Discussion: Improving Quality

Improving the quality of health care delivery and patient safety continues to be a political concern and has been at the heart of reform issues for many years. The American Nurses Association (ANA) and the Institute of Medicine (IOM) have increased awareness of health care quality and safety issues, as well as advocated for health care reform. The documents featured at the ANA and IOM websites listed in this week’s Learning Resources focus on many of the current issues surrounding quality and safety in the health care industry. 

                                              To prepare:

Review this week’s Learning Resources, focusing on the Six Aims for Improvement presented in the landmark report “Crossing the Quality Chasm: The IOM Health Care Quality Initiative.” 

Consider these six aims with regard to your current organization, or one with which you are familiar. In what areas have you seen improvement? What areas still present challenges? As a nurse leader, how can you contribute to improving the organization’s achievement of these aims?

Select one specific quality or safety issue that is presenting a challenge in the organization. Consider at least one quality improvement strategy that could be used to address the issue, as well as which of the six aims for improvement would then be addressed.

Reflect on your professional practice and your experiences with inter-professional collaboration to improve quality and safety. How has inter-professional collaboration contributed to your organization’s efforts to realize the IOM’s six aims for improving health care? Where has inter-professional collaboration been lacking?

Post a description of the quality or safety issue you selected and a brief summary of the impact that this issue has on health care delivery. Describe at least one quality improvement strategy used to address this issue. Then explain which of the six “aims for improvement” are addressed by the strategy. Finally, explain how inter-professional collaboration helps improve quality in this area.

                                           Required Readings

Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the united states (11th ed.). New York, NY: Springer Publishing.

Chapter 13, “High Quality Health Care” (pp. 273–295)

Chapter 2, “A Visual Overview of Health Care Delivery in the United States” (pp. 13–27) 

These chapters discuss the current state of health care quality, as well as efforts to measure and improve quality.

Chapter 14, “Managing and Governing Health Care Organizations” (pp. 297–309)

This chapter details the vital importance of developing a better understanding of why and how heath care organizations are governed and managed in order to improve accountability.

CHECK THE BOOK,  DOCUMENT, AND MEDIA PRESENTATION VIDEO  ATTACHED BELLOW TO COMPLETE THE DISCUSSION QUESTION

USE REFERENCES

 

Instructions

Writing and Pronunciation – Including QEP Enhanced Assignment

—Urology and Obstetrics & Gynecology Departments

By the due date assigned you will write 2 reports referring to the departments of

 Urology (Genitourinary System) and Obstetrics and Gynecology (Female Reproductive System). For the Urology Department, you write a 2 paragraph report and use that for the script of your Oral Report. For the Female Reproductive System, there are 2 audio clips containing spoken medical terms. See Instructions below for the special directions for this section only.

In order to earn the maximum credit for the written report you need to incorporate at least 10 medical terms for each department, using them in a manner that demonstrates your knowledge of their meaning.

• Include the major or most common diseases or conditions seen in each department.
• Include at least three of the principal procedures that are relevant to each department.
• Highlight pertinent laboratory and radiological diagnostic services relevant to each department.
• Limit your analysis of each department to two paragraphs.
• Special Addition of QEP Assignment for Spoken Medical Terminology.
• In addition, we have something for you auditory learners who prefer to listen for understanding. (This week only!) This only applies to the Female Reproductive Body System.
• Instructions: click on the audio clips to hear a Healthcare Professional describing 2 patients admitted to your fictitious hospital. One is a patient with a gynecological problem, and one is a patient with an obstetric problem. There are many medical terms used. You are to identify at least 20 (10 from each patient) medical terms, and list them with correct spelling, and a definition in your own words (to verify understanding! Copying a definition can bypass the brain altogether!)  Put your list in an MS Word doc. File and place that into the Submissions Area. (This might push down your other assignments already submitted, but the files are still safely in there and retrievable by your Instructor.)

Don’t forget your references!

Read chapter 29 and 30 of the class textbook and review the attached PowerPoint presentations.  Once done answer the following questions;     

1.  In your own words and quoting the appropriate evidence-based references define what is family and the different types of family.  Please tell us what type of family do you belong?  

2.   How do you feel that the value system differs from that of your parents? And from your grandparents? Why have these changes come about? As practicing nurses, why is it important to consider these generational differences in values and beliefs?     

3.  Discuss traditional health beliefs & practices that have been passed down by families. Are these cultural or regional beliefs? Do you continue to practice any of the same things? Why or why not?    

4.  How do you believe that family members and their upbringing have affected your own health or could affect a patient/individual’s health? Discuss positive & negative effects as well as physical, emotional & spiritual health. Give some examples.  

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used and 2 replies to any of your peers sustained with the appropriate references must be posted.  Only the assignment must be attached in a word document in the forum, replies do not.  References must be no older than 5 years.  A minimum of 700 words is required.  Please follow the instructions on how to present the first page and the name of the assignment when you post should be Week 9 discussion questions, not my name or blackboard posting.

  

Details: Benchmark – Professional Capstone and Practicum Reflective Journal

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

1. New practice approaches

2. Intraprofessional collaboration

3. Health care delivery and clinical systems

4. Ethical considerations in health care

5. Population health concerns

6. The role of technology in improving health care outcomes

7. Health policy

8. Leadership and economic models

9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

Students will develop a 1,250-1,500-word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, you are required to retrieve and assess a minimum of 8 peer-reviewed articles. an abstract is not required, CITE WEBSITE SOURCE.

  

Epidemiology and Population Health

Reflect on your nursing practice for a moment. If you could wipe out one illness, what would it be? How would that impact not just an individual patient, but your entire patient population? What would be the long-term benefits of eliminating that one illness?

The eradication of smallpox by 1979 provides an excellent example of this scenario. This eradication came about as a result of global collaborative efforts involving many countries and organizations, as well as the application of epidemiologic methods. In spite of high initial financial costs, it is estimated that millions of dollars continue to be saved around the world each year as a result of the eradication of this disease.

The eradication of smallpox illustrates the rich history of epidemiology and demonstrates the cost/benefits and implications of improving health at the population level. The application of epidemiologic methods and principles to other critical population health issues continues to play an essential role in improving health and health outcomes.

For this Discussion, you will identify a current population health problem, and you will examine how, and if, the problem is being addressed through the application of epidemiologic principles. You will also discuss the cost-effectiveness of dealing with the problem at the population level.

To prepare:

• Review      the Learning Resources, focusing on the smallpox epidemic of the 1960s and      1970s and how health organizations applied principles of epidemiology to      eradicate this disease. (See attached file)
• In      light of this example, consider the cost effectiveness of addressing      smallpox at the population level.
• Using      the Learning Resources, research a current population health problem      (local or global). Select one on which to focus for this Discussion.
• Think      about how principles of epidemiology are being applied—or could be      applied—to address the problem.
• What      lessons from the use of epidemiology in the eradication of smallpox might      be applicable to this selected problem? What are the financial benefits of      addressing this issue at the population level as opposed to the individual      level?

By tomorrow Wednesday 02/28/18 by 12pm, write a minimum of 550 words in APA format with a minimum of THREE scholarly references from the list of required readings below. Include the level one headers as numbered below:

Post a cohesive response that addresses the following:

1) Briefly summarize your selected population health problem and describe how principles of epidemiology are being applied—or could be applied—to address the problem.

2) Are there any lessons learned from the use of epidemiology in the eradication of smallpox that can be applied to your selected problem?

3) Evaluate the cost effectiveness of addressing this health problem at the population level versus the individual level.

Required Readings

Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.

Chapter 1, “History and Scope of Epidemiology”

Chapter 2, “Practical Applications of Epidemiology” (pages 49–80 only)

Epidemiology is defined and introduced in Chapter 1. This chapter also presents an interesting historical overview that explains the emergence of the field. The assigned section of Chapter 2 addresses several uses of epidemiology.

Nash, D. B., Fabius, R. J., Skoufalos, A., Clarke, J. L. & Horowitz, M. R. (2016). Population health: Creating a culture of wellness (2nd ed). Burlington, MA: Jones & Bartlett Learning.

Building Cultures of Health and Wellness (xxvii)

In the “Population Health Mandate” section of the course text, the authors provide an introduction to population health, noting that it has three core components: health outcomes, health 

determinants, and policies.

Chapter 2, “The Spectrum of Care”

In Chapter 2, the authors examine the purposes of the population health approach. Two key themes are introduced in this chapter: 1) population health as it relates to the challenges of quality and cost in health care, and 2) population health as an approach to not only reducing the burden of chronic illness but also to promoting wellness and increasing prevention.

Chapter 8, “Behavioral Economics”

In Chapter 8, the authors examine effect of social and cognitive function on an individual’s economic decisions. Reinforced by legislation, behavioral economics can be applied in population health to influence and change health outcomes. Compelling examples of incremental improvements (e.g., corporate wellness programs) are provided throughout the chapter.

Larkin, H. (2010). Managing population health. Hospitals & Health Networks, 84(10), 28–32. 

This article uses examples from a diabetes pilot program to demonstrate the value of population health management. The author discusses how the application of individual patient interventions can positively affect the entire target population, as well as improve the cost effectiveness of management programs.

Center for Global Development. (n.d.). Case 1: Eradicating smallpox. Retrieved March 5, 2012, from http://www.cgdev.org/doc/millions/MS_case_1.pdf

This reading presents the eradication of smallpox in the form of a case study. Many lessons can be learned from the successful global effort to eliminate smallpox.

Centers for Disease Control and Prevention. (2011). Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/

The Morbidity and Mortality Weekly Report (MMWR) is a weekly epidemiological report distributed by the U.S. Centers for Disease Control and Prevention (CDC) to provide, according to the MMWR website, “timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.” It is one of the most important sources of timely public health data published anywhere.

World Health Organization. (2001). Smallpox. Retrieved from http://www.who.int/topics/smallpox/en/

The World Health Organization provides a succinct overview of the eradication of small pox and its impact on population health.

Note: Explore population health issues presented at the websites below as you prepare for this week’s Discussion and Assignment:

American Public Health Association. (2011). Retrieved from http://www.apha.org/

Centers for Disease Control and Prevention. (2011). Retrieved from http://www.cdc.gov/

Food and Agricultural Organization of the United Nations. (2011). Retrieved from http://www.fao.org/index_en.htm

U.S. Food and Drug Administration. (2011). Retrieved from http://www.fda.gov/

Healthy People 2020. (2011). Global health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=16

U.S. Food and Drug Administration. (2011). Public health focus. Retrieved from http://www.fda.gov/NewsEvents/PublicHealthFocus/default.htm

Required Media

Laureate Education (Producer). (2012). Epidemiology and population health: Introduction to epidemiology and population health [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

In this week’s program, “Introduction to Epidemiology and Population Health,” Dr. Hull and Dr. Frerich introduce foundational concepts related to epidemiology, noting that this scientific arena focuses on the study of human populations rather than individuals.

Laureate Education (Producer). (2012). Epidemiology and population health: Epidemiology in nursing practice [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 4 minutes.

In “Epidemiology in Nursing Practice,” Dr. Rebecca Lee, Dr. Donna Shambley-Ebron, and Dr. Missie Willmarth discuss how epidemiology is utilized in nursing practice and, in particular, why it is salient for DNP-prepared nurses.

Optional Resources

Long, D. A., & Sheehan, P. (2010). A case study of population health improvement at a Midwest regional hospital employer. Population Health Management, 13(3), 163–173.

Oudin, Åström D., Bertfil, F., & Joacim R. (2011). Heat wave impact on morbidity and mortality in the elderly population: A review of recent studies. Occupational and Environmental Medicine, 69(2), 99–105.

Excite. (2004). An introduction to epidemiology. Retrieved from http://www.cdc.gov/excite/classroom/intro_epi.htm