List key points for a professional reference letter about yourself that could originate from a supervisor.
Evaluate your readiness to assume this position. State areas in which you need to grow.
Integrate knowledge of the following in answering this question:
making ethical decisions using the various codes of ethics in social work.
issues of diversity, social, economic and environmental justice.
managing personal and professional values in practice;
advocating for individuals, groups, communities that have no voice;
knowledge of social work with individuals, groups, families, organizations, and communities; evidenced based research.
serving people with addictive behaviors in urban communities remaining professional by consistently assessing, reflecting and attending to the personal biases that impact treatment and recovery experiences and influence practice with people with addictive behaviors.
\”Being in a position of leadership is the most important job of any health professional anywhere along the continuum of care\” (Ledlow & Coppola, 2013, p. 3). Leaders and ultimately the boards of directors of health care organizations are accountable for the safety of those they serve.\” National quality organizations and regulatory bodies … are growing in their emphasis on leadership accountabilities for safe, reliable care as well as excellence in the experience of care\” (Youngberg, 2013, p. 39).
With this emphasis on leadership accountability for the delivery of safe, high-quality health care services, health care leaders need to be able to drill down on what exactly safety and quality mean in the health care environment. Likewise, they also need to be able to design measures that help to ensure their organizations are able to deliver those kinds of outcomes. Read Measurement Perspectives [PDF] to examine key elements related to this issue.
In this final course assessment, you will have a unique opportunity to examine a health care organization\’s safety and quality dashboard from the perspective of four organizational leaders. You will explore each leader\’s specific interests regarding patient safety and quality. In particular, you will have the opportunity to perform a more in-depth analysis of the dashboard, the type of analysis a quality director might perform to further the organization\’s safety and quality objectives.
References
Ledlow, G. R., & Coppola, M. N. (2013). Leadership for health professionals (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Youngberg, B. J. (2013). Patient safety handbook (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 2: Explain the risk management function in the health care organization.
Analyze areas of a safety and quality dashboard of concern to a risk manager.
Competency 3: Analyze the importance of patient safety in health care.
Describe how a health care organization chooses the metrics to include in its safety and quality dashboard.
Analyze areas of a safety and quality dashboard of concern to a patient safety officer.
Competency 4: Apply leadership strategies to quality improvement in a health care organization.
Assess senior leadership\’s role in setting a health care organization\’s strategic safety and quality objectives.
Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
Create a clear, organized, persuasive, and generally error-free presentation on a leadership team\’s assessment of an organization\’s safety and quality dashboard that is reflective of professional communication in the health care field.
Provide citations and title and reference pages that conform to APA style and format.
Preparation
To help prepare for successfully completing this assessment:
Your organization has just updated its safety and quality dashboard. Please review the Vila Health Mercy Hospital Safety and Quality Dashboard [PDF]. Note: You do not need to create a dashboard for this assessment. You are simply being asked to work with the one provided.
The CEO has asked each of the organizational leaders below to prepare a joint PowerPoint presentation. In it, they are to prepare a set of slides outlining their analysis of how the new numbers will inform their particular activities for the next quarter. The organizational leaders include:
The quality director.
The patient safety officer.
The risk manager.
Senior leadership.
Because of the quality director\’s critical role in implementing the organization\’s safety and quality strategic objectives, this individual will open the presentation and provide additional background about how the new dashboard was developed. This individual will also close the presentation. Use the following outline to organize your presentation. Be sure to include the introduction and conclusion and address all the questions listed under these headings. Also be sure to address each role and the corresponding questions.
Introduction (3–4 slides)
What is a safety and quality dashboard?
What role do safety and quality dashboards play in helping health care organizations drive their strategic safety and quality objectives?
How do health care organization determine what they want to measure? Be sure to consider:
Pressures from regulators, payors, and the industry.
Self-identified improvement areas. For example, one organization\’s safety and quality dashboard may highlight patient falls because its rate of falls is higher than the national average. This may also have resulted in increased costs to the organization.
What CQI tools did the organization use to obtain, measure, and report data?
What was the quality improvement team’s role in addressing the reported measures?
Quality Director (2–3 slides)
Which metric on the dashboard would draw the quality director\’s attention the most?
What does this dashboard metric mean and why is it important?
What three recommendations to leadership would help to address this metric?
What (if any) quality models could be used to increase the quality of patient care and outcomes for this metric? Consider PDCA, Six Sigma, Lean, Hoshin Kanri planning, et cetera.
Patient Safety Officer (2–3 slides)
Which metric on the dashboard would draw the patient safety officer\’s attention the most?
What does this dashboard metric mean and why is it important?
What role does the patient safety officer play in improving this metric?
Risk Manager (2–3 slides)
Which metric on the dashboard would draw the risk manager\’s attention the most?
What does this dashboard metric mean and why is it important?
What role does the risk manager play in improving this metric?
Senior Leader (1 slide)
What is the role of senior leadership (for example, CEO, COO, president, senior VP) in driving safety and quality improvement initiatives?
What next steps might senior leadership take given the dashboard findings and the quality director\’s three improvement recommendations?
Conclusion (2–3 slides)
Which regulatory agency(ies) may be concerned about the findings in this dashboard?
Why would regulators be concerned about these findings?
Why are safety and quality dashboards important for monitoring key metrics in health care organizations?
Your slides need to be concise and offer main ideas in bulleted format. Use the speaker notes to expand upon your findings as if they were the transcript of your presentation for the leadership team.
In the health care environment, it is unlikely for a presentation and speaker notes to be in APA style. Do make sure they are concise, organized, clear, and free of errors in grammar, punctuation, and spelling. Do make sure they address all the required headings and all of the questions under each heading.
Your senior leaders will want to know the sources of your information. Be sure to cite your sources in APA style in your speaker notes.
Additional Requirements
Presentation length: Your presentation should be a maximum of 20 slides, including title and reference slides. Format your title and reference slides according to APA format.
Speaker notes: Be sure to include these with your slides. They provide an opportunity for you to expand on the information you are highlighting in your slides.
Number of references: Cite a minimum of two references.
Scoring Guide: Please read the scoring guide for this assessment so you understand how your faculty member is going to evaluate your work.
Independence Medical Center is a rural referral hospital with 115 beds in Independence, Iowa. Like all hospitals, administrators and providers try to avoid errors, and it’s the patient safety officer’s role to monitor the hospital’s safety posture and recommend better practices. But what happens when a mistake leads to a medication error?
Patient Identification
At Independence Medical Center, the patient safety officer conducts daily safety rounds. Today, she’s rounding at the pediatric unit on the eighth floor.
Kyra Dilley and Virginia Anderson
Kyra Dilley: Hi, where’s the charge nurse?
Virginia Anderson: That’s me. What’s up?
Kyra Dilley: Well, I’m doing my safety rounds and I noticed that there are two patients on this floor in rooms directly across from each other: B. Moore and B.R. Moore.
Virginia Anderson: That’s not all — they have really similar birthdates! B. Moore was born on 8/11/05 and B. R. on 11/8/05.
Kyra Dilley: Okay, that’s even more concerning. How are you making sure not to confuse those patients?
Virginia Anderson: It’s not a problem. We’re making sure that the two patients always have different nurses.
Kyra Dilley: Well, that’s good, but I have to warn you that this is a troubling situation. Are all shifts aware of the need to schedule nurses around this?
Virginia Anderson: There are notes in both charts. We had to do that; we’ve been short staffed this week and there’s been a lot of shifting around.
Kyra Dilley: Oh, no. Was it B. Moore or B.R. Moore?
Arthur Chester: How did you know? It was B. Moore, birthdate 8/11/05. My investigation isn’t complete but there were two patients with similar names and birthdates in rooms in close proximity.
Kyra Dilley: Okay. Have you interviewed the nurses involved yet? There should have been different nurses for each patient.
HIPAA
The day after the medication error, B. Moore’s mother signs in at the front desk to get her visitation pass. As she is standing at the front desk, she overhears an inappropriate conversation between Ida Feeney, the unit secretary, and a nurse from a different unit of the hospital.
Ida Feeney and Brenda Turner
Ida Feeney: Did you hear about the Moore kid? It’s a good thing they caught that right away. She’s small for her age, and that insulin could have really done a number on her.
Brenda Turner: Jeez, how much did they give her?
Ida Feeney: Well, she wasn’t supposed to have any. But I forget the actual dose. I’ll look in the EHR later, but I think it was pretty high.
Write a 5-7 page recommendation to senior leadership about steps the organization needs to take to resolve a patient safety issue that occurred. Include an explanation of why it is important to address the issue and the role the patient safety officer will play in helping to resolve the issue.
Alarming numbers of unnecessary patient deaths occur in U.S. hospitals and around the world. \”Quality and patient safety in health care have been on the forefront of the public\’s mind since the publication of the Institute of Medicine\’s (IOM) seminal report, \’To Err Is Human,\’ in 1999\” (Johnson, Haskell, & Barach, 2016, pg. xv). The literature supports revising systems and processes in an effort to narrow the difficult safety and quality gaps. Worldwide, issues of patient safety and patient-centered quality care drive health care reform. Current approaches are not adequate; patients remain at risk for needless harm.
Demonstrating a firm understanding of the various components of patient safety is fundamental to understanding health care quality, risk management, and patient safety overall.
For this first assessment, you will assume the role of a patient safety officer at your local hospital. You will analyze a patient safety issue that occurred and then prepare a five- to seven-page recommendation for senior leaders about why it is important to address the issue, along with your recommendations about how to address it. You will also need to detail the role you as the patient safety officer will play in helping the organization resolve the issue.
Reference
Johnson, J. K., Haskell, H. W., & Barach, P. R. (2016). Case studies in patient safety. Burlington, MA: Jones & Bartlett Learning.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:
Competency 1: Analyze the quality and performance improvement activities within the health care organization.
Recommend evidence-based best practice tools and techniques to reduce or eliminate patient safety threats.
Competency 3: Analyze the importance of patient safety in health care.
Apply the health care safety imperative to a patient safety issue.
Evaluate the risk to patients, employees, and the organization if patient safety threats are not addressed.
Analyze regulatory agencies\’ role and impact on organizations\’ patient safety programs.
Competency 4: Apply leadership strategies to quality improvement in a health care organization.
Analyze the patient safety officer\’s role in implementing patient safety plans.
Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
Write a clear, persuasive, organized recommendation plan that is generally free of errors and is reflective of professional communication in the health care field.
Provide citations and title and reference pages that conform to APA style and format.
Preparation
To help prepare for successfully completing this assessment:
Select one of the three scenarios from the Vila Health: Patient Safety simulation activity that interests you the most for further analysis in your assessment:
Scenario 1: Patient Identification Error.
Scenario 2: Medication Error.
Scenario 3: HIPAA/Privacy Violation.
Instructions
For the scenario you selected, write a five- to seven-page recommendation for leadership that describes the safety threat, the importance of addressing the threat, and your recommendations for resolving it. Be sure to include all of these headings in your paper and to address all of the bullets underneath each heading:
Potential threat to patient safety:
Identify the issue you selected from the simulation activity as the potential safety threat.
Describe the issue that occurred with sufficient detail so that leadership has a clear understanding of what happened.
Implications of not addressing threat:
Evaluate the risk to the organization if this issue is not addressed. In your evaluation, be sure to address all of the following:
What does the health care safety imperative say about the issue?
How does the health care safety imperative apply in this case?
Which regulatory agency(ies) have oversight about the issue?
What specifically do the regulation(s) state about the issue? For example, you might consider the Joint Commission\’s national patient safety goals.
What impact do regulatory agencies have on organizations\’ patient safety programs?
How do health care organizations incorporate regulatory agencies\’ guidance when establishing reporting and investigation best practices?
If the hospital fails to correct the threat, what are the potential consequences to patients, employees, and to the organization?
Patient safety officer\’s role in effective implementation of patient safety plans:
Explain the role patient safety officers assume in implementing patient safety plans in health care organizations.
Clarify your responsibility and role as the patient safety officer in this specific instance.
Provide one example from the literature to illustrate your points.
Recommendations to reduce patient safety threat:
Describe your five-point plan to reduce or eliminate this patient safety threat.
What best practice tools or techniques does your plan include to reduce or eliminate these types of errors? Consider processes for responding, rounding, detecting, incident reporting, operational considerations, et cetera.
In a health care professional setting, recommendations to leadership would typically not be in APA format. As a result, your paper does not need to conform to APA format and style guidelines. It does, however, need to be clear, persuasive, organized, and well written without spelling, grammar, and/or punctuation errors. In addition, recommendations you write in a professional setting would be single-spaced. For the purpose of this assessment, however, please use double-spacing.
Also, health care is an evidence-based field. Your senior leaders will want to know the sources of your information, so be sure to include at least two peer-reviewed sources. You may use the suggested resources for this assessment. Your citations and references do need to conform to APA guidelines.
Additional Requirements
Length: Your recommendation will be 5–7 double-spaced pages, not including title and reference pages.
Font: Times New Roman, 12-point.
APA Format: Your title and reference pages need to conform to APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
Scoring Guide: Please review this assessment’s scoring guide to ensure you understand how your faculty member will evaluate your work.
Propose one solution to each challenge you have researched.
Describe at least five standards recognized by the Office of the National Coordinator for Health Information Technology (ONC-HIT) that are applicable to interoperability.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
