Discussion: Quality Improvement Proposal

Discussion: Quality Improvement Proposal

Discussion: Quality Improvement Proposal

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Question Description

Please see attached part 1 for summary to be included in this paper. Please also include sources in reference list

In NURS 410, you developed the first part of a Quality Improvement Intervention/Proposal to address an identified patient care need. For part this paper, Quality Improvement Intervention/Proposal, Part 2 – you will develop an evidence-based implementation and evaluation plan for your identified patient care issue.

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– Utilizing the research that you conducted in NURS 410, you will develop an implementation and evaluation plan for your identified patient care need.

– The research findings should come from peer-reviewed scientific journals.

– Please note: You are required to submit the paper that you wrote in NURS 410 – Quality Improvement Intervention/Proposal Part 1 along with the submission of this paper.



– Identifies problem that needs to be addressed, (summary of issue identified from meeting with nurse leader in NURS 410).

– Explain why an intervention is needed for this problem

Literature Review Summary

– Findings from the literature review are summarized (summary of literature review from NURS 410)

– Findings are related to the proposed intervention

– Uses seven or more scientific journal articles

Intervention Plan

– States proposed intervention plan (based on findings from the literature)

– Outlines timeline for implementation of plan

– Outlines responsibilities for implementation and feedback

– Apply a relevant nursing leadership theory/concept to be utilized in order to implement plan

– Outline how responsibilities for implementation and feedback will be addressed.


– Identifies the stakeholders needed to implement the plan including their roles

– Addresses the management structure/process issues

– State how the identified nursing theory would be utilized when interacting with the stakeholders

Resources Needed to Implement Plan

– Identifies the resources needed to implement the plan

– If resources are not available, makes recommendations for needed resources

– Outlines the budgetary needs, including type of budget, to implement plan

Evaluation Plan

– Describe a clear and concise method of monitoring the outcomes of the quality improvement plan (based on findings from the literature).

– Identify a clear and ongoing reassessment strategy

– State how the identified nursing leadership theory/concept will be utilized in developing a reevaluation plan with the stakeholders

– Outline a timeline for reevaluation of the plan.


– Restate the patient care issue, including summary statement about the findings from the literature

– Summarizes the proposed intervention, role of the stakeholders, recommendations for reevaluation and ongoing assessment strategies.

– States nursing theory/concept to be utilized to implement and evaluate the plan

– Makes future recommendations.

Your Final Paper should be between 14-20 pages (not including cover page and references)

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

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Experimental research, in the form of a randomized control trial, involves the use of both randomization and a control group. By randomly assigning one group to receive routine care (medication, procedure or intervention), the other group (also randomized) undergoes manipulation of the independent variable. After which data is collected, scrutinizing the results and effects of both groups. This data is then compared, establishing or ruling out causation (Helbig, 2021). An example of this is seen in the study by Perika et al. (2019), in which psychomotor recovery was compared in patients receiving dexmedetomidine versus propofol via spinal anesthesia. After randomly assigning the patients to receive either propofol or dexmedetomidine, the patients baseline psychomotor function was tested the day before surgery to serve as the control. The same psychomotor tests were administered post-anesthesia for up to 4 hours after surgery.



Quasi-experimental research does not use randomization, unlike experimental research, instead looking for casual relationships. Selection is often based on inclusion and exclusion criteria, and does not control for extraneous variables. This puts the research in question at risk for compromised internal validity (Helbig, 2021). As an example, Iftikhar, et al. (2022) compared the effects of norepinephrine versus phenylephrine on blood pressure and heart rate during spinal anesthesia for cesarean sections. This study does not have a control group and while this study divided the groups by lottery method to determine which group would receive norepinephrine and which would receive phenylephrine, inclusion and exclusion criteria rather than randomization is used to determine the sample, therefore, this study is characterized as a quasi-experimental model.



Nonexperimental research aims to find a correlation or lack thereof, between two variables. This is done through collecting data, either retrospectively or prospectively, and examining how the variables exist naturally versus when one of the variables is manipulated (Helbig, 2021). In the example of Eggerstedt et al. (2020), the authors seek to show whether anesthesia-collected variable compared to drug-induce sleep endoscopy (DISE) correlate to patterns of upper airway collapse seen on sleep endoscopy. By collecting this data retrospectively from the electronic health record, a statistical analysis was performed via a chi-square//Fischer exact tests for significance of majority of the variables, except for the apnea-hypopnea index (AHI) and Airway Assessment score, in which the Mann-Whitney U Test was utilized. Upon statistical analysis, the researchers were then able to determine that anesthesia airway assessments algorithms and physical exam findings do not correlate well with findings on sleep endoscopy.



Eggerstedt, M., Urban, M. J., Chi, E., Ritz, E. M., & Losavio, P. (2020). The anesthesia airway evaluation: Correlation with sleep endoscopy findings. American Journal of Otolaryngology–Head and Neck Medicine and Surgery41(2). https://doi-org.lopes.idm.oclc.org/10.1016/j.amjoto.2019.102362

Iftikhar, H., Hassan, A., Rehman, H.U., Ayaz, S.B., Ali, Z., & Majeed, K. (2022). Appraisal of the effect of norepinephrine versus phenylephrine on blood pressure and heart rate during spinal anaesthesia for a caesarean section; A quasi-experimental study. Pakistan Armed Forces Medical Journal72(4). https://doi-org.lopes.idm.oclc.org/10.51253/pafmj.v72i4.7674

Helbig, J. (2021). Statistical analysis. In Grand Canyon University (Ed.). Applied statistics for health care (ch.4). https://bibliu.com/app/#/view/books/1000000000581/epub/Chapter4.html#page_46

Perika, T., Gupta, S.L., Elakkumanan, L.B., & Kattimani, S. (2019). Psychomotor recovery of dexmedetomidine compared with propofol after sedation during spinal anesthesia: A randomized control trial. Journal of Anaesthesiology Clinical Pharmacology35(2), 236–241. https://doi-org.lopes.idm.oclc.org/10.4103/joacp.JOACP_390_17

HLT-362V Topic 4 Assignment: Quality Improvement Proposal 

One quality improvement opportunity that our organization has identified is in the area of patient data management. In particular, the management have identified ways to improve how employees collect, store, and retrieve patient data. Acme Healthcare System currently contracts with a third-party vendor for the electronic health records (EHR) systems. One of the recommendations from our quality improvement team was to invest in a new EHR system that would better suit the needs of the organization. Another recommendation was to develop a comprehensive patient data governance policy. This policy would set forth how patient data should be collected, stored, and accessed by employees across the organization. The purpose of this assignment is to identify a quality improvement opportunity in my healthcare organization describe the problem or issue and propose a quality improvement initiative based on evidence-based practice.   

Overview Of the Problem and The Setting in Which the Problem or Issue Occurs 

The problem of patient data management in my healthcare organization is that we have a lot of data, and we not sure what to do with it. The healthcare organization have data from patients’ electronic health records (EHRs), from the billing system, from the laboratory information system, and from other sources. The organization need to find a way to use this data to improve the quality of care given to patients. One idea is to use big-data analytics tools to analyze the data and find patterns that can help us improve approaches for caring for patients. Another idea is to use the data to identify high-risk patients and develop interventions specifically for them. The management is still trying to figure out the best way to use EHR system to enhance patient’s data management.  

The problem of patient data management occurs in healthcare settings where accurate and up-to-date patient information is essential for providing quality care. This may include hospitals, clinics, and private practices. The problem arises when there is a lack of communication and coordination between different medical staff members who are responsible for managing different aspects of a patient’s care. This can lead to duplication of records, missed appointments, and even incorrect diagnoses. To solve this problem, healthcare organizations need to put systems in place that allow for better communication and collaboration between all medical staff members involved in a patient’s care. 

Why A Quality Improvement Initiative is Needed in This  

Area and The Expected Outcome 

A quality improvement initiative is needed for patient data management in order to enhance the quality of patient outcomes and to reduce the cost of healthcare. Healthcare providers are collecting more data than ever before on patients, but much of this data is not being used effectively to improve patient care. By improving the way that data is collected, tracked, and analyzed, healthcare providers can make better decisions about how to treat patients and improve their quality of life. In addition, reducing the cost of healthcare will be critical in order to make it affordable for everyone. By improving patient data management, we can reduce waste and ensure that our resources are being used most effectively. 

A quality improvement initiative is also needed for patient data management to reduce patient’s data loss. A recent study found that nearly one-third of patients reported they had experienced a loss of health information, largely due to human error. Incidents of lost or corrupted patient data can have significant consequences for both individuals and the healthcare system as a whole. For example, patients may experience delays in receiving care or incorrect treatment as a result of missing medical records. In addition, organizations may face financial penalties and reputational damage when data breaches occur. A quality improvement initiative can help to prevent such incidents by improving the accuracy and consistency of patient data handling processes across all areas of the healthcare system.  

How The Results of Previous Research Demonstrate Support for The Quality Improvement Initiative and Its Projected Outcomes 

In order to quality assure patient data, health information technicians use a variety of methods which have been found through research to improve the quality of data. The systematic application of these methods is what is referred to as a Quality Improvement Initiative or QI initiative. A recent study (conducted in Canada) set out to determine the effectiveness of a QI initiative on patient data management (Coles et al., 2020). The study found that the introduction of a QI initiative led to an increase in the accuracy and completeness of patient data. Furthermore, it was also found that there was an improvement in other key performance indicators such as turnaround time, staff satisfaction, and patient satisfaction. These findings demonstrate that a QI initiative can lead to significant improvements in data quality. 

The results of previous research provide strong support to the Quality Improvement Initiative and its projected outcomes in patient data management. A study by Silver et al. (2017) found that a multifaceted quality improvement intervention was effective in reducing preventable harm events, including readmissions, mortality, lengths of stay, and costs. Moreover, the study also found that the overall quality of care improved following the intervention. This indicates that hospitals which undergo a quality improvement initiative can expect to see tangible improvements in patient safety and outcomes. Such findings underscore the importance of investing in such initiatives and point to the significant potential benefits they offer healthcare organizations. 

A recent study published in the journal “Health Affairs” found that the Quality Improvement Initiative (QII) – which is a national effort to improve the quality and safety of healthcare – is projected to result in significant reductions in adverse events, including deaths, hospital readmissions, and costs (Main et al., 2018). The study used computer simulations to estimate the impact of QII on patient data management. The results showed that by 2020, QII could prevent: – Nearly 2 million adverse events, including more than 190,000 deaths, – More than 9 million hospital readmissions, and – More than $150 billion in costs (Main et al., 2018). These outcomes would be achieved through improvements in care coordination and patient engagement.  

Steps Necessary to Implement the Quality Improvement Initiative 

There are a few key steps necessary for the implementation of an EHR system for the effective management of patient data. First, it is important to consult with experts in the field to get a sense of what system would best fit the needs of your organization. Second, once a system has been selected, it is critical to have a dedicated team to manage its implementation and ensure that all staff are properly trained on how to use it. Third, ongoing communication and feedback from all stakeholders – including patients – is essential to monitor the effectiveness of the EHR system and make necessary adjustments. Finally, it is also important to have a robust back-up plan in place in case of technical difficulties or other issues that may arise. By following these 

Discuss steps necessary to implement the quality improvement initiative.  

How The Quality Improvement Initiative Will Be Evaluated to  

Determine Whether There Was Improvement 

When evaluating a quality improvement initiative on the implementation of an EHR system, it is important to collect data around patient management and quality. This can help determine whether there has been an improvement since the EHR system was put in place. The gathered data should be compared against benchmarks or standards to make sure that improvement has actually occurred. Additionally, it is important to get feedback from clinicians who are using the EHR system to see how well it is working for them in their daily workflows. By collecting all of this data and information, the management can create a well-rounded picture of how successful the quality improvement initiative has been. 

There are many factors to consider when evaluating the success of an EHR system, but one of the most important is whether or not it leads to improvements in patient data management and quality. When implemented properly, an EHR system can help streamline clinical workflows and make it easier for staff to access and enter accurate patient data. This can ultimately improve patient care by reducing errors and providing more timely and relevant information to clinicians. Additionally, better data management can help support population health initiatives by providing analysts with cleaner and more complete datasets. That said, it is important to keep in mind that improvement in patient data management is just one piece of the puzzle when it comes to assessing EHR success.  

The variables to be tested to determine effectiveness of the EHR system include clinical workflows, safety of patient data management, and reduction in errors in the patient data management. The hypothesis tests include: The application of EHR system leads to quality patient outcomes, EHR system leads to the reduction in erroneous patient’s data and leads to effective patient outcomes. The statistical tests needed to prove that the quality improvement initiative has succeeded include student t-test, ANOVA, and Z-test.  


Open data initiatives are vital in improving patient data management quality because they allow for interoperability between systems. When stakeholder resource development organizations (healthcare facilities, employer groups, and health plans) standardize on a specific platform or application such as an EHR system, it becomes difficult to manage care coordination. Different forms of electronic patient data platforms used by these organizations compound this problem. One way to improve patient care coordination is to use a system that can connect various types of electronic patient records. Another solution is for developers of EHR software solutions to provide the capability for their systems to exchange information with each other through application programming interfaces or “APIs.” 


Coles, E., Anderson, J., Maxwell, M., Harris, F. M., Gray, N. M., Milner, G., & MacGillivray, S. (2020). The influence of contextual factors on healthcare quality improvement initiatives: a realist review. Systematic Reviews, 9(1), 1-22. https://link.springer.com/article/10.1186/s13643-020-01344-3 

Main, E. K., Markow, C., & Gould, J. (2018). Addressing maternal mortality and morbidity in California through public-private partnerships. Health Affairs, 37(9), 1484-1493.  

Silver, S. A., Bell, C. M., Chertow, G. M., Shah, P. S., Shojania, K., Wald, R., & Harel, Z. (2017). Effectiveness of quality improvement strategies for the management of CKD: a meta-analysis. Clinical Journal of the American Society of Nephrology, 12(10), 1601-1614. https://doi.org/10.2215/CJN.02490317 

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