Discussion: Quality Improvement and Patient Safety Initiatives The vice president of nursing, Dr. Sasha Mendez, has had a lot of complaints from patients and their families about the difficulties they experience navigating the system at her organization, e.g., going from the E.R. to admissions. Dr. Mendez’s nursing specialty area is psych/mental health. As such, she is overly concerned about the stress this is causing the patients. What are the macro systems that are affecting patient satisfaction at Dr. Mendez’s facility? What micro systems should she also analyze to look at how the patient moves through—from entry to possible admission, to possible discharge? How do these systems relate? What impacts each system?

Discussion: Quality Improvement and Patient Safety Initiatives The vice president of nursing, Dr. Sasha Mendez, has had a lot of complaints from patients and their families about the difficulties they experience navigating the system at her organization, e.g., going from the E.R. to admissions. Dr. Mendez’s nursing specialty area is psych/mental health. As such, she is overly concerned about the stress this is causing the patients. What are the macro systems that are affecting patient satisfaction at Dr. Mendez’s facility? What micro systems should she also analyze to look at how the patient moves through—from entry to possible admission, to possible discharge? How do these systems relate? What impacts each system?

Quality Improvement and Patient Safety Initiatives

Question
Identification of Outcomes
“In a large, complex organization…the primary consequences of our actions may well be in the distant future or in a distant, but interrelated, part of a larger system in which we operate. For this reason, we are often puzzled by the underlying causes of current problems within our organizations. We are unable to look at underlying structures or patterns of behavior that may have resulted in less than stellar outcomes” (Zaccagnini & White, 2011, p. 45).
How can the perspective described above be shifted to provide a fuller view of the dynamics in today’s health care organizations? And, in doing so, how could this promote the achievement of positive outcomes related to quality and safety?
In previous courses you have examined systems theory, as well as the interrelationships of various areas within an organization. This week, you revisit these concepts as you assess an issue within an organization—analyzing the system at the macro- and the micro-level. You also identify strategies that can be used to assess the clinical environment and the associated nonclinical units that support the provision of quality. In addition, you develop outcomes related to quality and safety.
This week you continue to engage in your practicum experience and on Application 4.
Reference: Zaccagnini, M. E., & White, K. W. (2011). The doctor of nursing ractice essentials: A new model for advanced practice nursing. Sudbury, MA: Jones and Bartlett.
Learning Objectives
Students will:
• Apply systems theory to the evaluation of quality improvement and patient safety initiatives
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Learning Resources
Required Readings

Brooks, P., Spillane, J.J., Dick, K., & Stuart-Shor, E. (2014). Developing a strategy to identify and treat older patients with postoperative delirium. AORN Journal, 99(2), 256-276.

Jarden, R.J. & Sutton, L.J. (2014). A practice change initiative to improve the provision of enteral nutrition to intensive care patients. British Association of Critical Care Nurses, 20(5), 242-254.

McCluskey, A. & Middleton, S. (2010). Delivering an evidence-based outdoor journey intervention to people with stroke: Barriers and enablers experienced by community rehabilitation teams. BMC Health Services Research, 10(18). doi: 10.1186/1472-6962-10-18. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-18

Murfet, G.O., Allen, P., & Hingston, T.J. (2014). Maternal and neonatalhealth outcomes following the implementation of an innovative model of nursepractitioner-led care for diabetes in pregnancy. Journal of Advanced Nursing, 70(5), 1150-1163