Draft a 6-page report on outcome measures, issues, and opportunities for the executive leadership team or applicable stakeholder group.
*This assessment is based on the executive summary you prepared in the previous assessment.
Drafting the Report
Analyze organizational functions, processes, and behaviors in high-performing health care organizations or practice settings.
Determine how organizational functions, processes, and behaviors affect outcome measures associated with the systemic problem identified in your gap analysis.
Identify the quality and safety outcomes and associated measures relevant to the performance gap you intend to close. Create a spreadsheet showing the outcome measures.
Identify performance issues or opportunities associated with particular organizational functions, processes, and behaviors and the quality and safety outcomes they affect.
Outline a strategy, using a selected change model, for ensuring that all aspects of patient care are measured and that knowledge is shared with the staff.
Outcome Measures, Issues, and Opportunities
Student’s Name
Institutional Affiliation
Course
Instructor’s Name
Date
Outcome Measures, Issues, and Opportunities
Introduction
Measuring outcomes is a critical part of healthcare practice. An outcome measure is a tool used to evaluate or assess the patients’ current status. Outcome measures may provide a score, risk categorization of patients, as well as interpretation of results. Additionally, outcomes are critical indirect management of individual patient care (Nebre et al., 2020). Usually, before providing any intervention or treatment, an outcome measure provides baseline data. Once the intervention has commenced, outcome measures can be used in serial assessments to determine whether the patient has demonstrated change. The identified quality and safety goal in the previous assessment was to increase catheter-associated urinary tract infections (CAUTIs) due to improper use of the indwelling catheters (Nebre et al., 2020). Therefore, there is a need for improvement interventions. The purpose of this paper is to present a discussion regarding organizational outcome measures, issues, and opportunities to be considered when addressing catheter-associated urinary tract infections (CAUTIs).
Organizational Functions, Processes, and Behaviors in High-Performing Health Care Organizations
The functions, behaviors, and processes of a high-performing organization are critical in establishing the need for outcome measures. These characteristics are also crucial in establishing the opportunity for improvement. One major characteristic of a high-performing healthcare organization is its ability to maintain a culture of reporting and record-keeping. According to Ahluwalia et al. (2017), a common behavior of a successful healthcare organization is the ability to regularly measure and truck their program accurately. The aim of healthcare workers is not only to save lives but also to improve the lives of patients. The understanding of doctors regarding the effects of disease and treatment on patient’s daily lives is poor (Ahluwalia et al., 2017). As a result, many standardized measures have been developed to capture patient‐reported outcomes. Measuring and tracking progress facilitates continuous improvement in these high-performing organizations that are related to evidence-based practice (EBP).
Another important characteristic of high-performing health care organizations is the adoption and application of quadruple aims. These aims include cost reduction, improving population health, great patient experience, and productivity (Ahluwalia et al., 2017). The quadruple aim was developed from the triple aim (reducing costs, improving population health, and patient experience). These performance dimensions can be applied to a broad range of healthcare challenges such as reducing the rate of burnout present in healthcare workers, combating rising healthcare costs, improving quality of healthcare, and others.
Additionally, high-performing healthcare organizations are characterized by continuous learning, being well informed, and being insightful. A high-performing organization understands the current environment with its focus on the future change trajectory (Ahluwalia et al., 2017). It is only by remaining updated on several environmental factors that have multifaceted impacts, such as economic (market segment), political (government), social (population), technology, and others. It will enable the high-performing organizations can begin to make meaning of the trends and organizational changes required.
Furthermore, high-performing organizations should have respectful and optimized staffing. Failure to deploy staff at their highest and best use is one of the biggest wastes in healthcare (Ahluwalia et al., 2017). To save cost, the organization need to manage well labor costs such as salaries, wages, and benefits. However, the uneven focus tends to lead to certain problems that are likely to harm the organization. The organizations often engage their staff by the diagonal slice or from the ground up to help resolve the common challenges of more efficient and effective patient care (Ahluwalia et al., 2017). A high-performing organization would normally assess the entire human capital chain to ensure the best approaches in the workforce, talent management, and human capital operating model.
Effects of Organizational Functions and Behavior on Outcome Measures
Catheter-associated urinary tract infections (CAUTIs) are normally affected by the functions and behaviors in the health care organization. One aspect of such behaviors and functions is related to the organizational culture and processes of reporting catheter-associated urinary tract infections (CAUTIs). According to Nebre et al. (2020), catheter-associated urinary tract infections (CAUTIs) are associated with numerous negative outcomes. Besides the increased chances of getting the infection, the patient may also experience urethral strictures, non-bacterial urethral inflammation, mechanical trauma, or impaired mobility. CAUTIs may also lead to an increased length of hospital stay for the patient as well as some associated risks of mortality (Nebre et al., 2020). Organization cultures that victimize staff liable for improper use of indwelling catheters might reduce the rates of reporting.
Another issue affecting CAUTI outcomes measures is the lack of adequate training or continuous education regarding the use of an indwelling catheter. The purpose of training and education in healthcare is to ensure staff is knowledgeable about new treatment approaches, technologies, and equipment (Nebre et al., 2020). It also keeps them refreshing themselves to ensure they master the standards of practice. Training is, therefore, highly essential for the health care workers to enable them to apply the correct use of an indwelling catheter to reduce CAUTIs.
Another aspect that affects outcome measures related to CAUTIs includes the lack of enhanced interdisciplinary collaboration. There should be enhanced multidisciplinary collaboration when making decisions regarding catheterization (Nebre et al., 2020). This strategy is crucial to ensure the catheters are used at the right time and incorrect manner. Lack of occasional review of catheterization is another issue. The reviews are important to identify and determine the prevailing issues that may cause profound complications on patients. Additionally, the lack of catheter charts has contributed to the increasing rates of CAUTIs (Nebre et al., 2020). The creation of catheter charts may prove helpful in the documentation of patients’ information that has been catheterized.
Quality and Safety Outcomes Relevant to The Performance Gap
To make proper improvement decisions, it is important to first look into quality and safety outcomes related to CAUTIs. Certain measures of quality and safety have been identified were identified (Nebre et al., 2020). These safety and quality outcome measures include rates of adverse events, hospital 30-day readmission rates, CAUTI infection rates, length of hospital stay, mortality rates, and extra costs of care. All these measures should take and reported on the healthcare dashboard for monitoring levels (Nebre et al., 2020). These measures of quality and safety are presented in the attached spreadsheet.
Adverse events associated with CAUTIs include fever, blood in urine, cloudy urine, and foul smell. These adverse events indicate a crucial outcome and a measure of patient safety based on the quality of care delivered by the care providers (Nebre et al., 2020). Adverse events are undesirable events that patients experience that are not related to their initial illnesses. It is important to measure adverse events to determine the effect of care safety on patients. Higher rates of adverse events indicate unsafe to care for the patients (Nebre et al., 2020). Adverse events often indicate poor care management and supervision which puts the patients’ health at risk.
Additionally, readmission rates are insights into the effectiveness and efficiency of care. 30-day readmission rates are measures according to the Centers for Medicare and Medicaid Services (CMS). The organization used this performance to penalize healthcare organizations (Nebre et al., 2020). Usually, readmission within a month shows that the kind of care delivered to the patient was ineffective to produce a favorable prognosis. Furthermore, catheter-associated infection rates indicate both ineffective and low safety care. They indicate improper use of an indwelling catheter.
Other safety and quality outcomes associated with CAUTIs include the length of hospital stay, mortality rates, and extra costs of care. Patients who develop catheter-associated infections tend to stay longer in the hospital due to these complications (Nebre et al., 2020). The doctor has to treat the new symptom associated with CAUTIs which might take additional days. Additionally, the patient will have to spend more money due to extended admission. Mortality due to CAUTIs occurs in 10% of the patients (Nebre et al., 2020). Mortality rates are high when patients develop bloodstream infections.
Performance Issues and Opportunities
It is necessary to identify performance issues and opportunities associated with the mentioned performance functions and behaviors as well as the affected outcomes. One important issue is reporting behavior (Nebre et al., 2020). It is an important aspect of patient safety and quality of care. Reporting in healthcare is also considered crucial for evidence-based practice. In the healthcare organization, catheterized infections are reported as numbers as indicated in the spreadsheet. The methods of reporting cannot effectively monitor progress because these numbers do not address the changes in the number of patients (Nebre et al., 2020). Therefore, better reporting standards are needed.
Based on the analysis of the organizational functions and behaviors, other identified issues include staff training and collaboration. Therefore, an opportunity is identified in the analysis to enhance staff training and interdisciplinary collaboration (Nebre et al., 2020). Staff training and continued education will ensure the healthcare workers are competitive and keep refreshed on the use of an indwelling catheter. Additionally, the collaboration will help reduce readmission rates. It will reduce incidences of CAUTIs.
Strategy for Enhancing Measuring of Outcomes
One of the key strategies that can be used in achieving this is a nurse’s and other healthcare workers’ education on the effective use of catheters and the dangers associated with prolonged use or inappropriate use. Education improves workers’ knowledge and competence useful in effective catheterization and the management and monitoring of catheterized patients (Nebre et al., 2020). Education helps them understand catheterization indicators, effective insertion of catheters using aseptic technique, and the need to examine risks and benefits of catheterization for different patients. Besides, it helps them gain knowledge, skills, and competencies required for effective catheterization process, patient assessment, and care optimization consequently resulting in positive outcomes.
The proposed strategy will use Kurt Lewin Change Model to engage interdisciplinary in defining catheterization standards. The Lewin Change Model involves three major stages, such as unfreezing-change-refreezing (Hussain et al., 2018). The model will help create awareness among staff as to why the change is needed. It will then help in the implementation as well as in the sustenance of the new functions and behaviors (Hussain et al., 2018). The three stages will be applied to ensure the successful implementation of the strategy.
Conclusion
Measuring outcomes is an important part of healthcare practice. Usually, before providing any intervention or treatment, an outcome measure provides baseline data. Once the intervention has commenced, outcome measures can be used in serial assessments to determine whether the patient has demonstrated change. This paper presented a discussion regarding organizational outcome measures, issues, and opportunities to be considered when addressing catheter-associated urinary tract infections (CAUTIs).
References
Ahluwalia, S. C., Damberg, C. L., Silverman, M., Motala, A., & Shekelle, P. G. (2017). What defines a high-performing health care delivery system: a systematic review. The Joint Commission Journal on Quality and Patient Safety, 43(9), 450-459. https://doi.org/10.1016/j.jcjq.2017.03.010
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002
Nebre, G., Levine, M., Coleman, C., & Peterson, C. (2020). Catheter-associated urinary tract Infection (CAUTI) prevention in spinal cord injury unit. University of San Francisco.