Katrine Murray

Posted Date:

January 22, 2020 11:52 PM

Status:

Published

Using Evaluation Tools to Assess Quality Improvement Efforts

Quality improvement initiatives are a constant method utilized to address new knowledge and changes in practice and require an evaluation process to assess the effectiveness or challenges of a new intervention (Hickey & Brosnan, 2017). The balanced scorecard (BSC) is one of the most popular methods to evaluate and track organizational performance, including the consideration of linking both finance and quality outcomes (Sadeghi, Barzi, Mikhail, & Shabot, 2013). A BSC is part of the strategic plan, aligning the appropriate metrics that support a healthcare system’s mission and vision. Both the BSC and performance dashboards are evaluation tools utilized at my workplace, and the information reported is representative of multiple departments that contribute to the organizational goals for quality improvement. The BSC lists the institutional strategic goals and tracks progress while the performance dashboards includes the hospital-acquired conditions, including fall and infections, patient and staff satisfaction results, and length of stay, morbidity, and mortality. The finance department also reports out on budget and overtime data, which represents the cost-effectiveness of the patient care delivered across the health system.

My course project is focused on standardizing a process to address the central line-acquired bloodstream infection (CLABSI) rates across the five adult critical care intensive care units (ICUs). Due to the complex and high-acuity care provided in the ICU setting, patients often require expensive treatment modalities and excessive lengths of stay (LOS). In this situation, an ICU specific performance dashboard is particularly helpful with metrics that track mortality and morbidity, LOS, and a variety of infection types, including sepsis (Nouira et al., 2018). Hospital-acquired infection rates are also tracked and reported on the performance dashboard and provide the monthly CLABSI results for each unit, along with the Standard Infection Ratio (SIR), which measures the observed number versus the expected number of CLABSIs per 1,000 catheter days (CDC, 2019). The root cause analysis (RCA) is also reported on the performance dashboard, so you can review each incidence of CLABSI and what potential gaps in process or policy may have been missed. Compliance with the central line insertion bundle checklist is also reported and can be cross-referenced with the CLABSI rates. Other factors that could contribute to a CLABSI include the percentage of employees compliant with the hand hygiene policy and the number of patients receiving chlorhexidine gluconate (CHG) bathing treatments. The dashboards contribute to the health system’s strategic goal to become a zero harm organization and provide safe patient care and quality outcomes. They achieve this by trending data from the current or ongoing quality improvement initiatives, including my course project, to reduce CLABSI. Plus, provide a visual information tool for employees to review data and check progress in their home units or areas of responsibility. From here, successful projects can be shared with other units and more resources added to support these initiatives. In areas with below benchmark results, the dashboards help identify where to concentrate future efforts.

References

Centers for Disease Control and Prevention [CDC]. (2019). FAQs about HAI progress report. Retrieved from https://www.cdc.gov/hai/data/portal/FAQs-progress-…

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.

Nouira, H., Ben Abdelaziz, A., Kacem, M., Ben Sik Ali, H., Fekih Hassen, M., & Ben Abdelaziz, A. (2018). Which indicators used to assess quality performance in Intensive Care Units? A systematic review of medical literature. Anaesthesia, Critical Care & Pain Medicine, 37(6), 583–587.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

APA format, 2 references, discussion reply

Create an activity booklet that highlights language and literacy progression, shares developmentally appropriate lesson plans, and encourages parental involvement for English speaking children as well as English language learners.

Separate your booklet into four sections by age group—infant, toddler, preschool, and primary. Address the following in your booklet:

• Create a comprehensive list of the typical language and literacy milestones that occur in each age group. Be sure to include language, reading, and writing as appropriate.
• Include one developmentally appropriate language and literacy lesson plan for each age group. You may use the lesson plan template that you located or designed in Workshop 1. Lesson plans must include:
  • Topic
  • Lesson objectives
  • Grade level
  • Lesson steps
  • An activity with a parent or caregiver at-home extension
  • Assessment tool
  • Modifications/differentiation strategies for English language learners
• Include a rubric for the primary age lesson plan.
• Write a 175-word introduction to the booklet that answers the following questions:
  • What is the purpose of this booklet?
  • How can this booklet be used at home?
  • How might it support the various learning levels within a classroom?

Answer to this.

A 29-year-old female develops sepsis and, as a consequence, she experiences profound vasodilation.

a) What effect does vasodilation have on the afterload? Explain why.

b) What effect does vasodilation have on blood pressure? Explain why. How will her body try to bring her blood pressure back to homeostasis?

Be detailed in your explanation and support your answer with facts from your textbook, research, and articles from scholarly journals. In addition, remember to add references in APA format to your posts to avoid plagiarism.

Reply the peer’s comment

Afterload is the combined load of blood in the ventricle, end diastolic volume, and arterial resistance during ventricular contraction. Vasodilation is when the diameter of a blood vessel increases, therefore increasing the blood flow through the vessel. When blood flow is increased, then vascular resistance decreases as well. The dilation of arteries and arterioles causes a decrease in both arterial blood pressure and heart rate. It works to decrease the total peripheral resistance and blood pressure by relaxing the smooth muscle cells of large arteries and smaller arterioles. Increased afterload can cause elevated arterial blood pressure and loss of stretchability in the aorta. In order to keep a constant stroke volume once afterload increases, the ventricle must also increase it’s force of contraction. There are also baroreceptors within the blood vessels, which sends impulses to the cardiovascular center in order to regulate blood pressure. When blood pressure rises, the baroreceptors trigger the parasympathetic stimulation of the heart, causing cardiac output to fall. The sympathetic stimulation of the peripheral arterioles also falls, causing vasodilation. Together, this will allow blood pressure to go down.

References

Rice University (Ed.). (2013, March 6). Homeostatic Regulation of the Vascular System. Retrieved from https://opentextbc.ca/anatomyandphysiology/chapter/20-4-homeostatic-regulation-of-the-vascular-system/.

Siddiqui, A. (2011, December 20). Effects of Vasodilation and Arterial Resistance on Cardiac Output. Retrieved from https://www.omicsonline.org/effects-of-vasodilation-and-arterial-resistance-on-cardiac-output-2155-9880.1000170.php?aid=3452.

Discussion Board

The discussion assignment for this week includes a review of the Key Assignment Outline completed by one of your classmates, as well as a substantial response to at least 1 other student.

Primary Task Response: Your first task is to post your own Key Assignment Outline to the discussion area so that other students are able to review your plan. Attach your document to the main discussion post, and include any notes you feel are appropriate. The purpose of this assignment is to help improve the quality of the Key Assignment Draft you will complete next week.

400-600 words

Individual Project

For Company Alpha, draft a basic security plan that includes the security mission, recruitment procedures, training requirements, personnel deployment process, and physical security needs of the company. Your security plan must include the following points:

• What is the particular location you are providing security for (e.g., transportation facility, retail or commercial establishment, government or private building, education facility, health care service, and so on)?
• Identify the security objectives.
  • What is the purpose for a security system?
  • What are you protecting?
  • How do you plan to protect it (physical security, security officers, cameras, etc.)?
• What are the staffing needs?
  • Is this a 24-hour operation or partial daily or weekly coverage?
  • Determine the number of human resources necessary for this security operation.
  • Determine shifts, hours, regular days off, scheduling, and so forth.
• Define a hiring and selection process.
  • How will you develop and locate a pool of candidates, and what is the selection process to hire a qualified candidate?
• Develop a training plan for the new employees
  • How many hours of training are necessary, what are the topics in the curriculum, will there be on-the-job training (OJT), who are the mentors, who will conduct training and OJT, and so on?
  • APA format for references
  • 1,000–1,250 words

Purpose of Assignment

The purpose of this assignment is to provide a chance for the student to examine an existing organization and apply research to identify opportunities for strategic change.

Assignment Steps

Develop a 1,050-word essay to identify one global creative organization, as defined in Ch. 10 and 11 of Mastering Leadership.

Analyze the opportunities for strategic change that are evident, citing evidence.

Include considerations of culture and structure in addressing those opportunities.

Include the following:

• Identify one organization that could be considered creative, based on definitions in Mastering Leadership.
• Determine whether or not you believe the organization meets those criteria. Explain why.
• Discuss the impact of organizational culture and structure on that opportunity for strategic change.
• Formulate conclusions including personal learning on your analysis.

Format your assignment consistent with APA guidelines.

Use in-text citations, and reference all sources used.

TextBook

Mastering Leadership / An integrated Framework for Breakthrough Performance and Extraordinary Business Results

Authors: Robert J. Anderson and William A. Adams