HCM 403 Module 4 Assignment 2: Quality Assurance Implementation Concerns

HCM 403 Module 4 Assignment 2: Quality Assurance Implementation Concerns

HCM 403 Module 4 Assignment 2 Quality Assurance Implementation Concerns

Emergency departments (ED) at many hospitals have been overwhelmed in the past year, as more patients without health insurance use the ED as a primary care solution. Wait times in the ED are increasing as more and more Americans are using the Emergency Department for their general health concerns. Across the country, the average ED wait time is now 222 minutes (approximately 3 hours, 42 minutes).
Wishmewell Hospital’s average wait time in the ED is more than five hours, and the board of directors is concerned about this long wait time. The danger is that a patient’s condition may escalate during his/her waiting time in Wishmewell’s ED.
The board has tasked you to take on a new quality improvement initiative to decrease wait time in the ED using the Six Sigma approach.
Develop a quality improvement program using the Six Sigma approach to decrease waiting time in Wishmewell’s emergency department.
The quality improvement program must include the following elements in an approximately 10-page MS Word document:
·         Describe the goals and objectives of your plan to decrease ER wait times at Wishmewell.
·         Describe each step of the Six Sigma (DMAIC) process

·         Define the problem
·         Measure the process; what Six Sigma tools will you use?

·         Analyze the data; what tools will you use to analyze the data?
·         Improve the process; explain your improvement plan
·         Control; how will you continue to monitor the results and adjust as necessary?
·         Describe the key players (stakeholders) who should be members of your implementation team and explain why teamwork is an important factor in implementing a quality improvement program.
·         Explain at least three factors that might inhibit the implementation of your decreased wait time program.

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A Sample Answer For the Assignment: HCM 403 Module 4 Assignment 2 Quality Assurance Implementation Concerns

Nurses strive to ensure optimal patient care, irrespective of their patient’s level of knowledge, and offer reassurance to patients as needed. The establishment of the National Committee for Quality Assurance (NCQA) was aimed at enhancing healthcare standards (Soleimanpour et al., 2022). The NCQA plays a crucial role in ensuring the delivery of high-quality healthcare services to patients.

The NCQA often utilizes the Healthcare Effectiveness Data and Information Set (HEDIS) to evaluate the healthcare performance plans provided by healthcare organizations (Zvenyach & Dietz, 2023). The NCQA often utilizes the HEDIS to evaluate the healthcare performance provided by healthcare providers, their staff, and supporting institutions. This paper aims to propose three patient interventions for preventing adult obesity, utilizing the body mass index screening tool to assess the effectiveness of these interventions.

Adult Body Mass Index Assessment

Obesity is an illness that raises the likelihood of a patient being diagnosed with various other ailments (Fawcett et al., 2019). A significant portion of the American population lacks awareness regarding the heightened health hazards linked to obesity. Controlling obesity is essential in primary care. Obesity is characterized by an excess accumulation of body fat that exceeds the healthy range for an individual’s weight. The body mass index (BMI) is a commonly employed diagnostic tool in the medical field for identifying obesity in adult patients.

This preventive assessment tool is crucial in aiding nurse practitioners in evaluating patients for potential additional health issues. Elevated BMI increases the susceptibility of individuals to cancer, coronary artery disease, respiratory complications, and diabetes. Listed below are three interventions an NP can employ to assess the effectiveness of care when utilizing the BMI evaluation to assist patients in attaining a healthier BMI.

Patient Interventions

Intervention One Using the Adult Body Mass Index Assessment

The initial intervention proposed is the utilization of the adult BMI assessment tool. The BMI is a metric used to assess an individual’s total body fat by considering their height and weight. The nurse practitioner will evaluate each patient’s BMI to establish the patient’s weight status. According to Zheng Liu et al. (2019), individuals with a BMI exceeding 25 are classified as overweight or obese. The BMI is a self-reported measurement that considers an individual’s height and weight, measured in kilograms.

During each medical consultation, patients undergo weight and BMI assessments. The nurse practitioner uses a map-out graph to monitor patients’ weight and make informed decisions regarding their care. Monitoring the patient’s BMI facilitates the timely identification of obesity and the initiation appropriate interventions. Patients often lack awareness of their weight gain until they consult a healthcare professional. Patients may experience weight gain but may avoid using a scale due to apprehension regarding the extent of their weight gain.

Intervention Two-Educating Patients on The Risk of a Higher Body Mass Index

The subsequent necessary intervention is to provide education to patients who have a BMI that classifies them as obese. The nurse practitioner should educate the patient on the importance of maintaining a healthy BMI and the associated health risks and obesity statistics. Individuals with a medical background of obesity have an increased susceptibility to various health conditions, including cancer, respiratory problems, high blood pressure, hyperlipidemia, and type 2 diabetes (Fawcett et al., 2019).

The patient should receive instructions on BMI reduction. For the patient to achieve successful weight loss, their education must precisely depict a nutritious diet and a well-structured exercise regimen. The patient can achieve their goals by establishing incremental objectives, such as aiming to lose ten pounds within three months. Educating patients on maintaining a healthier BMI after achieving their goals is crucial. Weight maintenance is crucial for reducing the risk of comorbidities and enhancing the quality of life for patients.

Intervention Three-Nutritional Group Referrals

The third intervention is referring an abnormal BMI patient to nutritional groups the nurse practitioner. Patients with weight loss objectives and problems will benefit from nutritional categories. This group may help the patient make friends and support one another. Obese patients often have depression.

According to social mindset theory, embarrassment, and a competitive incentive structure enhance the possibility of self-criticism for self-regulation (Semlitsch et al., 2019). Overweight patients self-criticise, causing sadness. The domino effect of obesity affects physical and mental health. To calm the patient, the nurse practitioner reassures them.

Depression might demotivate people from following their weight loss regimen. Weight clinics are available should the patient or nurse practitioner prefer a structured atmosphere. This may motivate the patient to lose weight. Weight loss is psychologically and physically challenging, but nutritional support groups help patients succeed.

Improving Patient Outcomes

Patients who are overweight have a higher risk of cardiovascular disease, high blood pressure, and diabetes. Obesity causes several health problems and 20% of US fatalities (Zvenyach & Dietz, 2023). The nurse practitioner may enhance patient outcomes by accurately evaluating BMI and informing patients about high BMI risks. After learning about their weight control strategy, patients will be better equipped to reduce weight. The nurse practitioner employs a great BMI assessment tool to calculate the patient’s BMI and health risks.

The nurse practitioner’s treatment plan, which includes a balanced diet, exercise, and support group referrals, will enhance patient outcomes. Patients with hypertension or diabetes may improve their medical diagnosis after losing weight. When these illnesses improve, people may be able to reduce or discontinue hypertension or diabetic medication per doctor’s prescription.

Obese people may have impaired mobility and skin deterioration. Lowering the patient’s BMI increases mobility, making it more straightforward to remain active. A nurse practitioner will improve the prognosis for each patient’s health by devising the most effective treatment strategy, which may consist of support groups, education, exercise, nutrition, and exercise.

Cost Savings

Patients with many medical conditions often have higher hospital stays, doctor visits, and prescription drug costs. Obesity is linked to heart disease and acute cerebrovascular illness, including strokes. Obesity and stroke increase hospital admissions and healthcare costs (Semlitsch et al., 2019). High co-morbidities in obese people lead to several medications. Medical costs rise as patients use more prescriptions.

The hospital risks insurance denial if patients are readmitted for the same conditions. Lack of reimbursement burdens the hospital (Yuksel et al., 2020). The nurse practitioner will utilize the BMI assessment tool to reduce the patient’s risk of illness, hospitalization, and pharmaceutical expenses. The nurse practitioner helping patients decrease their BMI will reduce hospital visits and prescription costs, saving patients and the healthcare system money.

Improved Patient Rating

Improved NP patient evaluations will come from using a BMI measurement tool, teaching the patient the value of leading a healthy lifestyle, and having them participate in nutritional groups. Patients will thank the NP for giving them the skills to improve their quality of life after adapting to this lifestyle.

To successfully change their lifestyle, many individuals with a higher BMI must address their depression (Zvenyach & Dietz, 2023). Depression may cause fatigue and stress eating, which can lead to obesity. The patient’s physical and mental health will improve after using resources to decrease BMI.

Lifestyle intervention—dietary energy restriction, exercise, and behavior modification—is the primary line of therapy for obesity (Zheng Liu et al., 2019). A patient’s quality of life improves when they can adjust to lifestyle changes to lose weight. The nurse practitioner can assist high-BMI patients in managing their health issues via intervention and education. The patient may concentrate on BMI reduction when these health conditions are addressed.

Conclusion

Obesity is a condition that has mental, physical, and emotional repercussions. NCQA ensures that each patient gets exceptional treatment. The HEDIS lets customers assess healthcare providers’ disease prevention programs. The BMI screening tool helps doctors identify people at risk for obesity and co-comorbidities. Detecting patients with higher BMIs can help nurse practitioners reduce patient health risks, minimize healthcare costs by reducing readmission hospital rates, and improve patient quality of life.

Healthcare aims to enhance patient quality of life by providing the required instruments. These three strategies will help patients voluntarily decrease their BMI, improving NP patient ratings. Individualized therapies will help patients adopt healthier lifestyles.

References

Fawcett, E., Van Velthoven, M. H., & Meinert, E. (2019). Long-term weight management using wearable technology in overweight and obese adults: A systematic review (Preprint). JMIR MHealth and UHealth, 8(3). https://doi.org/10.2196/13461

Semlitsch, T., Stigler, F. L., Jeitler, K., Horvath, K., & Siebenhofer, A. (2019). Management of overweight and obesity in primary care—A systematic overview of international evidence‐based guidelines. Obesity Reviews, 20(9), 1218–1230. https://doi.org/10.1111/obr.12889

Soleimanpour, S., Geierstanger, S., Goddard, A., Cushing, K., Fields, P., & Love, H. (2022). Developing National Standardized Performance Measures for School‐Based Health Centers: The National Quality Initiative. Journal of School Health. https://doi.org/10.1111/josh.13236

Yuksel, H. S., Şahin, F. N., Maksimovic, N., Drid, P., & Bianco, A. (2020). School-Based intervention programs for preventing obesity and promoting physical activity and fitness: A systematic review. International Journal of Environmental Research and Public Health, 17(1), 347. https://doi.org/10.3390/ijerph17010347

Zheng Liu, Han-Meng Xu, Wen, L.-M., Yuan-Zhou Peng, Lin, L.-Z., Shuang Zhou, Li, W.-H., & Hai-Jun Wang. (2019). A systematic review and meta-analysis of the overall effects of school-based obesity prevention interventions and effect differences by intervention components. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 95. https://doi.org/10.1186/s12966-019-0848-8

Zvenyach, T., & Dietz, W. H. (2023). Quality Measurement Gaps and Future Directions in the Assessment of Obesity. Current Obesity Reports. https://doi.org/10.1007/s13679-023-00525-0

Thank you Melissa for your in-depth discussion on the best way to evaluate evidence-based practice project in nursing. I agree with you that evaluation is a critical component of assessing the effectiveness of EBP interventions as they are meant to improve the quality of care provided to patients and improving treatment outcomes.

Again, reducing the overall cost of care is also a part of implementing EBP in healthcare and therefore, evaluation of the success is critical. In this case, outcome measures and process measures can be evaluated to ascertain if the EBP project change is successful in attaining the set goals and objectives (Lehane et al., 2019).

Patient related outcomes will demonstrate the effectiveness of the project while process measures show if the changes have improved overall workflow, response to emergency situations and implementation of quality care approaches to reduce events like readmissions and even hospital acquired infections (HAIs). The effectiveness of change project depends on its ability to address organizational quality and patient safety goals, especially a reduction in adverse events like falls.

Again, as you posit effective patient monitoring and upon discharge is essential as it demonstrate a change in approaches to care management. Patient survey tool shows if the change project is successful when patients offer feedback by filing survey questionnaires. Providers in the facility can also demonstrate the effectiveness of the program when they answer to aspects like reliability, costs, and feasibility as well as the effects of the initiative on the overall workflow (McNiff & Petrick, 2018).

When providers attest to better workflow, a reduction in adverse events like falls, and effective coordination among the multidisciplinary teams, it illustrates that the initiative is attaining its set goals and objectives. The implication is that EBP change project should attain desired outcomes for patients and providers in different settings.

 

References

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., … &

Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an expert view. BMJ evidence-based medicine, 24(3), 103-108. doi: 10.1136/bmjebm-2018-111019.

McNiff, P., & Petrick, M. (2018). Quantitative Research: Ethics, Theory, and Research. In Grand

Canyon University (Ed.). Nursing Research: Understanding Methods for Best Practice. https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/3