In this course you will learn about the importance of quality in healthcare and how you can contribute by implementing a quality improvement (QI) project to improve processes of care and patient outcomes. You will learn about powerful tools to add to your QI ‘toolbox’ during short lectures and reflective exercises. You will apply these tools to the implementation of a QI project in your own practice setting or an area of personal improvement. At the completion of the course, you will have a storyboard that captures your QI project success to share with others. The QI project will be considered within the context of interprofessional teams and from a systems perspective. The objective of this course is to empower you, the working healthcare professional, to improve your knowledge and skills in the science of quality improvement so that you can take action in your own clinical setting to improve the quality of care for your patients and their families.
Application
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來自 Case Western Reserve University 的課程
医疗质量改进
20 個評分
與講師見面
Mary A. Dolansky, PhD, RNAssociate Professor, Frances Payne Bolton School of Nursing; Director, QSEN Institute; VA Quality Senior Nurse Fellow, Louis Stokes Cleveland VA
Shirley Moore, PhD, RN, FAANEdward J. and Louise Mellen Professor of Nursing and Associate Dean of Research
Frances Payne Bolton School of Nursing
Mamta K Singh, MD, MSPhysician Director of the Center of Excellence in Primary Care Education, Louis Stokes Cleveland VA; Associate Professor of Medicine, School of Medicine
[MUSIC]
Welcome to the application section for module two.
In application, we're really putting knowledge into action.
So you're taking what you learned in your theory component and then having some
tools then to particularly integrate them right into your practice.
For module two,
the application component is linking the current evidence to the problem at hand.
So, as you recall, the course objective is to apply what you learn and
then engage in a QI project.
We will be there to support you in this, and
as you build upon these eight assignments, your storyboard will grow.
And at the end, you will have a complete storyboard of your project.
So I often think about this as where the rubber hits the road.
That we can spend many hours in classrooms learning about the concepts of quality
improvement.
But truly, where the action is applied is in the field, in your units,
in your institutions, where the need for quality improvement is so great.
And this is really where the rubber is hitting the road.
As you remember from the orientation last in module one, there are eight assignments
that you will be building upon in order to create your storyboard for your project.
In module one, you created a global aim.
And you collected some baseline data.
For this model you're going to complete a literature and an industry assessment.
And there again, don't feel alone in this.
We really want you at the skills and confidence to carry these tools
into practice so that you too can have a successful improvement project.
We've created the worksheet to guide your progress and
you were exposed to the worksheet in module one.
I really want to encourage you to use the worksheet each week
to guide the application section of this course.
It's very important also to share the worksheet each week
with your organizational sponsor or your support person.
If you are actually able to do an improvement project,
at your institution, do use your organizational sponsor.
If you are unable to do an improvement project in an institution, than use
a support person to guide and to encourage your personal improvement project.
For module two, we're going to refer to the worksheet step two,
where you're linking the current evidence to your problem.
In module two then, for this application,
you're going to be looking at the literature, you're going to do some
searches to find out what's the evidence in the literature to support your project.
You'll also be performing an industry assessment
where you'll be looking at in the Internet and also maybe calling
other institutions to find out what best practices that they're using.
Or maybe what tips that they have identified in order to have a successful
project.
Here's the worksheet.
This is side a just to orient you.
And as you can remembered in module one, you did the goal, your general goal or
the problem that you're really interested in studying.
Then you identified some team members for
your project to get acceleration for enthusiasm for your project.
Then you moved to step one last week,
where you really looked at some problem identification.
Where you created global aim.
Sort of a statement of what you really want to accomplish in your improvement
journey during this course.
Then secondly, you collected some baseline data.
You collected some data on the specific outcomes.
For example, what is the incident of deep vein thrombosis on your unit?
Or what is the percentage of patients who are receiving aspirin who should be
receiving aspirin?
Then you maybe did a quick survey and interviewed some nurses or physicians to
find out what their understanding and perception of the problem at hand.
So your survey questions could indicate,
what do you do in practice in order to prevent deep vein thrombosis?
Or you could ask other physicians, what's your perception of ordering aspirin for
your patients?
For module two now though, we're moving to the next step, step two,
where you're really linking the current evidence.
For step two, you'll be doing two components.
The first is a literature search, where you'll be going out into the literature to
find out the evidence for your specific problem.
The second component is that you'll be doing an industry assessment.
Again, you'll be out on the Internet looking for
best practices of other hospitals, or maybe even calling hospitals.
For this application, the first step is to do a literature search.
There are many search engines out in the Internet for you to use.
One great search engine is PubMed.
PubMed includes many original research articles that you can use
as unfiltered background evidence.
There's also the TRIP database, that really compiles evidence and
searches many databases in order to find out the evidence for you.
Third is the Cochrane database.
And another really rich resource is the National Guideline Clearinghouse.
Now, I don't want you to feel overwhelmed with having to do these
literature searches.
Sometimes literature searches can feel quite heavy and
quite overwhelming because there is a tremendous amount of information
out there, but I'd like for you to see that this can be a simple process and
a process that is very necessary for you to engage in.
Sort of doing that level one evidence search where it's a quick search.
So the example I'm going to provide is
the reduction in hospital acquired complications or deep vein thrombosis.
That's our overall goal.
Then I'm gonna have some team members who are gonna help me with this problem.
I think the important people to include are the nurse manager, the certified nurse
specialist on the floor, and probably a quality center professional,
and a physician would be a good interprofessional player for
this particular problem.
Another good team member not listed on here would be some front line nurses
to help with our project.
As we move on to step one then, we can see that a global aim would be that we
really wanna really reduce the rate of deep vein thrombosis by about 20%,
because we found out that we are about 20% above the national average on our unit,
and we're not happy with those results.
And we think we can do better.
What we did then is we did a little survey of our nurses just to find out what they
were aware of as what they should be doing as far as deep vein thrombosis
prevention and we collected this data and we found out that there was some gaps.
That some nurses really weren't quite sure about the evidence regarding how to
prevent deep vein thrombosis.
So now we go to step two and it's our job then to look in the literature.
So I'd like to just share with you this quick Google search that I performed.
And as you can see I typed in the evidence on quality improvement and DVT,
a very quick little question, and
it came up with some really great resources for us to use as evidence.
Some of the evidence is unfiltered, like primary sources and
some of it is filtered evidence, where they're more synthesis based.
I would go then to these sites and
look in more depth as to what these specific citations were telling me.
Then I would complete a short matrix of each of these sites that I go to,
so that I can keep organized, and
I can just look at patterns of what is being displayed in the literature.
We are attaching to module two then, this matrix for
you to complete for this application section.
This matrix can be as simple or as complex as you wanna make it.
But the point of the matrix is for you to identify on each row a specific citation,
and then what that citation is really telling you about your problem.
Then I'd like do then an Internet search for the industry assessment.
And there are many opportunities for industry assessment for
you to complete for this application for module two.
One big site is the Institute for Healthcare Improvement, or ihi.org.
Here's their front page.
And as you can see on this site, there is a search capacity for you to put in
specific problems or projects that you would like to find out what the Institute
for Healthcare Improvement is advocating for those projects.
Actually, probably for
most of the problems that you're experiencing in your work, you'll find
some type of tip or evidence of what the industry is recommending on this site.
Another important Internet search for industry assessment would be to the Agency
for Healthcare Research and Quality or the ahrq.org website.
When I actually Googled that website, and their search strategy, and
put in deep vein thrombosis, I found this complete workbook,
on how you could prevent hospital acquired venous thromboembolism.
A complete guide for effective quality improvement.
So for this particular topic, most of the work has been done and following this
guide might be the answer that will solve some of your problems in this area.
A third area for
industry assessment would be to go to the innovations exchange website.
And in the Google search,
put in Innovations Exchange if you can't remember the website.
And it comes up with the tag to get to it, and this is their website homepage, and
on it there again is a nice search engine for you to look at
in order to find what the industry is saying about how to prevent DBT.
And the last Internet search for industry assessment would be to go to
the professional organizations who are really interested in prevention of DVT.
And when we Google search this as a search item,
we get many professional organizations that are interested and
possibly have guidelines for the prevention of DVT.
On this search I also found this great page for healthcare professionals and
how organizations involved in venous thrombosis education can be obtained.
Because I was slightly interested in learning about how we can better educate
our nurses about prevention of DVT.
So in conclusion, you can see them through the application of looking
at the Internet for specific literature in your area of interest and
also for looking at what the industry is telling you about this area of interest.
You are really launching for some great fun and some great clues as to how you
then will take the next step, for leading your improvement journey, thanks.
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