Phillip January 27, 2024 No Comments

NURS FPX 9100 Assessment 6 Project Charter

NURS FPX 9100 Assessment 6 Project Charter Name Capella university NURS-FPX 9100 Defining Nursing Doctoral Project Prof. Name Date Project Charter Information Project Name Provider Inbox Management Optimization (PIMO): Creating the Optimal Inbox Project Site Adelante Healthcare – Adult and Family Medicine Contact at Site Name with credentials: Robert Babyar, MD, Chief Medical Officer Organizational Email: robert.babyar@adelantehealthcare.org Phone Number: 877-809-5092 Preceptor Name with credentials: Adita Flagg Email: adita.flagg@adelantehealthcare.org Phone Number: 877-809-5092 Executive Sponsor Chief Executive Officer (CEO) of Adelante Healthcare The CEO is the key person responsible for the overall productivity and operation of the company. The CEO is instrumental in providing fiscal, political, and networking support. Gap Analysis Part 1 Project Charter Information Gap Analysis A January 2023 report revealed 75% of patient messages are not reviewed or addressed in the first three days. The Quality Department identified this problem following an investigation into delayed patient responses. Currently, no response time policy, procedure, or guideline is in place. The practice gap was identified in May 2022, and a root cause analysis was conducted. Appendix A shows a Fishbone diagram for the practice gap. The desired state involves implementing an evidence-based intervention, a response time policy. The 2023 National Patient Safety Goals published by The Joint Commission focus on improving communication among caregivers. Organizations devoting time to optimizing provider inbox management is proven to lead to information overload and has been found to be a leading contributor to job dissatisfaction and provider burnout (Murphy, Satterly, Giardina et al., 2019). Evidence to Support the Need Part 1 Project Charter Information Evidence to Support the Need Reviewing evidence-based interventions for inbox optimization, common themes emerged. Implementing a response-time policy demonstrated improved efficiency among clinical staff, higher patient engagement, increased involvement from nonprovider clinical staff, and timelier messaging and results sharing with patients engaged in portal messaging systems. It is imperative that appropriate policies and procedures are developed and then implemented for governing patient online portal use. The need for policy improvements is corroborated in the study by Hefner et al. (2019), as the researchers describe how policies need to be either revamped or established that require healthcare providers to undertake adequate training and education. Similarly, the findings of Lieu et al. (2019) also support the need for policy improvements that are used to oversee physician-to-physician training, as there are many different strategies that can be employed to improve how physicians manage their inboxes and respond to patients. Reynolds et al. (2021) found that patient portals must offer virtual patient-provider interactions and contextualized medical advice. NURS FPX 9100 Assessment 6 Project Charter Through these initiatives of response time policy creation and implementation, staff training of the organization’s inbox portal, and training on policy requirements, staff will learn how to better manage this patient portal secure messaging to ensure that patients are being responded to in a timely manner. Similarities are seen with Reynolds’ and Lieu’s findings that identify employee training as a crucial component to support policy implementation. Huang et al.’s (2022) study showed differential patient-provider communication patterns across various care settings and practice roles. Findings from this study indicate opportunities for care teams exist to optimize their inbox messaging system, helping to balance the workload and promote optimal efficiency. Securing and implementing policy changes within healthcare facilities focusing on provider training and integrating the latest patient portal messaging systems significantly improves patient safety, treatment delays, and patient satisfaction. Continued implementation and widespread use of response-time policy and adherence to time management expectations PICOT Part 1 Project Charter Information PICOT For staff and providers (P), how does the implementation of a patient-provider response time policy (I) to respond to portal messages compared to the current state (C) affect response times (O) over a two-month period (T)? Project Aim: The aim of the PIMO project is to improve patient-provider response times, achieving or exceeding the time measures as dictated by the policy and decreasing delays in care as measured by the policy description. Part II Stakeholders Part 1 Project Charter Information Stakeholder Identify the key stakeholders for your project. Think of key stakeholders (internal and external). This might include patients/clients, families, community leaders and organizations, health agencies, systems within the organization etc. List between 3-4 potential stakeholder members. C.A. Director of Nursing & Nutrition Services Project Lead Impact is had through direct involvement in the project to support implementation across both nursing and non-nursing disciplines. Project Lead. Will drive change, implementation, data collection, and analysis. Potential challenges may include scheduling conflicts with colleagues and additional stakeholders as well as potential staff resistance to change. A.F. Director of Quality, Safety & Clinical Risk Quality, Safety & Risk implications Impact is had through direct involvement in the project to support implementation. Support with implementation roll out in compliance with project site policies, procedures, and guidelines. A potential barrier to consider is increased workload or inability to prioritize another project. S.A.L. Regional Medical Director Advanced Practice Provider and Physician involvement Impact is had through direct involvement in the project to support implementation through the lens of medical providers. Support with implementation roll out in compliance with project site policies, procedures, and guidelines. A potential barrier to consider is increased workload or inability to prioritize another project. Team Leader Part 1 Project Charter Information Team Leader C.A. will be the team leader for the quality improvement DNP project. Successful project implementation requires participation from a multitude of departments, teams, and leaders. Effective collaboration and detailed communication are crucial to driving successful outcomes. Approaching the problem through different frames and perspectives is also necessary to facilitate high-level communication strategies and to keep the project on track. Exhibiting emotional intelligence, drive, and organization emotionally intelligent, organized, and driven, making C.A. the right leader to drive a quality improvement project of this size. C.A. has an extensive background in nursing and leadership over the past 14 years and currently serves as the Director of Nursing at the project site. Relationship building, technical skill, and change advocacy experience offer opportunities to

Phillip January 27, 2024 No Comments

NURS FPX 9100 Assessment 4 Virtual Check-in 1

NURS FPX 9100 Assessment 4 Virtual Check-in 1 Name Capella university NURS-FPX 9100 Defining Nursing Doctoral Project Prof. Name Date VIRTUAL CHECK-IN AND PROJECT APPROVAL My first virtual check-in occurred on March 3, 2023, with my instructor, Dr. Conner, and preceptor Adita Flagg. We discussed the approved topic for my quality improvement project, Provider Inbox Management Optimization (PIMO). This project aims to enhance timely provider responses to patients through the portal, supported by evidence indicating the positive impact of time response policies on patients (Steitz et al., 2019). I proposed the implementation of a response time policy to guide staff in responding to messages. Adita confirmed the relevance of this topic for improvement at the project site. Dr. Conner provided additional insights into project implementation, clarifying the PDSA process. The check-in lasted approximately 10 minutes, providing an opportunity for questions and reflections. PROJECT CHARTER DEVELOPMENT Currently, I am working on Part II of the Project Charter. Having chosen this project topic at the program’s onset, Part I was swiftly completed by drawing on previous work. However, challenges arise in collaborating with key stakeholders, particularly my preceptor and a work colleague. I aim to review the charter together to make improvements before submission. Despite no current questions, each iteration of topic approval or charter document enhances my learning. I eagerly anticipate implementing the project and making a positive impact. REFERENCES Steitz, B. D., Wong, J. I. S., Cobb, J. G., Carlson, B., Smith, G., & Rosenbloom, S. T. (2019). Policies and procedures governing patient portal use at an Academic Medical Center. JAMIA open, 2(4), 479–488. https://doi.org/10.1093/jamiaopen/ooz039 NURS FPX 9100 Assessment 4 Virtual Check-in 1

Phillip January 27, 2024 No Comments

NURS FPX 9100 Assessment 1 Obesity Topic Approval

NURS FPX 9100 Assessment 1 Obesity Topic Approval Name Capella university NURS-FPX 9100 Defining Nursing Doctoral Project Prof. Name Date WORKING PROJECT TITLE: Provider Inbox Management Optimization (PIMO) Primary Investigator: Cheryl Avila, MSN-Ed, BSN, RN Project Site: Adelante Healthcare – Central Support Office, Phoenix, Arizona Sponsor: Preceptor Adita Flagg, MSN, RN – Director of Clinical Quality, Risk & Safety at Adelante Healthcare. Robert Babyar, MD – CMO of Adelante Healthcare. PROJECT DESCRIPTION PICOT: For staff and providers using the online portal messaging systems, how does the implementation of a patient-provider response time policy compared to the current state affect response times over a two-month period? Brief Summary: The purpose of the quality improvement project is to improve the communication response rate from clinicians to patients via patient portal messages. A January 2023 report pulled by analysts at the project site revealed 75% of patient messages are not reviewed in the first 3 days. A 2019 qualitative study conducted by Kaiser Permanente across 4 months found consistently responding to patient messages saves on time as delayed responses inevitably generate more patient calls to the practice (Lieu, et al., 2019). An additional study by North et al., (2018) conducted a cohort study including 600 patients and implementation of a response time policy that provided staff direction to respond to all patient messages within 24 hours, excluding holidays resulting in timelier responses to patient inquiries. Primary Objective: The aim of the PIMO project is to improve patient-provider response times and decrease delays in care. Secondary Objectives: Improve staff compliance with messaging response times. Clarify scope of practice differences and responsibilities for clinical roles to support provider inbox management. Proposed Evidence-based Intervention(s): Time-based response policy and procedure implementation (Steitz et al., 2019). Integration of interdisciplinary teams and delegation. Clarify non-clinician responsibilities for inbox management (Lieu et al., 2019). Training of clinical staff to understand and adhere to the new policy (Lieu et al., 2019). PROJECT DESIGN AND METHODS Project Design: The PIMO project is a quality improvement project designed to optimize various processes and outcomes and guide future practice and policy within the project site using evidence-based practice interventions. Model For Improvement: PDSA. Target Population Undergoing the Practice Change: The target population will be the providers and supporting clinical staff. Inclusion Criteria: All full-time, part-time, doctors, advanced practice providers (NP and PA), registered nurses (RNs), medical assistants (MAs), and care coordinators at Adelante Healthcare practicing adult and family medicine. Exclusion Criteria: Dental and behavioral health providers and their respective ancillary staff will be excluded. OB/GYN and Pediatric practices will also be excluded. Estimated Project Length (weeks): 8 weeks. OUTCOME MEASURES AND ANALYSIS Primary Outcome Measures: Increased provider response times to patient messages Timelier first touch to incoming messages (opening and reviewing message) Secondary Outcome Measures: Staff compliance to newly implemented policy Data Analysis and Results Reporting: ​ MEASURE TYPE TYPE OF DATA COLLECTED ANALYSIS METHOD RESULTS REPORTING- DATA TYPE Timelier Provider Response Times Outcome Interval Descriptive Statistics Rate Staff Compliance to newly implemented policy Outcome Interval Descriptive Statistics Rate First touch rates to incoming messages (opening and reviewing message) Outcome Ordinal Descriptive Statistics Percentage References Lieu, T. A., Altschuler, A., Weiner, J. Z., East, J. A., Moeller, M. F., Prausnitz, S., Reed, M. E., Warton, E. M., Goler, N., & Awsare, S. (2019). Primary Care Physicians’ Experiences With and Strategies for Managing Electronic Messages. JAMA network open, 2(12), e1918287. https://doi.org/10.1001/jamanetworkopen.2019.18287 North F, Crane SJ, Chaudhry R, Ebbert JO, Ytterberg K, Tulledge-Scheitel SM, Stroebel RJ. (2018). Impact of patient portal secure messages and electronic visits on adult primary care office visits. Telemed J E Health, 20(3), 192-8. doi: 10.1089/tmj.2013.0097. Epub 2018 Dec 18. PMID: 24350803; PMCID: PMC3934543. Patel, M., Trojillo, Dones, & Dones Trojillo. (2019). SINI 2019: In Basket Management: Empowering Nurses to be First Responders for Patient Messages, Providing the Right Care at the Right Time. Item Type Conference Congress. Link

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