NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Name

Capella university

NURS-FPX 8010 Executive Leadership in Contemporary Nursing

Prof. Name

Date

Quality Improvement Proposal

[Slide 1] Greetings to all! My name is _______. Today, I will present the Quality Improvement (QI) proposal for the We Level Up (WLU) Treatment Center in Northern Jersey.

[Slide 2] The QI plan centers on departmental strategic priority investing in advancing staff abilities and growth and building a supportive workplace setting to offer efficient mental and substance disorder care to the NJ community. It reduces the Against Medical Advice (AMA) discharge occurrences by raising the standard of care at WLU organization. The WLU is dedicated to promoting health by providing effective, proven therapy and patient education to patients with addiction and mental illnesses (WLU, 2024). The WLU admission department has established priorities that are critical to achieving the organization’s broad goals of providing effective therapy to patients and reducing AMA discharges by boosting patient satisfaction.

The QI proposal underscores the strategic objectives of “development and training of staff and strengthening expertise” and “promoting supportive workplace setting” to address the critical healthcare issue of AMA departures among patients and boost patient satisfaction and care through improved WLU medical services. The WLU’s mission and aims are guided by the department’s strategic priorities, which include lowering the AMA depart rate within one year and promoting psychological care. Complying departmental priorities with organizational goals allows WLU to address barriers and enhance its efficacy by improving patient outcomes and decreasing AMA discharges (Trépanier et al., 2022).

Rationale of Strategic Priority

[Slide 3] Defining strategy priorities allows care organizations in educated decisions that aid in the attainment of goals. Prioritizing organizational efforts is critical for bringing about efficient advancement that improves medical services and patient satisfaction. Skilled staff can help patients receive competent care, which can lead to better medical outcomes and a better reputation for medical facilities. The rationale for prioritizing is reinforced by literature, as studies have underscored the requirement of competent and educated workers for medical care in organizations, improving care services and reducing premature departure (Mlambo et al., 2021). For instance, Azizzadeh and Pourranjbar (2021), stated several factors that cause AMA discharge, including a lack of hospital staff’s verbal communication skills and expertise related to care. Lack of these skills leads to inadequate care and patient dissatisfaction towards medical staff and care setting and ultimately results in AMA departures. So, it is crucial to invest in staff education and training to improve their expertise and standard of care.

Possibilities for continuing education and skill development enable employees to improve their risk assessment skills and foster a supportive workplace setting for staff and patients, allowing them to overcome risks associated with AMA discharges, such as poor communication about the impact of AMA, delays in conducting investigations, and the care process. According to Sadler et al. (2023), improving staff active listening skills, compassion, and awareness of patients’ particular demands through effective communication, as well as involving assets and fostering collaborative decision-making, can reduce AMA discharge rates and increase patient satisfaction. Staff can improve their skills via learning and Continued Professional Development (CPD) training. It helps facilities like WLU enhance medical practices. Investing in staff training enables the fostering of a learning culture and enhances services (Mlambo et al., 2020). 

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Literature findings support the justification for strategic priority, it is demonstrated that fostering a supportive setting through professional development improves patient satisfaction and retention, reducing AMA discharges. Supportive workplace settings improve interdisciplinary collaboration and aid in addressing staff’s and patients’ concerns. For example, Coombes et al. (2022), stated that professional development through learning drives interprofessional collaboration and patients’ involvement in the decision-making of patient admittance and treatment, reducing uncertainty and boosting patient satisfaction. Through a supportive setting, staff can address patients’ cultural needs and offer efficient care services.

The strategic priority implications underscore the necessity of talented staff and a supportive culture in medical delivery and workplace settings, which enhances the care services and patient trust, resulting in fewer AMA discharges. The implications of a competent medical workforce through skill growth training support the patients by efficiently addressing their concerns and needs and offering better care. It will improve patient safety and health outcomes (Albayati et al., 2021). The WLU supports a culture of continual learning and professional growth, ensuring employees retain to provide optimal mental care solutions. This leads to beneficial outcomes for patients and organizations like WLU to achieve targets.

SWOT Analysis for Chosen Strategic Priority

[Slide 4] WLU’s competence to offer appropriate care to drug-affected and mentally ill patients relies on sustaining optimal services, patient satisfaction, and reducing AMA departures. The primary strategic goal is to improve staff talents and knowledge by training for professional growth to maintain a competent workforce at WLU and fulfill its goals. A SWOT evaluation offers valuable insights into the importance and prospects for advancing strategy priorities like . “development and training of staff and strengthening expertise” and “promoting supportive workplace setting”. SWOT stands for Strengths, Weaknesses, Opportunities, and Threats. The SWOT approach is an analytical tool that facilitates the analysis of the challenges of external influences and internal opportunities and abilities, supporting efficient strategic planning (Saragih et al., 2022).

Strengths

Investment in staff development and skill-building initiatives boosts staff efficiency in medical care. Training and awareness empower workers to offer appropriate care, improving patient wellness and satisfaction. Additionally, improving employee skills leads to higher job satisfaction, which has a positive impact on a supportive workplace culture and aids in managing AMA discharges (Albayati et al., 2021). Developing clinical competence and implementing a supportive culture improves effectiveness and service quality, which is consistent with the organization’s strategy goal of offering efficient mental care.

Employee skill development through training fosters a sense of responsibility. Investing in developing a supportive setting for risk via interdisciplinary collaboration, including clinicians and psychologists. Improving communication skills through training helps to boost staff competence in playing their role in medical practices. It improves the care process and addresses AMA departure among patients, which aligns with the facility, such as WLU’s goal of lowering AMA discharge rates and enhancing patients’ well-being (Sadler et al., 2023). 

Weaknesses

The QI project also has major limitations, including budget constraints. Executing staff development initiatives, risk assessments, and maintaining a supportive environment require resources that surpass the WLU’s budget and reserves. Some stakeholders, such as medical staff, can be hesitant to participate in programs for staff growth due to fear of a shift and increased burden (Cheraghi et al., 2023). The worker’s unwillingness to participate in education and training programs also undermines the organization’s ability to retain competent staff. Medical personnel serve as a barrier due to a lack of knowledge and expertise to manage high-risk patients and AMA discharges. They can show an adverse attitude regarding the implementation of novel practices in the care process and patient engagement, affecting the fulfillment of strategic objectives such as reducing AMA discharge rates (Cheraghi et al., 2023).

Opportunities

The QI initiative presents an opportunity to build a competent workforce, which will improve the organization’s productivity. Investing in staff development enables WLU to retain educated and skilled staff who assist in addressing the medical needs of patients with mental illnesses, hence increasing their happiness and retention. The QI effort encourages expenditures in training to improve staff communication skills so that they can address patient concerns and participate in collaborative decision-making (Omaghomi et al., 2024). It mitigates AMA discharges. Collaboration with community groups can help in fund allocation to support hospitalized patient care. Engaging social workers offers opportunities to ensure patients’ safe discharge, like financial and insurance support. Collaboration enables innovative attempts to boost clinical practices and care access and reduce AMA departures (Albayati et al., 2021).

Threats

Major concerns entail a lack of financial resources, which prevents organizations from investing in programs for staff development. A lack of training and knowledge hinders the retention of proficient staff and affects organizational productivity. Additionally, internal restrictions like unstable politics and criticism from key stakeholders hamper efforts to prioritize risk assessment and support activities, as well as staff training, affecting organizational efficiency (Cheraghi et al., 2023). Other factors, like external variables, including economic difficulties and amendments in federal health policies, hinder the ability of organizations such as WLU to dedicate funding to QI projects. Recognizing threats is crucial for successfully adopting strategic ways to reduce AMA discharges (Mansour et al., 2020).

Key Performance Indicators

[slide 5] A medical Key Performance Indicator (KPI) is a specific metric applied to observe, track, optimize, control, and modify the productivity of a medical procedure in organizations such as WLU to ensure the efficacy of QI projects (Varela et al., 2023). The project invests in personnel training, the development of skills, and the establishment of a supportive workplace setting for QI. Customer satisfaction is the initial KPI used to assess the success of the QI plan. Improved staff awareness and skills enable them to provide better service, resulting in improved patient satisfaction (Mlambo et al., 2021). The success of educational and skill development programs can be measured using passing rates KPI for professional certificates, and staff satisfaction and retention.

The KPI investigates whether being competent workers at WLU increases patient satisfaction and retention while decreasing AMA discharge rates. Another KPI is WLU financing, which aids in the identification of innovative and supportive activities. Improved support through risk assessment and improved communication change organizations’ medical operations, resulting in efficient care and reduced AMA departures (Sadler et al., 2023). The final KPI assesses WLU’s financial health after the execution of QI efforts. Training sessions and competence advancement help employees provide proper mental health care to patients and tackle patient concerns in the WLU, reducing the chance of AMA discharges. Efficient care boosts patient influx and retention in hospitals, which leads to profit (Mlambo et al., 2021).

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Present measures, like patient satisfaction, emphasize the demand for QI activities, which aid in achieving WLU’s target. The evaluation revealed a patient satisfaction rate of 65%. Based on the departmental strategic plan, the goal is to raise patient satisfaction to 85% within a year while also increasing the quality of health care through training and skill development and support service initiatives. Another KPI is financing, which necessitates a QI effort. The current financing rate is under 2%. The intended objective is to raise financing by 10% in a year.

The staff satisfaction and retention KPI show that the observed rate is 5%; the aim is to increase it to 25% through skill development and education and reduce the rate of AMA discharge by 65%. These measures are aligned with the organizational strategic targets of reducing AMA discharge and the department’s balanced scorecard. The alignment of KPIs for the QI project to achieve strategic priorities helps analyze the efficiency of improvement efforts. These KPIs are quantitative indicators that correlate with the QI efforts and the organization’s objectives (Varela et al., 2023). Examining indicators enables a review of WLU’s QI program success in medical services and AMA departs reduction.

Stakeholder Collaboration and Feedback

[Slide 6] Recognizing and engaging stakeholders is crucial to the QI execution at WLU. Collaboration with stakeholders entails several phases, including stakeholder identification, group discussions, and input (Murphy et al., 2021). The first phase involves recognizing key stakeholders, such as medical and financial staff, administrators, lawmakers, and community and social organizations. Financial staff and administrator’s feedback aids in resource management and distribution. Lawmakers’ input aids in making policies like staff growth and adherence to AMA discharge policies to improve outcomes.

The second phase is a partnership to engage stakeholders and teams in the QI program, entailing staff training and skill development, building a supportive workplace setting, and integrating activities to improve medical outcomes by lowering AMA discharge rates. To collaborate with stakeholders, efficient communication approaches like open and clear debate will be adopted. Stakeholder involvement via different approaches, such as formal meetings and virtual conversations, helps to clarify stakeholders’ differing perspectives (Paxino et al., 2022). The last stage is feedback, which aids in the discovery of common trends and sources of conflict.

Fostering transparent interactions with stakeholders throughout the QI efforts keeps them updated on successes and opportunities for improvement. WLU leverages stakeholder feedback to improve its QI programs on improving abilities, training, and developing a supportive setting for patients and staff. Coordinating with stakeholders ensures that diverse perspectives and factors are considered, resulting in the sustainability of initiatives to reduce AMA departures. Stakeholder participation allows WLU to gather support for expected changes, which encourages continual improvement. Acknowledging support from stakeholders boosts the chance of achievement, leading to enhanced services and patient retention (Paxino et al., 2022).

Change Theory

[Slide 7] The Lewin’s Change theory offers an efficient structure for launching revolutionary QI endeavors within the WLU. The Lewin approach seeks to enhance staff growth and education to boost competence and care process while reducing AMA departures. The change theory supports comprehending the demand for advancement and change and executing adequate changes to achieve the intended outcomes. The change theory contains three phases: unfreeze, change, and refreeze (Harrison et al., 2021). In the unfreezing phase, leadership assesses the need for change and fosters collaboration among stakeholders to boost care quality, lower AMA departure rates, and increase patient retention. Engaging stakeholders in debates lessens unwillingness to change and improves commitment to the QI effort (Paxino et al., 2022).

In the changing phase, leadership conducts interventions and strategies to improve medical services through competent staff, such as communication skill training, a supportive environment, addressing patient concerns with empathy, and training to improve staff development and efficiency to provide efficient care (Sadler et al., 2023). Applying efforts to reduce AMA departure rates through risk assessment, feedback mechanisms, and financial considerations. Change leadership through effective communication with staff to discuss change and its impact on medical facilities, aiding in managing QI efforts. Leveraging these approaches allows staff to provide science-based care, increase patient satisfaction, and reduce uncertainty. In the freezing phase, leadership reinforces changes to maintain long-term viability. The priority will be on revising present regulations to stimulate continuous improvement by promoting the deployment of novel initiatives in hospitals to avoid AMA departure (Albayati et al., 2021).

Interpretation

[Slide 8] Lewin’s change theory encourages advancement and change by incorporating key stakeholders in the process of choices making. An adequate understanding of the change is essential to gaining assistance with the suggested strategy. The Lewin theory aids leadership or change makers in resolving barriers to establishing QI initiatives in healthcare. It provides a structured strategy for examining, controlling, and advocating change. The beneficial adoption of this shift allows leadership to build a supportive culture in healthcare (Harrison et al., 2021). Introducing change helps to improve WLU’s medical treatment and reduce AMA discharge.

Policy Recommendation

[Slide 9] Policies recommendations aid in encouraging skill progression, personnel growth, and a strong support system at WLU. It helps to offer patients reliable and effective care and is congruent with the goals of the proposed QI initiative, which are to reduce AMA departure. To encourage an intended QI program for AMA departure reduction and staff growth in medical facilities, federal budget allocation is crucial for developing a learning culture among personnel (King et al., 2021).

Criteria for accreditation must be devised to encourage skill growth, staff competency, and continual training in hospitals to provide outstanding patients and resolve healthcare issues like AMA (Mansour et al., 2020). Supporting incentives for medical facilities that implement continuing staff training initiatives impacts the QI project. In the end, fostering collaboration between clinical and social groups to develop a support structure, enhance patient insurance coverage and patient assistance, resolve staff’s concerns through interdisciplinary collaboration, and refine health services in facilities like WLU, delivering efficient care by lowering AMA discharges (Albayati et al., 2021).

Implications and Justification

[Slide 10] Policy recommendations influence WLU’s services, and efforts to address the AMA discharge issue contribute to improved care standards. Relying on staff training, improving their ability to identify high-risk patients, and providing the necessary assistance and expertise to improve medical practices. Training and development efforts improve their competency to offer proper care by emphasizing empathy and risk assessment. Accreditation regulations emphasize that facilities strive to provide qualified staff in healthcare. Legislators are interested in incentivizing hospitals to invest in personnel training and patient satisfaction and retention (Mansour et al., 2020).

Education and developing skills guarantee that employees have capacities to handle AMA discharges and high-risk patients, addressing their concerns, resulting in increased patient satisfaction and well-being (Albayati et al., 2021). Improving communication skills allows medical professionals to discuss their concerns, boost interdisciplinary cooperation, and offer empathic care and support to their patients. Communication among cross-disciplinary teams and local groups is vital for staff growth and improved health care. Collaboration assists organizations like WLU in achieving the goal of lowering the AMA rate. The policy implications contribute to the formation of employee competencies and supportive approaches, resulting in efficient medical services and AMA departure mitigation at WLU (Albayati et al., 2021).

Conclusion

[Slide 11] In conclusion, the QI plan focuses on investing in staff growth to increase WLU’s care services while also lowering AMA departures. A SWOT assessment offers helpful knowledge of the challenges and possibilities for advancing strategic priorities. Additionally, collaboration with stakeholders is crucial to the WLU’s QI initiatives. The Lewin change theory is a suitable framework for achieving transition in the ALU, boosting customer satisfaction and retention.

References

Albayati, A., Douedi, S., Alshami, A., Hossain, M. A., Sen, S., Buccellato, V., & Asif, A. (2021). Why do patients leave against medical advice? Reasons, consequences, prevention, and interventions. Healthcare, 9(2), 111. https://doi.org/10.3390/healthcare9020111

Azizzadeh, F., & Pourranjbar, S. (2021). The causes of discharge against medical advice and suggestions for its reduction in Tabriz Sina Medical Center (phenomenological study). Indian Journal of Medical Sciences, 73(1), 88-92. https://doi.org/10.25259/IJMS_64_2020

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Black, D., Held, M. L., Skeesick, J., & Peters, T. (2021). Measures evaluating patient satisfaction in integrated health care settings: A systematic review. Community Mental Health Journal, 57(8), 1464-1477. https://doi.org/10.1007/s10597-020-00760-y

Cheraghi, R., Ebrahimi, H., Kheibar, N., & Sahebihagh, M. H. (2023). Reasons for resistance to change in nursing: An integrative review. BioMed Central Nursing, 22(1). https://doi.org/10.1186/s12912-023-01460-0

Coombes, J., Hunter, K., Brook, K. B., Porykali, B., Ryder, C., Banks, M., Egana, N., T Mackean, S Sazali, Bourke, E., & C Kairuz. (2022). Leave events among Aboriginal and Torres Strait Islander people: A systematic review. BioMed Central Public Health, 22(1). https://doi.org/10.1186/s12889-022-13896-1

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 85-108. https://doi.org/10.2147//JHL.S289176

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

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Mansour, W., Boyd, A., & Walshe, K. (2020). The development of hospital accreditation in low-and middle-income countries: A literature review. Health Policy and Planning, 35(6), 684-700. https://doi.org/10.1093/heapol/czaa011

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta synthesis of the literature. BioMed Central Nursing, 20, 1-13. https://doi.org/10.1186/s12912-021-00579-2

Murphy, J., Qureshi, O., Tarik Endale, Esponda, G. M., Pathare, S., Eaton, J., Silva, D. M., & Ryan, G. (2021). Barriers and drivers to stakeholder engagement in global mental health projects. International Journal of Mental Health Systems, 15(1). https://doi.org/10.1186/s13033-021-00458-y

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Paxino, J., Denniston, C., Kron, W. R., & Molloy, E. (2022). Communication in interprofessional rehabilitation teams: A scoping review. Disability and Rehabilitation, 44(13), 3253-3269. https://doi.org/10.1080/09638288.2020.1836271

Sadler, K., Alwali, M., Nancarrow, L., Albalawi, M., Khan, S., & Alyami, H. H. (2023). Discharge against medical advice in pediatrics: A review and recommendation of a five-component approach. International Journal of Pediatrics and Adolescent Medicine, 10(3), 51-58. https://doi.org/10.4103/ijpam.ijpam_8_24

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Saragih, J. F. H., Nugraheni, S. A., & Adi, M. S. (2022). Benefits of using SWOT analysis and balanced scorecard for the development of the quality of health services: Narrative review. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7(S1), 263-272. http://dx.doi.org/10.30604/jika.v7iS1.1076  

Trépanier, G., Laguë, G. & Dorimain, M. V. (2022). A step-by-step approach to patients leaving Against Medical Advice (AMA) in the emergency department. Canadian Journal of Emergency Medical Care/CJEM, 25(1), 31–42. https://doi.org/10.1007/s43678-022-00385-y

Varela, T., Zamorano, P., Muñoz, P., Rain, C., Irazoqui, E., Sapag, J. C., & Tellez, A. (2023). Evaluation of the implementation progress through key performance indicators in a new multimorbidity patient-centered care model in Chile. BioMed Central Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-09412-9

WLU. (2024). About We Level Up treatment centers for addiction detox, rehab, and mental health programs. welevelup.com. https://welevelup.com/about-us/

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