In this course, you develop a comprehensive Course Project: Promoting Health Care

Quality. To initiate this project, this week you examine the systems and structures of an

organization with which you are familiar.

Organizational Systems and Structures, Part 1

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an

inclination to focus on a specific event rather than to examine the larger context

surrounding it. Analyzing the systems and structures within an organization provides a

foundation for generating a fuller understanding of how and why the event occurred and

for developing strategies to address the underlying issues. Perhaps more importantly,

such an analysis can be used to proactively identify potential challenges and improve

organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a

health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be

able to sufficiently analyze to complete the full scope of the Course Project. (Refer to

the Course Project Overview as needed.)

Select two or more of the following frameworks:

· Learning organizations

· Complex adaptive systems (CAS)

· Clinical microsystems

· Good to great

· The 5 Ps

With these frameworks in mind, analyze the systems and structures of the

organization. Be sure to research and consider:

· Mission, vision, and values

· Strategic plan, goals, and objectives, if possible

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

Week 4: Organizational Systems and Structures, Part 2

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay

attention to culture. Organizational culture provides the context in which all interactions

and processes occur and is therefore central to any effort to enact change.

To prepare:

Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of

the Course Project).

Continue to analyze essential elements of organizational culture and evaluate the

influence of culture on the ability to achieve goals within your selected organization.

To complete:

Write a 3- to 5-page paper in which you:

· Provide a description of the organization that you selected

· Present your analysis of the organization with attention to:

· Its mission, vision, values

· Strategic plan, goals, and objectives

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

· The essential elements of the organization’s culture

· The influence of culture on meeting organizational goals

Section 2: Quality Improvement Issue

To help you move forward with your Course Project, this week you identify a quality

issue that you would like to address and submit a description of this issue for Instructor

feedback.

Your proposed issue should reflect a genuine need for improvement within your

selected health care organization. Through your Course Project, you will analyze this

issue and propose strategies to improve outcome(s), including the redesign of a related

process.

To prepare:

· Review the six quality improvement aims from the Institute of Medicine (IOM)

· Safe: Avoiding harm to patients from the care that is intended to help them.

· Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

· Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

· Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

· Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

· Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

· Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement.

· Consider what you have surmised thus far through your analysis of the organization

that you selected. What have you noticed that could help you identify a quality related need for improvement? For instance:

· What has captured your attention in meetings, reports, and/or daily activities?

· Have you noticed discrepancies between activities in the organization and

recommendations in the research literature, quality standards, and/or the

organization’s stated policies and procedures?

· If so, what do you think could be the reason(s) for variations or gaps between

what you have observed and what is recommended?

Identify a quality improvement issue that you would like to investigate for this project.

Note: Review the Course Project Overview/full instructions, located in the Week 3

Learning Resources, as needed to identify a quality improvement issue that is viable for

completing the full scope of this project. Once you receive a response from your

Instructor on the quality improvement issue that you submit, be sure to integrate his or

her feedback before moving forward with Section 3 of your Course Project.

To complete:

Write a brief description of the quality improvement issue that you would like to address

for your Course Project.

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits.

To Prepare:

To take the Assessment, visit http://walden.gallup.com. Using the Guidance Document Resource(s) for the Strengths Finder assessment, follow the instructions for setting up an account. If the link does not work, please copy and paste the link into your web browser.

Please Note: This Assessment will take roughly 30 minutes to complete.

• Once you have completed your assessment, you will receive your “Top 5 Signature Themes of Talent” on your screen.
• Click the Download button below Signature Theme Report, and then print and save the report. We also encourage you to select the Apply tab to review action items.

NOTE: Please keep your report. You will need your results for future courses. Technical Issues with Gallup:
If you have technical issues after registering, please contact the Gallup Education Support group by phone at +1.866-346-4408. Support is available 24 hours/day from 6:00 p.m. Sunday U.S. Central Time through 5:00 p.m. Friday U.S. Central Time.

• Reflect on the results of your Assessment, and consider how the results relate to your leadership traits.

By Day 3 of Week 5

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific.

the result of strenghtfinder attached

Assignment 1: Application – Best Practices

For over 20 years, the Women’s Health Initiative (WHI) study has conducted research trials to examine factors that impact risks and development of conditions that impact women such as heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. Health care providers use results from these trials to develop guidelines for delivering care to patients. In your role in clinical settings, you must be familiar with these guidelines, and you must be aware that through clinical practice, guidelines frequently evolve and change. Often, what is considered a best practice today might not be a best practice in the future. For this Assignment, you compare guidelines outlined in the WHI study to current best practices for assessing and managing conditions.

By Day 7 of Week 11

To Prepare:

• Review the Women’s Health Initiative website in this week’s Learning Resources. Select one disorder presented in this study.
• Locate a research article focused on women’s health issue that you have learned about on the Women’s Health Initiative project. Be sure that the research article you select is from a reputable source.
• Discuss the best practices presented in the article about the health issue. Explain if there are any differences in the literature about best practices about health issue.
• Explain whether you think the current best practices in the article you selected should be used in clinical practice. Support your position with evidence-based research.

To Complete:

Write a 2- to 3-page paper that addresses the following:

• Describe the disorder you selected from the Women’s Health Initiative study.
• Explain the current best practices for assessing and managing this disorder as suggested in the research article you selected.
• Compare the best practices presented in the WHI study to the current best practices presented in the article. Explain how the differences in best practices might impact women’s health.
• Explain whether you think the current best practices in the article you selected should be used in clinical practice. Support your position with evidence-based research.

ABDOMINAL ASSESSMENT

Subjective:

CC: “My stomach hurts, I have diarrhea and nothing seems to help.”

HPI: MT, 45 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

PMH: HTN, Diabetes, hx of GI bleed 4 years ago

Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units phs

Allergies: NKDA

FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

Heart: RRR, no murmurs

Lungs: CTA, chest wall symmetrical

Skin: Intact without lesions, no urticaria

Abd: soft, hyperactive bowel sounds, pos pain in the LLQ

Diagnostics: None

Assessment:

Left lower quadrant pain

Gastroenteritis

Directions for assignment ( all aspects of instructions to be included). 

1. Analyze the subjective portion of the note.

2. List additional information that should be included in the documentation.

3. Analyze the objective portion of the note.

4. List additional information that should be included in the documentation.

5. Is the assessment supported by the subjective and objective information? Why or why not?

6. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?

7. Would you reject/accept the current diagnosis? Why or why not? Identify five possible conditions that may be considered as a differential diagnosis for this patient.

8. Explain your reasoning using at least four different references from current evidence-based literature.

9. Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.