D158 Healthcare Improvement Project Paper
Student Name
Western Governors University
D158 Strategically Planning the Execution of a Healthcare Improvement Project
Prof. Name
Date
D158 Healthcare Improvement Project Paper
Implementation Approach
What was the initial step in advancing the Healthcare Improvement Project (HIP)?
A dedicated project team was established, comprising several members from the organization, to focus on reducing surgical cancellations. The project began with an initial meeting between myself and my preceptor, marking the initiation phase. This session was pivotal in defining the scope of the HIP, which was then presented to the full project team to secure their consensus and commitment.
How did the team plan for the project’s execution?
During the planning phase, the team held biweekly meetings to evaluate the necessary resources for successful implementation. An important deliverable from this phase was the development of a budget, meticulously calculated using a detailed personnel pay and hours spreadsheet, ensuring financial transparency and resource allocation accuracy.
What consensus method was chosen for decision-making and why?
For decision-making during the implementation phase, I selected the Nominal Group Technique (NGT), an effective method suitable for small groups meeting in person. NGT follows a structured four-step process:
| Stage | Description |
|---|---|
| Silent Generation | Each team member independently writes down their ideas without influence. |
| Round Robin | Members sequentially share one idea each with the group. |
| Clarification | Group discusses and asks questions to elaborate on all ideas. |
| Ranking | Participants rank the ideas based on importance or relevance. |
This structured approach facilitated a harmonious team environment, culminating in unanimous agreement on the HIP plan.
How does the project maintain momentum during implementation?
To sustain progress, biweekly meetings are proposed. Meeting too often risks insufficient time for evaluating implemented changes, while less frequent meetings might reduce focus. The project manager is responsible for scheduling these meetings, creating agendas aligned with the action plan and the Gantt chart, which is regularly updated to track progress. Additionally, weekly email updates ensure consistent communication between meetings.
Were any policies reviewed or updated during the project?
An ongoing agenda item was the evaluation of existing policies to determine if updates were necessary. While the hospital’s exclusion criteria policy remained unchanged, modifications were made to the preadmission testing guidelines. The prior approach of a single phone call was replaced with weekly follow-up calls to enhance patient engagement. Given the overlapping membership between the project team and stakeholders, all changes were discussed and voted on during meetings, securing unanimous approval.
Action Plan
The action plan was developed collaboratively, detailing five critical steps, each with assigned responsibilities, phases, and target completion dates. This plan aligns closely with the accompanying Gantt chart, which breaks down each action item into specific subtasks.
| Phase | Action Item Description | Responsible Parties | Target Completion Date |
|---|---|---|---|
| Initiation | Identify HIP goal to reduce surgical cancellations by 5% | Project Manager, Preceptor | 01/29/2024 |
| Planning | Determine financial resources and complete Pro Forma budget | Project Manager, Preceptor, Team | 04/25/2024 |
| Implementation | Educate surgical, pre-op, operating, and preadmission staff | Project Manager, Preceptor, Team | 06/10/2024 |
| Control | Monitor and manage budget variances | Project Manager | 07/31/2024 |
| Evaluation/Closure | Assess HIP outcomes and present findings to leadership | Project Manager, Preceptor | 07/31/2024 |
The project spans from January through the end of July 2024, providing structured deadlines to guide each phase and keep the team aligned.
Gantt Chart Utilization
What role does the Gantt chart play in the project?
The Gantt chart is a dynamic planning and tracking tool that allows the project manager and team to visualize tasks, deadlines, and progress. The chart is updated collaboratively to reflect ongoing status and plan upcoming activities, reinforcing accountability.
| Phase | Key Tasks/Subtasks | Target Date |
|---|---|---|
| Initiation | Identify HIP, select stakeholders, complete needs assessment | 01/30/2024 |
| Planning | Complete financial analysis and personnel budget | 04/19/2024 |
| Implementation | Conduct educational sessions and process walkthroughs | 06/07/2024 |
| Control | Review monthly financial reports and weekly budget updates | 07/31/2024 |
| Evaluation | Analyze surgical cancellation data and prepare leadership presentation | 07/29/2024 |
Social Determinants of Health (SDOH) and Target Population
Who is the target population and what are their key social determinants?
The HIP targets reducing surgical cancellations by 5% by June 30, 2024, at Ortho Colorado Hospital (OCH) in Lakewood, Colorado—a 48-bed facility with 17 pre-op/PACU bays and 8 operating rooms, staffed by 187 employees (175 clinical). The target population reflects diverse sociodemographic characteristics:
| Factor | Description |
|---|---|
| Population | Lakewood population: 156,149 (2022) |
| Median Age | 38.1 years |
| Median Household Income | $82,786 |
| Ethnicity | White Non-Hispanic (68.2%), Hispanic (7.42%), Asian Non-Hispanic (3.89%), African American (1.6%) |
| Veteran Status | 5.25% of population |
| Education Level | Bachelor’s degree (20.8%), Some college (12.5%), High school diploma (14.8%) |
| Insurance Coverage | Uninsured rate slightly rose from 7.38% to 7.54% (2021-2022) |
| Poverty Rate | 8.8% living below poverty level |
How are social determinants addressed in the project?
- Education Access and Quality: Educational materials are written at a sixth-grade reading level and translated into Spanish to match community literacy and language needs.
- Economic Stability: Although median income is moderate, financial constraints for some may affect adherence to pre- and postoperative care; this is mitigated by frequent patient touchpoints.
- Neighborhood Environment: While Lakewood offers parks and transit, safety concerns regarding public transportation may affect mobility and recovery.
- Social and Community Support: Strong community networks, including food banks and pharmacies with discounted medications, support patient wellbeing.
- Healthcare Access and Quality: OCH’s partnership with Common Spirit Health provides discounted and free clinics, enhancing accessibility for underserved patients.
The project empowers patients with clear expectations and education to reduce anxiety and boost confidence, supplemented by weekly preadmission nurse calls to reinforce engagement and trust.
Force Field Analysis
What are the driving and restraining forces influencing the HIP implementation?
| Driving Forces | Restraining Forces |
|---|---|
| 1. Persistent rise in surgical cancellations | 1. Resistance from surgeon’s office leadership due to increased workload |
| 2. Strong executive leadership support | 2. Difficulty maintaining accountability among clinic staff |
| 3. Approved budget for additional preadmission staff | 3. Staffing shortages limiting communication capacity |
What strategies are planned to address these forces?
- Regular monthly executive updates sharing cancellation metrics to maintain leadership engagement.
- Leadership walkthroughs to foster empathy with front-line staff.
- Justifying hiring additional staff to reduce workload and improve patient communication.
- Including staff in developing educational materials to increase ownership and minimize resistance.
Scope Statement
The improved process focuses on enhancing patient engagement via multiple phone touchpoints and the creation of educational materials such as handouts, booklets, or classes. These resources aim to clarify surgical requirements and milestones, facilitating patient understanding and compliance throughout their surgical journey.
SMART Goal
The project’s SMART objective is to achieve a 5% reduction in surgical cancellations at Ortho Colorado Hospital by June 30, 2024. This goal will be realized by improving patient communication through increased touchpoints, comprehensive educational materials, and targeted staff education.
| Project Timeline | Start Date | End Date |
|---|---|---|
| HIP Duration | 01/29/2024 | 07/31/2024 |
Key Performance Indicators (KPIs)
| KPI Description | Target/Deliverable |
|---|---|
| 1. Develop and implement educational materials and preadmission screening with staff competency sign-off | Completion by June 10, 2024 |
| 2. Achieve 100% compliance with preadmission checklist by surgeon’s clinic and preadmission staff | Checklist deployed by June 7, 2024 |
Communication and Training Plans
Communication
| Communication Type | Audience | Purpose/Context | Expected Outcome | Medium |
|---|---|---|---|---|
| Biweekly Meeting Reminder | Project team | Maintain focus and engagement | Ensure attendance and attention | Email and Text |
| Biweekly Progress Update | Stakeholders, clinic & hospital staff, leadership | Inform on progress and upcoming tasks | Stakeholder awareness and support |
Training
Surgical, preadmission, pre-op, and operating room staff will receive training focused on:
- New informational materials
- Compliance checklist
- Additional preadmission communication touchpoints
Training Details:
- Four educational sessions per week over two weeks (May 20 – June 7, 2024), two hours each.
- Morning and evening huddles, plus virtual sessions at the surgeon’s clinic.
- Competency sign-off including a walkthrough and explanation of project goals.
References
Arakawa, N., & Bader, L. R. (2022). Consensus development methods: Considerations for national and global frameworks and policy development. Research in Social and Administrative Pharmacy, 18(1), 2222–2229. https://doi.org/10.1016/j.sapharm.2021.06.024
D158 Healthcare Improvement Project Paper
Data USA: Lakewood, Colorado. (n.d.). Data USA. https://datausa.io/profile/geo/lakewood-co/#demographics