1

EmoryUniversity

NellHodgsonWoodruffSchool of Nursing]

Sample Seminar Guide for Quality Improvement Exercise

NRSG 471: Professional Development IV 2008

Overview: Students complete the Quality Improvement Exercise in the final 6 weeks of the Professional Development course in the second semester of the senior year. Classroom lectures cover several of the QSEN knowledge competencies including those related to national quality and safety initiatives and the quality improvement process (PDSA). During a two-hour seminar period following class, students work through the exercise in teams. This is an example of the seminar guidelines provided to the student teams each week.

Contact for more information:

Gerri Lamb, PhD, RN, FAAN

----

This is the first seminar for the Quality: Policy and Practice series that will take us through to the end of the semester. You will be working through Assignment 2: Quality Improvement Exercise as a group exercise in seminar.

I. GETTING ORGANIZED:

  1. Read through Assignment 2: Quality Improvement Exercise
  1. The goals for this week are to:
  • Select a problem for your quality improvement exercise
  • Decide how you will collect baseline data about your problem
  • Compare your problem and the way you will track it to national quality indicators relevant to nursing practice in hospital, ambulatory, long-term care, and community settings.
  1. Teamwork: You are now members of a QI team. For the remainder of the semester you will work on a QI project together and present your process and outcomes to your classmates and faculty. Do any team preparatory work you think will be helpful in completing this exercise.

II. START PDSA – PLAN

  1. Select a problem for your quality improvement exercise

Your problem may be either

  • A quality issue or problem in your own clinical practices, like lack of handwashing, not following recommended guidelines to prevent patient falls, using medication abbreviations, lack of documentation of referrals, lack of blood sugar control, lack of adherence to diet, etc

Choose a problem that is common across your clinical settings and that most or all of you do fairly often. It needs to be something that is easy and quick for you to count – so you can track it at the beginning of this exercise and see how it changes with a few very small interventions. Choose a problem that you can try to improve in your own practice rather than something that will require that other staff will need to do. Last, choose something you are not likely to change quickly just because you’re looking at it.

OR

  • A health issue or problem common to your group members, e.g. not getting enough hours of sleep, getting too little exercise, not eating healthy foods, etc.

Choose something that everyone in your group is willing and interested to work on. Again, select something that is easy to measure.

Note: it’s ok to choose the same behavior change you did or are doing for your paper in NRSG 461. This exercise will be different: you willdo this as a group and you will be using standard QI processes and tools to improve performance.

5. Decide how each member of your group will collect baseline data over the next

week. To do this:

  • Define exactly what you will track, the timeframe, and how you will measure it.

For example:

Frequency of handwashing: each person in your group will

Track your patient encounters for 1 clinical session over the next week and count the percent of times you wash your hands. Measure: # of times you wash your hands

total number of new patient encounters

Number of hours of sleep: each person in your group will count the number of hours he/she sleeps each night for the next week or another possible measure: each person in your group will count the number of times in the next 7 days that he/she gets 8 hours of sleep.

6. Agree on how each person will bring baseline data back to your group next week. (Be very specific – what should each person write down)

7. Check if your problem is a national quality or safety priority or goal of the National Quality Forum (NQF), the Joint Commission on Accreditation of Health Care Organizations (JCAHO), the National Quality Assurance Committee (NCQA), or Healthy People 2010.

  1. National Quality Forum

Is your problem a “NQF endorsed national voluntary consensus standard for nurse sensitive care”?

Go into the NQF website, search on nursing

  1. Joint Commission

Is your problem a “national patient safety goal”?

Go into the JCAHO website, click on patient safety, then national patient safety goals, then on your desired setting(s)

  1. National Quality Assurance Committee

Is your problem one of the problems tracked in the Healthcare Effectiveness Data and Information Set (HEDIS) for health plans?

Go into the NCQA website, click on HEDIS and Quality Measurement, click on “more” information or search HEDIS Measures and then click on 2007 MCO (Managed Care Organization) Performance Measures.

  1. Healthy People 2010

Is your problem a “leading health indicator”?

Go into the Healthy People website, click on leading health indicators

7. Review what you have accomplished today and conduct a quick team debrief.