ESSAY Data Analysis and Quality Improvement Initiative Proposal

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Data Analysis and Quality Improvement Initiative Proposal

        Throughout the world, healthcare organizations are striving to provide high-quality care that conforms to the Triple Aim requirements of improving patient outcomes, decreasing costs, and improving patient satisfaction (Desebbe et al., 2016).  A Triple aim framework is an approach of optimizing healthcare system performance by the simultaneous development of three critical dimensions: the individual experience of care (patient satisfaction, reducing the cost of care, and improving patient outcomes.  The strategy used by healthcare organizations to achieve success is to implement quality initiatives (QI) to maximize healthcare systems while minimizing underperformance.  Healthcare systems with optimal performance and reduced costs are known to increase profitability and reimbursements (Upandyay et al., 2019).  Healthcare organizations have a better chance of referrals is it reports high levels of patient satisfaction and better health outcomes (Craig et al., 2015). The quality of care provided by the organization has a strong influence on its sustainability, and it can be attained and maintained by supporting and promoting education and continuous improvement. Data is essential for the success of healthcare quality improvement (QI)) initiatives. Besides, quality improvements (QI) are made up of systematic and continuous actions that can lead to measurable improvements in a target population’s health status and healthcare services (Arora, 2016). The concept of data is what brings about measurability. As noted by the Agency for Healthcare Research and Quality (2013), the basic principle of quality measurement is that if it cannot be measured measure it, then it cannot be improved. Quality improvement (QI) initiatives, when coupled with evidence-based practice (EBP), interprofessional collaboration, effective communication, and strong leadership, can lead to quality healthcare achievement. This paper highlights the role of data in quality improvement efforts and how such data can be used by healthcare organizations to improve patient outcomes, reduce costs of care, and increase patient satisfaction.

Problem Areas

The quality improvement problem at hand involves variations in key health indicators at St. Anthony Medical Center. The organization has a database of events and near misses for harms and potential harms in its hospice program. The 2014 and 2015 figures include the average length of stay of fewer than seven days due to events and near misses, inpatients admissions (IPUs) due to adverse events and near-misses, pain levels, and inadequate symptom reliefs associated with various events and near misses.

Evidence suggests that news of events and near misses negatively impact primary stakeholders within the healthcare systems. Patients, who are the primary victims of adverse events, do not often report them. According to Da Silva and Krishnamurthy (2016), adverse events and near misses could lead to patients’ physical and psychological pain. Their friends and family members may also be subjected to psychological stress associated with seeing their loved one in pain and suffering. The prolonged length of stay due to extensive hospitalization may also subject patients and their families unnecessary psychological burden. In the end, the hospital may suffer reputation damage to its brands and loss of clients.

Evidence also suggests that such scenarios may negatively impact healthcare professionals, the second stakeholder group within the events, and the near-miss cycle. The quality of healthcare services is solely dependent on the value and harmony of the healthcare workforce. The interdisciplinary workforce must work in harmony and with less stress. Evidence suggests that events and near-misses can lead to emotional distress among healthcare professionals (Lane et al., 2019). The situation may lead them to lose their confidence and subject them to self-doubt. Zoeckler et al. (2018) noted that occupational stress among healthcare workers leads to poor patient outcomes. The problem of the high number of avoidable events and near misses could cause a domino effect on healthcare organizations’ performance and the health outcomes of their patients.

Healthcare facilities and systems like St. Anthony Medical Center are the third class of stakeholders within the events and near misses loop. Such events, if not eliminated or minimized via an elaborate quality improvement (QI) process, could subject them to unnecessary lawsuits, loss of earnings, and reputation loss (Mira et al., 2017).

The solution

One of the best solutions to events and near misses is health informatics as part of quality management information systems. Such a system should have a dashboard to indicate trends and possibly display warnings. According to Martinez et al. (2018), increased reporting and analysis of adverse events and near misses is an essential process for improving care systems and increasing the safety of healthcare systems. Such reporting and analysis can only be possible if such events and near misses are identified, reported, and analyzed successfully. The lessons learned must then be translated into practices through the implementation of appropriate system improvements. Even though such systems may be implemented, lack of transparency and mandatory disclosures may lead to their underutilization. Data analytics is, therefore, a crucial tool in health quality improvement (QI) initiatives.

According to Okes (2019), the direct and analytical pathway that adverse events and near-miss systems have in common is based on incident data collection, analysis of root causes, and implementing changes based on such grounds. Ultimately, the gradual improvement of such systems can lead to better patient safety and performance.

Analysis of data to identify healthcare issues or area of concern

As noted earlier, this case study’s healthcare issue was varying levels of potential quality destroying adverse events and near-misses. The case involves variations in key health indicators at St. Anthony Medical Center. The organization has a database of events and near misses for harms and potential harms in its hospice program. The 2014 and 2015 figures include the average length of stay of fewer than seven days due to events and near misses, inpatient admissions (IPUs) due to adverse events and near misses, pain levels, and inadequate symptom reliefs.

The raw data is shown below:

Fig 1. Raw data for St. Anthony Medical Center’s Hospice Adverse Events in 2014 and 2015

The analysis of adverse events for 2014 indicated a lot of variabilities. From the research, it became clear that in 2014, most adverse events and near-misses led to a consistently high number of instances of increased lengths of stay (LOS). A similar trend can be seen in 2015. As seen in figures 2 and 3 below.

Fig 2. 2014 monthly trends in the hospital’s adverse events and near-misses

Fig 3. 2015 monthly trends in the hospital’s adverse events and near-misses

A review of the data reveals no specific pattern in terms of months in which certain adverse events and near-misses are reported. The data’s randomness suggests a level of stochastic appeal desired in data analytics (Glickmack et al., 2020). The data quality is excellent since its random and has no missing values.

A summary of the data is shown below.
Unit – Year LOS Less than 7 Days IPU Admission Pain Level 7-10 More than 24 Hours Inadequate Symptom Relief More than 24 Hours
Hospice 2014 50 47 13 13
Hospice 2015 46 27 17 22

The following dashboard was created from the summary data. From the displayed information, it can be seen that in order of severity, quality improvement (QI) initiatives should be focused on bringing down LOS days, IPU admissions, pain levels, and inadequate symptoms relief in that decreasing of severity. In other words, the organization is mainly affected by LOS days, IPU admissions, pain levels, and inadequate symptoms relief in that decreasing severity as consequences of its adverse events and near-misses.

QI initiative proposal based on a selected health issue and supporting data analysis

The data analysis revealed that adverse events and near misses leading to a high number of extended lengths of stay (LOS) cases and inpatient admissions more than the high level of pain and inadequate symptom relief lasting more than 24 hours. Reduced LOS benefits include reduced readmission rates, mainly due to decreased risk of infection and other types of hospital-acquired conditions.

There are several proposals for reducing LOS, IPU admissions, pain, and symptoms associated with adverse events and near misses. The most appropriate strategy is further data analysis aimed at root cause analysis. The quality initiative (QI) proposal is to reduce the effects of adverse events and near misses by identifying their root causes. A root cause analysis can then be used to develop a better strategy for identifying the issues. Statistically, the highest number of adverse events and near-misses can be linked to medication errors (Tariq et al., 2020). Therefore, information management appears to be at the center of most adverse events and near misses in hospitals. The best strategy, therefore, is to develop an elaborate information management system. The work of Jylhä et al. (2016) suggested that preventing adverse events in healthcare systems requires the envelopment of safe practices in areas of healthcare documentation and information transfer. The proposed strategy involves creating a hospital information management system capable of fostering safe practices and improving communication between interdisciplinary team members.

Health information technology presents the best strategy for streamlining patient history, medication, and care to allow a multidisciplinary team to make decisions based on accurate information. The result would be a reduction in cases of adverse events and near-misses. Ultimately, by eliminating the causes of adverse events before they happen, a comprehensive health information system can act as a proactive strategy for mitigating adverse events before they happen.

Integrating interprofessional perspectives

        The secret to reducing adverse events within the healthcare setting is interdisciplinary collaboration. According to Didier et al. (2017), more than 70% of errors leading to adverse events and near-misses are caused by ineffective communication, communication breakdown and disruptive behavior between physicians and nurses. Creating a culture of interdisciplinary collaboration can solve all those problems and eliminate most adverse events. Achieving success requires the collaborative efforts of a multidisciplinary team of physicians, nurses, pharmacists, and health informatics experts. The interdisciplinary team can work together to conceptualize and develop a health information management system and decipher or interpret information displayed by dashboards on potential cases f adverse events.

         According to Chapuis et al. (2019), interprofessional safety reporting and a review of adverse events can help manage such cases within healthcare systems. An interdisciplinary team working to implement a multidisciplinary safety program can help in reducing instances of such events. Part of the strategy is to create a communication channel for internal voluntary reporting of adverse events.  An interdisciplinary approach can lead to an improvement in patient safety and satisfaction (Simons et al., 2017).  Having a multidisciplinary team requires transformational leadership and a collaborative communication framework. Such a communication framework should be integrated into the technology and data-driven health information system. Therefore, information can be rapidly sent and accessed by various departments without the risk of distortion or delays. An interdisciplinary team cannot operate without proper leadership. Accordingly, hospital management must set up a supportive leadership structure to create a collaborative culture and drive up employees’ support for such a multidisciplinary system.  Clear and effective communication is crucial for the success of all QI initiatives.

Effective communication strategies to promote quality improvement of interprofessional care

        Healthcare professionals need to collaborate across their disciplines at every possible opportunity. Effective communication is, therefore, a crucial element of their collaboration. Having the ability to convey messages effectively, seamlessly, and easily understandable format is essential in solving miscommunications that lead to adverse events. The nature and form of communication must be compelling right from the top management to the rest of the organization. Therefore, organizational leaders must act as role models for the rest of the organization by creating a culture that fosters free and effective communication.

An atmosphere of free and collaborative communication can motivate the healthcare team members to voluntarily include adverse event information into the organization’s communication system and stream. They can report such events without fear of reprisals from the management. Employee satisfaction can, therefore, improve, thereby increasing organizational performance. There is a link between healthcare professional satisfaction and patient outcomes. A positive patient outcome also translates to positive patient satisfaction.

To assist healthcare professionals in using the latest information systems, healthcare organizations should train and educate them on these systems. While implementing such strategies, care must be taken to manage the change process carefully to prevent resistance to change (Ackah et al., 2017). There is a need for the hospital facility to assess the educational and communication skills of their employees. The focus of such an exercise would be a needs assessment. Nurses would need to b taught how to communicate with their patients effectively. They must also be able to advocate for their patients in a manner that promotes interdisciplinary collaboration. Any educational and skill gaps that are identified must then be bridged using appropriate training programs.

Conclusion

For healthcare organizations to reduce incidents of adverse events and near-misses, they must develop quality improvement (QI) initiatives targeted by patient-centered. The focus of such QI exercises would be to improve patient outcomes while also promoting the organization’s public profile as a safe place for patients. The outcomes can be included in elaborate quality and safety reports. Interprofessional collaboration is mandatory for the organization to mitigate the risk of adverse events and near-misses. Healthcare organizations must create a collaborative teamwork culture for effective communication and reporting of adverse events and near-misses.

References

Ackah, D., Alvarado, A. E., Nugroho, H. S. W., Polnok, S., & Martiningsih, W. (2017). Understanding the resistance to health information systems. Health Notions, 1(1), 45-50.

Arora, S. (2016). Editorial Note–Quality Improvement: For Better Health Outcomes. International Journal of Pediatric Nursing, 2(2), 23-24.

Chapuis, C., Chanoine, S., Colombet, L., Calvino-Gunther, S., Tournegros, C., Terzi, N., … & Schwebel, C. (2019). Interprofessional safety reporting and review of adverse events and medication errors in critical care. Therapeutics and Clinical Risk Management, 15, 549.

Da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: a patient case and review of Pennsylvania and National data. Journal of community hospital internal medicine perspectives, 6(4), 31758.

Desebbe, O., Lanz, T., Kain, Z., & Cannesson, M. (2016). The perioperative surgical home: an innovative, patient-centered and cost-effective perioperative care model. Anaesthesia Critical Care & Pain Medicine, 35(1), 59-66.

Didier, A., Campbell, J., Franco, L., Serex, M., Staffoni-Donadini, L., Gachoud, D., & Zumstein-Shaha, M. (2017). Patient perspectives on interprofessional collaboration between healthcare professionals during hospitalization: a qualitative systematic review protocol. JBI database of systematic reviews and implementation reports, 15(8), 2020-2027.

Glickman, S. W., Mehrotra, A., Shea, C. M., Mayer, C., Strickler, J., Pabers, S., … & Pines, J. M. (2020). A patient reported an approach to identify medical errors and improve patient safety in the emergency department. Journal of patient safety, 16(3), 211-215.

Jylhä, V., Bates, D. W., & Saranto, K. (2016). Adverse events and near misses relating to information management in a hospital. Health Information Management Journal, 45(2), 55-63.

Martinez, W., Lehmann, L. S., Hu, Y. Y., Desai, S. P., & Shapiro, J. (2017). Processes for identifying and reviewing adverse events and near misses at an academic medical center. The Joint Commission Journal on Quality and Patient Safety, 43(1), 5-15.

Mira, J. J., Lorenzo, S., Carrillo, I., Ferrús, L. E. N. A., Silvestre, C., Astier, P., … & Zavala, E. (2017). Lessons learned for reducing the negative impact of adverse events on patients, health professionals and healthcare organizations. International Journal for Quality in Health Care, 29(4), 450-460.

Okes, D. (2019). Root cause analysis: The core of problem solving and corrective action. Quality Press.

Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission rates and their impact on hospital financial performance: a study of Washington hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56, 0046958019860386.

Simons, P., Backes, H., Bergs, J., Emans, D., Johannesma, M., Jacobs, M., … & Vandijck, D. (2017). The effects of a lean transition on process times, patients and employees. International Journal of Health Care Quality Assurance.

Zoeckler, J. M. (2018). Occupational stress among home healthcare workers: Integrating worker and agency-level factors. NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, 27(4), 524-542.