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569. Quality health improvement initiative One of the recent quality health improvement initiatives is having a systematic and data-driven approach that reduces the length of stay but improves treatment efficiency—Gulfport memorial hospital. The main reason why the health facility started the initiative is that the revenue was so low, and the costs of operations escalated because of Medicare and Medicaid settlements (Griffiths, 2018). The management had to derive a way that would allow service providers and at the same time reduce or maintain the standard rates so that they did not burden the children’s families. The approach also involves improving care conditions by improving and lowering the length of stay.  Similarly, the patient is also prevented from hospital-acquired conditions. For instance, during the Covid 19 pandemic, patients can easily contract the virus because of its spread. The surfaces and contact with other patients make them more vulnerable to contracting Covid 19. Other conditions spread in the hospital may include pneumonia, urinary tract infections, and bloodstream infections. The initiative looks to provide the best services and ensure that the facilities discharge patients sooner unless family members cannot manage the condition outside the facility. Only critical conditions are admitted into the medical facilities. For instance, patients in ICU can stay in the hospital until they are medically cleared to leave the facility. The rest of the conditions are treated with the best care, and if need be, the patient can pop in for a checkup at agreed intervals. Therefore, those who are treated and allowed to go home become less vulnerable to getting other infections, and the quality of their lives improves.  The nurses’ role in the initiative was to help the doctors to monitor patients and keep the records that are used to determine which of the patients should be admitted and which ones can be discharged. They also help to advise the patients why they should opt for a shorter stay and how it makes them less vulnerable to contracting hospital acquired infections. Since the medical facility uses data driven approach, the nurses can also take part in decision making because they interact more with the patients and can analyze the reports and record the patients’ progress (Schmitt et al., 2019). The doctors will use these records to determine which patients can be allowed to go home and which situations require them to stay longer in the facility.  The outcome of the initiative was reduced costs of keeping the patient in the medical facilities. In so doing, the health center lowers maintenance costs and financial burden on the patient. Gulfport memorial hospital also adopted a systematic data-driven approach that keeps records and showing the initiative’s progress. The results showed that the facility saved $2 million in one year because the medical facility needed fewer supplies. Coordination care also improved, and an increase in discharges (Griffiths, 2018). The systematic system helps the hospital keep all the data, ensuring that the initiative is effective as days go. The doctors and nurses understand which cases can be discharged because practitioners can quickly retrieve the conditions’ treatments and records. REPLY 2 Colorectal cancer (CRC) is the third most prevalent cancer diagnosed in the USA. American Society of Cancer reports that by 2021, close to 104300 and 45200 new infections were colon and rectal cancer, respectively. However, the agency report that the testing rate is still low with ineffective techniques. Five years ago, Association gastroenterologists (AGA) projected testing of approximately 80%of the adults in the country.  By 2020, more than a quarter of these adults still did not know their CRC results. The meeting involving key stakeholders in the sector pinned down a roadmap for increased testing (Melson et al. 2020). Accordingly, the initiative uses AGA white paper as the aided modality to track and improve the testing. Our gastroenterology and hematology department received the recommendation with eagerness to implement the change. The hospital is in a strategic location with many people reported as overweight, alcohol abuse, and physically inactive, which are the risk factors. Previously, the organization organized annually free tests of the disease besides the community mobilization for behavior change. Throughout the year, the hospital only tested the people who voluntarily visited the department due to complaints. Marking ourselves with the national indicator, we realized that we did not improve community testing strategies. Most of the cases tested on demands were at an advanced level which Dougherty et al. (2018) report that they have increased mortality and morbidity due to delayed interventions. In early 2019, the organization embraced the AGA’s recommendation. Strength, Opportunity, Threats The tech has many opportunities in the community wellbeing; Besides improving outcome from the timely detection, Melson et al. (2020) affirm that the approach monitors the cases to know the burden and involve interdisciplinary for the holistic patient recovery. AGA developed the white paper from clinicians, nurses, physicians, and other agencies from the resonating modalities. However, the technology had some threats for implementation. Melson et al. (2020) acknowledge that varied behavioral, cultural, and economic orientations of different regions lowered the practicality of having similar results. Our organization was also straggling with other feasibility plans running for five years. Any recommendation that required more finance needed adjustments to the plans. Notably, the modality delineates the priority options for improved CRC surveillance. Traditional methods lacked efficiency in rightful case detection. Role of the Nurse and Tech’s Outcome Nurses were supposed to learn, teach and implement the technology. The nursing management created an awareness of the need for advancement in the screening process. Through a joint meeting with the board, the nurses understood the gaps in the traditional methods and their limitations. Necessarily, the meeting was a consensus for the new approach in case surveillance. Nurse leaders collected information on personal views. These collections were necessary to understand the organization’s position in implementing new technology. Noticeably, the change had minimal resistance due to the substantial evidence on the AGA white paper’s feasibility in patients’ outcomes. Afterwards, the management initiated the training modules to equip the frontline staff with new documentation skills and community surveillance. Nurses also influenced change among the resistant group. Notably, the organization evaluated the efficiency of technology teamwork, patient safety, and CRC testing. The first evaluation suggested improved testing of the CRC by 9%. The report also indicated that it was easy to track and monitor the tested people. The staff suggested the need to sustain the change yet tailor-suiting it to the context and the community.



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