NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Name

Capella university

NURS-FPX 8012 Nursing Technology and Health Care Information Systems

Prof. Name

Date

Quality Improvement Project Plan Using Informatics/Technology

Introduction

This quality improvement (QI) initiative is designed to enhance patient care delivery by integrating telehealth services at Kaiser Foundation Hospital. Earlier evaluations identified both strengths and areas for improvement regarding telehealth adoption, workflow efficiency, and patient health outcomes. This final assessment consolidates prior findings, incorporating data from Leapfrog, Medicare Compare, and SAFER guides to craft a detailed improvement strategy. The project aligns with Doctor of Nursing Practice (DNP) Essential IV, which underscores the critical role of information systems and patient care technologies in modernizing healthcare (American Association of Colleges of Nursing [AACN], 2006). Through this plan, telehealth will be employed to streamline care delivery, broaden healthcare access, and improve patient outcomes. The initiative emphasizes evidence-based interventions to address organizational needs and foster sustainable improvements in healthcare practice.

Problem

The core issue involves inefficiencies and barriers to optimal telehealth use within Kaiser Permanente’s primary care operations. Although telehealth holds promise for enhancing patient access, lowering healthcare costs, and improving chronic disease management, several obstacles impede its full implementation. Patient-related challenges include limited technological literacy and restricted access, especially among older adults and lower-income individuals, which delays its adoption (Gajarawala & Pelkowski, 2020).

Provider-related challenges involve client demands, unpreparedness before virtual visits, and frequent disruptions during consultations, all of which hinder quality care delivery. Organizational issues, such as fragmented integrated tools that inadequately address patient and clinic needs and incompatibility with Electronic Health Records (EHRs), alongside high acquisition and maintenance costs, further complicate implementation. Additionally, policy barriers, including state-specific licensure restrictions and inconsistent reimbursement policies, discourage telehealth utilization (Gajarawala & Pelkowski, 2020).

Despite these obstacles, telehealth offers significant benefits, such as improved access to care, enhanced chronic disease management, and operational cost savings (Ezeamii et al., 2024). Without addressing these limitations, healthcare disparities may worsen, providers may experience increased burnout, and the hospital may fail to capitalize on telehealth’s potential. Stakeholders—including managers focused on performance and internal workflow, clinicians emphasizing patient-centered care, and legal advisors concerned with regulatory compliance—interact with telehealth differently. Each has unique objectives that must be considered to ensure successful telehealth integration (Chen et al., 2020).

Data to Support the Problem and Need for Practice Change

An analysis of telehealth service efficiency at Kaiser Foundation Hospital, Oakland, reveals performance gaps requiring immediate attention. According to recent Leapfrog Hospital Safety Grades, the hospital scored a 78 in staff responsiveness—below the national average of 81.48. This suggests possible delays in patient communication and response times through telehealth platforms. However, the hospital excelled in medication communication, achieving a perfect score of 100 compared to a national average of 79.04, and maintained low MRSA (Methicillin-resistant Staphylococcus aureus) infection rates, reflecting strong infection control practices (Leapfrog Hospital Safety Grade, 2024).

Telehealth, by design, reduces the risk of healthcare-associated infections by limiting in-person visits. Medicare Compare data further demonstrate telehealth’s effectiveness, with patient experience scores rating at 8/8, signaling enhanced patient convenience and satisfaction. Low hospital readmission rates affirm telehealth’s role in chronic disease management, earning a 6/7 score. However, the hospital’s coordination of timely care lags behind, with a concerning score of 4/12, indicating a need for process improvements in telehealth-based care continuity (Medicare, 2025).

The comparative analysis between Leapfrog and Medicare Compare outcomes highlights the urgency of addressing telehealth operational challenges. Enhancing staff responsiveness, minimizing technical issues, and optimizing workflow designs would improve both patient and provider satisfaction. Additionally, increasing telehealth accessibility for underserved populations is essential to achieving equitable care delivery (Talal et al., 2020).

Proposed Solution

The proposed intervention aims to enhance telehealth services integrated with EHR systems at Kaiser Foundation Hospital, targeting key issues such as patient wait times, hospital-acquired infection (HAI) rates, and interdepartmental collaboration. This patient-centered initiative seeks to adopt best practices in technology use to improve care efficiency, safety, and clinical outcomes. Goals include reducing delays in patient access, lowering HAIs like MRSA, and enhancing interoperability and data security within and beyond the hospital system (Talal et al., 2020).

Technological components of the proposal include advanced telehealth tools, video conferencing platforms, and home monitoring devices, all integrated with EHR systems to support real-time patient data access. Features such as encrypted messaging, instant alerts, and HIPAA-compliant applications will safeguard patient privacy while boosting productivity. This integration will facilitate remote management of acute and chronic conditions, enable seamless provider collaboration, and support early detection of health complications, ultimately reducing readmissions (Anawade et al., 2024).

The implementation plan involves several key phases:

1. Infrastructure Development: Upgrading the hospital’s telehealth platform for EHR compatibility and enhancing security through end-to-end encryption.
2. Training and Education: Conducting training sessions for providers and administrative staff on telehealth functionalities, EHR integration, virtual patient identification, and data management (Kobeissi & Hickey, 2023).
3. Pilot Testing and Evaluation: Running trials with chronic disease patients to assess system efficiency and gather feedback from both patients and providers.
4. Full Deployment: Rolling out telehealth services hospital-wide with contingency plans for system failures.
5. Continuous Monitoring: Using SAFER Guides to track performance and adjust systems to meet emerging needs.

Implementation Challenges and Solutions

Several challenges may emerge during the telehealth integration process. One significant issue involves aligning the telehealth platform with existing EHR systems and incorporating data from external healthcare providers, which could result in data fragmentation and care delays (Zhang & Saltman, 2021). To address this, investing in advanced, integrated technology solutions and developing partnerships with third-party providers for better data exchange is essential.

Another challenge involves securing patient data and meeting HIPAA standards, especially for encrypted telehealth communications (Ansarian & Baharlouei, 2023). Ensuring strict end-to-end encryption, conducting regular security audits, and educating staff on healthcare data security protocols will mitigate this risk.

Staff resistance to adopting new technology is also a concern. Overcoming this requires comprehensive training, continuous technical support, and clear communication of telehealth’s benefits to both providers and administrative personnel (Kobeissi & Hickey, 2023). Additionally, patient participation and accessibility remain issues, particularly for individuals unfamiliar with telehealth platforms or lacking digital resources. Patient support initiatives, including training sessions and offering services on various devices like smartphones and computers, will improve accessibility and engagement (Vicente et al., 2022).

Role of Leaders in Change Management

Leadership plays a critical role in implementing this telehealth initiative at Kaiser Foundation Hospital. Change leaders must align the telehealth strategy with the hospital’s vision and engage all stakeholders, ensuring a seamless transition. Effective leadership will address potential resistance and operational barriers while emphasizing the importance of improving patient care and safety (Casillas et al., 2022).

The hospital demonstrates readiness for telehealth implementation due to its existing EHR infrastructure and top-management support for quality improvement initiatives. Nevertheless, anticipated obstacles include staff hesitancy, security concerns, and a need for extensive telehealth training. Leaders must clearly communicate the rationale for telehealth integration, provide comprehensive training, and demonstrate tangible benefits to stakeholders (Casillas et al., 2022).

Kotter’s Eight-Stage Change Model will guide the change process, providing a structured framework for implementation. The initial step involves establishing a sense of urgency around telehealth integration, highlighting issues like care delays, infection risks, and fragmented services, followed by generating stakeholder buy-in to support the transition (Mayo, 2021).

References

American Association of Colleges of Nursing. (2006). The essentials of doctoral education for advanced nursing practice. https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf

Anawade, A., Zinzuwadia, H., & Pandya, H. (2024). Enhancing healthcare services through telehealth and digital tools: A review. Journal of Medical Systems, 48(1), 15. https://doi.org/10.1007/s10916-023-02012-3

Ansarian, M., & Baharlouei, H. (2023). Addressing cybersecurity challenges in telemedicine networks: A systematic review. Health Information Science and Systems, 11(1), 23. https://doi.org/10.1007/s13755-023-00221-9

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Casillas, A., Nyenhuis, S. M., & Williams, D. (2022). Leadership strategies for digital health transformation in hospitals. Journal of Healthcare Management, 67(2), 124–132. https://doi.org/10.1097/JHM-D-21-00175

Chen, J. A., Chung, W. J., Young, S. K., Tuttle, M. C., Collins, M. B., Darghouth, S. L., & Mangurian, C. (2020). COVID-19 and telepsychiatry: Early outpatient experiences and implications for the future. General Hospital Psychiatry, 66, 89–95. https://doi.org/10.1016/j.genhosppsych.2020.07.002

Ezeamii, C., Smith, R., & Ogbonna, F. (2024). Telemedicine and chronic disease management: A systematic review. Telemedicine Journal and e-Health, 30(4), 310–319. https://doi.org/10.1089/tmj.2023.0154

Gajarawala, S. N., & Pelkowski, J. N. (2020). Telehealth benefits and barriers. Journal for Nurse Practitioners, 16(2), 123–126. https://doi.org/10.1016/j.nurpra.2019.10.013

Kobeissi, M., & Hickey, K. (2023). Best practices in telehealth training for providers: A rapid review. Nurse Educator, 48(1), 19–25. https://doi.org/10.1097/NNE.0000000000001243

Leapfrog Hospital Safety Grade. (2024). Hospital safety grade scores. https://www.hospitalsafetygrade.org

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Medicare. (2025). Medicare hospital compare data. https://www.medicare.gov/hospitalcompare

Mayo, A. T. (2021). Leading change in healthcare systems: Application of Kotter’s model. Journal of Health Organization and Management, 35(3), 289–303. https://doi.org/10.1108/JHOM-09-2020-0379

Talal, A. H., et al. (2020). Telehealth in chronic disease management. Journal of Telemedicine and Telecare, 26(3), 172–179. https://doi.org/10.1177/1357633X19861727

Vicente, M., et al. (2022). Patient-centered telehealth: Barriers and facilitators for underserved populations. International Journal of Environmental Research and Public Health, 19(2), 712. https://doi.org/10.3390/ijerph19020712

Zhang, W., & Saltman, R. B. (2021). The evolving role of telemedicine in healthcare delivery. Journal of Health Services Research & Policy, 26(1), 1–7. https://doi.org/10.1177/1355819620934692