Fishbone and PDSA Quality Improvement
Directions:
Use this template to complete the Week 6 Fishbone and PDSA Quality Improvement assignment as outlined in the assignment instructions in Canvas.
Click into the box below to add your name and date.
Click into each box where it says [Type Here] on the following slides.
Remove the words [Type Here] to insert your responses.
Name:
[Type Here]
Date: [Type Here]
Problem to Examine in Root Cause Analysis (RCA):
Low rates of compliance with preventive care screenings and routine immunizations among adult patients in the primary care setting.
Rationale for Problem Selection:
Preventive screenings and vaccinations create essential conditions for early illness detection and decreased disease-related problems. Medical services that are vital for patient health receive inadequate attention from many patients, which subsequently generates higher healthcare expenses and raises disease severity levels.
Brief Description of Literature Supporting the Need for Quality Improvement
(At least 2-3 sentences, cite 1-2 sources):
The CDC (2022) reports that influenza vaccination rates, together with shingles vaccination rates and pneumococcal disease vaccination rates, fall short of Healthy People 2030 objectives. Cheng et al. (2020) reveal that patients avoid preventive care because they receive wrong information from sources and face limited access to services and non-receptive provider guidance. The identified data indicates an obvious requirement for Quality Improvement methods that seek to boost acceptance rates Fishbone and PDSA Quality Improvement
There is a fundamental requirement for preventive care services that provide routine screenings and vaccinations to help people detect diseases early while improving long-term population health. Preventable illnesses, together with increased healthcare expenses, result from adult patients who postpone or avoid routine medical services. Our project aims to enhance preventive screening compliance rates within our patient demographic. The issue was chosen because it directly affects patient outcomes, while the CDC and other organizations have confirmed the widespread underutilization of preventive services. Resolving this gap would strengthen personal health outcomes and public well-being and decrease unnecessary healthcare costs. We aim to discover barriers and design specific interventions to enhance the desired outcomes.
The fishbone diagram presents all the various factors that drive down preventive screening and vaccination adoption rates. The analysis grouped identified factors under four categories: Environment, People and Method/Process, and Equipment/Supplies. Four causes were examined beneath each group, where two factors were chosen for practical change initiatives while two others presented challenges for change. The team selected realistic factors, including limited access to appointments, insufficient patient education, and the absence of reminder tools and outdated EHR platforms, as areas for direct intervention. The team acknowledges flood zones and total patient refusal as unrealistic, although they cannot serve as short-term change opportunities. The systematic analysis helps identify practical areas where our quality improvement project can make a difference while guiding us in choosing the most effective interventions.
Research showed inadequate screening reminders as the most realistic opportunity to enhance patient outcomes because they delivered high-impact results. Our team comprises primary care providers, EHR/IT personnel, care coordinators, and clinic managers. A SMART goal established to enhance adult patient completion rates of due preventive screenings by 20% through EHR-based automated reminder technology within three months. This goal contains specific, measurable objectives that can be achieved using existing tools for relevant clinical quality results while maintaining a time frame for accountability. The goal supports our organizational mission of encouraging proactive medical care and maximizing preventive health delivery Fishbone and PDSA Quality Improvement
An implementation protocol was created for automated reminders within our EHR system and trained our staff about its operation during the Plan phase. Our team deployed the system during the Do phase and conducted weekly reminder messages to appropriate adult patients. The hypothetical data showed a growth in screening completion rate from 50% to 70% during three months. Evaluation of the collected data was done in the Study phase to validate that our SMART goal had been successful. The Act phase led us to sustain the reminder system while extending vaccination notifications into the platform. The data success would have triggered a revision of our messaging approaches or the frequency of delivery methods.
References (Hanging Indent Not Required)
Cheng, H., Eames-Brown, R., Tutt, A., Laws, R., Blight, V., McKenzie, A., … & Denney-Wilson, E. (2020). Promoting healthy weight for all young children: a mixed methods study of child and family health nurses’ perceptions of barriers and how to overcome them. BMC nursing, 19, 1-14.
https://link.springer.com/article/10.1186/s12912-020-00477-z
Centers for Disease Control and Prevention. (2022).
Vaccination coverage among adults in the United States
.
https://www.cdc.gov/adultvaxview/publications-resources/adult-vaccination-coverage-2022.html
Fishbone and PDSA Quality Improvement
Complete this assignment following the steps below.
Download the Fishbone and PDSA Quality Improvement assignment PowerPoint template (attached) Open this document with ReadSpeaker docReader . Use of the template is required. A 10% deduction will be applied if the template is not used.
Select a quality improvement (QI) problem that requires quality improvement.
-Increasing Preventive Care Screenings and Vaccination Rates – Encouraging compliance with routine screenings and immunizations.-
It may be a real problem you are currently encountering in practice or clinical rotations, a concern, or a problem from scholarly sources you are familiar with. You are encouraged to choose something relative to your practice. Form a problem statement with that information.
Gather 1-2 scholarly sources that document this problem in healthcare and provide evidence supporting the need for quality improvement.
Complete the sections in the template outlining the problem, the rationale for the selection of the problem, and the sources documenting the need for a solution. Each section should include detail in 2-3 sentences. Cite sources where specified.
Use the fishbone diagram in the template to complete a root cause analysis of the problem.
Briefly describe the problem
Under each category (People, Environment, Method/Process, and Equipment/Supplies), list at least two contributing factors to the problem. The contributing factors may fall under more than one category. Mark each contributing factor as a realistic or unrealistic target for improvement efforts using the visual designations on the template. For example, staffing, while a contributing factor to many problems, is not a realistic target for improvement efforts.
If you prefer, you can use green or red highlight on the text of the contributing factors instead of using the visual symbols on the template.
Complete the PDSA Quality Improvement Project outline using the spaces provided on the template (replacing the [Type Here] instructions with your text). Write this section acting as if you have completed the QI project.
Select one contributing factor from the fishbone diagram. This should be one of the realistic targets for improvement efforts identified on the fishbone diagram.
List 2-4 interprofessional stakeholders involved in the project (delete any unused [Type Here] text).
Write one SMART goal for the PDSA Quality Improvement Project. Include all elements of the SMART goal in one sentence.
Under the “Plan†phase, write a plan for the quality improvement project to meet the SMART goal. How will you meet your SMART goal? Describe your plan in 2-3 sentences.
Under the “Do†phase, imagine you have completed the project. Briefly describe how the Plan was hypothetically implemented. What were the results? Include hypothetical data. Describe your implementation in 2-3 sentences using past tense.
Under the “Study†phase, imagine that you have successfully completed the project and have positive data that demonstrates successful implementation and goal attainment. Describe your evaluation using 2-3 sentences using past tense.
Under the “Act†phase, imagine that you have completed the project. Briefly describe how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met. Describe your process in 2-3 sentences using past tense. See the example in the lesson.
Click the Submit button at the top of this page to upload your completed assignment.
Correctly cite and reference ideas and information that come from scholarly sources. Sources should be no more than five years old unless they are historical references. Hanging indent is not required. Fishbone and PDSA Quality Improvement
Follow grammar, spelling, word usage, and punctuation rules consistent with formal, scientific writing.
Abide by Chamberlain University’s academic integrity policy.
Include the following sections (detailed criteria listed below and in the grading rubric).
Description of the Problem
State problem to examine in Root Cause Analysis (RCA).
State rationale for problem selection.
Include a brief description from a scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
Include in-text citations.
Answer all questions/criteria with appropriate explanation and detail.
Fishbone Diagram
Identify the problem in the designated area.
Identify appropriate contributing factors for each category.
Include a brief description from scholarly source(s) supporting the need for quality improvement (QI) in at least 2-3 sentences.
Identify each contributing factor as realistic or unrealistic targets for QI efforts.
Correlation with Contributing Factor
Select one realistic contributing factor from the fishbone diagram.
List 2-4 interprofessional stakeholders involved in the project.
Write one SMART goal for the PDSA Quality Improvement Project.
Answer all questions/criteria with appropriate explanation and detail.
PDSA (Plan, Do, Study, Act)
Under the “Plan†phase, write a plan (in 2-3 sentences) for the quality improvement project to meet the SMART goal.
Under the “Do†phase, briefly describe (in 2-3 sentences using past tense) how the Plan was hypothetically implemented and what data was collected.
Under the “Study†phase, briefly evaluate (in 2-3 sentences using past tense) the data. Identify whether the goal was met or not met.
Under the “Act†phase, briefly describe (in 2-3 sentences using past tense) how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met.
Answer all questions/criteria with appropriate explanation and detail Fishbone and PDSA Quality Improvement
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