You have been talking with your team and interacting with patients. You see some patterns that you would like to change to improve quality. Your team is motivated to help.
identify the focus of your project and anticipate the ethical, legal, and regulatory concerns that may arise in your career as a nursing leader.
For this summative assessment, create a presentation that communicates the focus and scope of your project. You may select from multiple venues to explain the details of your plan. You will demonstrate problem-solving skills as you organize the details of your plan.
Review Appendix B – Question Development Tool from Johns Hopkins Nursing Evidence-Based Practice: Model and Guidelines.
Begin your plan with the following:
o Define the problem.
o Identify the problem to be addressed and the setting in which it occurs.
o Outline your proposal to address the problem.
o Identify and discuss ethical, legal, and regulatory concerns relating to the problem.
o Explain why you chose the problem.
Support your plan by gathering as much information about your selected problem as possible. Consider both qualitative and quantitative data. For example:
o Leader and peer interviews
o Patient/customer surveys
o Quality improvement (QI) reports from the facility
o Benchmarking studies/baseline data.
o If baseline data is available:
o What are the goals?
o Are current practices meeting the organizational goals?
o Are the prescribed practices followed?
Full Answer Section
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- Enhance communication and collaboration among healthcare providers involved in the discharge process.
3. Proposed Solution:
- Standardized Discharge Planning Protocol:
- Early Identification of Discharge Needs: Begin discharge planning upon patient admission, identifying potential barriers and developing individualized discharge plans.
- Daily Discharge Rounds: Implement daily multidisciplinary rounds involving physicians, nurses, social workers, case managers, and physical/occupational therapists to review discharge plans, address any concerns, and ensure timely coordination of services.
- Care Transition Checklist: Develop and implement a standardized checklist for all discharge planning activities, including medication reconciliation, patient education, and social support referrals.
- Post-Discharge Follow-up: Establish a system for post-discharge follow-up with patients, including phone calls, home visits, and remote monitoring as appropriate.
4. Ethical, Legal, and Regulatory Concerns:
- Patient Privacy: Ensuring patient confidentiality and data security throughout the discharge planning process.
- Informed Consent: Obtaining informed consent from patients regarding their discharge plan and any necessary referrals.
- Patient Autonomy: Respecting patient autonomy and preferences in discharge planning decisions.
- Legal Compliance: Adhering to all relevant laws and regulations, including those related to patient safety, data privacy, and anti-discrimination.
- Resource Allocation: Ensuring equitable access to discharge planning services for all patients, regardless of their socioeconomic status or insurance coverage.
5. Why I Chose This Problem:
- Direct Patient Impact: Delayed discharges can negatively impact patient outcomes, increase their risk of complications, and diminish their overall satisfaction with their hospital experience.
- Systemic Impact: Addressing delayed discharges can improve hospital efficiency, reduce costs, and enhance the overall quality of patient care.
- Team Motivation: My team is highly motivated to improve patient care and streamline processes. This project provides an opportunity for the team to collaborate and contribute to a significant improvement in patient outcomes.
6. Data Collection and Analysis:
- Baseline Data:
- Current ALOS for medical-surgical patients.
- Readmission rates within 30 days of discharge.
- Patient satisfaction scores related to discharge planning.
- Frequency of discharge planning delays and their root causes (e.g., lack of communication, social support issues, medication discrepancies).
- Data Collection Methods:
- Review of electronic medical records for patient demographics, diagnoses, length of stay, and discharge summaries.
- Analysis of hospital databases for readmission rates and other relevant data.
- Patient satisfaction surveys to assess patient perceptions of the discharge process.
- Staff surveys to gather feedback on current discharge planning practices and identify potential barriers.
7. Goals and Evaluation:
- Reduce ALOS for medical-surgical patients by 10% within six months of implementing the new discharge planning protocol.
- Decrease 30-day readmission rates for medical-surgical patients by 5% within six months.
- Increase patient satisfaction scores related to the discharge process by 15% within six months.
- Monitor key process indicators such as the timeliness of discharge planning assessments, the accuracy of medication reconciliation, and the effectiveness of communication among healthcare providers.
8. Conclusion
This project aims to address the significant issue of delayed hospital discharges by implementing a standardized discharge planning process. By focusing on early identification of discharge needs, improving communication among healthcare providers, and enhancing patient education, we can improve patient outcomes, enhance patient satisfaction, and improve the overall efficiency of hospital operations.