NURS FPX 9100 Assessment 6 Project Charter
NURS FPX 9100 Assessment 6 Project Charter
Name
Capella university
NURS-FPX 9100 Defining Nursing Doctoral Project
Prof. Name
Date
Project Charter Part 1
Project Charter Information
Project Name: Provider Inbox Management Optimization (PIMO): Creating the Optimal Inbox
Project Site: Adelante Healthcare – Adult and Family Medicine
Contact at Site:
- Name with credentials: Robert Babyar, MD, Chief Medical Officer
- Organizational Email: robert.babyar@adelantehealthcare.org
- Phone Number: 877-809-5092
Preceptor:
- Name with credentials: Adita Flagg
- Email: adita.flagg@adelantehealthcare.org
- Phone Number: 877-809-5092
Executive Sponsor:
- Title: Chief Executive Officer (CEO) of Adelante Healthcare
- Role: The CEO is responsible for the overall productivity and operation of the company and is instrumental in providing fiscal, political, and networking support.
Gap Analysis
A January 2023 report from analysts revealed that 75% of patient messages were not reviewed or addressed within the first three days. This issue was identified by the Quality Department during an investigation into patient complaints about delayed responses. Currently, no response time policy, procedure, or guideline exists to guide clinical staff. This gap, initially identified in May 2022, highlights challenges such as time constraints, duplication of efforts, and inadequate delegation. A root cause analysis was conducted, and the findings are illustrated in a Fishbone diagram (Appendix A). After discussing the issue with the executive sponsor, a quality improvement project was approved to address the gap. The desired state involves implementing an evidence-based response time policy to improve patient-provider communication and reduce delays.
The Joint Commission’s 2023 National Patient Safety Goals emphasize improving communication among caregivers. Organizations focusing on optimizing provider inbox management can mitigate issues like information overload, which is a significant contributor to job dissatisfaction and provider burnout (Murphy et al., 2019). Research by Lieu et al. (2019) and North et al. (2018) supports that implementing response time policies can result in timely patient communication and reduce patient calls. The PIMO project aligns with these objectives by addressing this critical practice gap.
Evidence to Support the Need
Evidence-based interventions demonstrate that implementing response time policies can improve clinical efficiency, patient engagement, and timely messaging. Studies by Steitz et al. (2019) and Hefner et al. (2019) highlight the necessity of policy improvements and staff training. Furthermore, Reynolds et al. (2021) emphasize the importance of virtual interactions and contextualized advice within patient portals. These findings align with Huang et al. (2022), who identify opportunities for optimizing inbox messaging systems to balance workloads and enhance efficiency.
To achieve this, the PIMO project will implement a response time policy, provide staff training, and upgrade the patient portal system. This initiative aims to improve patient safety, reduce treatment delays, and increase satisfaction.
PICOT Question
For staff and providers (P), how does the implementation of a patient-provider response time policy (I) to respond to portal messages, compared to the current state (C), affect response times (O) over a two-month period (T)?
Project Aim
The PIMO project aims to improve patient-provider response times to achieve or exceed time measures outlined in the response time policy and reduce delays in care.
Stakeholders
| Initials | Title/Role | Connection to Project | Impact | Potential Challenges |
|---|---|---|---|---|
| C.A. | Director of Nursing & Nutrition Services | Project lead supporting implementation across disciplines | Direct involvement ensures compliance and data analysis | Scheduling conflicts and resistance to change |
| A.F. | Director of Quality, Safety & Clinical Risk | Ensures compliance with policies and procedures | Provides guidance and support during rollout | Increased workload and prioritization challenges |
| S.A.L. | Regional Medical Director | Ensures provider involvement and compliance | Shares provider insights for informed decisions | Workload and prioritization challenges |
Team Leadership and Members
Team Leader: C.A., Director of Nursing
C.A.’s 14-year leadership experience and background in nursing make them ideal for this role. They utilize servant and transformational leadership styles, fostering team empowerment and effective communication. C.A. ensures collaboration across departments to achieve successful project outcomes.
Team Members:
| Initials | Title | Department | Credentials/Qualifications | Contribution to Project |
|---|---|---|---|---|
| N.V. | Data Analyst | Health Information Systems | BS | Measures project outcomes |
| S.K. | Informatics Director | IT/Health Information Systems | MSIT | Provides advanced data support |
| E.D.P. | Project Manager | Transformation Office | BS | Oversees implementation stages |
| S.A.L. | Regional Medical Director | Medical Provider Leadership | DNP, FNP, RN | Offers clinical insights |
Communication Plan
| Stakeholder | Purpose | Frequency | Method | Responsible Party | Potential Barriers |
|---|---|---|---|---|---|
| Executive Sponsor | Inform on project status and engage support | End of each project phase | Project Team Leader | Time constraints | |
| Project Team | Provide updates and discuss role-specific needs | Phase-end and ad hoc | Email, Microsoft Teams | Project Team Leader | Preconceived notions and diverse backgrounds |
| Stakeholders | Share project updates and discuss contributions | Phase-end and ad hoc | Email, Microsoft Teams | Project Team Leader | Misunderstanding of project scope |
Intervention and Measurement
Planned Intervention:
Implementation of a time-based response time policy. Steitz et al. (2019) highlighted the necessity of robust policies to support patient portal use. The intervention includes policy development, staff training, and system upgrades.
Improvement Model/Framework:
The PDSA (Plan, Do, Study, Act) model from the Institute of Healthcare Improvement (IHI, 2019) will guide the project, focusing on stakeholder-driven problem-solving.
The PDSA Model for Quality Improvement in Provider Inbox Management
The Plan-Do-Study-Act (PDSA) model is a well-documented and highly utilized framework in healthcare quality improvement initiatives. Its iterative nature makes it an ideal choice for this project, which aims to enhance provider inbox management and reduce patient care delays by implementing a structured response time policy. PDSA cycles will be initiated at the project’s onset and conducted weekly throughout its duration. This approach allows for real-time assessment of implemented changes, enabling timely adjustments to interventions and progressing toward the desired outcomes. Pre-implementation data will serve as a baseline for comparison with post-implementation results, which will be shared with the project team and executive stakeholders. These findings will inform future recommendations and foster continuous quality improvement.
Outcome Metrics and Measures
| Metric | Definition | Goal |
|---|---|---|
| Outcome Measure | Percentage of provider messages responded to within 24 business hours. | Providers will respond to 85% of messages within the 24-business-hour timeframe. |
| Process Measure | Percentage of messages reviewed by clinical staff within 12 hours of receipt. | Clinical staff will review 90% of incoming messages within 12 hours of notification. |
| Balancing Measure | Identification of any negative impacts on other workflows or areas of care. | Ensure that new processes do not cause delays or complications in other patient care areas. |
Key Performance Indicators
- Provider Response Times: Providers are expected to respond to at least 85% of patient messages within 24 business hours. Messages requiring clinical intervention will be escalated appropriately to ensure timely care.
- First Touch Times: Clinical staff will open and review 90% of patient messages within 12 hours of receipt, with exceptions for weekends and holidays, which must be addressed by the next business day.
- Data Collection and Reporting: Data will be collected pre-implementation and weekly throughout the project. Monthly reports post-implementation will ensure adherence and sustained improvements.
Data Collection and Management Plan
| Aspect | Details |
|---|---|
| Data to be Collected | Total messages received, total responses sent, messages reviewed within 12 hours. |
| Data Collection Team | Data analysts from the Health Information Systems (HIS) team. |
| Timeline | Baseline data collected on January 2, 2023, with weekly reviews during implementation. |
| Storage | Secure organizational laptops with password protection and VPN safeguards. |
| Protection | Access limited to authorized personnel; diversity and equity considerations incorporated. |
The data will be stratified by gender, race, ethnicity, age, disability, and socioeconomic status to identify disparities and inform equity-driven improvements. These findings will guide strategies to address population health challenges.
SWOT Analysis
| Category | Details |
|---|---|
| Strengths | Expertise of project team, improved patient care, enhanced clinical satisfaction, and revenue growth. |
| Weaknesses | Potential adherence issues, resource constraints, and lack of empowerment among clinical staff. |
| Opportunities | Talent retention, timelier communication, and improved patient advocacy through inbox optimization. |
| Threats | Staff turnover, system downtimes, and challenges in gaining stakeholder buy-in. |
References
Akbar, F., Mark, G., Prausnitz, S., Warton, E. M., East, J. A., Moeller, M. F., Reed, M. E., & Lieu, T. A. (2021). Physician stress during electronic health record inbox work: In situ measurement with wearable sensors. JMIR Medical Informatics, 9(4), e24014. https://doi.org/10.2196/24014
Akbar, F., Mark, G., Warton, E. M., Reed, M. E., Prausnitz, S., East, J. A., Moeller, M. F., & Lieu, T. A. (2021). Physicians’ electronic inbox work patterns and factors associated with high inbox work duration. Journal of the American Medical Informatics Association, 28(5), 923-930. https://doi.org/10.1093/jamia/ocaa229
Arndt, B. G., Beasley, J. W., Watkinson, M. D., et al. (2018). Tethered to the EHR: Primary care physician workload assessment using EHR event log data and time-motion observations. Annals of Family Medicine, 15(5), 419-426.
Ehrler, F., Tuor, C., Trompier, R., Berger, A., Ramusi, M., Rey, R., & Siebert, J. N. (2022). Effectiveness of a mobile app in reducing therapeutic turnaround time and facilitating communication between caregivers in a pediatric emergency department: A randomized controlled pilot trial. Journal of Personalized Medicine, 12(3), 428. https://doi.org/10.3390/jpm12030428
NURS FPX 9100 Assessment 6 Project Charter
Ghaleb, H., & Abdullah, A. A. (2021). A conceptual framework for the impact of project complexity on the success of railway construction projects: The moderating role of effective communications to all stakeholders. The Journal of Management Theory and Practice (JMTP), 2(1), 62-69. https://doi.org/10.37231/jmtp.2021.2.1.85
Institute for Health Care Improvement (IHI). (2019). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx
Lanham, H. J., Leykum, L. K., & Pugh, J. A. (2018). Examining the complexity of patient-outpatient care team secure message communication: Qualitative analysis. Journal of Medical Internet Research, 20(7), e218. https://doi.org/10.2196/jmir.9269
Murphy, D. R., Satterly, T., Giardina, T. D., Sittig, D. F., & Singh, H. (2019). Practicing clinicians’ recommendations to reduce burden from the electronic health record inbox: A mixed-methods study. Journal of General Internal Medicine, 34(9), 1825-1832. https://doi.org/10.1007/s11606-019-05112-5
NURS FPX 9100 Assessment 6 Project Charter
Musheke, M. M., & Phiri, J. (2021). The effects of effective communication on organizational performance based on the systems theory. Open Journal of Business and Management, 9, 659-671. https://doi.org/10.4236/ojbm.2021.92034
Nguyen, T. S., & Mohamed, S. (2018). Stakeholder management in complex projects. The 7th World Construction Symposium 2018. https://research-repository.griffith.edu.au/bitstream/handle/10072/385361/NGUYEN221601.pdf?sequence=1
Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of physician time in ambulatory practice: A time and motion study in four specialties. Annals of Internal Medicine, 165(11), 753-760. https://doi.org/10.7326/M16-0961