Continuous Quality Improvement Plan: Structural Elements

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Table of Contents

Team Types
Representation of Process/Activity
Benchmark Table
Leadership
References

Team Types

It is important to note that the project is designed to prevent or minimize the effect of nosocomial infections, which can also be described as hospital-acquired infections. In order to implement the proposed plan, teams will need to consist of different categories of healthcare professionals. In other words, these groups will be primarily multidisciplinary by nature because diverse expertise is necessary to ensure that patients do not acquire new infections after they are admitted to a hospital. It should be noted that nosocomial infections constitute the largest form of hospital-acquired conditions, which is almost 6% (Ellison & Cohen, 2018). Therefore, the Continuous Quality Improvement or CQI team will be comprised of a physician, an information specialist, a health care epidemiologist, an infection control specialist, a clinical microbiologist, and nurses. Nursing staff and physicians are needed to provide healthcare services in a traditional sense, but other specialists are critical due to the infectious nature of nosocomial issues.

Representation of Process/Activity

The detailed checklist for the process is shown in Table 1 below. The key checklist points revolve around the most common vulnerability points. Nursing staff must be provided with protective gear, which needs to be checked. The further steps will focus on the most vulnerable patients, which are at risk of nosocomial infections. The high-risk points requiring caution include physical injuries or surgical wounds, ventilator-associated pneumonia, and bloodstream infections. In addition, there are urinary tract infections as well as surgical wound infections (U.S. Centers for Medicare and Medicaid Services, 2022). Each patient type needs to be identified by using electronic health records and other sources of information. An additional level of caution needs to be taken by doubling the safety procedures, including protective gear use. The identified patients need also be constantly monitored from the moment of their admission until they fully recover from their primary health problem and leave the hospital. Lastly, the nature of nosocomial infections should be checked, such as bacterial, viral, or fungal origins. The latter statement is critical because it will determine the course of action if the infection is identified.

Table 1. Checklist

#	Measures	Check
1	Protective gear
2	Patients with physical injuries or surgical wounds: identification, caution, and monitoring
3	Patients at risk of ventilator-associated pneumonia: identification, caution, and monitoring
4	Patients at risk of bloodstream infections: identification, caution, and monitoring
5	Patients at risk of urinary tract infections: identification, caution, and monitoring
6	Patients at risk of surgical wound infections: identification, caution, and monitoring
7	Nature of infection: bacterial, viral, or fungal check

Benchmark Table

The detailed benchmark table to display a comparison of national quality standards against current standards at the healthcare organization for the CQI proposal is shown in Table 2 below. The table depicts the most relevant standards for the nosocomial infection case, where communication plays a critical role in ensuring that patients are safe from hospital-acquired infections. The problematic area can be seen in the close to benchmark section, which will be addressed with the leadership style and flexibility increase.

Table 2. Benchmark Table

Benchmark Table	Far away from benchmark	Close to benchmark	Achieved benchmark or better
National Quality Standards	“Adult hospital patients who strongly disagree or disagree that staff took their preferences and those of their family and caregiver into account when deciding what the patients discharge health care would be” (Agency for Healthcare Research and Quality, 2022).	Adult hospital patients who sometimes or never had good communication about medications they received in the hospital “Agency for Healthcare Research and Quality, 2022”.	Deaths per 1,000 adult hospital admissions with pneumonia “Agency for Healthcare Research and Quality, 2022”.
National Benchmark	Benchmark = 3.2	Benchmark = 7.8	Benchmark = 21.6
Current Standards	Benchmark = 4.9	Benchmark = 7.5	Benchmark = 22

Leadership

In order to successfully implement the project and achieve the desired objective of reducing or eliminating the rate of nosocomial infections, it is critical to apply a proper leadership framework. A study suggests that “strong clinical leadership is required to improve the quality of care … compassionate leadership is paramount in healthcare” (Graham & Woodhead, 2021). Since the CQI plan revolves around two main elements, which are protective gear and high-risk patient groups, there is a need for compassionate leadership with strong clinical management. In the case of personal protective gear or PPE, the emphasis needs to be put on balancing standardization procedures and staff flexibility. A study suggests that “the highest level of error reduction is found in circumstances in which employees are granted a high degree of discretion, standardization rigidity is intermediate, and, as a result, adherence to standardization is high” (Nissinboim & Naveh, 2018, p. 43). Medical experts need to be given room for autonomy and choice-making to introduce flexibility. In other words, standardization is effective to a certain extent in order to make the procedures and processes more consistent.

Subsequently, a leader at the organization should focus on compassionate transformational leadership to harness trust and support among the team members. The organization already has a rigid standardized structure of processes and procedures, which is why the emphasis needs to be put on flexibility factors. In addition, there are at least five high-risk groups, which include physical injuries or surgical wounds, ventilator-associated pneumonia, bloodstream infections, urinary tract infections as well as surgical wound infections. The standardization might become ineffective in addressing all of these vulnerable patients. The latter statement is further substantiated by the fact that nosocomial infections can be of three different origins. Therefore, the proper approach is to focus on healthcare staff development, flexibility, and support, which will allow them to be more responsive to diverse instances of infections.

References

Agency for Healthcare Research and Quality. (2022). National healthcare quality and disparities reports. Web.

Ellison, A., & Cohen, J. K. (2018). 224 hospital benchmarks | 2018.Hospital Review. Web.

Graham, R. N. J., & Woodhead, T. (2021). Leadership for continuous improvement in healthcare during the time of COVID-19. Clinical Radiology, 76(1), 67-72.

Nissinboim, N., & Naveh, E. (2018). Process standardization and error reduction: A revisit from a choice approach. Safety Science, 103, 43–50.

U.S. Centers for Medicare and Medicaid Services. (2022). Glossary. Web.

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Continuous Quality Improvement Plan: Structural Elements

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