Performance Improvement in Health Care

Now that you have learned how to conduct a Root Cause Analysis (RCA), please perform one for the following scenario in your role as Quality Director for a 300 bed Nursing Home in Manhattan:

Mr. Caring, a Nursing Home patient was identified at risk for elopement

They were given a wanderguard bracelet, which is connected to the front and stairwell doors

Resident has been at facility for 15 years, is alert and oriented x 2-3, smoker, walks a small amount of feet and usually sits in a wheelchair, which they propel.

The resident is on 30 minute safety checks

At 7:00 am on Monday, you are at the facility and informed that Mr. Caring’s empty wheelchair ws found at the back door a few minutes prior.

Next steps…. do your root cause analysis to find out what happened and when you do, develop a corrective action plan tp prevent it from happening again.

There are different RCA formats available. Explore the templates and select one you are comfortable with. JCAHO has a very comprehensive template available..

 

links and video:

https://www.ahrq.gov/patient-safety/about/concepts-of-patient-safety.html

https://www.ihi.org/Topics/PatientSafety/Pages/GettingStarted.aspx

https://catalyst.nejm.org/doi/full/10.1056/CAT.18.0197

https://www.sixsigmadaily.com/cause-and-effect-diagram/

Sample Solution

Although the climate was a motivational one, it was important that For the students to benefit from the iPad, they needed to be able to construct their learning socially. Resulting in the AT placing the students into specific groups as they were given a chance to construct knowledge through their interactions and engagements with others (Henderson and Yeow, 2012) and utilise the iPad to the highest level as student-produced digital video encourages active problem-based learning (Pellett et al, 2009) and higher -order thinking skills (Fu, 2013) creating challenge (Appendix 11) . The iPad was used to help students develop their skills through AfL (Appendix 11). The observing teacher wrote down on the observation sheet that ‘the iPad focuses the pupils on assessing their routine and making improvements’. The observing teacher then went on to say in a professional discussion that ‘’it was the best approach for the learning environment the students were in” and that it ‘’was clear to see that students had made progress due to being able to construct and assess learning in groups”. These comments highlight how well the iPad and the learning environment it created worked concerning pupil progress. It was evident to see the student’s social skills were developing as discussions between students were very informative with a clear aim of students wanting to develop their sequences which link back to the objectives of the lesson (Appendix 3) and the progress teaching standard(Appendix 11).

Moreover, it was evident that students were being challenged and the pitch of the lesson was right (Appendix 11) as, during students’ discussions, most of the students were thoroughly conversating to a high level. During this point, the AT and the observing teacher discussed the situation with each other where the observing teacher highlighted that ‘the use of the iPad was developing their cognitive and social skills at this point because they were figuring out how to improve their physical ability through social situations. In Contrary, the observing teacher specified in the same the lesson ‘’students have more of an understanding of the keywords and what they needed to improve, resulting in them showcasing higher level thinking skills, asking

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