Our focus during the past weeks has been to obtain an understanding of the basics of Quality Improvement: the various approaches/methods to improvement, types of measures, data sources, data analysis and display, change management, frameworks and methods for spreading improvement. Discussions and quizzes tested your understanding and knowledge.
This week’s assignment asks you to APPLY what you have learned through a series of case study exercises. Put yourself into each scenario. Engage your critical thinking as you recall, synthesize, integrate and apply the material from the course to formulate your best response to each scenario.BUS 573
Case Study 1: Quality Improvement Applications
This case study should include 3 sections. Please cite your sources and use APA format. Present your
responses in one, integrated, organized paper. Incorporate supporting evidence and external sources.
See the rubric for grading specifics.
Section 1
Review the 2015 Annual Progress Report for the National Quality Strategy. The National Quality Strategy
is organized around Six Priority Areas.
•
•
Which priority is most important to you as a healthcare provider/leader and why? Fully explain your
choice and provide supporting evidence and rationale. This will require a 2-3 paragraph response.
Consider the quality management cycle of measurement, assessment, and improvement. Thorough
discussion of the selected priority will require a 3-4 paragraph response and will address the topics
below:
o What are some of the challenges, issues, and concerns in effectively measuring performance
for this priority?
o How, specifically, is performance being measured for the priority? Critique the current
measurements that are being used.
o Summarize one real-life example of demonstrated improvement for the priority area? What
was improved? How was it improved? What were the measurable results?
Section 2
Many examples of improvement projects conducted by healthcare organizations can be found on the
Internet. Find a healthcare example for ONE of the following types of projects: PDSA, FOCUS-PDCA,
Lean, and Six Sigma.
Summarize the project by specifically describing the key elements using the appropriate steps for each
improvement model. Your goal is to clearly demonstrate understanding and appropriate application of
the selected models.
Consider the following websites or conduct your own search to find a healthcare improvement project
that uses the various types of improvement models. You may also use an example from your own
organization.
•
•
•
•
•
Institute for Healthcare Improvement: www.ihi.org
Clinical Microsystems, The Dartmouth Institute: http://dms.dartmouth.edu/cms/
Individual websites of the Quality Improvement Organizations. A list of the sites is available at:
www.qualitynet.org
Baldridge National Quality Program: www.nist.gov/baldridge
Centers for Medicare and Medicaid Services: www.cms.hhs.gov
Section 3
Constructing measures is a three step process:
1. Identifying the topic of interest.
2. Specifying the measure.
3. Designing the data collection system.
Choose one area of opportunity for improvement. Some examples are listed here OR you can choose
your own.
➢ Intensity of Hospital Services: Matching the type and amount of care provided to the severity or
urgency of the patient’s condition; reduction in usage of the Intensive Care Unit in favor of stepdown or routine medical/surgical care
➢ End-of-Life Care: Treatment decisions and care provided for terminal patients; increase
enrollment in hospice, earlier and more consistently
➢ Obstetrics: Awareness of delivery options; reduction of unnecessary C-sections
➢ Emergency Department: Optimal use of emergency services; reduction of unnecessary hospital
visits
For ONE topic of interest, develop a measure and design the data collection system.
•
•
•
Specify two (note only one measure is shown in the example table below) performance
measures that would be useful.
Describe the measure in fundamental terms. That is, specify the numerator and denominator
that would be used to calculate the measure. If there is no denominator, state why.
Describe a data collection plan for the measure. Where will you obtain data? How often?
Defend your choices.
Here is an example of a format that may be useful for summarizing your responses. The summary table
should be followed by a narrative description that explains, supports and defends your decisions.
Improvement
Opportunity
Decrease adverse
reactions to x-ray
dye
Performance
Measure
Percentage of
patients who
react adversely to
x-ray dye
Numerator
Denominator
Number of
patients who
react adversely to
x-ray dye
Total number of
patients receiving
an x-ray dye
injection
Data Collection
Plan
Retrospective
chart review of all
radiology patients
receiving x-ray
dye over the last
month
Rubric
QI Case Study Application
QI Case Study Application
Criteria
Ratings
Pts
This criterion is
linked to a Learning
OutcomeNQS
Priority: As a
provider/leader
15.0 pts
Thorough and complete
explanation
12.0 pts
Proficient
explanation
9.0 pts
Adequate
explanation
6.0 pts
Needs additional
explanation
0.0 pts
Missing
15.0 pts
This criterion is
linked to a Learning
OutcomeNQS
Priority:
Measurement
challenges, issues,
concerns
10.0 pts
Thorough and complete
explanation
8.0 pts
Proficient
explanation
6.0 pts
Adequate
explanation
4.0 pts
Needs additional
explanation
0.0 pts
Missing
10.0 pts
This criterion is
linked to a Learning
OutcomeNQS
Priority:
Measurement
specification and
critique
10.0 pts
Thorough and complete
explanation
8.0 pts
Proficient
explanation
6.0 pts
Adequate
explanation
4.0 pts
Needs additional
explanation
0.0 pts
Missing
10.0 pts
QI Case Study Application
Criteria
This criterion is
linked to a Learning
OutcomeNQS
Priority:
Demonstrated
improvement
This criterion is
linked to a Learning
OutcomeConstructing
Measures
This criterion is
linked to a Learning
OutcomeQI Project
Example
This criterion is
linked to a Learning
OutcomeAPA
Formatting
Total Points: 100.0
Ratings
10.0 pts
Thorough and complete
explanation
8.0 pts
Proficient
explanation
20.0 pts
Two measures
fully specified.
15.0 pts
Measures are
specified, but lacking
detail.
25.0 pts
Projects fully and
completely
described
20.0 pts
Project sufficiently
described, additional
detail could be added.
10.0 pts
APA used correctly.
Pts
6.0 pts
Adequate
explanation
10.0 pts
Measures specified are
incorrect, or only one measure
specified.
15.0 pts
Project adequately
described, but lacking
detail or not all steps
addressed.
5.0 pts
Some APA errors.
4.0 pts
Needs additional
explanation
0.0 pts
Missing
5.0 pts
Only one measure
specified incorrectly.
0.0 pts
Missing
10.0 pts
Project described, but
lacking detail or several
steps not addressed.
0.0 pts
Missing
0.0 pts
Did not follow APA formatting.
10.0 pts
20.0 pts
25.0 pts
10.0 pts
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