Health Care

In your response posts, provide feedback to your peers regarding their analyses and either (a) describe how the models they selected might be implemented in your professional field, and/or (b) illustrate how the model could be improved for application in a different professional setting.

For this discussion:
response posts: 250-300 words each
References required: 1 for each post

———-post 1————Plan-Do-Study-Act (PDSA)

The Plan-Do-Study-Act (PDSA) is a continuous quality improvement (CQI) tool meant to assess whether or not a change that is implemented is successful (Agency for Healthcare Research and Quality, 2020). It is meant to be a quick, efficient process that tests a specific change and can be applied over and over again if needed (Sollecito & Johnson, 2013). It can be applied to a wide variety of situations and contexts (Sollecito & Johnson, 2013). Each instance the PDSA is applied is known as a cycle and may test just one area of a process that is being improved (Agency for Healthcare Research and Quality, 2020). The Model for Improvement is a broader version of PDSA that has been specifically used in healthcare and is broken down into an inquiry component and an activity component (Sollecito & Johnson, 2013). The inquiry component asks the following three questions:

What is the goal of the CQI process being implemented, or what are we trying to change?
How will we measure that the changes made resulted in an improvement?
What changes or ideas can be implemented that will result in the desired outcome (Sollecito & Johnson, 2013)?”
The activity component then uses the PDSA component to test the ideas implanted during the inquiry stage to see if they are successful (Sollecito & Johnson, 2013). See the attached word document for the specific PDSA worksheet.

Strengths

One of the primary strengths of the PDSA model is its ability to performed quickly. This allows for the learning that occurs with the model to be applied and used in the next cycle using a scientific method model (Reed & Card, 2016). The other strength of the PDSA method is that it allows the stakeholders who are mostly closely involved in process to implement changes, i.e. the healthcare workers themselves, to make and assess changes (Sollecito & Johnson, 2013).

Limitations

The biggest limitation of the PDSA method is that it cannot be used by itself to perform CQI, but needs to be incorporated into a broader process, such as the previously mentioned Model for Improvement. In other words, you can have a successful PDSA cycle, but that does not necessarily equate to process improvement. It may simply highlight an additional problem that needs to be resolved.

Application of Tool for Insurance Authorization Process Improvement

The PDSA cycle is an appropriate tool to use to improve the processes for obtaining insurance authorization in an outpatient physical therapy clinic. Current clinic processes are inefficient and often result in delays in patient care. The PDSA cycle is something that can be applied by the healthcare workers who are most familiar with current processes. It can be used to test small changes in the current process to see if the desired outcomes of improved process efficiency and patient access to care are met. The scope of the quality improvement process could also be broadened by using the Model for Improvement, which incorporates cycles of PDSA.

References

Agency for Healthcare Research and Quality. (2020, September). Plan-Do-Study-Act (PDSA) directions and examples. https://www.ahrq.gov/health-literacy/improve/precautions/tool2b.html (Links to an external site.)

Reed, J. E., & Card, A. J. (2016). The problem with Plan-Do-Study-Act cycles. BMJ quality & safety, 25(3),
147–152. https://doi.org/10.1136/bmjqs-2015-005076

Sollecito, W.A. & Johnson, J.K. (2013). Continuous quality improvement in healthcare. Jones & Bartlett
Learning. ———–
post 2————
M3 CQI Models Discussion

For Continuous Quality Improvement (CQI) to be more successful and organized, healthcare organizations adopt various models which act as a guide to achieving their goals. Organizations have the option to choose a model that best fits the problem. I like what Johnson and Sollecito (2018) said. The authors noted that even though organizations know the intervention they need to approach the problem, they will still need a scientific approach to ensure that it results in effective use.

The example I am using is improving the quality of care by reducing the increased rate of Healthcare Acquired Infections (HAIs). Hospitals should ask what model works best in addressing this problem. Kimble et al. (2017) mentioned that HAIs are due to a lack of adherence to guidelines and evidence-based practice. The authors also stated that addressing HAIs requires improving adherence to best practices and guidelines in care delivery (prevention), monitoring outbreaks (surveillance and monitoring), and reviewing and responding appropriately to information from the surveillance system (response).

Therefore, the Baldrige Quality Criteria is the model I think will be the best option for addressing the increasing rate of HAI. I chose this because it focuses on total organizational improvement and instituting a culture of CQI (National Learning Consortium [NLC], 2013). This model promotes the achievement of strategic goals by aligning resources and improving the communication in leadership, workforce, customers, and operations to achieve its results (NLC, 2013). Since HAIs are mainly caused when clinicians do not follow the appropriate guidelines like handwashing, thoroughly wiping down equipment, and many more, it needs a strategy that involves everyone. Because slowing or stopping the rate of infection in the healthcare environment takes the effort of everyone involved, from leadership to the patients and everyone in between, it makes sense to take a model that promotes a culture of safety. An environment that enforces the culture of safety will stand a better chance of improving the quality of care because everyone knows what they are expected to do and their role in breaking the chain of infection. As a result, everyone will be on the same page in adhering to evidence-based best practices.

Strengths and Weaknesses

One of the strengths of this model is that it gets everyone involved, not only a specific group of people, and requires leadership in the process. And as a result, the Baldrige Quality Criteria model has proven successful. For example, Baldrige Foundation (n.d.) stated that there is overwhelming evidence that Baldrige makes a significant, positive impact in providing quality health care. In addition, Schneck Medical Center has maintained rates of hospital-acquired infections at or below 1 percent since 2008, and no patient has acquired ventilator-associated pneumonia since 2009 (Baldrige Foundation, n.d.). However, one weakness NLC (2013) mentioned is that it focuses less on specific steps to achie

ANSWER

Discussion Post one

Reply

Continuous Quality improvement is essential in healthcare as it ensures quality standards are upheld by caregivers. CQI tools analyze whether a certain change in healthcare institutions and ways of operations are successful and suit the needs of both the patients and the caregivers. An essential tool for promoting CQI is the implementation of the Plan-Do-Study-Act (PDSA) model (Christoff, 2018). The PDSA model is both functional and helpful as it tests a change that has been implemented. The four steps create a cycle that helps in critically analyzing the change. It helps in evaluating the outcome, improving the change, and testing again whether it works to suit the organization or not. Through PDSA, a projected change is able to be planned in advance, and analyze the needed resources to facilitate the change. After planning, the change is implemented by applying the resources needed and integrating other staff about its essentials (Christoff, 2018). The study allows the change to be assessed on whether it works according to the originally intended plan. Finally, acting allows room to improve unforeseen loopholes and implement a well-oiled change that effectively suits the institution.

However, certain strengths and challenges are associated with PDSA while promoting CQI. For instance, PDSA ensures the change is planned, implemented, and amended quickly to suit the change in an organization. This is suitable in healthcare institutions that cannot shut down; hence change is implemented while caregiving is upheld. On the other hand, a major challenge of PDSA is that it does not necessarily assure the promotion of CQI. It has to be integrated with other tools that facilitate CQI to work effectively.

Discussion Post Two

Reply

I agree with your statement that healthcare organizations adopt various models that act as a guide in achieving their goals to promote Continuous Quality improvement. Reducing the rate of increased Healthcare Acquired Infections (HAI) in the hospital requires institutions to be vigilant and render quality healthcare services (Parast & Golmohammadi, 2019). The lack of adherence to guidelines and evidence-based practice associated with HAI is one of the leading problems that lead to the persistence of the issue. Change is therefore paramount if the rate of HAIs is to be reduced through surveillance, monitoring, and prevention. The use of Baldrige Quality Criteria is effective in introducing and attaining changes in the quality of services that help reduce HAIs. The Baldrige criteria rely on evidence-based practices that prove the application of quality healthcare approaches and how they worked in other institutions. Thus, the Baldrige Quality framework entails frameworks that help organizations reach their goals through improving their results and becoming more competitive.

The framework focuses on success and innovation, delivering value and results, agility and resilience, and visionary leadership, among other traits, to improve CQI. According to the framework, every model of change depends on the quality of leadership at hand. The Baldrige framework focuses on challenging leaders to improve their teams while transitioning and implementing change. This is a key strength as the staff and leadership work in cohesion in a step-by-step framework to improve the quality of care in an institution. In addition, the framework also promotes CQI by enhancing diversity, equity, and inclusion. This gives room for views from different perspectives about the change and what areas need improvement to make the change a success, thus reducing cases of HAIs.

References

Christoff, P. (2018). Running PDSA cycles. Current problems in pediatric and adolescent health care, 48(8), 198-201.

Parast, M. M., & Golmohammadi, D. (2019). Quality management in healthcare organizations: empirical evidence from the Baldrige data. International Journal of Production Economics, 216, 133-144.