NURS 8302 Discussion: Identifying Practice Gaps for Quality Improvement ANSWER

 NURS 8302 Discussion: Identifying Practice Gaps for Quality Improvement ANSWER

A standard quality improvement tool used to identify gaps in services or within a program of services is the gap analysis.  The gap analysis incorporates a visual of what is desired versus the current status by answering the question of where we are now. Where do we want to be, and what do we propose to close the gap? I have chosen the gap analysis to identify a quality improvement gap within our organization of the lack of palliative and hospice service use early in the disease process.

Research has established a connection with palliative care early intervention to produce a better quality of life for those facing advanced disease processes. However, barriers to earlier access to palliative care remain, which might be attributable to the global lack of awareness of palliative care and the prevalence of negative perceptions and attitudes (Collins et al., 2018). Early palliative care is purported to improve quality of life, avoid unnecessary acute care use, and thus reduce health system costs(Seow et al., 2021). Palliative care may be helpful at any point in the disease trajectory and could be especially valuable soon after a person is diagnosed with a severe illness (IOM, 2015; NASEM, 2022; National Consensus Project for Quality Palliative Care, 2018).

I have identified two tools to address this quality improvement project: the Plan-Do-Check-Act (PDCA) Plan and the Matrix. The PDCA delivers guidelines for an action plan to test by first placing the theory into action by collecting data, checking the data strengths and weaknesses based on objective criteria, and acting by adopting, adapting, or abandoning the improvement theory. The Matrix shows a relation between categories (barriers) and can be used to identify themes such as workforce Core Competencies and prioritize workforce development needs to fill competency gaps(CMS, 2021). The measurable efforts of quality improvement should characterize change in the desired direction, contribute to various parts of the system, and progress toward acceptable outcomes.  Quality Improvement should reflect good-quality practice through research.

CMS Innovation Center 2021 strategy refresh, strategic direction: https://innovation.cms.gov/strategic-directionLinks to an external site.

Seow H, Sutradhar R, Burge F, et al., (2021). End-of-life outcomes with or without early palliative care: a propensity score-matched, population-based cancer cohort study

BMJ Open ;11:e041432. doi: 10.1136/bmjopen-2020-041432