Quality Improvement Initiative

Prepare an evaluation (5-7 pages) of an existing Quality Improvement initiative to determine if the initiative is effective.

Instructions

Imagine you have been asked to prepare and deliver an analysis of an existing QI initiative at your workplace. The QI initiative you choose to analyze should be related to a specific disease, condition, or public health issue of personal or professional interest to you. The purpose of the report is to assess whether the specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. Your target audience is nurses and other health professionals with specializations or interest in your chosen condition, disease, or public health issue.

In your report, you will:

  • Analyze a current QI initiative in a health care setting.

    • Identify what prompted implementation of the QI initiative.

    • Evaluate problems that arose during the initiative or problems that were not addressed.

  • Evaluate the success of a current QI initiative through recognized benchmarks and outcome measures as required to meet national, state, or accreditation requirements.

    • Identify the core performance measurements related to successful treatment or management of the condition.

    • Evaluate the impact of the quality indicators on the health care facility.

  • Incorporate interprofessional perspectives related to the success of actions used in the QI initiative as they relate to functionality and outcomes.

  • Recommend additional indicators and protocols to improve and expand outcomes of a current quality initiative.

  • Ensure your analysis conveys purpose, in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly writing standards.

Be sure to address all of the bullet points.

Guiding Questions

Quality Improvement Initiative Evaluation

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Quality Improvement Initiative Evaluation assessment. You may find it useful to use this document as a prewriting exercise, an outlining tool, or a final check to ensure you have sufficiently addressed all the grading criteria for this assessment.

Remember, you are analyzing a current QI initiative that is already in place. You are not creating a new QI initiative (Assessment 3).

Analyze a current quality improvement initiative in a health care setting.

What prompted the implementation of the quality improvement initiative?

What problems were not addressed?

What problems arose from the initiative?

Evaluate the success of a current quality initiative through recognized benchmarks and outcome measures.

What benchmarks or outcome measures were used to evaluate success? Consider requirements for national, state, or accreditation standards.

What was most successful?

Incorporate interprofessional perspectives related to initiative functionality and outcomes.

How does the interprofessional team contribute to the success of the QI initiative?

What are the perspectives of interprofessional team members involved in the initiative?

Who did you talk to? From what other professions? How did their input impact your analysis?

Recommend additional indicators and protocols to improve and expand outcomes of a current quality initiative.

Answer

Evaluation of a Quality Improvement Initiative

Evaluation of Quality Improvement (QI) initiatives is essential in explaining the project’s what, why, and how, despite it improving the quality of care and meeting the relevant recognized benchmarks. Quality Improvement initiatives aim at improving institution-related processes mainly related to vulnerable populations. Evaluating the improvement process is done to assess how the improvement initiative affects the delivery of patient-centered care, the adherence and acceptance to the new practices, and the improvement in the patient’s experience of care (AHRQ, n.d.). The essay presents a report on evaluating an obesity care quality improvement initiative implemented in a healthcare institution. The report aims to assess whether the specific quality indicators point to improved patient safety, quality of care, cost and efficiency goals, and other desired metrics. The report will entail an analysis of the initiative, an evaluation of its success based n recognized benchmarks, interprofessional perspectives, and additional indicators of improving and expanding the current quality improvement initiative.

Analysis of the QI Initiative

The current quality improvement initiative in my healthcare institution, which will be analyzed, is related to obesity, one of the major public health issues in the served community (Manitoba). The current QI initiative mainly focuses on two major issues, community education aimed at increasing awareness of obesity and working with community members and leaders to enhance mandatory community screening on obesity. The initiative was implemented in the last quarter of 2022, with the nurses and social workers taking the lead in the implementation.

Various issues prompted the implementation of the initiative in the healthcare setting. First and foremost, there was an increased prevalence of obesity among children and adults in the community. The statistics in 2019 showed that the rate of obesity in Manitoba was ranging at 30.8% of the total population, with the national average in Canada being 28.6% (Statistics Canada, 2019). Having the community prevalence of obesity higher than the national prevalence is alarming and thus requires attention due to the increased risks for other obesity-related health issues.

Furthermore, the main issues leading to the obesity crisis in the community are lifestyle and diet (Colley et al., 2019; Slater et al., 2022). Many individuals do not engage in physical activities such as waking and exercising. More so, the dietary intake for children, youths, and adults in Manitoba is poor due to the high intake of junk foods that are readily available as fast foods all over the community. In addition, community health assessment by the healthcare institution showed that maintaining a healthy diet was more expensive than an unhealthy diet. Therefore, the institution had to develop an initiative that would help address this issue,

The other issue that prompted the initiative’s implementation is the increased cases of obesity-related health conditions reported in the healthcare institution. Diabetes was the lead, with an approximately 30% increase in newly diagnosed patients across different health populations. The main root causes of the condition would be traced back to lifestyle, diet, and obesity; thus, there was a need to identify and implement a quality improvement initiative.

There are various problems that arose during the implementation of the initiative and which were not addressed. The issues include limited financial resources to facilitate the initiative, poor parental practices related to nutrition and diet, and inaccessibility of community spaces to promote physical exercise. The three were the major issues from the community perspective, acting as a barrier to the obesity prevention QI initiative. The healthcare institution had difficulties educating the community on obesity prevention and management due to these issues.

Evaluation of the Current QI’s Success

Quality improvement initiatives are usually evaluated to ensure their effectiveness. The success of a QI initiative is evaluated based on the recognized benchmarks and the outcome measures required to meet state, national, and accreditation requirements. The National Heart, Lung, and Blood Institute (NHLBI) obesity guidelines in primary care are among the national benchmarks that were used to evaluate the success of the QI initiative. The institution provides guidelines on the assessment, management, and therapies used for children and adults with obesity (Ciemins et al., 2021). The assessment of obesity should include body mass index, risk factors or comorbidities, readiness to lose weight, and waist. Management includes the prevention of weight gain and weight loss. Treatment guidelines include physical activity, pharmacotherapy, dietary and behavioral therapy, and bariatric or weight-loss surgeries. Based on the initiative’s focus on community education and encouraging mandatory screening, the initiative was able to achieve most of these assessment, treatment, and management guidelines.

The core performance measurements related to the successful treatment and management of obesity include operational tracking, quality performance, and patient-centered care. According to Ciemins et al. (2021), operational tracking entails keeping track of the prevalence of obesity/overweight and obesity-related complications. The quality performance measures include obesity diagnosis, change in weight over time, anti-obesity medication prescriptions, and assessment of obesity-related complications. Patient-centered care entails patient-reported outcomes. The most successful outcomes of the initiative based on these outcome measures were a reduction in the prevalence of obesity and obesity-related complications in the community, an increase in the number of obese patients being assessed and receiving medications and other therapies, and an improvement in the patient-reported outcomes in obesity care.

Furthermore, the quality indicators significantly impacted the healthcare facility in a number of ways. The initiative’s success based on the quality indicators enhanced the overall institutional performance and outcomes. The institution also received a better reputation for offering the appropriate obesity care, thus contributing to addressing the public health issue in the community. Additionally, meeting the recommended benchmarks on obesity care will attract reimbursements from health insurance companies that consider the performance of an institution.

Interprofessional Perspectives in Relation to the Success of the QI Initiative

The interprofessional team considerably contributes to the success of the initiative. The different professionals have different perspectives that provide insight into the implementation of the quality improvement initiative. The interprofessional team relevant to this initiative includes nurses, community health workers, endocrinologists, physical therapists, doctors, and institutional healthcare leaders. According to Tiwari and Balasundaram (2023), each professional in the interdisciplinary team has a significant role in initiatives regarding obesity. For instance, the nurses and the community health workers are in charge of the health promotion initiatives in the community. The healthcare leaders, on the other hand, provide the directions based on the current research and best practices and the required finances for the initiative.

Based on the input and perspectives of the interprofessional team, the initiative’s functionality and outcomes are improved. For instance, the team can monitor and evaluate the initiative to determine whether the implementation is going according to the plan and whether changes should be made in the current and future initiatives. Additionally, the team members may have different opinions and rationales based on the initiative’s implementation, which can be included in the decisions to improve the outcomes and functionality of the initiative. The different perspectives are included in the decisions of the initiative, thus ensuring that the initiative is holistic and developed in collaboration with all interdisciplinary team members to enhance acceptance. I considered the input of the community health workers consulted for this analysis. Their input provided strong evidence of the success of the initiative’s outcome measures since they pointed out the improvement in some of these measures, including increased health service seeking for obese individuals in the community.

Additional Indicators and Protocols

Apart from the above-mentioned outcome measures, other indicators can be used to improve and expand outcomes in the current obesity education and community screening quality improvement initiative. These indicators include the number of individuals enrolling in physical exercise programs, the number of people willing to lose weight, and voluntarily presenting themselves to the institution for obesity assessment, treatment, and management. The indicators will help improve the initiative’s outcomes since patients will seek help services voluntarily, thus contributing to addressing the public health issue. Community institutions and resources can also be involved in the health promotion initiative to increase access to community members.

Conclusion

The current quality improvement initiative analyzed in this report entailed community obesity education and mandatory obesity screening initiated by a local healthcare institution to address the current public health issue of obesity. The initiative’s implementation was prompted by the increased prevalence of obesity and obesity-related complications in the community. The initiative was successful since it met most of the nationally recognized benchmarks. However, there were barriers, such as inadequate financial resources to keep up with lifestyle and dietary modifications to prevent obesity. The interprofessional team’s perspectives are included in the initiative. Additional indicators to improve outcomes in the initiative are the number of individuals enrolling in physical exercise programs and the number of people willing to lose weight voluntarily.

 

References

Agency for Healthcare Research and Quality (AHRQ). (n.d.). Ways to Approach the Quality Improvement Process. https://www.ahrq.gov/cahps/quality-improvement/improvement-guide/4-approach-qi-process/index.html

 Ciemins, E., Joshi, V., Horn, D., Nadglowski, J., Ramasamy, A., & Cuddeback, J. (2021). Measuring What Matters: Beyond Quality Performance Measures in Caring for Adults with Obesity. Population Various problems arose24(4), 482–491. https://doi.org/10.1089/pop.2020.0109

Colley, R. C., Christidis, T., Michaud, I., Tjepkema, M., & Ross, N. A. (2019). Examining the associations between walkable neighborhoods and obesity and self-rated health in Canadians. https://www150.statcan.gc.ca/n1/pub/82-003-x/2019009/article/00002-eng.htm

Slater, J., Pilli, B., Hinds, A., Katz, A., Urquia, M. L., Sanguins, J., Green, C., Cidro, J., Chateau, D., & Nickel, N. (2022). The Food and Nutrition Security for Manitoba Youth (FANS) study: rationale, methods, dietary intakes, and body mass index. BMC Nutrition8(1), 116. https://doi.org/10.1186/s40795-022-00611-x

Statistics Canada. (2019, June 25). Overweight and obese adults, 2018. Statcan.Gc.Ca. https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00005-eng.htm

Tiwari, A., & Balasundaram, P. (2023). Public Health Considerations Regarding Obesity. In StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/34283488/

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