...Purpose. There are many reasons to conduct chart reviews such a required by a regulatory agency, justification of billing, and research. Another frequently used purpose of a chart review is to assist in measuring quality of care. This measurement is then used to help determine if a change in process is needed to improvement patient outcomes. There are several models used in process improvement including Juran’s Universal Sequence for Quality Improvement, the Seven-step problem-solving model, FOCUS-PDCA and Six-Sigma DMAIC (Langley, Moen, Nolan, Nolan, Norman & Provost, 2009). Chart reviews can be an integral step in all of these models in gleaning data to measure the depth of the problem or if it even exists. This paper will compare the advantages and disadvantages of reviewing charts, describe the basic considerations in performing chart reviews, and describe issues that can threaten the validity of data. Lastly, this paper will look closer at the Six-Sigma DMAIC process as this is the methodology used to guide process improvement in the facility for which this information is being obtained. Background. In 1966, Donabedian stated that the quality of health care is measured by structure, process, and outcome observation. Structure measurement includes resource quality, availability and accessibility (Donabedian, 1966). Process measurement looks at the health care services that clinicians and providers deliver (Donabedian, 1966). Outcome measurement is the end result...
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...training and development programs to assist employees in reaching their ultimate level of performance; however monitoring of performance is necessary to ensure individual and organizational goals are met. The process of assessing an employee’s performance, managing employee opportunities and identifying areas of weakness is evaluated and handled in the performance improvement plan (PIP). The PIP spells out the areas of need, determines goals to improve these areas, and develops training and educational needs associated with successful performance enhancement development. The PIP addresses both the areas of behavioral and performance. In the reflection, Team “D” will address training and development and the PIP process in more detail to gain a better understand of the process. Assessing, implementing, and re-evaluating behaviors and goals will be addressed. Training and development of an employee are closely related but also very different. The goal is to achieve the tasks the organization requires and improve upon productivity and efficiency. The training process of a new employee is a requirement of his or her orientation. The employee will need to understand the roles and responsibilities of his or her job (Difference Between, 2011). According to Difference Between (2011), “Training makes an employee more productive for the organization and is thus concerned with his immediate improvement” (para. 1). The development of an employee is...
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...attendant. • Ensure the safety of passengers aboard aircraft. • Notify the maintenance department regarding any and all discrepancies found in cabin equipment. • Maintain accurate inventory of all cabin property. In the event of an emergency, assist in the care and/or evacuation of passengers. 3. Key ratings for performance • 4 – Performance was always successful, consistent and respectable and at times clearly superior and exceeding standards. • 3.5 – Performance was at most times clearly superior and exceeding standards. • 3 – Performance was successful, consistent, and respectable in every regard with few exceptions. • 2.5 – Performance at times was inconsistent and did not meet standards. • 2 – Performance at most times was inconsistent and did not always meet standards. • 1 – Performance was overall unsuccessful and unacceptable with regard to expectations and the requirements of the position. 4. Job objectives List the objectives you set out for your staff to achieve in the past 12 months (or the period covered by this appraisal) with the measures or standards agreed – against each comment on achievement or otherwise, with reasons where appropriate. Score the performance against each objective (1-3 = poor, 4-6 = satisfactory, 7-9 = good, 10 = excellent): Then you create a table with columns: No – Objectives – Measure/standard - Score - Comment 5. Job competencies Using the 4 point scale below, fill up the following table: • 4 – Exceeds expectations • 3.5 – Somewhat Exceeds...
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...Writing Assignment As commissioner of an agency responsible for child welfare, I am dedicated to ensuring that our caseworkers provide the children our agency protects with the highest level of support and aid. I believe that issues which affect the execution of our mission must be addressed promptly and attentively. I will use my influence in the agency to attend to concerns in a thoughtful manner. Internally, this includes managing cases well, improving caseworker training and skills, and increasing employee motivation through workshops and mentoring. Externally, I hope to keep our public image in check by properly attending to the case children and communicating with the media. Firstly, I will address the issue related to the two caseworkers reported to have not visited the families of a murdered eight year old and a twelve year old arrested for drug sales, in over three weeks. I will arrange for separate in person meetings at my office to discuss these situations in depth. This will provide the employees with an opportunity to express their perspectives and the potential causes for these tragedies. I plan to start the conversation by recognizing the good work they have done for the Agency in the past. Following this, I will transition into the fact that they have been noticeably absent as of late. The absenteeism will be addressed delicately--without prying into private life, instead by asking sincerely if there are issues at home in addition to asking...
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...developing a quality improvement plan for any health care facility or organization. Measuring performance assessments establish a working foundation and insight as to how the foundation is doing respectively to taking on the quality improvement project. During the measurement phase of a quality improvement project, the health care organization gathers performance data and information to determine how the organization is doing respectively to quality. After an organization gathers the necessary data and information pertaining to quality improvement, the organization can move into the assessment phase of a quality improvement project. The assessment phase helps the organization establish whether quality performance...
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...become a source of confusion and sometimes a distraction from genuine value improvement” (McClellan, 2008, p. 23). Quality is affected by patient outcomes and satisfaction. At the same time, quality helps to determine the value in healthcare. Many quality and value initiatives are aimed at reducing health care disparities that exist in American healthcare system, as well as at improving the quality of care (McClellan, 2008). Generally speaking, various quality of care initiatives contribute to the overall success of any health are organization, including financial success and success of nursing practices. To achieve higher level of quality of health care services, it is necessary to use effective mechanisms, which involve certain changes, such as additional staffing, new equipment, adequate audits, and other changes. Health care organizations should be focused on overcoming any barriers to successful quality improvement. Quality and values initiatives in health care help to achieve this goal. The major goal of this paper is to discuss the relationship between the external quality and value initiatives in health care and their effect on the financial success of an organization and nursing practice. To achieve this goal, it is necessary to identify the initiatives and the specific nursing practices affected, as well as the role of nursing leadership in the success of meeting those goals and identify how nursing practice can help drive positive financial results. Some quality...
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...includes employee skills, personal histories, salary, capabilities and accomplishments. Now this workload has been reduced by increased usage of specific human resource management systems. Earlier the automation processes of human resource department were relegated to mainframe computers so as to handle large amounts of data transactions. Now, human resource management systems manage payrolls, work time, training and recruitment form in company (Human Resource System, 2011). The strategy for HRM technology systems improvement in a nursing home is to use the latest state of the art facilities for improvement of the nursing care organization. First, the recruitment process should be computerized with an online application system for applicants, computerized forms for interview evaluation, and job specification based selection system. The payroll system for the nursing home should be computerized and will support self-reporting by employees. Finally, the performance assessment system should be computerized so that custom criteria for evaluation are...
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...Concepts Analysis Paper Demis Rey BSN Theoretical Foundations of Advanced Nursing Kaplan University March 10, 2014 The concept of Quality has a close relation with nursing practices. Higher quality healthcare is the common goal of all healthcare team and improving healthcare quality has become the common focal point of all healthcare organization. Quality has become an important issue for healthcare facilities facing a changing of healthcare environment (Tsai, & Wu, 2013). Quality is derived from the Latin “quails” and is defined as essential character of nature…an inherent or distinguishable attribute or property, a character “trait” and is defined as superiority of kind and degree or grade of excellent (Wicks, & Roethlein, 2009). Every quality expert defines quality somewhat differentially, and there are a variety of perspectives than can be taken in defining quality. The most widely concept of quality is the Industrial Organization Society (IOS) definition as “the degree to wish a set of inherent characteristics fulfill requirements” (Wicks, & Roethlein, 2009, p. 85). The psychological concept is closely aligned with the dictionary definition when quality relates to logic: “quality is the positive or negative character of a proposition” (The Merriam-Webster Dictionary, 2014). Quality is a set of characteristics or properties, as supported by the multidimensional definitions of quality. Quality can focus on excellence or can be viewed as the degree of a...
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...CURRICULUM VITAE Profile Goal directed, results-oriented, professional Healthcare Manager successfully managed in diverse areas including Nursing Leadership, Clinical Audit, Quality Management, Training and Education. Personnel Information Name: Fatme Khodor Elrifai Sex: Female Date & place of birth: 09-01-1978 Lebanon Address: Specialized Medical Center Hospital -Riyadh Phone work: 0114343800 x 3990 Mobile number: 0502855808 E-mail: f.alrifai@hotmail.com Languages Arabic Fluently written and spoken English Fluently written and spoken French Fluently written and spoken Education 2013- 2014: Ongoing Masters in Healthcare Administration/ Quality Management – Al Jinan University, North of Lebanon 2006 -2007: BS Degree in Nursing Sciences – Bridging Program 2000 – 2003: Three years in the TS-Nursing program, Technical Superior Degree 1997 – 2000: Three years in the Nursing program, Technical Baccalaureate Degree 1993 – 1995: High school education in Saint Joseph, North of Lebanon 1989 – 1993: Secondary school education in Saint Joseph, North of Lebanon - Nursing Leadership & Management (Deputy Director of Nursing at Kingdom Hospital Consulting Clinics, KSA/ Riyadh, 130 Beds, private, CBAHI and JCIA accredited primary healthcare institution. KHCC is providing various range of medical services including, but not limited to, Internal Medicine,...
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...layout, spacing, technology, and furnishing; also staffing, training and development, supplies, absenteeism, turnover, and organization's policy (Singh, 2016). Preventive maintenance for negative outcomes in a nursing facility is critical to the aspect in conducting quality care. Negative outcomes that exists are preventable, such as injury, negligence and accidental death. Most situations that are harmful that do not result in negative outcomes include: clinical errors, sanitary conditions, repairs and maintenance elapses (Singh, 2016). Most impressions that are formed by a patient, pertaining to the nature of the quality...
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...Case Study: Evaluation and Morale An effective and productive performance evaluation is an opportunity for a health care manager and his/her staff to identify expectations, establish goals, give reinforcements for jobs well done, and identify areas that have opportunities for improvement. A successful performance evaluation will be one that fosters a healthy working relationship between manager and staff. The case study to be discussed involves a staff nurse who has completed his/her performance evaluation with his/her healthcare manager and has left the appraisal conference disappointed in its outcome and with concerns regarding one specific incident having weighed heavily on his/her evaluation (Mary & Joanne, 2011, p. 231). At the manger level the annual performance appraisal is a toll that should utilized to evaluate past and current performance, identify educational and professional development needs, give rewarding recognition for positive performance, and take disciplinary action if needed. Nursing professional standards of practice holds that each nurse has an obligation to adhere to the code of ethics. The standards of professional practice should be utilized as a criterion when evaluating a nurse’s practice ("Professional Standards," 2012). In reviewing the information provided by the case study this author has evaluated potential problems that could have contributed to the deterioration of the evaluation of this particular staff nurse. It appears that active participation...
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...Organizational Quality Improvement Plan Part 1 HCS/588 June 3, 2013 Organizational Quality Improvement Plan Since the Institute of Medicine’s report “To Err is to Human” enacted in 2000, effort has been made to improve the quality of health care. To implement correctly a quality improvement plan (QIP) the perception of the organization culture and the stakeholder’s culture need to be explored (Centers for Medicare & Medicaid Services, 2013). Quality improvement plan improves quality and efficiency of services to the highest levels rendered. In the United States, for example, consumers have the right to choose, bargain, and express their dissatisfaction or concerns about a product or service. The economy is based on consumerism and the opinion of the consumer is valuable. In the health care arena, consumers have the right to choose the right providers when they looking for medical attention. They have the option to choose the one that can accommodates their needs. This also can create competition in an open market. Competition is very good because it helps competitors to improve the quality of their goods and services. In this paper, a quality improvement plan will be developed for Mary Washington Hospital, the difference between performance measurement and quality improvement will be addressed along with the organization mission and goals. The role of the stakeholders, and which external quality indicators are available will also be discussed in this...
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...organizations, and the benefits and challenges that go hand in hand. Overview of the Magnet Recognition Program The Magnet Recognition Program is not an award but a “performance-driven recognition credential” designed to achieve excellence in patient outcomes and satisfaction of nurses (Drenkard, 2010). Magnet Recognition is the highest and most prestigious distinction a healthcare organization can receive for nursing excellence and high-quality patient care. The Magnet program model organizes 14 Forces of Magnetism into five model components. The five model components are transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation, and improvements, and lastly, empirical quality results. The first component, transformational leadership, identifies the need for more involvement with nursing in leadership roles. The second component, structural empowerment, provides an innovative environment where strong professional practice flourishes and relationships and partnerships develop among many types of community organizations. Exemplary professional practice, the third component, involves the application of knowledge and evidence with patients, families, communities, and interdisciplinary team. The fourth component, new knowledge, innovation, and improvements, is the practice of constantly redesigning and redefining existing systems and practices for future...
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...Running head: ACCREDITATION AUDIT- TASK 4 COMPLAINCE STATUS Joint Commission clearly explained that a Periodic Performance Review is as an assessment tool designed to help in assisting the healthcare organization contributes greatly in the improvement and monitoring performance all through the year. The periodic performance focuses more on the measures that has to do with patients safety and care and at same time given the facility for unremitting standards fulfillment. NCH is 100% compliance with most standards of Joint Commission in the following area; Emergency Management, Human resources, Infection Prevention and Control, Performance Improvement, Right and Responsibilities of the Individuals, Transplant Safety. During the inspection at the facility, the hospital was found to be non- compliant in this listed areas; Environment of Care, Leadership, Life Safety, universal protocol, Medication Management, Medical Staff, National Patient Safety Goals, Nursing, Record of Care, Treatment and Services, and provision of care During the PPR, the hospital was found with an increase cluster in the hallways, it is a fire hazard and a safety issue. The nurses are not familiar with verbal order procedures, using the range of orders that received and the abbreviations that are prohibited in the documents. From the trend, there are areas at which the hospital needs to implement proper education and audit. An action plan needs to be implemented by the administration to address the fallout...
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...Organizational Systems Task 1 Western Governors University Task 1 A. Nursing-sensitive indicators By understanding nursing sensitive indicators, the nurses in this case could improve the structure, process, and outcomes of their nursing care. The structure of nursing care is indicated by the supply of nursing staff and the skill level of the nursing staff. By the nurses having increased knowledge of the issues hip fracture patients are prone to having, such as decrease mobility, increase need for surgical intervention, and increase risk of falls, could help improve the quality of patient care. A patient with decrease mobility is at higher risk for pressure sores. The nurses in this case may have prevented the one by proper padding and repositioning every 2 hours. The nurses in this case should aim to prevent surgical complications and infection (Sauls, 2013). With proper knowledge of dementia, fall prevention, restraint prevalence could lead to improved patient safety and satisfaction. Maybe with an understanding of dementia the patient could have been reoriented, medicated, moved to a room across from the nurses desk, or had a CNA sit with the patient to prevent the need for restraints. If the patient was drowsy there is a good chance the restraints in this case were not medically indicated. Dementia patients are more prone to weight loss and inadequate nutrition which could lead to other risk. In this case the staff should have offered a variety of foods the...
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