Week 6 Reflective Journal- Quality Applications

1) I expected to learn about applying quality measures to healthcare.

2) I actually learned from this unit what benchmarking and balanced scorecards are, in addition to best practices for urinary catheters and venous thromboembolism prevention guidelines.  Benchmarking is “the use of external comparisons to understand how one is doing compared to one’s peers and/or one’s competitors” (Sollecito & Johnson, 2013, p. 173). It requires a type of decision regarding the standards that should be used when comparing outcomes across facilities or within a facility over time including Normative, Empirical, and Institutional. The Normative approach are standards that reflect best possible outcomes that can be achieved under optimal circumstances, so results are determined by evidence-based medicine. In the Empirical approach, results are assessed relative to other institutions treating similar patients (Sollecito & Johnson, 2013, p. 174). The Institutional approach is where results are based on a self-comparison over time.

I was able to look up different hospital balanced scorecards, via a google image search, indicating how well institutions have performed over time. They would post targeted goals in an organized framework and then post their actual percentages to determine if they met their goals. These scorecards made performance information easily accessible and showed where improvement was needed in different categories such as patients (customers), employees, enablers, and financers. By viewing their companies’ scorecard, quality improvement teams could easily compare their benchmarks with other organizations to determine their level of standing.

I also looked up the guidelines for preventing catheter-associated urinary tract infections from the Center for Disease Control and Prevention. The Case Study activity I completed reminded me of the trainings I went through while working at Utah Valley Specialty Hospital. We completed ERASE CAUTI programs and implemented them on our patients. We followed specific protocols by assessing our patients for the actual need of a catheter, inserted them aseptically with the specialized/updated kits, ensured we removed them as soon as possible with documentation, and then did bladder retraining for the patients to help with urinary continence afterwards. This program helped decrease UTIs in our patients, and helped us ensure our patients only received catheters if indicated.

3) I enjoyed the team discussion on best practice guidelines for preventing venous thromboembolism (VTE). It was a great refresher to remind me of standards of care and how pharmacists, physicians, and nurses are all needed to help prevent VTEs in patients. The team approach is what will provide the most thorough and safe care to patients, leading to better benchmark outcomes.

4) I plan to look at my own hospital’s benchmarks, determine where improvement is needed, and help implement that with my manager. This way, patient outcomes will be better  because they are based on standards of care, and our benchmark scores will improve.  

5) I enjoyed this unit on Quality Applications. I didn’t realize how much is involved when it comes to measuring the strengths and weaknesses of one’s company. It is an intricate process involving a lot of analyzing, planning, implementation, and additional research on ways to improve--a definite difficult task requiring teamwork.  

Reference

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