On 2015 Apr 30, University of Kansas School of Nursing Journal Club commented:

Team 12: Stacy Hanson, Jen Huynh, Sami Johnson, Valerie Melin, Shannan Orpin, Chelsi Puskas, Chandler Schoen. SON Class of 2015.

Background Introduction: As a team, we chose to review this article on quality improvement to emphasize the importance of involvement from all staff members in order to achieve optimal health system performance. The contents of this article covers topics both mentioned during our current module and in our previous microsystems course. During this current module, we’ve discussed the importance of quality patient care measures in the health care organization and its financial impact on the organization as a whole. The article examines this component by surveying all staff members of the hospital, including hospital and nursing managers, medical doctors, nurses, and records officers, to get a better perspective of what quality improvement means to them, how they utilize it in their practices, and what does it mean for the organization as a whole. The article also supports previous topics of managerial and leadership styles, and reflects positive evidence for the “bottom up” approach to making changes in the organization.As we prepare to begin our nursing careers, it has been emphasized that the greatest impact on patient care is bestowed upon the “frontline” staff. Not only will we be the faces of the organization, we will also be responsible for making the greatest changes in striving to obtain an optimal health system.

Methods: In our quest to finding this article, we used CINAHL and Nursing and Allied Health databases, using “quality improvement,” “quality improvement projects,” and “nursing quality improvement,” as keywords during the search. We narrowed our search parameters to populate peer-reviewed articles published within the last five years. Our chosen article is a cross-sectional study conducted over the period 2009 to 2010 (Hashjin et al., 2014). As mentioned, the study consisted of questionnaire surveys to 75 hospitals across nine regions in Iran. The self-administered surveys were given to three groups that included managerial staff, clinical staff, and other health professionals. The survey focused on twenty-seven hospital indicators, in which “seven indicators was obligatory under the Iranian hospitals’ annual evaluation program” and the remaining twenty were voluntary indicators recommended by an expert panel (Hashjin et al., 2014). The study population of managerial staff, clinical staff, and other health professionals represent members from all across the hospital organization. The survey was created to analyze the perspective of hospital staff on the organizational, clinical process, and outcome quality indicators. The data found here allows us to reflect upon the different perspectives that staff have in regards to quality indicators and quality improvement. With this information, we are able to have a deeper level of understanding of what these components mean to them, how they perceive their role in the process, and what it means to the organization as a whole. We can then take this information to create an environment that places everyone on the same level, pinpoint the areas in which we can make the most effective changes, and make movements toward an improved system. As a team, we believe that positive patient outcomes can be obtained with the help from all members within the organization. Striving to make improvements in the healthcare system is a continual process that requires analyzing and reanalyzing of data and research to find systems that allow us to reach optimal status.

Findings: The article found differences of perspectives from each population study group that impacts the overall perception of quality improvement across the hospital. Agreement existed across all three populations in regards to the importance of quality indicators, but variation could be detected when surveyed on how these indicators are used in their practices. The most interesting finding in the article is the gap between “theory and practice in the utilization of quality indicators by hospital frontline staff,” (Hashjin et al., 2014). It seems as though the approach of implementing quality indicators from the “top down “ was losing effectiveness as it made its way to the clinical staff members. According to Hashjin et al. (2014), “ having a top-down implementation method may not be sufficient to achieve a maximum expected implementation and effective application of quality indicators.” It was also concluded that a different approach to maximizing the importance of quality indicators and improvements was to target clinical staff and increase their involvement in the development. Being involved with the development of quality indicators from the start and directing progress allows for the overall increase in autonomy and ownership in clinical staff. In comparing the U.S to Iran, we have come across similar obstacles in achieving regulated quality indicators. Similarly, we have discovered that the approach to getting people interested and involved is to start from the bottom and to move upward.Limitations to the study included non-response and exclusion of 48.7% of the questionnaires, leading to a lower response rate than anticipated. Also, there was no clear standardized classification of quality indicators for the study (Hashjin et al., 2014).

Implications: We believe our chosen literature is important to nursing and nursing practice because it allows us to understand how quality improvement throughout the hospital is a group effort. This group effort begins with us as nurses. We must take into consideration the perspectives of other health care members and break barriers when solving problems that present with few answers. As “frontline” staff, we need to understand how large of an impact we can make in changing the hospital structure. We are also able to make the greatest changes in how patient care is delivered, and the direct impact we have on meeting quality indicators. As future nurses, we bring in the freshest perspectives to problem solving.

Hashjin, A. A., Ravaghi, H., Kringos, D. S., Ogbu, U. C., Fischer, C., Azami, S. R., & Klazinga, N. S. (2014). Using quality measures for quality improvement: the perspective of hospital staff, Plos One,9(1): e86014. doi:10.1371/journal.pone.0086014

On 2015 Apr 30, University of Kansas School of Nursing Journal Club commented:

Team 12: Stacy Hanson, Jen Huynh, Sami Johnson, Valerie Melin, Shannan Orpin, Chelsi Puskas, Chandler Schoen. SON Class of 2015.

Background Introduction: As a team, we chose to review this article on quality improvement to emphasize the importance of involvement from all staff members in order to achieve optimal health system performance. The contents of this article covers topics both mentioned during our current module and in our previous microsystems course. During this current module, we’ve discussed the importance of quality patient care measures in the health care organization and its financial impact on the organization as a whole. The article examines this component by surveying all staff members of the hospital, including hospital and nursing managers, medical doctors, nurses, and records officers, to get a better perspective of what quality improvement means to them, how they utilize it in their practices, and what does it mean for the organization as a whole. The article also supports previous topics of managerial and leadership styles, and reflects positive evidence for the “bottom up” approach to making changes in the organization.As we prepare to begin our nursing careers, it has been emphasized that the greatest impact on patient care is bestowed upon the “frontline” staff. Not only will we be the faces of the organization, we will also be responsible for making the greatest changes in striving to obtain an optimal health system.

Methods: In our quest to finding this article, we used CINAHL and Nursing and Allied Health databases, using “quality improvement,” “quality improvement projects,” and “nursing quality improvement,” as keywords during the search. We narrowed our search parameters to populate peer-reviewed articles published within the last five years. Our chosen article is a cross-sectional study conducted over the period 2009 to 2010 (Hashjin et al., 2014). As mentioned, the study consisted of questionnaire surveys to 75 hospitals across nine regions in Iran. The self-administered surveys were given to three groups that included managerial staff, clinical staff, and other health professionals. The survey focused on twenty-seven hospital indicators, in which “seven indicators was obligatory under the Iranian hospitals’ annual evaluation program” and the remaining twenty were voluntary indicators recommended by an expert panel (Hashjin et al., 2014). The study population of managerial staff, clinical staff, and other health professionals represent members from all across the hospital organization. The survey was created to analyze the perspective of hospital staff on the organizational, clinical process, and outcome quality indicators. The data found here allows us to reflect upon the different perspectives that staff have in regards to quality indicators and quality improvement. With this information, we are able to have a deeper level of understanding of what these components mean to them, how they perceive their role in the process, and what it means to the organization as a whole. We can then take this information to create an environment that places everyone on the same level, pinpoint the areas in which we can make the most effective changes, and make movements toward an improved system. As a team, we believe that positive patient outcomes can be obtained with the help from all members within the organization. Striving to make improvements in the healthcare system is a continual process that requires analyzing and reanalyzing of data and research to find systems that allow us to reach optimal status.

Findings: The article found differences of perspectives from each population study group that impacts the overall perception of quality improvement across the hospital. Agreement existed across all three populations in regards to the importance of quality indicators, but variation could be detected when surveyed on how these indicators are used in their practices. The most interesting finding in the article is the gap between “theory and practice in the utilization of quality indicators by hospital frontline staff,” (Hashjin et al., 2014). It seems as though the approach of implementing quality indicators from the “top down “ was losing effectiveness as it made its way to the clinical staff members. According to Hashjin et al. (2014), “ having a top-down implementation method may not be sufficient to achieve a maximum expected implementation and effective application of quality indicators.” It was also concluded that a different approach to maximizing the importance of quality indicators and improvements was to target clinical staff and increase their involvement in the development. Being involved with the development of quality indicators from the start and directing progress allows for the overall increase in autonomy and ownership in clinical staff. In comparing the U.S to Iran, we have come across similar obstacles in achieving regulated quality indicators. Similarly, we have discovered that the approach to getting people interested and involved is to start from the bottom and to move upward.Limitations to the study included non-response and exclusion of 48.7% of the questionnaires, leading to a lower response rate than anticipated. Also, there was no clear standardized classification of quality indicators for the study (Hashjin et al., 2014).

Implications: We believe our chosen literature is important to nursing and nursing practice because it allows us to understand how quality improvement throughout the hospital is a group effort. This group effort begins with us as nurses. We must take into consideration the perspectives of other health care members and break barriers when solving problems that present with few answers. As “frontline” staff, we need to understand how large of an impact we can make in changing the hospital structure. We are also able to make the greatest changes in how patient care is delivered, and the direct impact we have on meeting quality indicators. As future nurses, we bring in the freshest perspectives to problem solving.

Hashjin, A. A., Ravaghi, H., Kringos, D. S., Ogbu, U. C., Fischer, C., Azami, S. R., & Klazinga, N. S. (2014). Using quality measures for quality improvement: the perspective of hospital staff, Plos One,9(1): e86014. doi:10.1371/journal.pone.0086014