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:

  1. Improve staff compliance with messaging response times.
  2. Clarify scope of practice differences and responsibilities for clinical roles to support provider inbox management.

Proposed Evidence-based Intervention(s):

  1. Time-based response policy and procedure implementation (Steitz et al., 2019).
  2. Integration of interdisciplinary teams and delegation. Clarify non-clinician responsibilities for inbox management (Lieu et al., 2019).
  3. 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:

  1. Increased provider response times to patient messages
  2. Timelier first touch to incoming messages (opening and reviewing message)

Secondary Outcome Measures:

  1. 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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