Quality Improvement Project Plan

NURS FPX 8012 Assessment 5 Quality improvement has become a mandatory component of healthcare practice that enables the delineation of the developments in improving the results of interventions and the organisation’s functioning. It is within this context that, as a DNP-prepared nurse, I acknowledge the significance of dynamic leadership and motivation for quality improvement initiatives in an organization. The purpose of this quality improvement project plan is to work on a major area in the healthcare environment: information systems/technology and patient care technology improvement and changing. This project plan has been prepared to tackle a major challenge in the healthcare environment through utilising information technology as well as patient care technology. The problem identified, and its implications for our healthcare setting are significant, and I will briefly explain them.

Impact and Significance of the Problem

In our health system, there is a massive issue of medication errors, more so when a patient is discharged from the hospital and is expected to continue their treatment from home. It is estimated that medication errors occur frequently in healthcare delivery practices, thus resulting in serious negative impacts on patients’ health and cost implications on limited healthcare resources. Medication errors are cited as being among the causes of many preventable deaths; for instance, in the United States of America, about 7,000 patients lose their lives due to medication errors every year, as highlighted by the Leapfrog Group (2021). It is important, therefore, to appreciate the fact that this problem is very significant. It is evident that medication errors are not only risky to patients’ lives but also reduce confidence in healthcare delivery systems and practitioners. Medication errors also lead to a higher risk of patient readmission, prolonged hospital strikes, and other kinds of health issues.

Proposed Technology Solutions and the Plan to Implement Them

These solutions are designed to improve medication use, improve transitions between care locations, and provide real-time information to the decision-makers in the patient care process. The above and other recommendations will help in improving the care quality through medication reconciliation that helps to accurately compile and maintain an up-to-date medication list of the patients across the continuum of care (Brown & White, 2021). This system will extract medication information in the form of Medication history, Discharge summary and Outpatient prescription from the electronic health record (EHR) database. The applicability of this solution is in focusing on the significant problem of medication mismanagement during care transitions based on the factor of the difference in MALs (Johnson, 2019). This means that if medication information is accurate and complete, there are minimal chances of a healthcare provider making prescription mistakes, ordering wrong medications, and ordering medications with potential drug interactions or duplication.

NURS FPX 8012 Assessment 5 Implementation Plan

As part of the process of assessment and planning, there is going to be an assessment of medication management in the current system to identify the gaps that need to be filled; a consultation with relevant stakeholders is also going to be conducted to come up with the implementation plan (Wilson et al., 2022). With the help of IT experts, the EHR system will be designed and developed to facilitate the use of the medication reconciliation system and other tools used in managing patient care. Education sessions would also be conducted to introduce healthcare providers to the new technological solutions. The next and last step is the conduct of pilot implementation of the technologies in selected units or departments to determine the usability and efficiency of the new technological tools in healthcare (Adams & Green, 2020). Further to the above steps, after the implementation receives further feedback refinement, it will be scaled up to all the appropriate departments and creases of care. Checks and balances will be made to ascertain the level of development that took place on the implementation of the proposed solution and this would help identify areas that need improvement most (Harris & Miller, 2021).

Potential Implementation Challenges

Though there is a potential for improvement in medication safety through the proposed strategies involving a detailed medication reconciliation program and the use of clinical decision support tools, several constraints to implementation may be realised. However, for each of these challenges, it should be possible to find the ways of solving them or the sources and support that will help avoid their negative effect on the successful implementation of the plan.

Resistance to Change: It is crucial to note that the implementation of new technology solutions in the healthcare sector has always been accompanied by challenges in promoting change among providers (Green & Johnson, 2021). Healthcare professionals, especially ones entrenched in their place of work, can resist change, which means that new and untested systems will be resisted. This reality indicates that if there is resistance to change, it will act as a momentum to delay implementation and even diminish the impact of the recommended solutions.

Potential Solution: As regards resistance to change, much emphasis should be placed on the identification of healthcare providers and their inclusion in the planning phase to ensure that they are aware of the necessary changes to be made. Gaining ‘buy-in’ from the frontline staff involved in the new technology solutions may be a challenge; therefore, offering relevant and comprehensive training and educating the staff on the advantages of using the new technology solutions can assist in alleviating some of the fears. Moreover, providing continuous encouragement, as well as encouragement and offering subsequent feedback, can enable professional caregivers to become more receptive to change as well as actively participate in the implementation process (Smith & Davis, 2020).

Technical Challenges: Some of the technical considerations include the feasibility of integrating the medication reconciliation systems and other CDS tools into the existing system Frameworks, data migration challenges emanating from incompatible software systems, and Eight (Clark et al., 2019). Sometimes, technical problems prevent the function of machinery or the smooth running of departments, which hinders effective patient care.

Potential Solution: Regarding technical difficulties, systematic implementation presents some risks and it might be difficult to avoid them completely, but working in cooperation with IT specialists and vendors can certainly mitigate these risks to a great extent. The main argument is that any possible problems can be figured out and solved before the program is run on a large scale by performing testing and quality control procedures. Creating and/or maintaining sound support structures or infrastructures like help desks or proper IT support teams that can make possible corrections for technical plights at the earliest time is another solution (Lee & Wilson, 2021).

Role of Leaders

NURS FPX 8012 Assessment 5 Termination of effective leadership is undeniably a critical factor when it comes to managing change regarding the recommended innovative technology/informatics solutions for medication safety improvement in the context of our healthcare setting. Managers should ensure that people are committed to change initiatives by creating awareness of change, demonstrating desired behaviours, engaging staff actively in change, and providing exemplary models. More so, in regard to the present quality improvement project plan, leaders should exhibit effective leadership behaviors, involve the stakeholders, as well as support the venture with an aim of enhancing the effective use of new technological systems.

Setting the Vision and Direction: To achieve a successful result of using the medication reconciliation system and clinical decision support tools, leaders are supposed to present a strategic vision of the change stating that it is necessary to increase the patients’ medication safety and to improve the outcome which the proposed solutions can deliver (Smith et al. , 2020; Johnson & Brown, 2019). From this paper, it can be concluded that leaders can involve key stakeholders in the process of achieving change by effectively presenting a change vision.

Engaging Stakeholders: As pointed out by leadership scholars Green and Garcia (2021) and Taylor and Clark (2020 ), frontline staff, clinical leaders, IT specialists, and organisational executives are -among the key stakeholders that require leaders to actively involve them in meeting organisational goals. Managers have to ensure that there is free flow of information with stakeholders, encourage them to bring out their issues, and address them if they act or resist change in some ways. This paper will argue that by engaging the stakeholders in decisions that are made regarding the change and supporting the implementation effort through choice and decision to be part of the change, leaders will get not only commitment but also hearts as well.

Communication Plan for Leaders

From the above change management challenges, one should understand that it is possible to enhance the change process by employing a change communication strategy that will be used to coherently communicate with various people. The communication plan should include the following elements: The communication plan should include the following elements:

Stakeholder Engagement: Clearly incorporate the diverse stakeholders’ interests and communication styles by outlining their needs and expectations (Brown & Roberts, 2021; Taylor et al., 2022). Use e-mail, face-to-face communication, posting on notice boards, or even communication where everyone in the company can read them to share information and to share with those who are concerned as well.

Vision and Objectives: To support this strategy of change, it needs to be clearly and properly explained why the change initiative is needed and what value for the organisation and its patients will be achieved through the implementation of the proposed solutions (Smith & Wilson, 2020). Outline the goals, targets, and specific timing of the change management, and ensure that the prospective audiences comprehend the rationale and scope of the change management programme.

Workflow Related to the Technology, Providing Visual Depictions

There are many ways to analyse the workflow, and this assignment showed that even using such simple tools it is possible to gain a better understanding of the existing process and make detailed and clear visual depictions as well. Namely, prior to the application of the suggested technology/informatics solutions to increase the safeguard of medication administration, the organization’s healthcare environment can be characterised by the following key areas of weakness within the multilevel workflow complexes impacting medication management: From the analysis of the workflow of the environments where patients receive medication-related care, a set of issues that caused suboptimal functioning of the delivery system and safety risks for patients and caregivers was established. In addressing these issues, post the implementation of the proposed plan, these aspects will be tackled, and the efficiency and effectiveness in designing, developing, and implementing work processes, as well as clarity in communication and work referral patterns, will improve the patient safety outcomes.

Pre-Implementation Workflow

NURS FPX 8012 Assessment 5 adopting the medication reconciliation process, it was performed in a traditional and manual approach, which had inconsistencies, duplication, miscommunication, and failure in the documentation of patient medication history (Garcia & Wilson, 2021). Patient medication information was collected frequently from various sources such as from the notes written by the nurse, from the doctor, sometimes verbally, and from the paper-based list of medication being used for the patient. This isolated strategy of medication reconciliation was leading to mismatches in medication profiles, duplication of the process, and potentially creating or enhancing adverse medication events at transition points in care. Also, patients’ medication reconciliation surveys were not done and / or followed similar GAPs as the admission medication reconciliation surveys due to poorly documented nursing standard operating procedures.

Areas of Inefficiencies and Breakdowns

Scribe notes, narrative notes, and handwritten documentation were inefficient, along with manual data entry, which were error-prone and affected medication list accuracy (Jones & Clark, 2022). There was a breakdown of communication involving organises, nurses, doctors, and pharmacists due to ineffective information sharing that led to a lack of information sharing when a patient was being discharged. There was little understanding of medication history and allergies and challenges in quickly and accurately making timely decisions about potential risks to patients’ safety. This lack of a smooth and unbroken workflow and the lack of uniformity, which were rife in the different institutions, aided in precipitating variability in practice as well as in enhancing the possibilities of medication errors and discrepancies.

Post-Implementation Workflow

After the integration of the above-mentioned technology/informatics solutions, the checklist-based medication reconciliation process will be automated, and the EHRs that will be integrated with CDS tools will act as key technologies that will increase the rate of medication safety, as recommended by Taylor et al. (2022). A clear picture of movements after implementation explains a streamlined mechanism for managing medication reconciliation and management.

NURS FPX 8012 Assessment 5 Improvements and Solutions Implemented

Electronic medication reconciliation: Various sources such as hospital records, outpatient prescriptions, and/or pharmacy data will automatically feed into the EHR system information about the medication the patient is taking. This will eliminate cases of having to write down a docket number repeatedly and minimise chances of errors, hence pulling wrong documents (Roberts & Miller, 2020). Real-time decision support: Some of the CPOE opportunities include Clinical decision support alerts, which will enable healthcare providers to be on alert when prescribing certain medications since the system will provide alerts relating to medication interaction, allergy, and effect dosage form, among others. These decision support tools will help in making specific decisions and may prevent potential adverse effects on the safety of the patient. Standardised workflows: Specific and general indicators of care coordination will include Development: Medication Reconciliation – Meaningful use will incorporate standardised processes for medication reconciliation across care settings. To ensure the medication management process is effective, clear roles and responsibilities will also be set down for the healthcare team members involved.

Addressing Inefficiencies and Breakdowns

Automated data entry and integration: Automated medication reconciliation documentation will enhance its documentation process as compared to a manual form, where there is increased error likelihood due to data entry duplication (Adams & Green, 2020). NURS FPX 8012 Assessment 5 pulling together the medications list from all the available sources into a single list, discrepancies arising from similar lists in different sources will be eliminated, and there will be a reduction of repeated efforts to develop different lists of medications. Enhanced communication and decision support: This real-time alerting tool shall enhance communication between the caregiver and the recipient by informing the healthcare provider about a need to take appropriate action due to potential medication-related problems. In its essence, decision support tools will offer usable knowledge in the context of decision-making, ensuring that safety issues are dealt with without delay and facilitating pool provider cooperation in the provision of outstanding patient care. Standardisation and consistency: Adherence means consistent practice and documentation across specialties, agencies, regions, and other formal facilities involved in the medication management of patients, which will be achieved through standardisation of policy and planning for medication reconciliation.

Conclusion

In conclusion, NURS FPX 8012 Assessment 5 quality improvement project addresses a pressing need identified within the healthcare environment: the improvement of medication safety through the effective application of technology/informatics. Given the fact that medication reconciliation is a complex process that often involves pen and paper or word documents and that there are still many medication-related errors, in this context, with the help of electronic medication reconciliation systems and clinical decision support tools, we plan to make that process safer. By breaking down the problem into all its aspects, reaching out to the stakeholders and coming up with a change management plan, we have been able to devise the following strategic operations that will enable us to address the various challenges and enhance patient outcomes. The revolutionary aspect of this project is anchored on the fact that should be successful in changing the medication management practice, reducing safety concerns and also improving the quality of care for the benefit of our patients. Through setting up best practices, implementing technologies to support structural work, and supplying clinical decision-making information to caregivers, we can reduce the chances of drug-order inconsistencies, increase compliance with protocols, and, in so doing, enhance the general well-being of the populace.

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