- Three most important care indicators (consider patient satisfiers and NDNQI).
Care indicators are measures of aspects regarding the care that is useful to most if not all patients involved. They mainly focus on the structure, process, and outcome, which act as focal points of assessments. The three most important care indicators include; National database of nursing quality indicators (NDNQI), Patient satisfaction indicators, and Clinical indicators. ( Lloyd, 2017)
- The goal for each care indicator and how it will be measured.
The national database of nursing quality indicators is used in the evaluation of nursing care, identification of linkages between nurse staffing and patient outcomes, and in the improvement of patient outcomes at the unit level. The indicator show implications of different levels of nurse staffing economically. These aspects are measured according to different classes, which include; structure, process, and outcome. They include the measure of nursing hours per patient day, skill mix, job satisfaction, falls with injury, healthcare-associated infections, pain management, restraint use, nursing turnover, education levels, and vacancy rates. Most of the above measures help towards achieving the general goal, which is to provide quality health care. ( Ganey, 2017)
Patient satisfaction is data collected to measure the quality of the emergency care unit and aid in pointing out areas that need improvement. This is achieved by observing and conducting interviews with patients to note what their opinion is and their level of satisfaction with the health care services they receive. Time, efficiency, and patient-centered are the significant aspects that influence patient satisfaction and therefore used in measuring the indicator.
Clinical indicators are measures of issues concerning clinical care to provide ways of assessing quality and safe care to patients in the health service. They are mainly collected or measured by various organizations as administrative data and through clinical based audit programs. ( Lloyd, 2017)
- Plan for intra and inter-professional reports and communications.
Intra-professional involves different health care professionals coming together to work on delivering quality care within the health sector. Inter-professional, on the other hand, refers to a case where health professionals, other individuals along with their families and the community at large come together in an open, collaborative and responsible manner for a general course regarding health care in general. (Foronda et al., 2016)
For intra-professional;
- Using interns and technicians for procedural work
- Employing career medical officers and general practitioners in the fast track stream
- Collocating ED physiotherapy service to aid in fast track patients.
For inter-professional;
- Nurses working together with patients to promote the most suitable practice approach to reduce unnecessary ordering of radiology services.
- IT system technicians and hospital nurses work together to provide a working electronic patient management system in the fast track unit.
- Plan to help the patient/ family collaborate in plan care.
- Educate the patients and their families on the benefits of the fast track service, which includes timely treatment, access to a wide variety of services in a single location, and high-quality services.
- Use of diversified yet aligned objectives in dealing with overarching goals of both the patient and their families to address the effectiveness of the system to each discipline.
- Plan to integrate evidence-based practice and research in unit routines.
- Mapping of the general process when attending to patients to identify tasks that do not add value to patient care. According to Kaushal et al. (2015), these tasks include waiting in queues, transportation of patients and equipment from one location to the other, searching for paperwork, unnecessary tests, and duplications.
- Delivering on the redesigning hospital care program, which was launched at the fourth Australasian redesigning health care summit in Melbourne in 2008. (Department of Human Services, 2008). The program aims to build health service capability to create, spread, and sustain improvements in the delivery of patient care by applying process redesign methodologies.
- Pros/cons of the fast track ER. Consider cost/ benefit.
Pros
- Significant reduction in time stayed by a patient before being attended to is achieved, which translates to more patient satisfaction.
- The utilization of resources is improved, with only those in critical need getting to use them.
- Less critical patients get a chance to be treated when there are many critical patients.
- Total medical costs and laboratory fees of less severe patients are reduced as a result of development in the Fast track unit.
Cons
- A lot of resources need to be used to achieve this system, making it costly for most health institutions. (Kaushal et al., 2015)
- Delay in tests inclusive of X-ray due to a lack of dedicated radiology for the fast track system.
- Implementation has to be undertaken on the clinical governance and credentialing process to enable advanced practice roles to be developed and implemented into the fast track ER unit.
- Work in a fast track stream lacks the variety, continuity, and challenge emergency department work generally affords medical consultants.
References
Lloyd, R. (2017). Quality health care: a guide to developing and using indicators. Jones & Bartlett Learning.
Ganey, P. (2017). Nursing Quality (NDNQI). 2017.
Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse education in practice, 19, 36-40.
Kaushal, A., Zhao, Y., Peng, Q., Strome, T., Weldon, E., Zhang, M., & Chochinov, A. (2015). Evaluation of fast track strategies using agent-based simulation modeling to reduce waiting time in a hospital emergency department. Socio-Economic Planning Sciences, 50, 18-31.
Department of Human Services (2008). Redesigning hospital care program preliminary program guidelines, Melbourne.