Draft a written proposal and implementation guidelines for an organizational policy that you believe would help lead to an improvement in quality and performance associated with the benchmark metric for which you advocated action in Assessment 1.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guidelines change proposals that will enable a team, unit, or the organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care.

As a master’s-level health care practitioner you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assessment offers you an opportunity to take the lead in proposing such changes.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 2: Analyze relevant health care laws and regulations and their applications and effects on processes within a health care team or organization.
  • Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.
• Competency 3: Lead the development and implementation of ethical and culturally sensitive policies that improve health outcomes for individuals, organizations, and populations.
  • Recommend ethical, evidence-based strategies to resolve a performance issue related to health care policy or law.
• Competency 4: Evaluate relevant indicators of performance, such as benchmarks, research, and best practices, for health care policies and law for patients, organizations, and populations.
  • Explain the need for creating an organizational policy or practice to address a shortfall in meeting a prescribed metric benchmark. 
• Competency 5: Develop strategies to work collaboratively with policy makers, stakeholders, and colleagues to address environmental (governmental and regulatory) forces.
  • Analyze the potential effects of environmental factors on recommended strategies.
  • Propose stakeholders and groups that would need to be involved in further development and implementation of the recommended strategies, policy, and guidelines.
• Competency 6: Apply various methods of communicating with policy makers, stakeholders, colleagues, and patients to ensure that communication in a given situation is professional, clear, efficient, and effective.
  • Communicate a proposed policy and guidelines and recommended strategies in a professional and persuasive manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
  • Effectively support arguments with relevant sources, correctly formatting citations and references using current APA style.

Preparation

After reviewing your benchmark evaluation, senior leaders in the organization have asked you to draft a policy change proposal and practice guidelines addressing the benchmark metric for which you advocated action.

In their request, senior leaders have asked for a proposal of not more than 2–4 pages that includes a concise policy description (about one paragraph), practice guidelines, and 3–5 credible references to relevant research, case studies, or best practices that support your analysis and recommendations. You are also expected to be precise, professional, and persuasive in justifying the merit of your proposed actions.

When creating your policy and guidelines it may be helpful to utilize the template that your current care setting or organization uses. Your setting’s risk management or quality department could be a good resource for finding an appropriate template or format. If you are not currently in practice, or your care setting does not have these resources, there are numerous appropriate templates freely available on the Web.

You may also find it useful to have worked through the Problem Identification and Policy Development | Transcript media piece. This activity could be useful in refining your understanding about aligning policy development to address specific problems.

Instructions

The senior leadership has stressed that they hope you are precise and professional in your proposal, as well as persuasive in demonstrating the merit of your proposed actions. They have stressed that the following must be addressed in your proposal.

Note: The tasks outlined below correspond to grading criteria in the scoring guide.

In your proposal, senior leaders have asked that you:

• Explain why a change in organizational policy or practice guidelines is needed to address a shortfall in meeting a performance benchmark prescribed by applicable local, state, or federal health care laws or policies.
  • What is the current benchmark for the organization? What is the numeric score for the underperformance?
  • How might the benchmark underperformance be affecting the quality of care being provided or the operations of the organization?
  • What are the potential repercussions of not making any changes?
• Recommend ethical, evidence-based strategies to resolve the performance issue.
  • What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark?
  • How would these strategies ensure improved performance or compliance with applicable local, state, or federal health care laws or policies?
  • How would you propose to apply these strategies in the context of your chosen professional practice setting?
  • How would you ensure that the application of these strategies is ethical and culturally inclusive?
  • Does your policy encompass the key components of your recommendations?
• Analyze the potential effects of environmental factors on your recommended strategies.
  • What regulatory considerations could affect your recommended strategies?
  • What organizational resources could affect your recommended strategies (for example, staffing, finances, logistics, and support services)?
  • Are your policy and guidelines realistic in light of existing environmental factors?
• Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law.
• Identify colleagues, individual stakeholders, or stakeholder groups who should be involved in further development and implementation of your proposed policy, guidelines, and recommended strategies.
  • Why is it important to engage these colleagues, individual stakeholders, or stakeholder groups?
  • Do your proposed guidelines help colleagues, individual stakeholders, or stakeholder groups understand how to implement your proposed policy?
  • How might engaging these colleagues, individual stakeholders, or stakeholder groups result in a better organizational policy and smoother implementation?
  • Are your proposal and recommended strategies realistic, given the care team, unit, or organization you are considering?
• Communicate your proposed policy, guidelines, and recommended strategies in a professional and persuasive manner.
  • Write clearly and logically, using correct grammar, punctuation, and mechanics.
• Integrate relevant sources to support your arguments, correctly formatting source citations and references using current APA style.
  • Did you cite an additional 3–5 credible sources to support your analysis and recommendations?

Additional Requirements

• Structure: Include a title page and reference page.
• Length: 2–4 pages should be sufficient for presenting a thorough and concise evaluation, not including your  titles and reference pages.
• References: Cite 3–5 current scholarly or professional resources.
• Format: Use APA style for references and citations.
  • You may wish to refer to the following APA resources to help with your structure, formatting, and style:
    • APA Style and Format.
    • APA Paper Tutorial.
    • APA Paper Template.
• Font: Times New Roman font, 12 point, double-spaced for narrative portions only.

Grading Rubric:

1.  Explain the need for creating an organizational policy or practice to address a shortfall in meeting a prescribed metric benchmark. 

Passing Grade:  Explains the need for creating an organizational policy or practice to address a shortfall in meeting a prescribed metric benchmark, acknowledging costs and benefits both of changing and of not changing the policy or practice. 

2.  Recommend ethical, evidence-based strategies to resolve a performance issue related to health care policy or law. 

Passing Grade:  Recommends ethical, evidence-based strategies to resolve a performance issue related to health care policy or law, and identifies areas of uncertainty or knowledge gaps. 

3.  Analyze the potential effects of environmental factors on recommended strategies. 

Passing Grade:  Analyzes the potential effects of environmental factors on recommended strategies, and proposes mitigation or potential responses to those factors. 

4.  Propose a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law. 

Passing Grade:  Proposes a succinct policy and guidelines to enable a team, unit, or the organization as a whole to implement recommended strategies to resolve the performance issue related to the relevant local, state, or federal health care policy or law; makes explicit links to evidence that supports the soundness of the proposal. 

5.  Propose stakeholders and groups that would need to be involved in further development and implementation of the recommended strategies, policy, and guidelines. 

Passing Grade:  Proposes stakeholders and groups that would need to be involved in further development and implementation of the recommended strategies, policy, and guidelines, and suggests collaboration strategies. 

6.  Communicate proposal in a professional and persuasive manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling. 

Passing Grade:   Proposal is professional, effective, and insightful; content is clear, logical, and persuasive; grammar, punctuation, and spelling are without errors. 

7.   Effectively support arguments with relevant sources, correctly formatting citations and references using current APA style. 

Passing Grade:  Effectively supports arguments with relevant sources, correctly formatting citations and references using current APA style. Citations are free from errors. 

 

Problem Identification for a Planned Change Practicum Project

Selecting a problem to address through a planned change project will require careful consideration of many variables. Here are a few suggestions to help you identify a problem that is relevant, feasible, and appropriate for a planned change practicum project:

• In collaboration with your faculty and/or mentor, brainstorm problems, concerns, or opportunities for improvement which you could address by leading a planned change project.
• Consider the overall scope of the project, realizing that it should fit into the timeframe of the practicum, be feasible, and be something for which you have the power to facilitate change.
• Remember that in order to secure support, most organizations will want validation that a project is worthwhile and necessary. Toward that end, be sure to identify the potential value added to the organization through the project:
  • Improved health outcomes for patients
  • Improved compliance with regulatory guidelines
  • Improved fiscal outcomes (the financial bottom line)
  • Improved health care delivery methods or practices (to enhance quality, safety, or best practices)
• Review current scholarly literature and professional publications regarding the problem to make sure you have a clear understanding of the facts, relevant health policy compliance, and evidence-based practice.
• Obtain feedback and insights from key leaders and experts within the organization, and within the field, as you identify a problem to address.

Make the Connection

Here are a few examples that may serve as a springboard for additional ideas. As always, remember that the scope of your project and available timeframe must be considered as you identify a problem or opportunity for improvement:

• Reduce 30-day readmission rates as mandated by the Hospital Readmissions Reduction Program (through the ACA)
• Improve compliance with National Patient Safety Goals (or other standards of care)
• Improve HCHAPS scores
• Reduce rates of infection
• Increase compliance with core measure indicators (or other standards of care)
• Reduce the patient safety risks
• Implement nurse peer-review program in your agency (just one example of performance improvement)
• Coordinate transition to patient bedside reporting (just one example to enhance communication)
• Initiate patient navigation of CHF patients to improve health outcomes and decrease readmissions

Think About It

As you think about next steps and identifying a problem of interest or need, ask yourself:

• Is there a problem or need that I can address?
• Is there an opportunity for quality improvement that I could lead?
• Are there specific best practice standards of care that need to be instituted?
• Are there specific regulatory guidelines for which compliance must be assured?
• Are there expenses that could be diminished or contained?
• Is there a health outcome that needs to be improved?
• Is there a healthcare delivery process that needs to be enhanced?

Often these items are prime targets for planned change initiatives that will benefit the patient and the organization.  Contact your mentor to discuss ideas you have, and they may have additional ideas to share.  Collaborating with your course instructor, mentor, and the organization to determine the focus of your project creates a win-win situation for you, the organization, and all involved stakeholders.

How will you make a difference?  How will you lead change in your corner of the world?

Assessment of the Problem

In order to investigate the organizational context and external factors impacting your selected problem, you will need to intentionally examine the following:

• SWOT analysis of the organization (strengths, weaknesses, opportunities, and threats relevant to your planned change project)
• Stakeholder involvement and support (identification of who is impacted by the problem, who will be impacted by the planned change, and strategies to engage these stakeholders to garner their input and support)
• Financial implications of the problem and proposed planned change (present financial impact of the problem or need, cost of the change initiative, anticipated cost savings realized through the planned change, etc.)
• External factors which drive or impact the problem (i.e., legislative mandates, health policy compliance, national quality directives, evidence-based standards of practice, accreditation requirements, external benchmarking, reimbursement guidelines, etc.) Note: Support from current professional publications and scholarly literature will be required to validate the external influencing factors.

As you consider each influencing factor, it is helpful to also consider the necessary assessment strategies for each element. Additionally, please note that the process of assessing internal and external influencing factors is iterative, rather than a ‘one-time’ task. As new evidence unfolds, or as stakeholder agendas change it is important to stay abreast of the elements, and relationships, which impact your project. There may be financial implications, regulatory, compliance, reimbursement, or accreditation factors relevant to your project that emerge over time. It will be important to maintain an ongoing assessment of these factors throughout your journey.

Strategies for Data Collection

Take a look at the data collection methods described below. How might you use these strategies to assess internal and external factors impacting the problem?

Influencing Factor

Strategies for Data Collection

SWOT Analysis

• Internal assessment of the organization to determine the strengths, weaknesses, opportunities, and threats relevant to the problem and the planned change project
• Review of organizational documentation regarding the problem
• Key informant interviews with organizational leaders, team players, and other experts when necessary to define the SWOT

Stakeholder Involvement

• Identification of all stakeholders who are affected by this problem or will be impacted by your planned change project
• Consider stakeholders both internal and external to the organization (i.e., organizational departments, health care professionals from other disciplines, community members, patients, families, administration, etc.)
• Develop strategies to engage stakeholders in order to solicit their feedback and perspective regarding the problem, and to garner their support of the planned change

Financial Implications

• Information regarding this element will likely require discussion with the appropriate leader or health care administrator. Information to discover includes:
  • What is the present financial impact of the problem?
  • What are the anticipated costs involved with the planned change project?
  • What are the anticipated cost savings realized through the planned change?

External Factors

• This element will likely require review of the literature, current best practices, related policies, etc. relevant to the problem or problem:
  • Legislative mandates
  • Health policy compliance
  • National quality or patient safety directives
  • Evidence-based standards of practice
  • Accreditation requirements
  • External benchmarking (such as HCAHPS, core measures, accountable care organizational practices, CMS guidelines, value-based purchasing, etc.)
  • Reimbursement guidelines
• Be sure to cite and reference sources as you validate these external factors within the literature
• Make sure that your literature support is current within five years, and that it is from credible scholarly sources
• Key informant interviews may also provide insight to additional external factors within the community

Practicum Application and Activities

Earlier in your MSN coursework, you may have identified a problem and initiated a SWOT analysis, as well as investigation of influencing factors that shape this problem. Take time to revisit any previous work and take the necessary ‘next steps’ to complete an actual or hypothetical SWOT analysis, and an actual investigation of the external variables that shape the problem. Review the Johns Hopkins Appendix G and the SWOT Analysis and Assessment of Influencing Factors Worksheet located in the MSN Toolbox area of the course. Proceed with the following activities. Document your practicum-related activities on the Practicum Log:

• Prepare a plan with specific talking points to meet with your faculty (and practicum mentor if available) regarding the implementation and evaluation of your planned change project.
• Meet by phone with faculty (and practicum mentor if available) to discuss assessment of the problem and influencing factors.
• Revisit current, scholarly publications that support the identified problem. Document your findings using a literature review tool or the Johns Hopkins Appendix G document, located in the MSN Toolbox for this activity.
• Complete the SWOT Analysis and Assessment of Influencing Factors Worksheet located in the MSN Toolbox.
• Validate your work on Phase 1 with your faculty (and practicum mentor if available) as needed.
• Revise your work as necessary.
• Submit the following with your time log, once Phase 1 is completed:
  • Submit your literature review tool that supports the identified problem or the John Hopkins Appendix G
  • SWOT Analysis and Assessment of Influencing Factors Worksheet

In this assignment, you will be writing a 1,000-1,250 word paper describing the differing approaches of nursing leaders and managers to issues in practice. To complete this assignment, do the following:

1. Select an issue from the following list: bullying, unit closers and restructuring, floating, nurse turnover, nurse staffing ratios, use of contract employees (i.e., registry and travel nurses), or magnet designation.
2. Describe the selected issue. Discuss how it impacts quality of care and patient safety in the setting in which it occurs.
3. Discuss how professional standards of practice should be demonstrated in this situation to help rectify the issue or maintain professional conduct.
4. Explain the differing roles of nursing leaders and nursing managers in this instance and discuss the different approaches they take to address the selected issue and promote patient safety and quality care. Support your rationale by using the theories, principles, skills, and roles of the leader versus manager described in your readings.
5. Discuss what additional aspects mangers and leaders would need to initiate in order to ensure professionalism throughout diverse health care settings while addressing the selected issue.
6. Describe a leadership style that would best address the chosen issue. Explain why this style could be successful in this setting.

Use at least three peer-reviewed journal articles other than those presented in your text or provided in the course.

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

1.1:       Exemplify professionalism in diverse health care settings.

1.3:       Exercise professional nursing leadership and management roles in the promotion of patient safety and quality care.

3.4:       Demonstrate professional standards of practice.

In order to evaluate yourself as a learner, it is important to have these “schools of thought” in mind, seeing how they differ and being able to choose between them.

Think of your past learning. 

Answer In a discussion- What are the “schools of thought” you would discuss and move between as a self-actualized, self-transforming learner?

 250 words 

 

Build a slide presentation (PowerPoint preferred) of the health promotion plan you developed in the first assessment. Then, implement your health promotion plan by conducting a hypothetical face-to-face educational session addressing the health concern and health goals of your selected community nonprofit support group. How would you set goals for the session, evaluate session outcomes, and suggest possible revisions to improve future sessions?

As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session activity. The information gained from completing this activity will help you succeed with the assessment as you consider key issues in conducting an effective educational session for a selected audience. Completing activities is also a way to demonstrate engagement.

Although study materials in this course refer to face-to-face communication and meetings with individuals and groups, all assignments in the course are based upon hypothetical individuals or groups.

Professional Context

Health education is any combination of learning experiences designed to help community individuals, families, and aggregates improve their health by increasing knowledge or influencing attitudes (WHO, 2018). Education is key to health promotion, disease prevention, and disaster preparedness. The health indicator framework identified in Healthy People 2020 helps motivate action in such areas as health service access, clinical preventive services, environmental quality, injury or violence, maternal, infant and child health, mental health, nutrition, substance abuse, and tobacco use.

Nurses provide accurate evidence-based information and education in various formal and informal settings. They draw upon evidence-based practice to provide health promotion and disease prevention activities to create social and physical environments conducive to improving and maintaining community health. When provided with the tools to be successful, people demonstrate lifestyle changes (self-care) that promote health and help reduce readmissions. They are better able to tolerate stressors, including environmental changes, and enjoy a better quality of life. In times of crisis, a resilient community is a safer community (ODPHP, n.d.; Flanders, 2018).

This assessment provides an opportunity for you to apply teaching and learning concepts to the presentation of a health promotion plan.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
  • Evaluate educational session outcomes in terms of progress made toward Healthy People 2020 goals and leading health indicators.
• Competency 4: Integrate principles of social justice in community health interventions.
  • Evaluate educational session outcomes and the attainment of agreed-upon health goals in collaboration with participants.
• Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
  • Present a health promotion plan to an individual or group within a community.

References

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (ODPHP). (n.d.). Healthy People 2020. Retrieved from https://www.healthypeople.gov/

Flanders, S. A. (2018). Effective patient education: Evidence and common sense. Medsurg Nursing, 27(1), 55–58.

Note: This is the second part of a two-part assessment. You must complete Assessment 1 before completing this assessment.

Preparation

This assessment builds upon Assessment 1 where you contacted and secured a hypothetical individual or group who were open to a presentation about concern and health promotion strategies. Once again, you will assume the role of a nurse tasked with addressing the specific community health concern identified in the first assessment. This time, you will implement the health promotion plan that you developed in Assessment 1 as a PowerPoint presentation complete with audio-recorded voice over and speaker notes. You must determine an effective teaching strategy, communicate the plan with professionalism and cultural sensitivity, solicit input on the value of the plan to its audience, and consider how you might revise the plan as applicable to improve future educational sessions. To engage your hypothetical audience, you decide to develop a slide presentation to communicate your plan. Note: you are not presenting to an actual individual or group. This is a hypothetical presentation.

Remember that your first assessment (Assessment 1) MUST be satisfactorily completed to initiate this assessment (Assessment 4).

Please review the assessment scoring guide for more information.

To prepare for the assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session simulation. You may also wish to review the health promotion plan presentation assessment and scoring guide to ensure that you understand all requirements.

Note: Remember that you can submit all, or a portion of, your draft plan to Smarthinking Tutoring for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Instructions

Complete the following:

1. Hypothesize what a face-to-face educational session would consist of, addressing the health concern and health goals of your selected community member, friend, family member, or group. Imagine collaborating with the hypothetical participant(s) in setting goals for the session, evaluating session outcomes, and suggesting possible revisions to improve future sessions.
2. Prepare a PowerPoint presentation, which should include audio-recorded voice over, of the health promotion plan you developed in Assessment 1, with detailed speaker’s notes that include your evaluation of session outcomes. Speaker notes should reflect what you would actually say were you to conduct the presentation with an actual audience.

As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Conducting an Effective Educational Session activity. The information gained from completing this activity will help you succeed with the assessment as you consider key issues in conducting an effective educational session for a selected audience. Completing activities is also a way to demonstrate engagement.

PRESENTATION FORMAT AND LENGTH

You may use Microsoft PowerPoint (preferred) or other suitable presentation software to create your presentation. If you elect to use an application other than PowerPoint, check with your faculty to avoid potential file compatibility issues.

The number of content slides in your presentation is dictated by nature and scope of your health promotion plan. Be sure to include title and references slides per the following:

• Title slide:
  • Health promotion plan title.
  • Your name.
  • Date.
  • Course number and title.
• References (at the end of your presentation).
  • Be sure to apply correct APA formatting to your references.

The following resources will help you create and deliver an effective presentation:

• Record a Slide Show With Narration and Slide Timings.
  • This Microsoft article provides steps for recording slide shows in different versions of PowerPoint, including steps for Windows, Mac, and online.
• Microsoft Office Software.
  • This Campus page includes tip sheets and tutorials for Microsoft PowerPoint.
• PowerPoint Presentations Library Guide.
  • This library guide provides links to PowerPoint and other presentation software resources.
• SoNHS Professional Presentation Guidelines [PPTX].
  • This presentation, designed especially for the School of Nursing and Health Sciences, offers valuable tips and links, and is itself a PowerPoint template that can be used to create a presentation.

SUPPORTING EVIDENCE

Support your plan with at least three professional or scholarly references, published within the last 5 years, which may include peer-reviewed articles, course study resources, and Healthy People 2020 resources.

GRADED REQUIREMENTS

The requirements outlined below correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

• Present your health promotion plan to your hypothetical audience.
  • Tailor the presentation to the needs of your hypothetical audience.
  • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.
• Evaluate educational session outcomes and the attainment of agreed-upon health goals in collaboration with participants.
  • Which aspects of the session would you change?
  • How might those changes improve future outcomes?
• Evaluate educational session outcomes in terms of progress made toward Healthy People 2020 goals and leading health indicators.
  • What changes would you recommend to better align the session with Healthy People 2020 goals and leading health indicators?

Additional Requirements

Before submitting your assessment, proofread your presentation slides and speaker’s notes to minimize errors that could distract readers and make it difficult for them to focus on the substance of your presentation.

Portfolio Prompt: Remember to save the assessment to your ePortfolio so that you may refer to it as you complete the final capstone course.