I originally posted this on the Week 11 page on Thursday, but for some reason it is “awaiting Moderation” so I am reposting here.
Measurability and Sustainability
My DNP project seeks to transform the obstetric triage and admissions process at Ben Taub General Hospital into one that is safe, highly reliable, patient centered, and cost effective. The scope of the project is dependent on the institution, but above all, I hope to change the culture of the obstetric intake area to one of respect, not only for patients and families, but also for residents, nurses, and others.
In order to make any changes sustainable, I must be able to show that the changes benefit the hospital financially, as well as key stakeholders such as patients and staff (Fraser, 2007). I must also engage the leadership of the organization, and align the project with the priorities of the hospital, because sustainable projects have full support of an organizations leadership (Bodenheimer, 2007).
One way to measure the improvement that would include measuring the cost-effectiveness of the project is a balanced score card. Because Ben Taub is a not-for-profit community hospital, the framework would include customers & stakeholders, employee organization capacity, internal business processes, and financial elements, all coming from the strategy of improvement for obstetric triage and admissions (Rohm, H., n.d.).To develop the performance measures, the improvement team can search the literature for evidenced-based performance measures, and select relevant measures for each of the four areas of the balanced scorecard framework (Safdari et al., 2014). In order to prioritize the measures, we can create a Pareto chart, which will help us identify the interventions likely to have the most impact, as well as survey key stakeholders (Fraser, 2007; Safdari et al, 2014).
Ensuring that the project is aligned with the organizations values and mission makes it more likely that the improvement will be adopted (Greenhalgh et al., 2004). The mission of the Harris Heath System, of which Ben Taube General Hospital is a part, is: “We improve our community’s health by delivering high-quality healthcare to Harris County residents and by training the next generation of health professionals” (Harris Health System, n.d.) My DNP project goals easily align with this mission, but emphasizing the alignment could serve to further engage the leadership, which is key to the projects sustainability (Bodenheimer, 2007).
Bodenheimer,T. (2007). The science of spread: How innovations in healthcare become the norm. Oakland, California: California Healthcare Foundation. Retrieved from https://classes.emory.edu/webapps/portal/frameset.jsp?tab_group=courses&url=%2Fwebapps%2Fblackboard%2Fcontent%2FcontentWrapper.jsp%3Fcontent_id%3D_2314971_1%26displayName%3DLinked%2BFile%26course_id%3D_92580_1%26navItem%3Dcontent%26attachment%3Dtrue%26href%3Dhttps%253A%252F%252Fclasses.emory.edu%252Fbbcswebdav%252Fpid-2314971-dt-content-rid-2706800_2%252Fxid-2706800_2
Fraser, S. (2007). Undressing the elephant: Why good practice doesn’t spread in healthcare. Raleigh, NC: Lulu.
Greenhalgh, T., Robert, G., MacFarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematice review and recommendations. The Milbank Quarterly, 82(4), 581-629. Retrieved fromhttp://www.jstor.org/stable/4149085
Harris Health System (n.d.) Mission, vision & values. Retrieved fromhttps://www.harrishealth.org/en/about-us/who-we-are/pages/mission-vision-values.aspx
Rohm, H. (n.d.) A balancing act. Perform: Performance Measurement in Action. 2(2), 1-8. Retrieved fromhttp://balancedscorecard.org/Portals/0/PDF/perform.pdf
Safdari, R., Ghazisaeedi, M., Mirzaee, M., Farzi, J., & Goodini, A. (2014). Development of balanced key performance indicators for emergency departments strategic dashboardsfollowing analytic hierarchical process. 33(4), 328-34. doi: 10.1097/HCM.0000000000000033.