Name
Capella university
NURS-FPX 9901: Nursing Doctoral Project 1
Prof. Name
October, 2024
Quality/Performance Improvement
QI/PI is the scientific method that improves the quality of processes and products in various sectors to make them efficient and effective (Hu et al., 2022). The approach includes the discovery of opportunities for improvement of existing workflows, which can then be modified to change for improved outcomes. In health care, QI/PI plays an essential role in optimizing patient care, through education and interventions aimed at diagnosis and treatment. The “right end” is continuous progress toward consistent, measurable improvements over time.
Quality/Performance Improvement is the hallmark of a healthcare system that creates accountability and proactive behavior in solving problems (Sreeramoju et al., 2020). Healthcare organizations can determine inefficiency, avoid errors, and enhance patient outcomes using data-driven methodologies in the form of the PDSA cycle or principles of Lean. For example, educating staff on relevant programs, with the use of telehealth to accelerate diagnosis, becomes important for those patients with chronic conditions like COPD. After all, QI/PI will ensure that healthcare practices evolve to meet needs, thus promoting safer and more effective care delivery.
Describe the Current Practice Needing Improvement
The current practice that needs to be changed is the treatment of COPD regarding the education of the workforce on nutritional modification and the use of telehealth to make the diagnostic processes more convenient (Coster et al., 2020). A patient suffering from COPD requires an individualized care plan, such as making lifestyle changes, which is well-nutrition will greatly improve lung function and health. It further leaves a knowledge gap as staff is not taught how to counsel the patients to effect these nutritional changes. This gap means that most healthcare providers lack the skills and know-how to provide generous counseling on diet to COPD patients, which then reflects poorly on the patient’s outcomes.
While telehealth has promised to be an answer for diagnosing and managing COPD across different remote settings, its use remains underdeveloped. Many healthcare facilities have not yet adequately implemented these systems, thus preventing them from being able to provide patients with COPD such timely interventions, especially in areas that are rural or serve less well-populated regions. In this way, the unabated poor infrastructure of telehealth systems, coupled with the inadequate training of healthcare providers, delays the earlier detection and intervention for the diseases, hence increasing high hospitalization and lowering the quality of life of many patients affected by COPD (Sutrisno et al., 2023). Improving those areas through targeted education and technological adaptation are important measures to progress toward better quality of care for patients with COPD.
A QI/QP Framework that Will Support and Guide the Project
The PDSA cycle is an excellent QI framework to support and guide this project. The PDSA model gives a cyclical and incremental approach toward effecting changes in healthcare practice (Toles et al., 2021). In the context of educating staff about nutritional modifications and including telehealth for diagnosis of COPD, the structure starts with a Plan – having specific goals set that include a question about training staff in nutrition and how to utilize telehealth. The Do phase entails the implementation of training programs and the introduction of telehealth in the management of COPD. In conducting the interventions, the Study phase focuses on monitoring outcomes, that is to establish whether the competence of the staff improves and if telehealth enhances the earlier and exact diagnosis of COPD. Finally, in the Act phase, the findings are taken and further used to modify the interventions for the continuous improvement process.
This promotes the flexible and data-driven PDSA cycle process to adjust and improve if needed. For instance, in case a delay in the diagnosis of COPD results from the initial integration of telehealth, then analysis during the study phase will identify the causes of the problem, and that would then mean the act phase introducing a solution; for example, refining the protocol or adding technical support to the staff (Konstantinidis et al., 2022). This framework ensures that interventions are continuously tested and refined for staff education on nutritional modifications and telehealth adoption to be evolved to meet the needs of patients and improve outcomes in COPD care effectively.
How QI/PI Data Will Be Collected and Analyzed
For this project, some methods will be employed in the efficient gathering and scrutiny of Quality Improvement data. To educate the personnel working with the nutritional changes, the organization shall conduct pre-training and post-training evaluations on the behavior shift that may have been positive or negative in terms of knowledge and competency among the staff members (Poitras et al., 2021). Evaluations shall include quizzes, surveys, and practical assessments which should be compatible with the dietary needs of COPD patients. Patient outcome measures of additional nutritional status changes, readmission rates in hospitals, and quality-of-life scores will also be collected electronically through EHRs to evaluate the effect on patient care from improved education of staff.
Data for this telehealth implementation will be based on key performance indicators including the time it takes to make a diagnosis of COPD, the number of patients utilizing the services provided, and satisfaction with a remote doctor. This will be done by assimilating data from the telehealth platform usage metrics, diagnostic reports, and patient surveys. The analysis for the comparison of outcomes before implementation and after implementation would ascertain that telehealth aids in improving the early diagnosis process with COPD patients, further reducing hospitalization (Totten et al., 2022). This can be achieved through statistical tools such as trend analysis and control charts to analyze performance over time or even track the areas where improvements are needed in such projects. The interventions involved have to meet the criteria of being measurable as well as adaptive in nature, based on real-life data.
Changes in Quality or Performance Will Be Evaluated
The process, as well as outcome measures tracking, will demonstrate quality or performance changes concerning the education of the staff on nutritional changes and telehealth as applied in COPD. Subsequently, an evaluation of the evaluation of education of staff shall be done focusing on the effective improvement of healthcare providers’ knowledge towards the application of nutritional interventions after they undergo training. This will be measured through post-training evaluations, direct observation of patient interactions, and patient feedback on the nutritional advice they receive (Kristjansdottir et al., 2021). Outcome measures like changes in the patient’s nutritional health, stable weight, and fewer complications due to COPD will be followed up to see how education can have a real-life impact on patient outcomes.
In terms of assessing telehealth performance, diagnostic accuracy, timeliness, and levels of patient engagement will be observed. The use of telehealth will be assessed through measures such as the number of COPD diagnoses made via telemedicine and the reduced time from the first contact to diagnosis (Barbosa et al., 2020). More importantly, through the completion of patient satisfaction surveys, the overall experience and acceptability of this approach in the treatment of COPD will be measured. The results will be analyzed by the project to see if changes in practice lead to improved quality of care, a more efficient system of service delivery, and a better outcome for the patient. Continuous evaluation will also help in detecting aspects where more refinement is needed to sustain quality improvements.
NURS FPX 9901 Assessment 2 Conclusion
Therefore, a QI project implementation into education for staff on nutritional modifications and the adaptation of telehealth in making COPD diagnosis even more efficient can work towards great improvement in patient care (Siu & Gafni-Lachter, 2024). Through using a structured cycle such as the PDSA cycle, the interventions will be constantly evaluated and refined to ensure the benefit is taken beyond improved knowledge for the staff and the patient. It will allow for the collection and analysis of appropriate data to ensure continued improvements in performance, leading to tangible progress in patient outcomes, as well as in COPD. The initiative has further enhanced the quality of service offered while introducing a proactive approach to health issues.
NURS FPX 9901 Assessment 2 References
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Coster, S., Li, Y., & Norman, I. J. (2020). Cochrane reviews of educational and self-management interventions to guide nursing practice: A review. International Journal of Nursing Studies, 110, 103698. https://doi.org/10.1016/j.ijnurstu.2020.103698
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Poitras, M. E., Bélanger, E., Vaillancourt, V. T., Kienlin, S., Körner, M., Godbout, I., Bernard, J., O’Connor, S., Blanchette, P., Khadhraoui, L., Sawadogo, J., Massougbodji, J., Zomahoun, H. T. V., Gallani, M. C., Stacey, D., & Légaré, F. (2021). Interventions to improve trainers’ learning and behaviors for educating health care professionals using the train-the-trainer method. Journal of Continuing Education in the Health Professions, Publish Ahead of Print. https://doi.org/10.1097/ceh.0000000000000375
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Sutrisno, S., Rondhianto, R., & Susanto, T. (2023). Factors affecting the quality of life of COPD patients: A literature review. UNEJ E-Proceeding, 262–270. https://jurnal.unej.ac.id/index.php/prosiding/article/view/40229
Siu, D. C. H., & Gafni, L. (2024). Addressing barriers to chronic obstructive pulmonary disease (COPD) care: three innovative evidence-based approaches: a review. International Journal of Chronic Obstructive Pulmonary Disease, 19(19), 331–341. https://doi.org/10.2147/COPD.S426050
Toles, M., Colón, C., Moreton, E., Frey, L., & Leeman, J. (2021). Quality improvement studies in nursing homes: a scoping review. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06803-8
Totten, A. M., Womack, D. M., Griffin, J. C., McDonagh, M. S., Davis-O’Reilly, C., Blazina, I., Grusing, S., & Elder, N. (2022). Telehealth-guided provider-to-provider communication to improve rural health: A systematic review. Journal of Telemedicine and Telecare, 1357633X221139892. https://doi.org/10.1177/1357633X221139892
