Healthcare: Quality Improvement, Research Paper Example

Introduction

Education is a very important aspect of patient satisfaction.  In this presentation a research will be conducted into how quality improvement in patient education could be designed and implemented at Davis Health care. In part one of this research data needed for implementing the change will be explored. The second part examines how data retrieved will be displayed and findings measured for accuracy in implementation purposes.

Part 1

Data needed to monitor this quality improvement project relates to finding out what, when, where, how and by whom is patient education delivered. In reference to what, it encompasses the content of patient education meaning what patients are told about a particular health issue or the one they are experiencing at the time. When pertains to the time education is given to the patient. Is it at the onset of a condition as a preventative measure or as a supportive intervention? Where is asking if education is delivered in the community, at the patient’s bedside or at home. How investigates the teaching methods nurses/nurse educators apply along with strategies to impart knowledge to patients regarding their health care and condition. Significantly, understanding who is responsible for patient education is valuable information if any improvement is to be realized

Quality improvement has been described as  the science of process management (Haughom, 2015). The process here is patient education. What are the best tools that could be used in improving the management process involved in answering the what, when, where, how and by whom of patient education

Three data collection tools that can  be used to collect performance information are surveys, interviews and focus groups. Surveys utilize questionnaires as the instrument. There are administered to a target population and data concerning a specific phenomenon such as patient education is retrieved. Interviews are face to face interactions between an interviewee and interviewer. An interviewing schedule is used to collect information regarding the issue. Focus groups employed structured discussions whereby participants offer ideas on the subject being evaluated. The data is recorded and analyzed (Olney & Barnes, 2013).

Surveys will collect information that is expected to answer the questions what, when, where, how and by whom is patient education delivered. This would be answered by designinf questions on a questionnaire created to specifically address thei concern. Interviwed wjhile collecting the same information due to the differences in sample the data collected could be interpreted differently while the same questions are asked in the interview. Focus groups gather information pertaining to how persons in a group setting perceive a particular issue. This is a perfect data collection tool to acquire first hand data on how differences in perception concerning an issue are perceived when discussion occurs in a group (Olney & Barnes, 2013.

The strengths of applying a survey tool in a quality improvement project is that it can capture a wide cross-sections of views on how patient education could be improved in the organization. Strength is that questionnaires used in surveys do not take up much time to fill and are very cost effective. However, since they are filled out online or mailed the response rate might be lower since the target population do not have to respond. Interviews give first hand information and the interviewer could observe the person being interviewed demeanor. Non-verbal responses could be taken into account. This is unlike in a survey. A notable weakness, however, is the length of time it takes to conduct an interviews and the cost of recruiting people when conducting them (Olney & Barnes, 2013).

A great advantage of using the focus group in collecting data for quality improvement is that then tool allows for a variety of responses on a particular issue under a single setting. However, then data gained may be fragmented requiring immense coding and analysis before deciphering its usefulness to the topic. For example, in focus groups while the facilitator may try to structure the discussion directly on specifics of the issue the tendency for extraneous irrelevant maternal to enter the interaction is highly likely (Olney & Barnes, 2013.

These data tools are similar since the focus is on providing answerers to what, when, where, how and by whom is patient education best delivered as a quality improvement venture they collect data from a sample of the population targeted. The difference that occurs between questionnaire and focus group/interview relates to the questionnaire administration involving no face to face contact with the population. In the survey questionnaire tool process the client is offered the questionnaire ether electronically or during a visit to the clinic or health care provider. The distinction between focus group and interviews while both being face to face interaction is that interviews tend to be a long drawn out process, which make take days to complete, but s focus group data could be collected in one session.

 Part 2

Experts have recommended the run chart as a simple data analytical tool applicable to health care processes. It is graphical data display chart plotted in a specified order. The horizontal axis shows a scale such as time, what is done, how conducted and where. It could include a sequence of patients as well with respect to visits and procedures. The vertical axis presents a quality indicator such as facilities where education is delivered, patient perceptions, content, and effectiveness of delivery (Anhøj & Olesen, 2014).

A median must be calculated in order to chart a centerline for the graph. If probability-based rules are applied during interpretation of the run calculating the median is very important. Essentially, it offers the point at which most observations can be viewed. Also the median is not affected by extreme data values. Changes depicted by goal lines and annotations’ are displayed on a run chart. Importantly, run charts support visualization of various impacts data a variable has on the process desired to be improved in the organization. Objectivity is determined through the flow chart representation and interpretation process improvement is evident (Anhøj & Olesen, 2014)

Another analytical display tool applicable to healthcare improvement data analysis is the cause -and – effect diagram. It is also known process fishbone, time delay fish bone, cause enumeration diagram, desired–result fishbone and reverse fishbone diagram. This diagrammatic representation provides possible causes for a perceived problem such as inadequate delivery of patient education at Davis healthcare. It is a very effect focus group analytical tool because the diagram readily categorizes ideas to facilitate interpretation. Experts recommend the tool for team group thinking and brain storming interpretation. Materials needed for constructing a cause- and – effect diagram are a flip chart or marking board pens or marker (Phillips & Simmonds, 2013).

The similarities of these two tools are that they both measure data retrieved from surveys, interviews and focus groups.  Cause –and- effect charts are more designed for a focus group data analysis and explanation process.  Run diagram may not adequately display this type of data. However, its strength lies in being able due calculate the median, which offers more accuracy in data analysis due to its statistical nature. A notable weakness is that the run diagram cannot analyze qualitative data. Similarly the cause and effect diagram while being strong in presenting qualitative data cannot display quantitative ones (Phillips & Simmonds, 2013).

References

Anhøj, J., & Olesen, A. (2014) Run Charts Revisited: A Simulation Study of Run Chart Rules for Detection of Non-Random Variation in Health Care Processes. PLoS One, 9 (11); 14 -22

Haughom, J. (2015). Five Deming Principles that Help Process Improvement. Retrieved on November 28^th, 2015 from https://www.healthcatalyst.com/5-Deming-Principles-For-Healthcare-Process-Improvement

Olney, C., & Barnes, S. (2013). Collecting and Analyzing Evaluation Data. Retrieved on November 28th, 2015 from https://nnlm.gov/evaluation/bookletsPDF/bookletThreePDF.pdf

Phillips, J., & Simmonds, L. (2013). Change management tools part 1: using fishbone analysis to investigate problems. Nursing Times; 109: 15: 18-20.