assessment 3 QI initiative Brianna Mingo

The audio is a proposal for a quality improvement initiative at Capella University. The project aims to analyze data on falls in hospitalized patients and propose a QI initiative to improve metrics. Falls in hospitals are considered adverse effects and have several risk factors. The Joint Commission has identified falls as a nationwide issue. The proposal includes objectives to reduce falls by 30% within 12 months and improve staff awareness and adherence to fall prevention protocols. Interventions include staff education, environmental modifications, risk assessment and monitoring, patient and family engagement, and technology and equipment. The implementation plan spans 12 months and includes forming a multidisciplinary team, staff training, environmental modifications, and launching interventions. Evaluation and monitoring will use process and outcome metrics, with continuous data collection and quarterly reviews. Interprofessional collaboration and communication methods such as SBA This is the audio for a quality improvement initiative proposal for Brianna Mingo at Capella University for the course Quality Improvement of Interprofessional Care. Our first slide is going to discuss a healthcare issue and data quality analysis. This project is aimed at analyzing the data of falls in hospitalized patients and proposing a QI initiative to improve the metrics. There is a high incidence of falls which are considered adverse effects in hospitals. Several risk factors for falls are involved in the data such as muscle weakness, history of falls, gait deficit, balance deficit, utilization of assistive devices, visual deficit, arthritis, impaired activities of daily living, depression, and cognitive impairment. Extrinsic risk factors include specific medications, polypharmacy, dark lighting, loose carpets, and a lack of bathroom safety devices. The Joint Commission has identified falls as an issue within hospitals nationwide. In-hospital falls are significant clinical, legal, and regulatory problems and are not noted to be one of the leading causes, excuse me, and are noted to be one of the leading causes of preventable injuries that occur within the hospital setting. This can occur at any age, however, the severity of injury increases with age with patients over the age 65 at higher risk for severe injury or death. Reducing in-hospital falls is imperative to deliver appropriate safe care to patients. Developing and implementing evidence-based fall prevention programs within the hospital setting is essential in reducing falls. Hospitals must identify patients who are at risk of falling. Proper and consistent assessment, communication with colleagues on a patient's fall history, status, and medication, and a team approach are essential for a patient-focused program. Several tools can be used to prevent falls or limit injury if a fall occurs. Proper use of tools such as bed alarms, chair alarms, fall mats, and fall risk alerts on the chart, door, and patient's room is critical. Our next slide will outline the QI Initiative proposals. The proposal summary consists of our problem, primary objective, and secondary objective. Patient falls within a healthcare setting are a critical safety issue. Current data indicates that the fall rate at Parkland Health is above the national benchmark which necessitates a structured QI Initiative proposal to enhance patient safety. Primary objective is to reduce falls by 30% within 12 months. Secondary objectives are to improve staff awareness and adherence to fall prevention protocols, enhance patient and family education on fall prevention, and increase the use of fall prevention equipment and technology. Parkland Health, located in Dallas, Texas, has metrics directly related to patient safety of falls based on the national average. The Center for Medicaid and Medicare Services have adopted patient safety indicators developed by the AHRQ for reporting of hospital quality data. These metrics provide comparison to other hospitals that are comparable to their own. Their metrics make us aware of what interventions need to be put in place or those that need improvement. To the right of this slide, you will see the rate at Parkland Health has steadily increased over time. And the preferred method, the preferred direction of the rate is downward. So, this is a direct reflection of patient safety. Our next slide is going to go over our interventions, staff education and training, environmental modifications, risk assessment and monitoring, patient and family engagement, and technology and equipment. This slide will discuss the proposed interventions to address the increased occurrence of patient falls in hospitals. The first step is staff education and training to address the potential lack of knowledge and clarity on the detriment that falls have on patient safety and experience. The next step is to identify any environmental modifications which may consist of measures that decrease the likelihood of incurring a patient fall. Removing clutter, improving lighting, keeping doors open, maintaining dry floors, or placement of safety rails in high traffic areas may be useful in positive modification of the environment. Next is risk assessment monitoring, which is vital to this initiative. Most patients that are victims of falls already have some risk factor associated with falling, such as use of assistive devices, medication side effects, increased age, muscle weakness, et cetera. It is our job to identify those risks and provide safety. Next is patient and family engagement, which involves patients and their families being educated just as much as the staff. Family must encourage patients to adhere to the safety nets that are in place to prevent adverse events. Family must be able to recognize when a patient is in danger of falling and encourage them to be able to seek help and encourage them to seek help. Lastly, technology is a key piece of this intervention plan as technology is constantly developing to contribute to the safety of patients. With use of clinical input, risk scores can be calculated and interventions can be suggested based on their scores along with the implementation of bed or chair alarms to alert staff of fall potential. Our next slide is the implementation plan. This slide is an overview of the timeline for implementation of the proposed interventions. This implementation process will be completed over the course of 12 months and will aim to be in full action by the 12th month. Phase one consists of forming a multidisciplinary team that involves all disciplines involved in direct patient care, including informatics and information technology department. The team will conduct baseline data collection and analysis on current fall data and what measures are in place attempting to reduce the rate. Phase two, to reduce the fall rate, excuse me. Phase two is where staff training will begin and fall education will be completed on each unit. In this phase, the environmental modifications will take place to augment the launch of the new initiative. Piloting the new falls risk assessment tool on specific units will also take place in this phase to trial the effectiveness and receive feedback on improvement areas. The last phase is where the interventions will launch on each medical unit. Continued monitoring and data collection will occur as well as quarterly review and intervention modification will take place in this phase as needed. Phase one is over the first three months, phase two is over the four to six month period and phase three is the ending period, which is seven to 12 months. Evaluation and monitoring, continued evaluation and monitoring is necessary to improve hospital quality. Constant feedback is required to understand where changes need to be made. There are two key measures we will use, which are process metrics and outcome metrics. Process metrics will involve the measurement of the actual process in place to address fall prevention. In this project, we will assess the percentage of staff trained in fall prevention. Outcome metrics involve the measurement of our outcomes. For this project, the metrics will assess, the outcome metrics will assess monthly fall rates per 100 patients. For continued monitoring, the use of electronic health record data and incident reporting systems will be used to collect continuous data and make sure numbers are going in the right direction. Quarterly reviews will also be conducted to discuss incident reports and review data with the leadership team. Interprofessional collaboration and contribution is vital in the success of this initiative. With members of the multidisciplinary team, we will have regularly scheduled meetings and involve each member's input. There will be meetings to review any fall incidents and identify what patterns are contributing to these falls and develop stronger prevention strategies. A holistic approach will be vital in our collaboration as it is important to incorporate diverse perspectives on patient care and safety. Daily rounds will also be conducted to observe what is taking place in the absence of leadership and address the unsafe patterns in real time. Several communication methods will be in use for this initiative. One vital mode is the use of SBAR, which addresses the patient and gives a summary of their background and current issue as it pertains to fall risk. The use of this tool will promote clarity and completeness in the exchange of patient information. Electronic health record alerts will be another key component to communication to keep all team members informed on the risk score of each patient identified. And lastly, patient and family communication will be the glue to this initiative as they are the sole providers of information and patient needs. Each patient, if able, must make us aware of any unseen effects on their mobility and express to us as healthcare providers what is needed to support them. For sustainability of this initiative, we will need to have embedded fall prevention protocols into standard operating procedures. We'll need continuing ongoing staff and competency assessment education, regularly updated educational materials and risk assessment tools based on the latest evidence. This slide discusses the group effort to maintain the success of the interventions and ultimately reduce fall incidents in hospitalized patients. Continued staff education and competency assessments will be necessary to ensure the interventions remain effective. All educational materials and risk assessment tools will be adjusted and updated based on the most current evidence and data.