Leading Organizations for Quality Improvement Initiative

Leading Organizations for Quality Improvement Initiatives

Discussion response

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding on your colleague’s post and explaining how the quality indicators selected by your colleague may influence your practice setting.

PEER #1

Roxanne Salvary 

Main Post Discussion Question 1

Quality Indicator 1 Hospital Readmissions:

In the acute hospital centers, re-admission are costly to both health care centers and insurance providers. They also inflict negative occurrences for both families and patients. Health care system re-admissions are a result of several reasons. Among them are failure of patients  to fully understand their disease process and treatment modalities, lack of support and communication from staff, patients being discharged too soon, and lack of understanding of discharge instructions. Congruency regarding goal setting between the health care team and the patient needs to be established. Other factors may originate from lack of community and family support place patients at higher risk for readmission. As a perinatal case manager, I follow workflows that include ongoing assessments during the pregnancy and postpartum to assess the patients’ needs, and to identify gaps in care delivery.The appropriate resources are shared with the patients and families. The patients are given my direct contact information to contact me PRN.

The US congress came up with a plan in 2012 to reduce hospital admissions. They would penalize hospital for having unplanned readmissions within 30 days. Even though health care systems have improved the re-admission reduction rates that have been significant, improvements are still needed.

The Study

The Intensive case management (ICM) program is currently utilized in health care systems to provide services to patients that have complex medical and social needs. The services include frequent, scheduled contact between patient and case manager to address these needs. ICM is also strategically involved with assessing needs for discharge planning, and ensures that the patient and family has access to  treatment modalities post discharge. Patient education and advocacy play an important role for active participation in health care treatment. An assessment of social determinants of health  will reveal in barriers that exist, to direct the case manager to the appropriate resources. ICM is essential to decrease the incidence of health care readmissions.

Quality Indicator 2

Fall Prevention

The incidence of falls that occur in health care facilities are alarming. Among the elderly the fall rate is high at 40% within six months of discharge(Fehlberg et al 2020). Some will experience serious injuries that may include major fractures, damage to organs or lacerations. This places significant financial burden and liabilities on health care systems. The potential for these organizations to reduce the incidence of falls and harmful outcomes can be significantly reduced. This can be accomplished by implementing steps, policies and procedures, or workflows that lead to fall prevention.

The Study

The value of bed alarms are proven to be valuable, and most health care facilities are utilizing beds with alarms. The study concludes that staff  should respond to bed alarms regardless if the patient is a fall risk or not (Fehlberg et al, 2020). This action could prevent a fall, or provide time for the staff to respond to injuries almost immediately. This should be the unit’s expectation of their staff. The principle and thoughts behind the use of bed alarms is that it that i warns staff and is some cases patients that there is a risk of falling out of bed. Even though they serve to lower fall risk, they can’t be classified and restraints, and do not serve that purpose; therefore bed alarms are warnings that should not be ignored.

when I worked in labor and delivery, patients that had epidurals for pain management were considered fall risks as they did not have complete function of their lower extremities. All bed had alarms, and the policy and procedure stated that all available staff are to respond.

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