver appropriate interventions and meet patients’ preferences regarding comfort (Mayahara & Fogg, 2020). Last but not least, it is hypothesized that the resources and support needed to facilitate the implementation of training programs, system adoption, and workflow changes would be available and, in turn, increase patient safety, staff’s quality work-life, and organizational efficiency of hospice care.
Collaboration Strategies to Promote Quality Improvement
Slide 8: Some of the important strategies to promote patient-centered care for Hospice patients include collaboration among the team members and patients. This will allow them to keep in touch about patient care standards and also help reduce late responses due to unawareness on the part of the patients, their families, or the hospice staff at SMAC.
- Interdisciplinary Team Meetings: Monthly multidisciplinary case conferences/teleconferences attended by hospice care professionals, including physicians, RNs, social workers, and chaplains, will permit optimum discussion of the care needs of the target patient population and identification of potential areas for improvement (Burokas et al., 2022). This means that before a decision is made regarding the patient, all views are considered, and this can be done through video conference meetings such as Zoom or Microsoft Teams.
- Caregiver Involvement: Communication tools such as follow-up and feedback will give caregivers a favorable feeling about the care delivery process (Drossman et al., 2021). The tools for active engagement may be WhatsApp or an email to collect updates and feedback from patients and their families. This smoothes out team dynamics, improving caregivers’ work and patient satisfaction.
NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal
- Joint Training Programs: Organization of seminars for the members of staff from various fields such as nursing, pharmacy, medical or physical therapy, nutrition, occupational therapy, speech and language regarding the aspects of active hearing, compassion, and conversant will enhance the quality of care and mutual communication (Mueller et al., 2021). It will also train the staff on communicating verbally and written using communication means such as SBAR (Situation, Background, Assessment, Recommendation), which is proven to be an effective approach while transitioning from one staff member to another (Pinto et al., 2024).
- Clear Communication Channels: These protocols will replace guilty-until-proven-innocent assumptions, and the CUS (Concerned, Uncomfortable, Safety) model will enable staff members to raise issues when patients’ safety or communication deteriorates. It will assist in fixing problems as they arise and raise the chances of creating a safer care environment at higher levels (McCoy et al., 2020).
Assumptions
Slide 9: The following assumptions have been made when implementing the proposed strategies. Cross-coverage collaboration is expected to improve care outcomes based on several healthcare professionals’ input. Moreover, it is purposefully assumed that such caregivers can benefit from the care processes with enhanced communication and support anchored in the proposed approach.
Integrated orientation, with the participation of CUS and SBAR communication models during training, should enhance interdisciplinary communication within a team and might assist in detecting desires or wants that may become a problem early (McCoy et al., 2020; Pinto et al., 2024). Adopting integrated technology platforms can also improve inter-organizational communication efficiency and coordination. Last of all, it is presupposed that the team members will have the appropriate available resources to enact these strategies; the commitment to constantly advancing the quality of the provided care is to remain unswerving.
Conclusion
In conclusion, the key takeaways from today’s presentation emphasized the importance of addressing communication gaps, improving response times, and fostering collaboration within the hospice care team. By implementing the proposed Quality Improvement initiative, which includes targeted staff training, caregiver involvement, and enhanced use of technology, we can significantly enhance patient care, improve caregiver satisfaction, and create a more supportive work-life environment for our staff. These efforts, underpinned by clear communication models like CUS and SBAR, will ultimately help SAMC achieve its quality improvement goals and provide dignified, compassionate care to our patients and their families. Thank you for your attention, and I look forward to discussing any questions or feedback you may have.
References
Bhatnagar, M., Kempfer, L. A., & Lagnese, K. R. (2023). Hospice care. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/sites/books/NBK537296/
Burokas, S., Parker, S., & Sirard, C. (2022). Improving end-of-life care for nursing home residents using an interprofessional approach. Journal of Hospice & Palliative Nursing, 26(1), 10.1097/NJH.0000000000000991. https://doi.org/10.1097/NJH.0000000000000991
Drossman, D. A., Chang, L., Deutsch, J. K., Ford, A. C., Halpert, A., Kroenke, K., Nurko, S., Ruddy, J., Snyder, J., & Sperber, A. (2021). A review of the evidence and recommendations on communication skills and the patient–provider relationship: A Rome foundation working team report. Gastroenterology, 161(5), 1670–1688. https://doi.org/10.1053/j.gastro.2021.07.037
NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal
Hoff, T., Trovato, K., & Kitsakos, A. (2023). Hospice satisfaction among patients, family, and caregivers: A systematic review of the literature. American Journal of Hospice and Palliative Medicine, 41(6). https://doi.org/10.1177/10499091231190778
Jeong, E., & Han, A. Y. (2023). Nurses’ subjectivity in patient-centered communication for end-of-life patients. Journal of Hospice & Palliative Nursing, 25(6). https://doi.org/10.1097/njh.0000000000000987
Ko, E., Fuentes, D., Carlson, S. S., & Haiem, F. N. (2020). Challenges and facilitators of hospice decision-making: a retrospective review of family caregivers of home hospice patients in a rural US–Mexico border region—a qualitative study. BMJ Open, 10(7), e035634. https://doi.org/10.1136/bmjopen-2019-035634
Mayahara, M., & Fogg, L. (2020). Examination and analysis of after-hours calls in hospice. American Journal of Hospice and Palliative Medicine®, 37(5), 324–328. https://doi.org/10.1177/1049909119900377
NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initative Proposal
McCoy, L., Lewis, J. H., Simon, H., Sackett, D., Dajani, T., Morgan, C., & Hunt, A. (2020). Learning to speak up for patient safety: interprofessional scenarios for training future healthcare professionals. Journal of Medical Education and Curricular Development, 7(1). https://doi.org/10.1177/2382120520935469
Mueller, E., Arthur, P., Ivy, M., Pryor, L., Armstead, A., & Li, C.-Y. (2021). Addressing the gap: Occupational therapy in hospice care. Occupational Therapy in Health Care, 35(2), 1–13. https://doi.org/10.1080/07380577.2021.1879410
Pinto, F., Roberto, P., Ferrario, L., Marotta, L., Montani, D., Auletta, G., Zoppini, L., & Foglia, E. (2024). Using “Situation‐Background‐Assessment‐Recommendation” method in palliative care to enhance handover quality and nursing practice: A mix method study. Journal of Clinical Nursing, 34(1). https://doi.org/10.1111/jocn.17537
Wermuth, H. R., & Tadi, P. (2022). Hospice Benefits. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554501/