BHA FPX 2110 Assessment 3 Performance Improvement Plan: Poster Presentation and Reflection

Performance Improvement Plan: Poster Presentation and Reflection

Student Name

Capella University

BHA FPX-2110

Professor Name

Submission Date

Poster Presentation

A context of a Hospital (Green Valley Hospital) where many problems occur regularly in the Emergency Department (ED), which negatively affect the efficiency of staff members and patient treatment. The average wait times of patients have increased to 45 minutes in the first instance and 90 minutes in the second instance before they can see a physician, especially during busy times. Patient dissatisfaction, work overload, delays with patient workflow, and potential patient safety issues are associated with these long wait times.

Understaffing, inefficient triage, and workload of patients in rural healthcare facilities, which were identified during the Quality Improvement Team meeting, are associated with these problems. These challenges are addressed by the project that was selected, focusing on reducing the time spent in the ED for patients by improving the speed of triage, patient flow, and coordination of the team in a structured approach to quality improvement.

Key Challenges in the GVH Emergency Department and Focused Initiative

A context of a Hospital (Green Valley Hospital) where many problems occur regularly in the Emergency Department (ED), which negatively affect the efficiency of staff members and patient treatment. The average wait times of patients have increased to 45 minutes in the first instance and 90 minutes in the second instance before they can see a physician, especially during busy times. Patient dissatisfaction, work overload, delays with patient workflow, and potential patient safety issues are associated with these long wait times.

The issues that will be addressed during the QI team meeting are linked to understaffing, lack of efficient triage, and an increased number of patients in rural health care facilities. These challenges are addressed by the project that was selected, focusing on reducing the time spent in the ED for patients by improving the speed of triage, patient flow, and coordination of the team in a structured approach to quality improvement.

Balanced Scorecard

GVH Performance Improvement Initiative 1

The balanced scorecard was chosen because it allows the hospital leadership to have some idea of the improvements in different areas, linking all the financial, patient, internal, and staff development aspects to Green Valley Hospital’s strategic goals. In terms of finances, it’s focused on maximizing the usage of resources and eradicating unnecessary costs. Specific goals include reducing the amount of overtime by 15% and improving the current Emergency Department resources. Key performance indicators (KPI) such as overtime cost trends and resource usage rates are used to monitor progress. Optimizing cost management with cost minimisation will help to ensure financial sustainability and will support quality-based reimbursement.

From the patient, it’s all about improving patient experience and satisfaction. The aims are to reduce the average waiting time of Emergency Department patients from 135 minutes to 90 minutes and increase the patients’ satisfaction index by 20%. Some of the actions taken to monitor performance include average time patients wait and surveys of patient satisfaction.

The reduced waiting times are essential to achieve these goals, as this would create more trust and safety amongst patients and the overall perception of quality care. The internal process perspective aims at enhancing patient flow and triage processes; some of the desired outcomes include having a 95% adherence to the new triage and reducing patient flow bottlenecks. These are the most important: compliance with the triage system and pre-treatment time. Internal processes will be enhanced, which will reduce delays, increase coordination, and enhance the overall quality of care delivery.

Lastly, the learning and growth focus is on boosting the capacity and motivation of staff. This will involve training about 100% of the staff within the Emergency Department on the new workflows and improving staff satisfaction by 15%. Progress measures are the progress towards training and the result of a Staff engagement survey. Long-term change is only possible if employees are trained, informed, and interested in the change; as is accountability. It also emphasizes the culture of continuous improvement, which is continued in the department.

Best Practices for Addressing Goals

There are various good practices that are proven and can be applied in achieving the objectives of the balanced scorecard. Patients are triaged following a standardized process, and ranked according to their acuity with a minimum of unnecessary delays in the process of ranking patients, thereby improving patient flow. Standardized triage systems have shown a possible reduction in waiting time for patients in the Emergency Department of 20- 30% while also improving the timing for patient prioritization.

The use of evidence for care practices also has a role in making care more efficient, including in providing timely diagnostic tests, avoiding unnecessary tests and procedures, and uniformity in clinical decision-making of those providing care. The practices can help to minimise the variation in the quality of care and improve safety and care outcomes.

Furthermore, special staff training is also a must to improve communication, coordination of the flow of work, and adherence to a uniform procedure.

Application of Quality Tool: Plan-Do-Study-Act (PDSA)

 The Plan-Do-Study-Act (PDSA) cycle was selected as the primary quality improvement strategy for this program, as it provides an agenda that is loose but focused and brings change to a rapidly changing healthcare facility. During the Plan phase, wait-time data analysis, the input of staff members to the project, and observation in the ED were done to identify specific problems in the triage and patient flow. It gave a set of goals and measurable outcomes to aid in the improvement efforts. The adapted triage processes and specific required changes in staff roles were trialled during the Do phase to assess feasibility and effectiveness during the peak time, patient safety, and quality of care.

A detailed review of all of the performance data was carried out during the Study phase, which included: measures of waiting times for patients; results from patients’ satisfaction surveys; feedback from clinical staff. This work helped to direct the most effective interventions and helped to pinpoint areas that needed to be enhanced. The implementation of an effective approach became part of the routine of the Emergency Department while less effective approaches were adapted and/or discontinued.

PDSA cycles will be used on an ongoing basis to continuously test the process and results as the number of patients and staffing needs increase and decrease. This approach will contribute to the culture of continuous improvement, encourage participation by staff to make decisions in improving efficiency and treatment for Emergency Department patients, and ensure continuing improvements to the Efficiency and Treatment of Emergency Departments (ETED) are sustainable.

Maintaining Gains

Though this is a one-time improvement, Green Valley Hospital will set up a continuous monitoring system of the wait time and patient satisfaction metrics using data analysis to sustain the improvement and track how well it is working. Standardised patient flow will be reinforced through regular audits and refresher training to ensure consistency of patient flow between all shifts. Staff and Leadership Feedback will allow for the quick identification of emerging issues, quick problem-solving, and shared responsibility. Additionally, the performance data will be used to track progress and make evidence-based changes in the regular quality and safety conferences.

The benchmarking and trend analysis will assist the leadership in determining what further improvements are needed and to make sure they don’t fall for the temptation to repeat inefficiencies of the past. Ongoing learning, staff mentorship, and cross-training will enable staff to be involved, develop clinical skills, and deepen their knowledge and expertise to be flexible when dealing with high numbers of patients. Some of these interventions will help create a change in the way the Emergency Department is operated, and ensure the benefits that come from the Emergency Department are sustainable over time.

Conclusion

The Green Valley Hospital’s Emergency Department (ED) has work areas on reducing patient waiting time in the ED, improving staff performance, and boosting the overall quality of the care provided, as these areas could lead to increased patient satisfaction. It’s a multifaceted solution to the problem, using the balanced scorecard framework, and subsequently, the financial sustainability, patient experience, internal processes, and growth of the employees will be aligned to the organization’s targets.

The Plan-Do-Study-Act cycle provides a systematic, evidence-based strategy of triage and patient flow improvement, testing, and refinements. These strategies are sustainable and can be implemented within an Emergency Department to improve performance and ultimately, provide better care for patients if they are continually monitored, staff members are engaged, and their leaders are supportive.