Discussion Board
Part 1
o Outcome measures are significant in showing the worth of the Doctor of Nursing Practice's role in health care. Identify a practice-level outcome study or project and describe the expectation of its effect on health care. Which outcome measure do you think aligns with your DPI project (Quality Improvement Project)? Why? Provide examples and literature support.
o In this week's readings, theories of accident causation, human error, foresight, resilience, and system migration were discussed. Identify a safety theory and propose quality measures to improve patient safety. Which theory or framework are you using to guide your DPI Project's intervention and outcome? Please define what constructs of your chosen DPI Project theory will help you change/improve clinical practice to improve a specific patient outcome? Provide examples and literature support.
Resources
Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the "way we work" to improve patient safety outcomes. American Journal of Critical Care, 26(4), 272-277. doi:10.4037/ajcc2017812
Smith, S. A., Yount, N., & Sorra, J. (2017). Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. BMC Health Services Research, 17,1-9. doi:10.1186/s12913-017-2078-6
Part 2
o Discuss economic methodology, including the concept of cost-based analysis. If you will not be addressing this in your DPI Project, provide an example of a program where it could be used to show outcomes. Provide examples and literature support.
o Discuss a change theory and how it can be or has been applied in nursing practice to integrate care delivery sustainability. How will you use change theory in the design of your project to support the sustainability of your practice improvement intervention? Provide examples and literature support.
Resources
Uluskan, M., McCreery, J. K., & Rothenberg, L. (2018). Impact of quality management practices on change readiness due to new quality implementations. International Journal of Lean Six Sigma, 9(3), 351-373. doi:10.1108/IJLSS-05-2017-0049
Steele Gray, C., Wilkinson, A., Alvaro, C., Wilkinson, K., & Harvey, M. (2015). Building resilience and organizational readiness during healthcare facility redevelopment transitions: Is it possible to thrive? HERD: Health Environments Research & Design Journal, 9(1), 10-33. doi:10.1177/1937586715593552
Allen, B. (2016). Effective design, implementation and management of change in healthcare. Nursing Standard, 31(3), 58. doi:10.7748/ns.2016.e10375
Part 3
o New health care delivery models are being presented to accommodate the shift in health care objectives. Many of these models are community-based and focused on improving quality outcomes, population health, and reducing readmissions to acute care settings.
i. Describe a new health care delivery model and discuss whether or not it is sustainable.
ii. How will you use a health care delivery model in the design of your project to support the sustainability of your practice improvement intervention?
Provide examples and literature support.
o Two major models of care exist: for-profit and not-for-profit. Does one or the other provide more ethical care? Why or why not? Provide examples and literature support.
Resources
Largent, E. A. (2016). Health care organizations and the power of procedure. American Journal of Bioethics, 16(1), 51-53. doi:10.1080/15265161.2015.1115155
Graber, A., Carter, S., Bhandary, A., & Rizzo, M. (2017). The case for enrolling high-cost patients in an ACO. HEC Forum, 29(4), 359-365. doi:10.1007/s10730-017-9333-4
Kirby, J. (2016). Balancing legitimate critical-care interests: Setting defensible care limits through policy development. American Journal of Bioethics, 16(1), 38-47. doi:10.1080/15265161.2015.1115141
Part 4
o Explore a country that provides universal health care. What are its health outcomes? How do these outcomes compare to those in the United States? Should universal health care be a concept that the Doctor of Nursing Practice should support? Why or why not? As a nurse leader, how would you integrate your faith and work into any health care delivery concept? Provide examples and literature support.
o The Commonwealth Fund provides an international review of health care systems. Read the Commonwealth Fund report, International Profiles of Health Care Systems, 2017. Discuss what knowledge you gained from reading the report and describe any changes you would apply to the U.S. health care system. What is the DNP's role in the policy needed to enact the changes you identified? Provide examples and literature support.
Resources
Ruggles, B. M., Xiong, A., & Kyle, B. (2019). Healthcare coverage in the US and Japan: A comparison. Nursing, 49(4), 56-60. doi:10.1097/01.NURSE.0000553277.03472.d8
Expenditure growth under single-payer systems: Comparing South Korea and Taiwan. Value in Health Regional Issues, 15, 149-154. doi:10.1016/j.vhri.2018.03.002
Rajfur, P., & Hys, K. (2018). Management of the healthcare system in Germany and France. Medical Science Pulse, 12(4), 55-60. doi:10.5604/01.3001.0012.7213
Part 5
o Review one of the tutorials on quality measures from the AHRQ: National Quality Measures Clearinghouse website. Provide an overview of what you reviewed and its application in your practice. Provide examples and literature support.
o Review "How Can Healthcare Organizations Implement Patient-Centered Care," and discuss evaluation models that can drive large-scale cultural transformation in health care or in your current practice. What are the strengths and weaknesses of these models? Provide examples and literature support.
Resources
Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., Hill, J. N.,...VanDeusen Lukas, C. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Services Research, 18(168). doi:10.1186/s12913-018-2949-5
Nel, H. (2018). A comparison between the asset-oriented and needs-based community development approaches in terms of systems changes. Practice: Social Work in Action, 30(1), 33-52. doi:10.1080/09503153.2017.1360474
Lindau, S. T., Vickery, K. D., Choi, H., Makelarski, J., Matthews, A., & Davis, M. (2016). A community-powered, asset-based approach to intersectoral urban health system planning in Chicago. American Journal of Public Health, 106(10), 1872-1878. doi:10.2105/AJPH.2016.303302
Part 6
o The Doctor of Nursing Practice/Advanced Practice Nurse role empowers nurses to create programs for improving quality outcomes. What barriers need to be alleviated to increase the DNP/APN role in health care change? Provide examples and literature support.
o Patient-centered care has been shown to increase positive patient outcomes. Provide an example of how collaboration within the health care team (interprofessional collaboration) has enhanced patient outcomes in your practice. Provide literature support.
Resources
Will, K. K., Johnson, M. L., & Lamb, G. (2019). Team-based care and patient satisfaction in the hospital setting: a systematic review. Journal of Patient-Centered Research and Reviews, 6(2), 158-171. doi:10.17294/2330-0698.1695
Brown, L., & Overly, F. (2016). Simulation-based interprofessional team training. Clinical Pediatric Emergency Medicine, 17(3), 179-184. doi:10.1016/j.cpem.2016.06.001
Van der Biezen, M., Wensing, M., Poghosyan, L., Van der Burgt, R., & Laurant, M. (2017). Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study. BMC Health Services Research, 17, 1-9. doi:10.1186/s12913-017-2548-x
Barratt, J., & Thomas, N. (2018). Nurse practitioner consultations in primary health care: A case study-based survey of patients' pre-consultation expectations, and post-consultation satisfaction and enablement. Primary Health Care Research & Development, 20, 1-8. doi:10.1017/S1463423618000415
Part 7
o Utilize the National Committee for Quality Assurance (NCQA) website to examine the criteria that a Patient Centered Medical Home (PCMH) must meet to be credentialed. What is the value of the PCMH to patient outcomes? How does the NCQA website help you define and measure the results of your DPI Project intervention on patient outcomes? Provide examples and literature support.
o What are some of the current assessment tools to improve patient understanding and adherence to prescribed treatment? What assessment tools are available to determine a level of health literacy and how can these tools help improve patient outcomes? Provide examples and literature support.
Resources
Read Chapter 6 in Outcome Assessment in Advanced Practice Nursing 4e.
Tucker, C., Arthur, T., & Roncoroni, J. (2013). Patient-centered, culturally sensitive health care. American Journal of Lifestyle Medicine, 9(1), 63-77. doi:10.1177/1559827613498065
Park, Y., & Martin, E. G. (2018). Geographic disparities in access to nursing home services: Assessing fiscal stress and quality of care. Health Services Research, 53, 2932-2951. doi:10.1111/1475-6773.12801
Barsell, J., Everhart, R. S., Miadich, S. A., & Trujillo, M. A. (2018). Examining health behaviors, health literacy, and self-efficacy in college students with chronic conditions. American Journal of Health Education, 49(5), 305-311.
Nguyen, T. H., Park, H., Han, H-R., Chan, K. S., Paasche-Orlow, M. K., Haun, J., & Kim, M. T. (2015). State of the science of health literacy measures: Validity implications for minority populations. Patient Education & Counseling, 98(12), 1492-1512. doi:10.1016/j.pec.2015.07.013
Part 8
o Discuss effective means for translating and disseminating research by discussing the role of the DPI Project (Quality Improvement) and the opportunities for its dissemination. Include a discussion of the role of inter-professional collaboration. Provide examples and literature support.
o Discuss recent health care innovations in your practice and your role in implementation. Provide examples and literature support.
Resources
Hassan, A., Scherer, E. A., Pikcilingis, A., Krull, E., McNickles, L., Marmon, G.,...Fleegler, E. (2015). Improving social determinants of health: Effectiveness of a web-based intervention. American Journal of Preventive Medicine, 49(6), 822-831. doi:10.1016/j.amepre.2015.04.023
Curtis, K., Fry, M., Shaban, R., & Considine, J. (2016). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872. doi:10.1111/jocn.13586
The response should include a reference list. Double-space, using Times New Roman 12 pnt font, one-inch margins, and APA style of writing and citations.