Reflective Journal Week 8: Quality Improvement Strategies III

1)         I expected to learn about more quality improvement strategies that I can implement into my work environment.

2)         I actually learned about measures of consumer satisfaction and its effect on healthcare. Sollecito and Johnson (2013) stated that consumer satisfaction data is now recognized as the best source on communication, education, and pain management. It is a requirement of patients and payers in health systems. Who is the consumer? In healthcare it is the patient or any party that will be potentially using the product or service on offer (Sollecito & Johnson, 2013). So, hospitals purchasing from vendors, managed care organizations contracting doctors for clients, and Medicare contracting with insurers can all be considered consumers.

            Measuring patient satisfaction in healthcare is of utmost importance since hospitals desire to maintain public images of quality and service. Government and other authorities regulate and continue to require patient satisfaction data. Ratings about different hospitals are displayed online so patients can look up information and then make an informed decision about their choice of providers or hospitals (CMS, 2015).  A Balanced Scorecard influences patient’s choices of hospitals as well.

            HCAHPS surveys to patients include communication with doctors, nurses and the responsiveness of staff. Questions also include if pain was managed, education was given on medication, discharge information was given, and how quiet and clean the hospital environment was. Patient feedback and ratings help guide Continuous Quality Improvement (CQI) measures in healthcare.

3) I enjoyed our discussion on how nurses can implement evidence-based practice (EBP) in their work environment. Our group members thought of ideas for incorporating EBP by questioning the nursing practice and then actively researching scholarly articles that show EBP. This can be presented in staff meetings or to the chain of command in healthcare. Teams can then be created to design quality improvement processes to implement the EBP standards of care. We discussed an important point that nurses likely are not engaged in EBP implementation because they feel they are of only modest education and lack the ability to understand research and statistical terminology (Majid, et al., 2011).  Nurses may not feel there is enough incentive too. I wondered if nurses who engage in EBP could be monetarily compensated for their efforts. Another idea we considered is if nursing schools could require EBP courses where they simulate implementing research into different possible healthcare environments. These courses could be so beneficial for new graduate RNs since they would feel more competent in research and implementing EBP in their practice when they land their first jobs.

4) My goal is to look up EBP whenever I have a question in my nursing environment and speak up about it to my provider I am working with. I work in an InstaCare and even though it is a part of a large corporation, practices and processes still differ from the other Medical Group settings and the larger hospital. This variance is largely due to traditions and healthcare team members’ levels of experience.

5) My personal feelings are that EBP is the gold standard of care.  Healthcare team members should continually strive to be knowledgeable about and implement EBP in their own personal environments. Their examples of engagement will help others want to be committed as well. Patient care would begin to improve on a larger scale and this would be reflective in consumer satisfaction data.   

References

Centers for Medicare and Medicaid Services (2015). Medicare.gov: Hospital compare. Retrieved from https://www.medicare.gov/hospitalcompare/search.html

Majid, S., Foo, S., Luyt, B., Zhang, X., Theng, Y., Chang, Y., & Mokhtar, I. (2011). Adopting evidence-based practice in clinical decision making: nurses' perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229-236

Sollecito, W. A. & Johnson, J. K. (2013). Mclaughlin and Kaluzny’s continous quality improvement in health care. Burlington, MA: Jones and Bartlett Learning, LLC.