Free Essay: Patient-Falls Assessment and Prevention Program Establishment at Tallahassee Community General Hospital

While accidents are commonplace in many occupations, they are not as common in the fields of medicine and nursing compared to other technical areas. If such accidents happen, however, they often affect the patients more than they can change the personnel specializing in the industry. In this context, such accidents may often involve complications during procedures, botched surgical operations, and even in less severe forms like falls. Consequently, this confab will explore a case of increased patient falls at the community general hospital, focusing on quality improvement as well as the creation of a prevention program on the same.

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Methods

Before delving into the dynamic process and methodology required for quality improvement, and Chief Nursing Officer (CNO) must define the purpose of quality assessment and development (Goldsteen et al., 2020). Consequently, in the field of medical practice, quality assessment exercises are purposefully designed to better service delivery, ensure reliability, and cost-effectiveness as wells as contribute to sustainable healthcare processes. Therefore, all of the approaches that are implemented are aimed at this singular purpose as an experienced CNO one can attest to the efficacy and reliability of the Plan-Do-Study-Act (PDSA) cycle and the Lean Six Sigma methodologies in achieving quality assessment and improvement.

The PDSA cycle, as indicated above, is the first methodology that would be implemented in the assessment of patient-falls within the Community General Hospital Tallahassee. According to the model, the rules of quality improvement revolve around frequent testing of any alterations or changes introduced in a healthcare setting since uncertainties are often inevitable (Granger, 2018). The cycle is initiated through a plan and concludes with an action. On the other hand, the study component of the method revolves around the discovery of new knowledge on the subject. In this context, the study aspect of the issue affecting Tallahassee Community General Hospital will involve research on patient-falls and other related accidents, covering new information on the causal factors, the prevalence across more significant regions, and also any other pertinent and useful facts of the same (Goldsteen et al., 2020). The facet is essential since the new knowledge gained is utilized in improvement science, which, when applied, will enable the team to make better predictions about the impact of the fall-prevention program that will be introduced.

It is also worth noting that the PDSA cycle is suitable for this type of assessment and improvement exercise due to its versatility. According to the quality improvement model developed by Deming, the PDSA cycle operates through the asking of three questions.

The questions are:

• What is one as CNO trying to accomplish?
• How will the CNO recognize improvement from the resulting change?
• Which changes translate to an improvement?

Deming insists that the questions if applied and answered in order, result in the transformation of the lay “trial and error” concept into the PSDA model as described above (Warren, 2008). The cycle, which is more systematic and adept, can then be applied in any assessment and improvement initiatives in healthcare, including the case with Tallahassee Community General Hospital. By using the PSDA method, the team under the direction of its CNO will develop a plan on how to deal with the patient’s accidents due to falling. Such a project in this context would involve making it easy to identify high-risk patients, providing personnel assigned to monitor the patients for their safety, setting bed alarms and maintaining regular safety rounds through the second floor (Goldsteen et al., 2020).

The next methodology for the assessment and improvement initiative is the Lean Six Sigma model. According to Pande et al. (2000), the six sigma model was developed by Hewlett-Packard, General Electric, Motorola, among other major corporations during the 1980s and 1990s. The primary purpose of the application of the six sigma method is the elimination of variations in essential business processes. Through analysis of the fluctuation of statistical data, managers can succinctly predict outcomes. In scenarios where the intended outcomes fail to manifest, the managers can then use associated tools to gain more knowledge of the factors influencing the process (Warren, 2008).

The methodology includes five consequent steps: define, measure, analyze, improve and control (DMAIC):

1. Define – the definition stage of the sigma process involves the identification of the specific process or issue affecting the target population. In the case of Tallahassee Community General Hospital, this stage would be the identification of the problem of interest, which is the increased cases of patient falls in the surgery room on the second floor of the hospital’s building.
2. Measure – the second step involves the categorization of the critical characteristics, in this context, the increasing figures of patient fall, verifying systems of analysis of the statistics being investigated and finally, the collection of relevant data (Byrnes, 2005).
3. Analyze – the third step involves the statistical and analytical examination of the data collected pertinent to the issue.
4. Improve – fourthly. The team develops solutions to reduce or, if possible, to eliminate the problem. Here the strategies mentioned above, for example, the setting of bed alarms and the conduction of regular monitoring rounds across the entire floor, will contribute immensely to arresting the problem.
5. Control – upon the implementation of the steps above, the final level is the maintenance of the preventive program adopted to ensure its efficacy holds in case of future calamities.

While the Lean Six Sigma model and the PDSA cycles are different methods developed by professionals from distinct scholarly disciplines, they both possess some similarities and differences (Granger, 2018). Consequently, one of the similarities between the two is their efficiency and versatility. For instance, Six Sigma was developed by professionals in the telecommunications industry, yet it suffices for this assessment and improvement exercise. The next similarity is their utilization within the context of continuous improvement. The critical difference between the two methodologies, on the other hand, is that the PDSA uses more straightforward statistical tools while the Six Sigma method applies advanced resources. Moreover, the Six Sigma method employs a more extensive and comprehensive planning stage.

Tools

For the specific purpose of solving the patient-falls issue in Tallahassee Community General Hospital, the two most appropriate tools considered were the fishbone diagram and benchmarking. Typically, institutions, including those in healthcare, often compare the processes and successes of other players within their industry to their own and thus make the necessary adjustments. For a Community General hospital, such a methodology would be useful since it is simple and does not involve a lot of resources. Moreover, such benchmarking sessions often result in the creation of great partnerships that prove beneficial in future endeavours. Fishbone diagram, which is sometimes referred to as the cause-and-effect tool, highlights the causes of a problem. In the description, the issue or the effect is aligned in a box on the right side of the chart while the probable causes are stated around the headings (bone) that contribute to the occurrence.

In this context, the tools above, for example, benchmarking, will involve the members of staff working in the surgery room being organized for a workshop with a more successful hospital with limited cases of accidents associated with falling (Warren, 2008). During the benchmarking, the staff will be allowed to work jointly with their compatriots from the other hospital trying to fit in and in the process learning from their better systems and they from theirs and vice versa. Such an exercise could be made to last for a week or two for maximum efficiency of the improvement process.

Conclusively, quality assessment, and improvement processes are an essential and continuous part of healthcare practice. It enables the professionals working in the industry to continually improve their service delivery and products contributing to patient satisfaction. Moreover, through the methodologies and tools applied in such exercises, the practitioners gain experience and knowledge that is essential to any patient-centred care practice.

References

Byrnes, J. J. (2005). Data collection. In HEALTHCARE (p. 109).

Goldsteen, R. L., Goldsteen, K., & Benjamin Goldsteen, M. B. A. (2020). Jonas' introduction to the US health care system. Springer Publishing Company.

Granger, B. B. (2018). Science of improvement versus science of implementation: Integrating both into clinical inquiry. AACN advanced critical care, 29(2), 208-212.

Pande, P. S., R. P. Neuman, and R. R. Cavanagh. (2000). The Six Sigma Way: How GE, Motorola, and other top companies are honing their performance. New York: McGraw-Hill.

Warren, K. (2008). Quality improvement: the foundation, processes, tools, and knowledge transfer techniques. In HEALTHCARE (p. 63).