Feb 23, 2024 DNP 835 Topic 2 Assignment: Innovative Approaches to Health Care, Change Theories, and Sustainable Change
DNP 835 Topic 2 Assignment: Innovative Approaches to Health Care, Change Theories, and Sustainable Change
DNP 835 Topic 2 Assignment: Innovative Approaches to Health Care, Change Theories, and Sustainable Change
Topic 2: Innovative Approaches to Health Care, Change Theories, and Sustainable Change
The IHI module TA 103: increasing value and reducing waste at the point of care, is important for all healthcare professionals to view. Healthcare cost are continuously on the rise from a global standpoint and there are ways to reduce cost without impact quality of care. Common barriers to cost management include, per the module, established habits such as providers being trained to order test, disapproval of doing nothing, lack of feedback, time pressure, discomfort with diagnostic uncertainty, ease of access to service, and lastly incentives for overuse. Prescription medication is a large cost. Bouayad et al. (2020) suggest a common approach for reducing medication costs without compromising on outcomes is through the use of generic drugs.
The role of a DNP prepared nurse in managing cost can include utilizing resources effectively, therapeutically communicating with patients about necessity of test or procedures while still maintaining their autonomy. Providing proactive care with an emphasis on prevention and health promotion, keeping up to date with evidenced based practice recommendations and risk vs benefits of procures and testing. “Healthcare settings provide opportunities for nurse scholars prepared with a DNP degree to explore and address practice gaps where evidence-based practice (EBP) could be implemented to support patient safety and quality outcomes. Practice scholarship led by nurses enables healthcare organizations to build cultures that support value-driven care and sustain quality and safety initiatives” (Kesten et al., 2022).
One of the biggest barriers suggested in the module was time pressure. The physician described a scenario in which the emergency department resident needed an open bed and there were a lot of outside pressure for things needing to be done right away. In this situation the provider defaulted to an easier time saving tactic which presents as a system challenge within the organization. Solutions include creating new delivery system and point of care services, increased staffing, improved hours and support services.
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Lewin’s change theory is applicable to healthcare including healthcare economics. His major concepts include driving forces, restraining forces, and equilibrium. The stages in his theory include unfreezing, change, and refreezing. Change in any organization has multiple phases and stages to become an integrated part of sustainability including evaluation. With healthcare cost and changes to reduce barriers for improved value of care, change needs to occur at multiple levels and be sustained. Globally healthcare is continuing to rise but there are areas to save on cost. Change theories can help guide the process and anticipate any opposing forces to help crate solutions for a smooth transition through planning.
DNP 835 Topic 2 Assignment: Innovative Approaches to Health Care, Change Theories, and Sustainable Change References
Bouayad, L., Padmanabhan, B., & Chari, K. (2020). Can Recommender Systems Reduce Healthcare Costs? The Role of Time Pressure and Cost Transparency in Prescription Choice. MIS Quarterly, 44(4), 1859–1902. https://doi-org.lopes.idm.oclc.org/10.25300/MISQ/2020/14435
Kesten, K. S., Moran, K., Beebe, S. L., Conrad, D., Burson, R., Manderscheid, A., Pohl, E., & Corrigan, C. (2022). Impact of Practice Scholarship as Perceived by Nurses Holding a DNP Degree. JONA: The Journal of Nursing Administration, 52(2), 99–105. https://doi-org.lopes.idm.oclc.org/10.1097/NNA.0000000000001109
Objectives:
1. Describe the role of the DNP-prepared nurse in managing costs.
2. Discuss barriers to cost management in health care.
3. Apply a change theory to ensure care delivery sustainability.
4. Evaluate a quality and/or safety issue in a health care setting.
May 12, 2022 – May 18, 2022 Max Points: 160
Resources
Building a Culture of Safety and Quality: The Paradox of Measurement
Read:
Bliss, K., Chambers, M., & Rambur, B. (2020). Building a culture of safety and quality: The paradox of measurement. Nursing Economic$, 38(4), 178-184.
https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi? T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006073-202007000-00002&LSLINK=80&D=ovft
Perspectives in Ambulatory Care. Return on Investment of a Centralized Telephonic Case Management Program in a Commercial Population
Read:
Russell Rodriguez, S. (2021). Perspectives in ambulatory care. Return on investment of a centralized telephonic case management program in a commercial population. Nursing Economic$, 39(1).
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx? direct=true&db=ccm&AN=148820889&site=eds-live&scope=site
Understanding Change Theory
View:
NDSUExtension. (2020, October 26). Understanding change theory [Video]. YouTube. https://www.youtube.com/watch?v=-F9tegnmiTo
The Business of Healthcare Podcast, Episode 38: Aligning Financial Incentives With Quality Incentives
View:
Kaiser, B. (Host) (2019, June 11). Aligning financial incentives with quality incentives (No. 38) [Audio
DNP 835 Topic 2 Assignment Innovative Approaches to Health Care, Change Theories, and Sustainable Change
podcast episode]. In The business of healthcare podcast. Center for Healthcare Leadership and Management.
https://businessofhealthcarepodcast.com/the-business-of-healthcare-podcast-episode-38-aligning-financial- incentives-with-quality-incentives#
Decreased Pediatric Trauma Length of Stay and Improved Disposition With Implementation of Lewin’s Change Model
Read:
Abd El-Shafy, I., Zapke, J., Sargeant, D., Prince, J. M., & Christopherson, N. A. (2019). Decreased pediatric trauma length of stay and improved disposition with implementation of Lewin’s change model. Journal of Trauma Nursing, 26(2), 84-88. https://doi.org/10.1097/JTN.0000000000000426
https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi? T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00043860-201903000-00008&LSLINK=80&D=ovft
Implementing and Sustaining Bedside Shift Report for Quality Patient-Centered Care
Read:
Becker, S., Hagle, M., Amrhein, A., Bispo, J., Hopkins, S., Kogelmann, M., Porras, E., & Smith, M. M. (2021). Implementing and sustaining bedside shift report for quality patient-centered care. Journal of Nursing Care Quality, 36(2), 125-131. https://doi.org/10.1097/NCQ.0000000000000509
https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?
T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00001786-202104000-00007&LSLINK=80&D=ovft
Outcome Assessment in Advanced Practice Nursing
Read Chapters 2 and 8 in Outcome Assessment in Advanced Practice Nursing.
ADKAR: A Framework for Successful Change
View:
Massey, K. (2019, July 3). ADKAR: A framework for successful change [Video]. YouTube. https://www.youtube.com/watch?v=zXwJTZ2EA2Q
Implementation Science and Nursing Leadership: Improving the Adoption and Sustainability of Evidence-Based Practice
Read:
Nelson-Brantley, H. V., & Chipps, E. (2021). Implementation science and nursing leadership: Improving the adoption and sustainability of evidence-based practice. JONA: The Journal of Nursing Administration, 51(5), 237-239. https://doi.org/10.1097/NNA.0000000000001006
https://lopes.idm.oclc.org/login?url=http://ovidsp.ovid.com.lopes.idm.oclc.org/ovidweb.cgi? T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00005110-202105000-00003&LSLINK=80&D=ovft
COVID-19: Why the Economics of Healthcare Will Never Be the Same
View:
Glenn, L. (2020, August 11). COVID-19: Why the economics of healthcare will never be the same [Video]. YouTube. https://www.youtube.com/watch?v=HRboT_SsxP8
Assessments
IHI Module TA 103: Increasing Value and Reducing Waste at the Point of Care
Start Date & Time Due Date & Time Points May 12, 2022, 12:00 AM May 18, 2022, 11:59 PM 10
This module examines value in health care. The concepts include cost, value, and their relationship to quality,
health care spending, the practitioners’ role in managing costs, and identifying and overcoming barriers to provide high-value and cost-effective care.
General Requirements:
Log into your IHI Portal using the link located in the Class Resources to access and complete the assigned module.
You are not required to submit this assignment to LopesWrite.
Upon completion of the module, submit your certificate to the assignment dropbox.
Learners will submit this assignment using the assignment dropbox in the digital classroom. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.
Directions:
Complete the “IHI Module TA 103: Increasing Value and Reducing Waste at the Point of Care” module before day 4 of this week. You will use the information learned in this module to answer the Topic 2 discussion question due day 5.
The estimated time for completing this module is 45 minutes, but for some learners it may take longer
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Quality and Sustainability Paper: Part 1
Start Date & Time Due Date & Time Points May 12, 2022, 12:00 AM May 18, 2022, 11:59 PM 125
This assignment will be completed in two parts, which will be synthesized into a final paper.
The purpose of this assignment is to investigate a quality and/or safety issue in a health care entity. You will use the issue and health care entity that you select in this assignment for Part 2 of the paper and for the sustainability assignments. You may use an issue identified at the practice site in your DPI Project.
General Guidelines:
Use the following information to ensure successful completion of the assignment:
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment requires that you support your position by referencing six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Directions:
Write a paper (1,500-1,750 words) discussing the role of quality or safety in nursing practice. Include the following:
1. In your own words, define quality and safety measures and describe their relationship and role in nursing practice today.
2. Create a table that identifies three barriers, and three facilitators or methods for addressing the barriers, in today’s health care that impact both patient outcomes and organizational outcomes. Evaluate two of the barriers and provide solutions for how health care organizations can overcome them. Describe two of the
facilitators or methods and explain how the facilitators or methods will assist overcoming or reducing barriers. Attach the table as an appendix to your paper.
3. Identify a health care entity. Provide an overall description of this entity without using the real name (e.g., location, size, profit or nonprofit, years in operation). In addition to not using the name of the health care entity, do not use the name of any person described.
4. Select a specific contemporary quality and/or safety issue that is measured at the health care entity and explain how that measure is applied in nursing practice. You will use this selected issue for all quality and sustainability assignments.
5. Describe the current quality and/or safety program the health care entity has in place to address the quality and/or safety issue you selected. Describe the key quality measures or components currently used to analyze the health care program’s outcome. Discuss what is working and what is not working.
6. Summarize the specific variables used to track improvement of the health care quality and/or safety
program’s outcome.
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