Quality Improvement Milestones

Throughout history, major events have influenced quality improvement efforts in health care. For example, the Institute of Medicine’s report To Err is Human: Building a Safer Health System revealed statistics about errors in patient safety that result in thousands of deaths annually. Health care providers must be cognizant of the purpose and philosophy of quality improvement efforts as they lead the charge for improving health outcomes and patient safety. This Discussion is intended to help you understand how various developments have shaped contemporary perspectives and approaches to promoting health care quality.

By tomorrow 11/28/17, write a minimum of 550 words essay in APA format with 3 references from the list below which addresses the level one headings as numbered below:

Post a cohesive scholarly response that addresses the following:

When “To Err is Human” was published in 1999, it marked an important milestone in Quality Improvement Science.

1) Analyze how this milestone has influenced the health care delivery system and nursing practice.

2) Provide an example from your own work history and experience as to how the patient safety movement has affected your practice. 

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

• Chapter      1: “Healthcare Quality and the Patient”
• Chapter      2: “Basic Concepts of Healthcare Quality”

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press. 

Executive summary: Released in 1999, this groundbreaking report provides the rationale for implementing comprehensive improvements in patient safety, an important subset of health care quality. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. 

Executive summary: This report was published by the Institute of Medicine in 2001 to highlight the significant gap between the state of health care quality and where it should be. The report draws attention to the need to improve the U.S. health care delivery system as a whole, and identifies six areas for improvement: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Wachter, R. M. (2010). Patient safety at ten: Unmistakable progress, troubling gaps. Health Affairs, 29(1), 165–173.

This article presents an analysis of progress in patient safety since the publication of the IOM report, To Err is Human. As you read this article, evaluate the author’s critique, and consider recent developments that continue to shape patient safety efforts in health care.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Concepts of quality and patient safety. Baltimore: Author. 

This video examines the recent history of the quality improvement movement, including two pivotal IOM reports, To Err is Human and Crossing the Quality Chasm. Dr. Donald Berwick introduces six dimensions of quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Other topics addressed include transparency, the prevention of adverse events, and the usefulness of international comparisons for quality assessment and improvement.

respond

Staffing issues have always been a major area of concern within the health field. Adequate staffing affects the patient safety, staff morale and finances of the organization. It’s important that organizations take note of concerns related to their staffing and take the necessary steps to ensure that adequate staffing within the units.

The staffing in my organization varies depending on the unit and level of care or acuity of the patients. For starters, patients enter into the Emergency Department and are typically cared for by a nurse who is assigned a team of 3-4 patients. Nurses who work on the medical/ telemetry units are assigned a 1:6 nurse: patient ratio. Nurses who work on the Intermediate Care or Step Down unit is assigned a 1:3 nurse:patient ratio. ICU and CVICU patients are assigned at a 1:2 or 1:1 nurse to patient ratio.

There could be a number of variables that affects the staffing ratio. The shortage in healthcare professionals is one of the greatest variables affecting the staffing ratios. When there is not enough employees on duty, nurses and nurses assistants are forced to work under staff. Patients and families notice when there is a shortage of staff, and they tend to lose their faith in their provider when they’re working short. It’s important that staff understand the importance of managing up the organization and notify their leader if they are feeling overwhelmed instead of venting to the patients.

As it stands now, my organization has some of the lowest nurse to patient ratios which is currently mandated by the organization itself. Our organization takes pride in patient safety, and focuses on safe quality care as a whole. This staffing ratio affects the organizational budget as a great deal of resources is put into recruiting qualified staff as well as using alternative staffing agencies to assist with nursing and support staff coverage.