Patient Outcomes
Patient Outcomes
Purpose
This week’s graded discussion topic relates to the following Course Outcome (CO).
CO 5: Apply improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of healthcare. (PO 8)
The Assignment
Review the story at the link below before posting to the discussion:
Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)Links to an external site.
After you have finished, consider how you would respond to the following situation:
Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates.
As a BSN prepared nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity.
Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.
Patient outcomes are a direct result of quality care. What would be your primer for one area of improvement that data has presented as an opportunity? What national benchmark are you comparing your benchmark to?
Example
I have been asked, as a BSN prepared nurse to evaluate and promote a quality performance improvement plan process for patient readmissions involving those patients with congestive heart failure, CHF (Rau, 2015). The first step is to review the pharmacy medication reconciliation to ensure the medications prescribed reflect the core measures for the type of CHF the patient has. Patients with systolic dysfunction with an ejection fraction less than 40%, require an angiotensin receptor blocker. Other targeted measures require some patients to take a beta blocker (American Heart Association, 2013). The diagnosis of hypertension needs to be addressed. If present, an ACEI or ARB, beta blocker, and hydralize should be on the medication list. In addition to cardiac medications, an evaluation of diuretics such as Lasix needs to be evaluated with consideration of the dose and if a dose increase is warranted. The second step requires a recent echocardiogram within the last six months to be on the record, if there is not, then one needs to be done during the concurrent hospitalization. During the hospitalization, DVT prophylaxis needs to be given, as many patients with CHF are non-ambulatory (American Heart Association, 2013).
