Section # 2-Strategies for Implementing a Quality Improvement Project in a Hospital.
a) Transformational Leadership
Theory-transformational Leadership is a leadership style used by leaders whose primary focus is to empower their followers to do things they would not do in normal circumstances because leaders have visions and strongly influence and encourage their followers in their jobs (Gammon et al., 2019).
Practice—The concept of continuous improvement has identified the importance of transformational leaders in delivering healthcare services in the hospital. Such behavioral changes in staff will change healthcare practices and outcomes and help achieve better healthcare goals.
Example: The hospital’s CNO can engage in transformational Leadership by holding town hall-style meetings on the floor to underscore the need for stricter infection control. These meetings can act as a forum where nurses and other healthcare workers can address their grievances and share their ideas; they can thus feel important in the establishment(Gammon et al., 2019).
Actions by Management: Senior-level workers must be encouraged to take hospital leadership courses to implement the transformational leadership style. They can also set up a reward system to recognize the people participating in the Q.I.P. and incentivize other staff to be involved.
b) Engaging Frontline Staff
Theory: Kouzes and Posner identify frontline staff as key; liberation engages them in the entire process because they become committed and motivated to the improvement plan for success (Casey & Moscovice, 2004).
Practice: It makes the system’s loopholes insignificant or somewhat absent, and the approach is conveyed directly by the staff practically engaged in patient care.
Example: It is also advisable to form groups of nurses, doctors, and other staff to support and enhance the adoption and success of hospital-wide infection prevention and control strategies. The other approach is for such teams to conduct regular meetings to derive meanings from data and identify issues that must be addressed to resolve the identified problems.
Actions by Management: An example of an approach through which such broad engagement can be made possible is through the use of committees or working groups that the hospital managers set up for the staff to engage in Q.I. projects. They may also provide freedom since, in this case scenario, their workers can provide feedback, and they will not retaliate against their workers.
c) Data-Driven Decision Making
Theory: Quantitative research is a method that involves using quantitative data at specific points in time to make a decision. The strategy derived from the subject has evidence-based support rather than being subjective or emotive (Weiner et al., 2005).
Practice: The most appropriate data to collect and compile with the related data include incidence rates, personnel hand hygiene observance, and patient outcomes to determine the concerning areas and the change outcomes.
Example: This type of rate digital dash may be used to keep track of infection rates per ward in certain hospitals. The hospital will then be able to track the trends in infection rates and use the periodic analysis of this data to identify any notable increases in the measure of thresholds and can take prompt action to mitigate them.
Actions by Management: For hospitals to implement decision-making approaches in the most appropriate ways, hospital management needs to install the correct electronic information to help gather process and data analysis. They can also avail themselves of services that will train their staff to best use these systems and interpret the data they produce.
d) Continuous Education and Training
Theory: Continuous education and training also highlight the need to repeat the learning process to retain best practices, maintain compliance with best practices, and achieve goals toward quality outcomes regarding healthcare delivery (Kriegova et al., 2021).
Practice: Frequent training programs are provided to make the staff well aware of infection control methods and the current procedures for their prevention. Training can also be formal through training, workshops, and e-learning.
Example: A hospital may also include a reminder on infection control practices once every three months, such as properly performing handwashing or using the proper E. These sessions can be compulsory for all clinical and supportive professionals.
Actions by Management: Hospital management can contribute to lifelong learning through donations and training modules. They can also use the services of organizations that provide critical information for staff, like articles and best practices from academics and professionals.
e) Lean Six Sigma
Theory: Lean Six Sigma combines lean manufacturing and Six Sigma, involving strategies to eliminate process waste (Montella et al., 2016).
Practice: The Lean Six Sigma model can be effectively applied in the health sector to reduce excess work processes, variations, and non-value-added work.
Example: A hospital would have to discover how the Lean Six Sigma concept can be used in the medication administration process to identify the causes of delays and medication errors. In this regard, processes need to be reorganized and standard operating procedures adopted to assist the hospital in improving efficiency levels and minimizing mistakes.
Actions by Management: These Lean Six Sigma tools can be used in hospitals to educate and train employees. They can also offer to form cross-functional project teams to facilitate holistic organizational processes.
f) Patient and Family Engagement
Theory: Encouraging patients and their families to take part in care processes will increase the safety, quality, and satisfaction of the healthcare system
Practice: Q.I. in hospitals can be done by actively engaging patients and their family members in care practices and protocols included in Q.I.
Example: A hospital can implement a patient and family advisory council that meets regularly to provide information on an infection control program and feedback on changes being implemented. This council can help guide interventions to deliver patient-centered care that addresses the interests of the people under its care.
Actions by Management: Organizations may also assist patients and families in the following ways: They can incorporate strategies that foster communication and structures for involving patient families. They can also ensure that the staff is adequately trained to develop communication and relationships with patients and their families.
g) Assessment of Effectiveness
Reduced Infection Rates
Strategy: Protecting the Organization from Pathogens: Implementing handwashing practices and promoting cleaning policies (Mishriki et al., 1990).
Effectiveness: One of the interventions is replacing the current number of HAIs at this healthcare facility with a high percentage of reducing the number of HAIs.
Example: The infection rate for a hospital, hence before initiating any Q.I. project, is 3%, for example. 5% and 1% once a project is ready to be deployed. A 5% reduction in HAIs in the first year and the subsequent average of 4% in four successive years.
Actions by Management: To increase the number of cases, organizations’ management can also regularly track hand washing and environmental disinfection. They can also provide feedback to the staff members and request to change some protocols.
Improved Compliance
Strategy: The optimal strategies involve workers in the development of policies and in continuing education to address ineffective workers’ behavior (Neiderud, 2015).
Effectiveness: More compliance can also mean that more employees in an organization comply with infection control procedures, among other policies.
Example: This failure in the Q.I. project should be addressed, and with the effective implementation of this project, the 60% compliance rate in hand hygiene should be boosted to 90%.
Actions by Management: Management can make generic inquiries and utilize the results to decide if further actions can be taken to enhance efficiency. They can also identify higher compensation through bonus activities that motivate the employees.
Enhanced Patient Safety
Strategy: Organisational Commitment Among Front Line Staff Endorsing the Use of Transformational Leadership (Pittet, 2005).
Effectiveness: Another symptom of patients’ safety in the healthcare industry can be indicated by decreased patient infections and complications.
Example: The changes in the survey findings may be positive, with evidence of better hygiene or sanitation activities.
Actions by Management: Regarding the number of safety protocols, management can use patient feedback to enhance patient safety. They can also create awareness of safety measures on the hospital premises and make it a point to carry out safety activities in all hospitals.
h) Challenges and Solutions
The project faced several implementation challenges:
Some staff’s attitude change towards new practices took a lot of work. To continue with this meant training workers, regular communication, and change champions who would live the change and be an example for others. It is recommended that the change management process be composed of six steps concerned with combating resistance to change in terms of communication, seeking support from the top, and involving the right people.
The most challenging issue was time management, as it was only sometimes possible to combine daily duties such as caring for the patients with the new Q.I. project tasks. Options such as integrating and eliminating time-consuming processes also allowed us to deal with this issue. It stresses the need to integrate Q.I. initiatives into our regular work so that the changes continue after one or two years of changes.
The scarcity of hand sanitizer devices and cleaning chemicals was an issue. Both finding new funds and the replenishment of resources that the project already involved were needed to realize this project. Using this social theory emphasizes the significance of resource distribution in establishing Q.I. endeavors.
