Quality Improvement Initiative Proposal: South Perth Hospital

This report proposes a quality improvement initiative at South Perth Hospital, addressing issues of care quality and revenue loss. The core problem identified is a discrepancy in patient care quality, largely attributed to documentation errors, nurse workload, and communication breakdowns. The solution proposed is the implementation of Electronic Health Records (EHR) to enhance documentation accuracy, communication, and overall patient satisfaction. The report discusses the importance of quality improvement, citing the systemic approach to healthcare improvement and its impact on patient outcomes. It reviews previous research supporting EHR implementation, highlighting improved communication, reduced medication errors, and increased patient satisfaction as projected outcomes. The report outlines the steps for implementing the initiative, including prioritizing improvement opportunities, defining objectives, defining requirements, implementation, and evaluation. The evaluation process involves assessing indicators such as improved patient experience, reduced medication errors, and reduced clinician burnout, with T-tests and ANOVA suggested for statistical analysis. The conclusion emphasizes the need for quality improvement initiatives like EHR implementation to enhance healthcare services and patient outcomes in clinical settings.

Running head: QUALITY IMPROVEMENT INITIATIVES
Name of the Student
Name of the University
Author Note

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Introduction:
With the global burden of disease, the demand for high-quality care in the hospital of
Australia has become increasingly important. In the current context, South Perth Hospital is
experiencing an issue regarding the quality of care provided to the patients which further affected
the yearly revenue. It was observed that in the hospital, a significant number of patient is
experiencing a discrepancy in the quality of care and questioning the safety of patients. In recent
times, a problem associated with documentation was observed that affected the interventions
designed for the patients. After conducting a detailed survey it was observed that shortage of
nurses influences the quality of care since the significant number of nurses are required to do the
overtime which left that emotionally burnt out and affected their clinical practice (Drach‐Zahavy
& Hadid, 2015). Due to heavy workload, nurses failed to engage patients in the effective
communication followed by an error in documentation which contributes to wrong interventions
and low patients satisfaction (Ramadaniati et al., 2018). Error in documentation also contributes
to medication error and question safety. Hence, a quality improvement initiative is required in
this area. This paper will illustrate different process of quality improvement initiatives in
following paragraphs.
These statement:
Implementation of the electronic health records will improve documentation and communication
between patients and doctors.
Discussion :
Importance of quality improvement:

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Quality improvement is defined as a systemic approach to the healthcare which leads to
the measurable improvement in the health care services and health status of the patients who
were targeted (Pandhi et al., 2018). In the area of the clinical setting, quality improvement
initiatives required in order to provide safe and responsive care to each patient with high patient
satisfaction. While clinicians play a massive role in providing the best possible care to the
patients, nurses being the front line health professionals are also a fundamental part of quality
care service (Zaka et al., 2019). As discussed before that because of the high workload as well
as lack of proper literacy, the majority of nurses failed to communicate with the patients which
further affected the documentation (Lam,'Donnell & Robertson, 2015). The documentation error
is also common for the patients belongs to different culture since the language barrier is present
which further leads to medication error and low patient satisfaction. Hence, a quality
improvement initiative such as the implementation of electronic health record (EHR) is crucial
to improve the quality of care in the clinical sectors. The expected outcome for this initiatives
would be accurate, update the information of patients, quick access to the patient record and
sharing journal, reduced, medication error, more effective diagnosis and treatment, enabling
confidentiality of care and improved communication between patients and health care providers
(Sandoval et al., 2019).
Previous research data:
Health care delivery system which is working to improve the care experience of
patients is experienced an array of challenges in behavior and practice in multiple levels as well
as areas of organizations, Hence, in this case, a health care organization can adopt the established
approach and principles of quality improvement. As discussed by McLean, Antony and
Dahlgaard (2017), in order to support quality improvement process a priority on encouraging

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communication and engagement as well as the partnership with stakeholders may influence the
quality improvement initiatives, implement it in the proper away by engaging each stakeholder
and evaluate the outcome of the result. In this case, the previous research demonstrated that in
order to implement electronic health record, strong leadership approach has been adopted and all
clinical staffs were involved in this and with the partnership, electron health record has been
implemented (Jauch et al., 2018). The staffs were provided with proper training for using
electronic health record. The projected outcome was improved communication between patients
and care providers, improved documentation process, patient satisfaction gained from the
patients who are leaving away from the hospital and failed to come to the hospital because of
transportation issues, reduced medication error (Liu, Choden & Yazdany, 2019).
Process of quality improvement:
Quality improvement initiatives are a national effort which built upon the existing work
of the long term as well as post-acute care profession (Liu, Choden & Yazdany, 2019). The
quality improvement initiatives follow five fundamental principles such as facilitate adoption
through hands-on improvement projects, define quality and get the agreement, measurement of
improvement, use of quality improvement framework and learn from variation in data (Holtrop
et al., 2017). The basic steps of implementation of quality improvement initiative are the
following:
• List and prioritize improvement opportunities:
List and prioritizing improvement opportunities is required since it would provide an
opportunity to narrow down the opportunity and choose the best one (McFadden, Stock &
Gowen 2015). In the current context, before the implementation of EHR as quality

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improvement, it is required to point of opportunities such as improvement of documentation,
communication, medication prescription (Bauer et al., 2015).
• Define the improvement objectives:
Defining improvement objective is a vital part of the project since it helps to gain a
specific result health care system is required to improve within a timeframe. In this case, the
objective would be the implementation of Electronic health record with the intention of
improving documentation and patient satisfaction along with improved care service within 3
months.
• Define the requirements:
The requirements for implementing a quality initiative is the necessary action required
to implement the initiatives since it will facilitate the process of implementation. In this case,
choose the target population, the requirement is to involve stakeholders, adopt leadership, and
amend policies, mandatory staff training, adherence to budget and timeline (Bauer et al., 2015).
.
• Implement the initiative:
In order to implement initiatives, required actions are needed to proceed such as
involvement of stakeholders in the implementation and amendments of the policies associated
with. After involvement, accurate staff training is required to provide, especially to the registered
nurses with illiteracy of documentation and adherence to the process. It would help them to
provide the best possible care to the patients and successful implementation (Bauer et al., 2015).
• Evaluate outcome:

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Evaluating outcome would help to gain an understanding of the successful
implantation and gap in implementation. In this case, the outcome would be improved
documentation, high patient satisfaction, accurate intervention, reduced workload (Govaert et al.,
2016).
Evaluation:
The evaluation of the implementation of the quality improvement initiative is the
process of measuring the outcome of the implementation process which provides the idea of the
success of the implementation process and gap associated with it. In the current context, in
order to evaluate the implementation in order to determine whether there would be an
improvement or not, few indicators of the improvement is required to consider (Jauch et al.,
2018). These indicators include improved patient’s experience of care, improved health of the
population or patients, reduced medication error, reduced clinicians as well as staff burn out,
minimized per capita cost of health care. In order to measure this indicator clinical audit using a
survey as well as on field observation is required where the target group would be registered
nurses (Ramadaniati et al., 2018). Moreover, for gaining the perspective of patients, interviews,
as well as local feedback, can be collected to identify initiative was successful or not.
Method of evaluation:
In the current context of implementing electronic health care, variables are an
adaptation of device in registered nurse, adherence to using of device, proper documentation
through the device. The hypothesis is electronic health record improve patients satisfaction,
accurate documentation, and reduced burnout. For Texting hypothesis, T-test can be used since it

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used for testing the null hypothesis and reject the null hypothesis by accepting the alternative
hypothesis (Cramer et al., 2016). For the statistical test, ANOVA can be used since it is a
collection of statistical models which examine the relationship between variables (Cramer et al.,
2016).
Conclusion:
Quality improvement is defined as a approach to the healthcare which leads to
improvement in the health care services for patient. In the area of the clinical setting, quality
improvement initiatives is required in for South Perth Hospital where nurses failed to practice
accurate documentation. Hence, electronic health record can be implemented for improvement of
documentation. The evaluation can be done by considering indicators include improved
patient’s experience of care, improved health of the population or patients, reduced medication
error, and reduced clinicians.

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