In assessing policy recommendations, it is noted that no current policies exist detailing inbox management or expected response times for patients. The largest recommendation would be to develop and institute a policy which clearly delineates when messages or tasks are received who manages them and in what time frame are patients having their needs addressed. For example, within 30 days of implementation, all patient messages will be addressed and receive a response within 48 business hours for routine, non-urgent needs.

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

Development and implementation of this type of policy level sets expectations across the organization and extends to the patients so they know what to expect as well. Additionally, if implemented, this policy would allow clinical leaders to hold their teams accountable for their respective productivity and responsiveness that directly contribute to the patient experience.

“Good communication skills are indispensable to basic concepts of nursing care as communicating effectively can help reduce the risk of medical errors, ensure better patient outcomes, and nurture patient satisfaction. A good patient experience– while considered merely desirable in the past – is moving center-stage” (Lang, 2012). The success of this project, if implemented would be determined by patient satisfaction numbers, which would demonstrate timelier patient-provider communications, and improved patient experiences. Continued success will also promote Adelante’s reputation in the community which may also drive more revenue through increased patient referrals.

SWOT Analysis and Contemporary Change Theory

In assessing the political landscape at Adelante Healthcare, traditional power dynamics exist as seen in the traditional organizational chart with the Chief Executive Officer at the head of the company. Along with this, however, is a strong display of informal power lines. Many of the executive leaders have built strong relationships with their peers, direct reports, and community contacts which, in turn, has built deep bonds of trust and respect. Understanding these power dynamics is crucial when considering change theories, policy recommendations, and/or quality improvement projects as these key stakeholders can help garner support and leverage resources that project leads may not otherwise have the access or capability to do.

Alongside the leveraging of key stakeholder support, the application of Lewin’s Change Theory could be a practical advantage. Lewin’s Change Theory “theorized a three-stage model of change known as the unfreezing-change-refreeze model that requires prior learning to be rejected and replaced” (Petiprin, 2020). Drawing from the unfreezing stage, Lewin suggests that teams and people let go of old, counterproductive habits that no longer serve a purpose; in this case, a lack of policy or procedure around patient-provider communications.

NURS FPX 8010 Assessment 4 Quality Improvement Proposal

The change stage theorizes that those same people or teams need to process and work through the newly implemented changes, which may require leaders to take a more vested interest in their teams and their adjustment to a new version of productivity. Lastly, the refreezing stage is a method of solidifying the new change to make it habitual. For this project, the standard operating procedure and supporting policies would be finalized and disseminated across the organization and leaders would be expected to hold their teams accountable and

prevent them from returning to old habits which diminish the patient experience.

Adelante’s strategic priorities are spread across 4 domains: finance, people, patients, and wellness. The selected nursing department priority for this quality improvement proposal is patient experience which aligns directly with Adelante’s patient satisfaction objective in the patient domain. In conducting a SWOT analysis (Avila, 2022), strengths, weaknesses, opportunities, and threats were reviewed and can be seen below.

SWOT Analysis

Strengths

  • The project team is comprised of individuals with extensive medical knowledge, background, and experience such as leadership, operations, quality, nursing, and clinical informatics.
  • The project will focus on the quality measures relevant to the organization through an improvement in key performance indicators (KPIs) such as patient satisfaction scores.
  • Using an optimized provider inbox within the EMR will improve the quality of care provided to patients and enhance clinical staff satisfaction.
  • Increased patient satisfaction can promote increased patient referrals and visits to the clinics, which

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