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.

  

Assignment 3: Policy Analysis Paper

In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience.

For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week’s Discussion) and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due day 5 of Week 11. This paper will also serve as your Major Assessment for this course.

To prepare:

Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.

To complete:

Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:

1) An introduction

2) Part 1: Define the policy issue.

a) How is the issue affecting the policy arena?

b) What are the current politics of the issue?

c) At what level in the policy making process is the issue?

3) Part 2: Apply a policy analysis framework to explore the issue using the following contexts:

a) Social

b) Ethical

c) Legal

d) Historical

e) Financial/economic

f) Theoretical underpinnings of the policy

Include in this section:

a) Who are the stakeholders of interest?

b) Is there a nursing policy/position statement on this health care issue? If so, who developed it?

4) Part 3: Policy options/solutions

a) What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.

b) What are the theoretical underpinnings of the policy options/solutions?

c) What are the health advocacy aspects and leadership requirements of each option?

d) How does each option/solution provide an opportunity or need for inter-professional collaboration?

e) What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.

5) Part 4: Building Consensus

a) Outline a plan for building consensus around your recommended option/solution for solving the policy issue.

6) A Conclusion 

7) Part 5: References

a) Limit your references so this section is no more than 2 pages.

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in- text citations and reference list are correct.

Required Readings

Blackman, V. S. (2005). Putting policy theory to work: Tobacco control in California. Policy, Politics, & Nursing Practice, 6(2), 148–155. doi: 10.1177/1527154405276289

In this article, the author applies Kingdon’s multiple streams theory to agenda setting and the public policy issue of tobacco use. In addition, the author points out two limitations of Kingdon’s model—the need to build alliances and the varying power levels among stakeholders.

Craig, R. L., Felix, H. C., Walker, J. F., & Philips, M. M. (2010). Public health professionals as policy entrepreneurs: Arkansas’s childhood obesity policy experience. American Journal of Public Health, 100(11), 2047–2052.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing, 2(2), 108–116. doi: 10.1177/152715440100200205 

Fawcett and Russell provide a five-level conceptual model of nursing and health policy and diagram the relationship between the model and new health policies. Guidelines for health policy analysis and evaluation are also provided.

Hewison, A. (2007). Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7), 693–6 99. doi: 10.1111/j.1365-2934.2006.00731.x

Initially, this article presents a broad analysis of policy making and then provides a specific framework of policy analysis for nurse managers. The author focuses on the necessity for nurses to become involved in health care policy making

Policy analysis: A framework for nurse managers. Journal of Nursing Management, 15(7) by Hewison, A. Copyright 2007 by BLACKWELL PUBLISHING – JOURNALS. Reprinted by permission of BLACKWELL PUBLISHING – JOURNALS via the Copyright Clearance Center.

Howie, W. O. (2009). Mandatory reporting of medical errors: Crafting policy and integrating it into practice. Journal for Nurse Practitioners, 5(9), 649–654. doi:10.1016/j.nurpra.2009.07.012

John, P. (2003). Is there life after policy streams, advocacy coalitions, and punctuations: Using evolutionary theory to explain policy change? Policy Studies Journal, 31(4), 481–4 98. doi: 10.1111/1541-0072.00039

This article advances the use of evolutionary theory as policy theory. The author proposes that aspects of evolutionary theory such as randomness, competition, and selection be applied to policy theory but cautions that more research regarding its applicability is needed.

Rawat, P., & Morris, J. C. (2016). Kingdon’s “Streams” model at thirty: Still relevant in the 21st century? Politics & Policy, 44(4), 608-638. doi: 10.1111/polp.12168

Russell, G., & Fawcett, J. (2005). The conceptual model for nursing and health policy revisited. Policy, Politics, & Nursing, 6(4), 108–116. doi: 10.1177/1527154405283304

In this article, Russell and Fawcett revise their 2001 conceptual model of nursing and health policy and provide guidelines for nursing-specific research.

Optional Resources

Bardach, E. (2004). Presidential address—The extrapolation problem: How can we learn from the experience of others? Journal of Policy Analysis and Management, 23(2), 205. doi: 613545361

  

To prepare:

Review the articles presented in this week’s Learning Resources and analyze each study’s use of nonparametric tests.

Critically analyze each article, considering the following questions in your analysis:

What are the goals and purpose of the research study each article describes?

How are nonparametric tests used in each study? What are the results of their use?

Why are parametric methods (t tests and ANOVA) inappropriate for the statistical analysis of each study’s data?

What are the strengths and weaknesses of each study (e.g., study design, sampling, and measurement)?

How could the findings and recommendations of each study contribute to evidence-based practice in the health care field?

Reflect on the quantitative statistical analyses presented throughout this course in the research literature, the Learning Resources, media presentations, and those articles you reviewed for your abbreviated research proposal.

Ask yourself: Which method is most commonly used in research studies that pertain to my area of nursing practice, and why this might be so?

TO COMPLTE

Post 1-2 PAGES PAPER ON : A cohesive response addresses the following:

Critically analyze each article, including the items noted above.

Identify one statistical analysis method that you found recurring in many of the articles you used in your literature review for your research proposal. This method does not necessarily have to be nonparametric.

Based on your area of nursing practice ( family Nurse Practitioner) , which method of statistical analysis is most frequently used in the research literature? Why do you think other forms of statistical analysis are less frequently used? Provide a rationale for your response.

References

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 25, “Using Statistics to Determine Differences”

Chapter 8, “Chi-Square and Nonparametric Tests”

See these attached articles :

Fisher, K., Orkin, F., & Frazer, C. (2010). Utilizing conjoint analysis to explicate health care decision making by emergency department nurses: A feasibility study. Applied Nursing Research, 23(1), 30–35. doi:10.1016/j.apnr.2008.03.

Tjia, J., Field, T., Garber, L., Donovan, J., Kanaan, A., Raebel, M., … Gurwitz, J. (2010). Development and pilot testing of guidelines to monitor high-risk medications in the ambulatory setting. American Journal of Managed Care, 16(7), 489–496.

Development and pilot testing of guidelines to monitor high-risk medications in the ambulatory setting. American Journal of Managed Care, 16(7) by Tjia, J., Field, T., Garber, L., Donovan, J., Kanaan, A., Raebel, M., & Gurwitz, J. Copyright 2010 by INTELLISPHERE, LLC. Reprinted by permission of INTELLISPHERE, LLC via the Copyright Clearance Center.

 I need to complete 3 research articles, which means I have to do 3 complete rows, 3 citations, 3 abstract/purpose, ect… , the sections are listed below, provide references

This is a Collaborative Learning Community (CLC) assignment. 

Locate no more than 10 research articles related to your EBP project.

Use the assigned Topic Materials “CLC: EBP Research Table” and “CLC Assignment: Evidence-Based Practice (EBP) Project Student Guide.” You will use the “CLC: EBP Research Table” to consolidate and present the findings. Pay attention to the prompts for each column

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CLC: EBP Research Table

  

Citation

Include the APA reference   note.

Abstract/Purpose 

Craft a 100-150 word   summary of the research.

Research/Study 

Describe the design of   the relevant research or study in the article.

Methods

Describe the methods   used, including tools, systems, etc.

Setting/Subject

Identify the population   and
  the setting in which the study was conducted.

Findings/Results

Identify the relevant   findings, including any specific data points that may be of interest to your   EBP project.

Variables

Describe the independent   and dependent variables in the research/study.

Implication for Practice

Articulate the value of   the research to the EBP project your group has chosen.

 

Independent   Variable

Dependent   Variable