Identify a quality improvement opportunity in case management

Describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice”

Provide an overview of the problem and the setting in which the problem or issue occurs.

Explain why a quality improvement initiative is needed in this area and the expected outcome.

Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.

Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.

Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded

USE APA 7th
May use
https://www.americannursetoday.com/quality-improvement-research/
https://www.ncbi.nlm.nih.gov/books/NBK2682/

ANY ARTICLE USE NO LESS < 5 YEARS and must be obtainable.
No reference straight quotes on paraphrase with correct citation

ANSWER

Reduction of Medical Errors

Studies have shown that up to 70% of the medical errors related to the lab do occur before the analysis; many patients have fallen victim to misdiagnosis and getting wrong treatments due to medical errors. The subject errors have various root causes; for instance, some common causes include inadequate information, poor communication, organizational knowledge flow, patient-related issues, staffing patterns and workflow, inadequate policies, and technical failures. Types of medical errors include errors related to anesthesia, hospital-acquired infections, avoidable delay in treatment, failure to take recommended precautions, medication errors, missed/delayed treatment, and technical errors. These errors can be solved by applying ‘The Road to Evidence-Based Practice’; this is a life-long procedure based on problem learning. The procedure involves various steps; asking a compelling question of issue, searching the literature, appraising the evidence, selecting the appropriate evidence, linking the evidence with experience and patient values, developing an action plan, implementing the findings, and evaluating the results (Anderson & Abrahamson 2017).

A quality improvement initiative is indeed a recommendation in this area since most medical errors lead to wrong drug prescriptions, and in some cases, a patient’s life is lost. Research shows that most patients have lost their lives and gotten wrong treatments due to these medical errors; a strategic quality improvement is a key to improving and preventing the prevalence of occurrence of the subject errors. Mitigating and minimizing these errors will ensure minimal or no life loss due to the errors and restore the trust initially lost in lab technicians and doctors. Research shows that most of these errors are prevalent to care providers in pre-analytic and post-analytic stages; the mistakes are common to inpatient and outpatient care. To improve the quality of service provision in this sector, various strategies and approaches have been recommended to enhance the solution; one is the Root Cause Analysis (RCA). RCA is a systems-based approach that bases its solution on three questions to provide the necessary information collection framework; what is the problem? Why did it happen? What can be done to bar from recurring? (Kellogg et al., 2017).

This approach emphasizes the actions that led to the error by finding the real culprits irrespective of how deeply they might be. Errors can be grouped into two; dynamic error and latent error; RCA follows precise procedures beginning with data collection and reconstruction of the subject event by looking into various records and active participation from the stakeholders and the healthcare workers. Various disciplinary committees are then allowed to evaluate and analyze the events that led to the errors in question. The second approach is the Plan-Do-Study-Act (PDSA) Cycle approach; this approach acknowledges that change is recurrent naturally and is a beneficiary to small and frequent PDSAs compared to the big and slow ones. The PDSA focuses on carrying out a plan to evaluate the change before implementing the test; it also observes and learns from the effects by highlighting the test’s necessary modifications. Research shows that many institutions and healthcare organizations have used the subject approach, thereby deeming it effective and worth considering.

The third approach is the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) approach. The approach bases its solution that as much as teamwork is recommended, most healthcare workers are rarely trained together since most of them come from different disciplines with special educational skills. This approach highlights teamwork’s significance to effective and quality delivery of services and in ensuring patient safety. Studies show that teams are rarely related to mistakes than individuals since each team member will be concentrating on ensuring his/her duty stands out. The subject approach includes three main stages in ensuring its effective implementation. The first stage involves assessing, evaluating, and setting up the stage. The second stage involves planning, training, and implementation. Finally, the last stage involves sustaining and spreading improvements in teamwork performance, clinical methods, and the results. A key point to note in this approach is that training and team installation structure do not necessarily guarantee effective team operations (Rodziewicz & Hipskind 2018).

Finally, the last strategy is the Lean Six Sigma for Healthcare approach; this is a combination of Lean and Six Sigma processes. The Lean method focuses on eradicating waste in a process, while Six Sigma aims to minimize variation and defects. The Lean Six Sigma approach has its primary pillars; Define, Measure, Analyze, Improve, and Control (DMAIC) lifecycle. Define involves creating a problem statement, identifying the critical issues to quality, and defining performance standards. The measure includes understanding and validating the measurement system, determining the process capability, and finalizing the performance goals. Analyze involves the identification of variation sources and highlighting of the potential causes. Improve includes the determination of variable relationships, establishing tolerances, and implementing improvements by confirming and validating results. Lastly, control includes redefining process capabilities, implementing the process control, and completing the project documentation. This approach demands extensive training due to its vast nature; it has proven to minimize medical errors, thereby enhancing results.

References

Anderson, J. G., & Abrahamson, K. (2017, January). Your Health Care May Kill You: Medical Errors. In ITCH (pp. 13-17).

Kellogg, K. M., Hettinger, Z., Shah, M., Wears, R. L., Sellers, C. R., Squires, M., & Fairbanks, R. J. (2017). Our current approach to root cause analysis: is it contributing to our failure to improve patient safety?. BMJ quality & safety, 26(5), 381-387.

Rodziewicz, T. L., & Hipskind, J. E. (2018). Medical error prevention.