Reflective Journal Week 9: Quality Improvement Strategies IV

1) I expected to learn more about quality improvement strategies and how they pertain to my role as a nurse. 

2) From this unit and chapter 7 of our textbook (Sollecito & Johnson, 2013), I learned about the role of the patient in quality improvement (QI), how to involve patients in QI and different models of patient involvement. Since health systems have changed and become more developed, patients have been expected to be involved in healthcare. A greater knowledge of health has increased knowledge of errors in the media and public domains. Health systems have been forced to acknowledge the patient or caregiver perspectives. CQI is part of the shift to patient-centered health care because patients are ultimately customers. Factors affecting patient involvement are their willingness to participate due to health literacy or self-efficacy, minority social positions, severity of conditions, the health setting and issues around power relations. Clinician attitudes and beliefs also affect patient involvement.  

Measuring patient involvement via customer satisfaction surveys has become widespread in healthcare. HCAHPS are posted online for patients to review results and compare different hospital levels and quality of care. Different models to facilitate patient involvement have been designed, including the MAPR model. National Patient Safety goals have been implemented to involve patients in their own safe care. The Joint Commission published a “Patients as Partners” toolkit to support patients and caregivers in identifying safety issues. These efforts, in addition to many others, are supportive of involving patients in their care and hopes to identify how patient involvement can have a positive impact on the medical errors/rates that continue to exist in health care.  

3) I enjoyed the Root Cause Analysis (RCA) critical thinking assignment where we asked the question “Why?” five times to a certain problem I have been struggling with as of late. I decided to try this method on another problem I have been facing and interestingly, both answers to my fifth WHY question were the same for both problems. I am excited to learn more about RCA because this is what our team will be presenting on for the final project.

The discussion was more difficult to come to a consensus on since everyone seemed a bit confused about creating indicators for preventing Surgical-Site Infections. I enjoyed learning that clipping hair, as opposed to shaving hair, is the standard of care. It makes sense that clipping would be performed instead of shaving, so hair follicles aren’t entirely exposed leading to bacteria becoming embedded in the follicle and not scrubbed off during the surgical scrub procedure.

4) I plan to continue involving patients more in their own health care by educating them more thoroughly during their discharge about instructions, who to follow up with, and their medications/side effects. I also plan to encourage patients to keep a list of their current medications and bring them with them to all doctor’s appointments, urgent care visits, or hospital stays.

5) I enjoyed this unit on quality improvement. The patient is the customer. Involving them in their healthcare, I feel, can help us find ways to reduce medical errors, HAIs, etc.

Reference

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