Quality Management in Nursing & Health Care

NURS 5305

3 Credit Hours

This course provides a multidisciplinary background in the science of health care quality management.

The history and evolution of the quality movement, theories and thought leaders, current quality of care issues, research and innovations, intervention strategies, and instruments will be covered; as well as an analysis of quality management system models in health care.

At the conclusion of this course the student will be able to:

1.       Assess healthcare settings to determine existing quality management systems.

2.       Develop strategies, using common quality measures, to implement continuous quality improvement in a variety of healthcare settings.

3.       Demonstrate professional accountability for competent nursing administrative practices in quality management activities that incorporate professional nursing values.

4.       Discuss ethical/ legal factors affecting healthcare quality management.

Prerequisite:  NURS 5301 Nursing Administration I

I.       Introduction to Quality Management

A.     Definitions Related to Quality management

B.      Rationale for Quality Management

C.      History of Quality Management

D.     The Patient Safety Movement

E.      Implications for Nursing Administration

II.      Theories and Thought Leaders in Quality Management

A.     Nightingale

B.      Donabedian & Bloch

C.      Structure, Process, Outcome

D.     Quality Beyond Healthcare

E.      Statistical Process Control

F.      Deming’s Principles

G.      Theories of Error

H.     Cultures of Safety and Blame

I.       Specialization & Volume

J        Failure to Rescue

K.      Aiken, Berwick and Others

III.    Major Quality Issues in Healthcare

        A.       Patient Safety

        B.       Nurse Sensitive Indicators

        C.      Teamwork & Collaboration

        D.      Medication Errors

        E.       Pressure Ulcers

        F.       Pain Management

        G.       Staffing

        H.       Patient Satisfaction            

IV.   Intervention Strategies

A.           Process Improvement Teams

B.           Evidence-Based Practice

C.           Structured Care Methodologies

D.           Case and Care Management

E.            Technology

F.            Surveillance

G.           Rewarding Quality

a.       Baldridge Award

b.       Magnet Hospitals

c.       Beacon Award

         H.      Financial Incentives

V.    Research and Innovations

A.          Evidence-Based Healthcare

B.          Outcomes Measurement

C.          Outcomes Research

D.          Research Designs

E.           Breakthroughs and Innovations

VI.    Organizations, Reports and Regulatory Influences

A.     Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

B.      Institute of Medicine (IOM)

C.      Agency for Healthcare Research and Quality (AHRQ)

D.      Institute for Healthcare Improvement (IHI)

E.      Emergency Care Research Institute (ECRI)

F.      Institute for Safe Medication Practices (ISMP)

G.      National Committee on Quality Assurance (NCQA)

H.     National Patient Safety Foundation (NPSF)

I.       Leapfrog Group

J.       American Nurses Association (ANA)

VII.   Ethical, Legal, and Policy Implications

A.         The Balance Between Quality and Access

B.          The Technologic Imperative

C.          Ethical Issues with Financial Incentives

D.         Legal Systems as Users of Standards & Guidelines

E.          Mandating Quality

Henriksen, K., Battles, J., Marks, E., & Lewin, D. (2005). Advances in Patient Safety: From Research to Implementation (Volumes I-IV). Rockville , MD : Agency for Healthcare Research and Quality.

Please note: these four volumes are available for FREE in the format of 4 books, approx. 500 pages per book, or in a searchable CD-ROM format, also FREE. The books usually take longer to ship than the CD-ROMs. To order free single copies of the CD-ROM or the printed set, contact the AHRQ Publications Clearinghouse at    1-800-358-9295, or at ahrqpubs@ahrq.gov.  Individual articles that comprise the four volumes are also available at www.ahrq.gov/qual/advances.

Journal articles and web-based resources will also be assigned in relation to each module.

Please visit the Virtual Bookstore to obtain information on this textbook. http://rodp.bkstr.com

Supplemental journal articles and web-based resources will be assigned by the instructor.

The minimum requirements can be found at http://www.rodp.org/students/hardware_software.htm. 

The minimum requirements can be found at http://www.rodp.org/students/hardware_software.htm. 

Additional software requirements for this course include Microsoft Office (Word and PowerPoint), Acrobat Reader, and media player software (e.g. Real Player).

Please see the separate page inside the course to find instructor contact information as well as a statement of virtual office hours and other communication information.

All course requirements are submitted online. 

A  = 93-100
B  = 85-92
C  = 77-84
D  = 70-76

F  = <70

Online Discussions (25%) - All students are expected to actively participate in online class discussions. The aim is to encourage thoughtful interaction among students and faculty, not simply to present information. Student responses to discussion questions must be substantive, and should demonstrate an awareness of comments previously posted and discussed. Repetition, or mere statements of concurrence (e.g. Yes, I agree with what the last person said.) are not usually helpful. If you agree or disagree with another student’s comment, explain why. Because the WebCT system has its own way of formatting material posted on the discussion feature, students will not be expected to strictly follow APA guidelines for discussion board submissions. However, the student is held to academic standards of writing style and the use of proper grammar, punctuation and spelling, as well as the expectation of documenting sources when citing the work or opinions of others.

 Quality Improvement Plan (30%) - Students will document a quality of care problem and develop a quality improvement plan for a specific clinical setting, preferably a setting where they are employed. The problem focus and the setting must be approved by the instructor. More specific criteria for this project will be provided separately. The final plan will be due by the 8^th week of class.

 Quality Leader Project (15%) – Each student will select a prominent health care quality leader from a list provided by the instructor. Students will prepare powerpoint presentation to introduce their leaders to the class via the course website. Each presentation should include a brief biography, a description of the leader’s philosophy(ies), his or her major professional contributions, the current status of this leader and his or her work, and a list of references in APA format. Powerpoint files are due to the instructor by the 3^rd week of class. After review by the instructor, the files will be posted for other students to review.

 Paper (30%) – Students will select a topic (problem, issue, or concept) relevant to health care quality that is suitable for publication, and choose a journal that might be interested in publishing such a paper. This assignment will include the following components:

1. Approval of the topic and target journal by the instructor by the 4^th week of class.

2. Submission of a query to the journal editor, copied to the instructor by the 6^th week of class, to determine the journal’s interest in publishing this type of article. The query should include an overview of the article, why the topic was selected, why it would be a good fit for this journal, and the student’s qualifications for writing it.

3. An outline of the paper, a reference list in the journal’s format (e.g. APA, AMA, etc.), and a copy of the journal’s contributor guidelines is submitted by the 10^th week of class.

4. A final draft of the manuscript is submitted to the instructor by the 13^th week of class. The paper should reflect a thorough review and synthesis of professional literature related to the topic; documentation of the current status of the problem, issue, or concept; and strategies for addressing the issue. The paper must adhere to the guidelines for the journal (e.g. page length, reference style, etc.).

The student is expected to:

•         Learn how to navigate in the WebCT system.

•         Check the course calendar for specific assignment due dates.

•         All assignments for this course will be due using Central Standard Time.

•         Check the course home page, discussion board, and email frequently for announcements.

•         Participate by responding to discussion questions.

•         Use the assigned college or university e-mail address as opposed to a personal e-mail address.

•         Contact the instructor if unclear about assignment expectations.

•         Address technical problems immediately.

            Email:

•         Always include a subject line.

•         Correspond through the course website, rather than through other email mechanisms.

•         Remember without facial expressions some comments may be taken the wrong way.

•         Be careful in wording your emails. Use of emoticons might be helpful in some cases.

•         Use standard fonts.

•         Do not send large attachments without permission.

•         Special formatting such as centering, audio messages, tables, html, etc. should be avoided unless necessary to complete an assignment or other communication.

•         Respect the privacy of other class members.

             Discussion Groups:

•         Review the discussion threads thoroughly before entering the discussion.

•         Try to maintain threads by using the "Reply" button rather starting a new topic.

•         Do not make insulting or inflammatory statements to other members of the discussion group.

•         Be respectful of others’ ideas.

•         Be patient and read the comments of other group members thoroughly before entering your remarks.

•         Be cooperative with group leaders in completing assigned tasks.

•         Be positive and constructive in group discussions.

•         Respond in a thoughtful and timely manner.

The Tennessee Virtual Library is available to all students enrolled in the Regents Online Degree Program. Links to library materials (such as electronic journals, databases, interlibrary loans, digital reserves, dictionaries, encyclopedias, maps, and librarian support) and Internet resources needed by learners to complete online assignments and as background reading must be included in all courses.

Qualified students with disabilities will be provided reasonable and necessary academic accommodations if determined eligible by the appropriate disability services staff at their home institution. Prior to granting disability accommodations in this course, the instructor must receive written verification of a student's eligibility for specific accommodations from the disability services staff at the home institution. It is the student's responsibility to initiate contact with his/her home institution's disability services staff and to follow the established procedures for having the accommodation notice sent to the instructor.

The instructor reserves the right to make changes as necessary to this syllabus. If changes are necessitated during the term of the course, the instructor will immediately notify students of such changes both by individual email communication and posting both notification and nature of change(s) on the course bulletin board.

If you are having problems logging into the course, timing out of the course, using the course web site tools, or other technical problems, please visit the AskRODP Customer Support web page at http://help.rodp.org or call the AskRODP Help Desk at 1-866-550-RODP (1-866-550-7637