Week#6Paper - Improvement Model


  1. Identify a problem; it may be related to structure, process, or an outcome. Be clear in your problem and be cautious to not identify multiple problems. Identify a quality improvement methodology from Hughes (2008) Chapter 44, Tools and Strategies for Quality Improvement and Patient Safety, that you will use to frame your improvement initiative.
  2. Note: You will be writing this paper essentially as a plan for improvement (to the problem you identify).
  3. Identify the key stakeholder to the problem/ improvement initiative. Why is it important to identify/engage stakeholders? 
  4. Discuss the root cause of the problem. You might use the formal root cause analysis (RCA) process to do this or simply your determination of the root cause.
  5. Describe your planned improvement steps. It will be important here that your steps match those of whatever quality improvement methodology you choose. For example, if you choose to use a Plan, Do, Study, Act methodology, this section of your paper would be writing about what you would be doing (relative to your problem) in the planning phase, in the doing phase, in the study phase, and in the act phase.  
  6. Finally, describe how you would evaluate the effectiveness of your actions/improvement initiative. In other words, how would you know you were successful?


Goeschel, C. A., Weiss, W. M., & Pronovost, P. J. (2012). Using a logic model to design and evaluate quality and patient safety improvement programs. International Journal of Quality Health Care, 24(4). 330-337.

 Hughes, R. G. (2008). Tools and strategies for quality improvement and patient safety. In R. G. Hughes (ed.), Patient safety and quality: An evidence-based handbook for nurses (AHRQ Publication No. 08-0043, Vol. 3, pp. 1-39). Rockville, MD: Agency for Healthcare Research and Quality (US).

 Stevens, K. R. (2010). What is improvement science? Improvement Science Research Network (ISRN).

 Hybarger, K., Steigmeyer, C., Lee, B., & Woolley, L. (n.d.). Quality improvement process using Plan, Do, Study, Act (PDSA) – Planning for action.

 Larman, C., & Vodde, B. (2009). Lean primer.

Tetteh, H. A. (2012). Kaizen: A process improvement model for the business of health care and preoperative nursing professionals. AORN Journal, 95(1),104-108. doi:10.1016/j.aorn.2011.11.001

 Silich, S. J., Wetz, R. V., Riebling, N., Coleman, C., Khoueiry, G., Rafeh, N. A., Bagon, E., & Szerszen, A. (2011). Using six sigma methodology to reduce patient transfer times from floor to critical-care beds. Journal for Healthcare Quality, 34(1), 44-54.

Kring, D. (2008). Research and quality improvement: Different processes, different evidence. Medical Surgical Nursing, 17(3), 162-169.

Shelly, J. A., & Miller, A. B. (2006). Called to care: A Christian worldview for nursing (2nd ed.). Downers Grove, IL: InterVarsity Press



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In pediatric healthcare, communication among clinicians and the patients specifically during the assessment and diagnostic phases has been challenging especially in cases where the patient is an adolescent. In my current practice, dealing with adolescents has been challenging but manageable in normal situations. However, in cases where the adolescent is grieving or is emotionally or behaviorally troubled, it becomes difficult to assess and diagnose them properly. The challenge that I will be identified in such situations is the lack of clear guidelines on handling such situations. This paper will focus on the improvement of the identified problem above through the Plan, Do, Study, Act methodology basing the arguments on my experiences and peer reviewed literature on the same.

Plan, Do, Study, Act methodology

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