NURS FPX 6004 Assessment 4 Training Session for Policy Implementation

Sample Answer

The benchmark metric underperformance identified in the dashboard evaluation in our health organization was patient safety. Underperformance in the patient safety metric was evidenced by medical errors, falls, pressure ulcers, and hospital-acquired infections (HAIs). Underperformance in this metric is attributed to increased hospital stays, comorbidities, complications, high readmission rates, and increased healthcare costs. This paper will discuss a policy proposal and practice guidelines that improve quality and performance associated with underperformance in the patient safety metric.

Need for Creating a Policy and Practice Guidelines

The current benchmark for our organization is performance benchmarking, where the organization gathers and analyzes its quantitative data and compares it to established measures or key performance indicators. Data from the benchmarking helps to recognize performance gaps and informs decision-making. Patient safety scored 24% based on reported incidences of patient falls, skin breakdown, and HAIs. Underperformance in the patient safety metric potentially affects operations of the organization since it is associated with consequences of increased hospital stays, complications, high readmission rates, and increased healthcare costs (Weggelaar-Jansen et al., 2018).

The consequences result in a high workload for healthcare providers, especially for nurses, due to a high nurse-to-patient ratio. An increased workload significantly reduces nurses’ motivation due to burnout resulting in a high turnover rate. Nursing turnover affects the organization’s operations as the management is forced to spend more resources paying nurses for overtime to cover the shortage left or to hire temporary nurses.

Failure to implement changes to improve patient safety can have dire repercussions for patients, staff, and the organization. Consequences for patients include increased hospital stays, high readmission rates, comorbidities, and increased morbidity and mortality rates (Weggelaar-Jansen et al., 2018). These consequences not only increase costs but also affect their economic productivity since a lot of time and resources are spent in hospitals. Repercussions for the staff include high workloads, burnout, and reduced motivation attributed to physical and emotional stress and poor health outcomes (Weggelaar-Jansen et al., 2018).

According to Khoshakhlagh et al. (2019), reduced patient safety adversely affects the staff since it contributes to occupational stress, job burnout, psychological load, and higher levels of stress. Repercussions to the organization include reduced profits due to high operational costs, resources spent on recruiting staff, resources from legal actions from patients, and a damaged reputation of the organization. Mira et al. (2017) explain that there is a connection between perceived safety and reputation. Medical errors and associated judicial decisions adversely affect the perception of patient safety among the general public.

Evidence-Based Practice Guidelines to Improve Targeted Benchmark Performance

Concerns of patient safety have been present for a long time, way before modern healthcare. Various evidence-based practice guidelines recommend creating a positive safety culture in the organization to improve patient safety. Creating a culture of safety is a fundamental element of numerous efforts to enhance patient safety and care quality. According to Khoshakhlagh et al. (2019), a positive safety culture influences health providers’ behaviors, so that patient safety becomes a priority.

Interventions proposed to create a positive safety culture include teamwork, organizational learning, open communications, feedback, and non-disciplinary responses to errors. This is an effective way of improving safety since the initial step in creating a positive safety culture is assessing the current safety culture. Furthermore, a safety culture influences clinician and staff perceptions about the correct behavior concerning patient safety in the patient care setting.

The strategy of creating a positive safety culture would improve patient safety by enhancing clinician behaviors such as error reporting, reducing adverse events, and reducing mortality. Farokhzadian et al. (2018) explain that organizations with a positive safety culture have communications founded on common perceptions of the essence of safety, mutual trust, and confidence in the efficacy of preventive interventions and support for the workforce.

Besides, a safety culture focuses on preventive or predictive interventions of safety more than retrospective one. Hospitals with well-developed positive safety culture have reduced hospital stay lengths, decreased medication reconciliation errors, and increased nursing retention. The strategy would foster a continuous learning environment by encouraging staff to report and discuss clinical risks and safety incidents without fear of disciplinary actions.

I propose creating a positive safety culture in my organization by writing to the management on the importance of the strategy and how it would help improve patient safety and outcomes. I would also encourage supervisors to support health providers to report and evaluate their errors in order to create a positive safety culture. I would ensure that the interventions are ethically and culturally inclusive by analyzing and balancing their benefits and harm and whether they will promote justice in delivering patient care.

Potential Effects of Environmental Factors on Creating a Positive Safety

Developing a positive culture that supports patient safety is one of the major challenges facing healthcare organizations. Regulatory considerations and resources may affect the recommended guideline on creating a positive safety culture in an organization. Regulations that limit providers from sharing patient information without a patient’s consent hinder providers from sharing the treatment plans. As a result, health providers may not collaborate in evaluate errors in patient care. Shortage of financial resources may affect safety management programs and strategies, thus hindering an organization from developing a positive safety culture.

Health providers’ efforts to improve safety in patient care interventions may be impeded by a shortage of resources to procure adequate medical supplies, medical devices, and technology. Besides, a lack of resources can result in failure in innovating safety programs. Farokhzadian et al. (2018) explain that creating a safety culture may be challenging due to staffing shortage which contributes to lack of time, hard and tedious work due to high workloads, poor communication with co-workers, and environmental stress.

Involvement of Particular Stakeholders and Groups

Stakeholders and groups that should be involved in developing and implementing a culture of a positive safety culture include the organization’s management and healthcare providers. The organization’s management must be involved because a continuing commitment must be present from the management to promote and facilitate the safety culture by availing the needed tools to identify the most common cultural patterns. Participation by the organization’s leadership can facilitate the redesigning of systems to minimize opportunities for error. It can also help in developing comprehensive patient safety programs to improve the detection of adverse events.

Healthcare providers must be engaged in policy development and implementation because patients’ safety depends on the ability of each provider to do the right thing. When providers constantly work at enhancing quality, their performance shifts to doing the right thing right. Involving health providers will facilitate the policy implantation since providers get a clear insight of the patient’s safety aspects that require attention and recognize the strengths and weaknesses of their safety culture.

Conclusion

Underperformance in the patient safety metric in my healthcare organization has been associated with complications and poor health outcomes for patients, and a high workload for health providers. The workload is associated with reduced motivation resulting in high turnover rates that cost the organization resources to recruit new staff. Evidence-based literature recommends creating a positive safety culture that supports health providers in reporting and analyzing their errors.

Interventions to develop a positive safety culture are teamwork, organizational learning, open communication, feedback, and non-disciplinary responses to errors. However, the strategy can be hindered by a shortage of financial and human resources since they are crucial to achieving a positive culture supporting patients’ safety. Stakeholders that must be included in developing and implementing a positive safety culture in a healthcare organization include the management and healthcare providers.

References

• Farokhzadian, J., Dehghan Nayeri, N., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture challenges perceived by nurses. BMC health services research, 18(1), 654. https //doi.org/10.1186/s12913-018-3467-1
• Khoshakhlagh, A. H., Khatooni, E., Akbarzadeh, I., Yazdanirad, S., & Sheidaei, A. (2019). Analysis of affecting factors on patient safety culture in public and private hospitals in Iran. BMC health services research, 19(1), 1-14.
• Mira, J. J., Lorenzo, S., Carrillo, I., Ferrús, L. E. N. A., Silvestre, C., Astier, P., … & RESEARCH GROUP ON SECOND AND THIRD VICTIMS. (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. https //doi.org/10.1093/intqhc/mzx056
• Weggelaar-Jansen, A., Broekharst, D., & de Bruijne, M. (2018). Developing a hospital-wide quality and safety dashboard a qualitative research study. BMJ quality & safety, 27(12), 1000–1007. https //doi.org/10.1136/bmjqs-2018-007784