NU 606: Continuous Program Improvement & Risk Management Syllabus

NU 606: Continuous Program Improvement & Risk Management Syllabus COURSE START DATE: July 9, 2012 ONLINE DATES: July 9 15, 2012 ON CAMPUS DATES: July 16 20, 2012 COURSE END DATE: August 17, 2012 COURSE DESCRIPTION For more information on this course, including the official course description and any prerequisites, can be found in the GPS Catalog at http://www.sjcme.edu/gpscatalog/ COURSE INTRODUCTION Welcome to NU 606 Continuous Program Improvement & Risk Management. This course focuses on the theories, concepts, and principles of quality improvement and risk management. Emphasis will be on the methods used to improve efforts in healthcare delivery while minimizing potential risk. Each unit of content focuses on a different issue confronting the individual nurses at every level of current In Unit One, a basic overview of quality management is provided, including the history and development of continuous process improvement. This unit focuses on the quality of care and provides thought provoking exercise to facilitate an understanding of the current environment in health care delivery. Unit Two focuses on outcomes measures and basic tools used in continuous process improvement. The student has an opportunity to visit different websites to explore the measurement process and understand challenges in data analysis. Unit Three provides an opportunity for students to examine different stakeholders perspectives on and approaches to quality management as it impacts the changing landscape of healthcare. Current practice guidelines are reviewed and discussed as a means of appreciating the challenges providers and consumers face in obtaining quality health care. Principles in Risk Management are the focus of Unit Four. Students will have an opportunity to evaluate the components of a risk management program in an effort to learn about methods in risk reduction. Additionally, federal and state

regulations affecting nursing practice are reviewed culminating in a discussion of negligence and malpractice. In the final unit of the course, Unit Five, risk management strategies are discussed that impact issues in the workplace. Healthcare ethics and ethical guidelines are also reviewed. The final portion of this unit provides an understanding of how quality management and risk management work hand in hand to provide a safe environment of care. Interactive exercises that utilize a case study approach are used to facilitate learning. The final assessment of this course is the development of a risk management plan which incorporates learning from all of the units of study. COURSE OBJECTIVES Upon completion of this course, you should be able to do the following: Upon completing this course, you will be able to do the following: 1. Identify specific continuous program improvement tools that focus on consumer satisfaction and organizational efficiencies. 2. Explain the objectives of health care regulatory agencies and principles related to improving patient outcomes. 3. Apply continuous program improvement principles to the health care setting. 4. Explain the steps in the risk management process and methods for identifying risk. 5. Describe the legal requirements of an internal risk management program. 6. Differentiate between continuous program improvement and risk management. 7. Analyze how professional standards are the basis for risk management and quality improvement within the facility.

COURSE FORMAT This is an accelerated five week online course with an additional week in the classroom, providing the opportunity to continue the online dialogue in a group setting. You will acquire the skills outlined in the course objectives through the following: Readings from the textbook and required readings, which may include case studies. Lecture notes Active dialogue with your instructor and fellow learners via the course bulletin board Active dialogue and discussion in person with your instructor and classmates. Class Participation: You are expected to participate in the online dialogue at minimum three times per week per discussion question, preferably on non-consecutive days. COURSE GUIDELINES Because this is an accelerated course and the onsite component of the course occurs on week 2, it is recommended that you complete as much of the assigned reading in advance of the onsite attendance as possible. You do not need to participate in on-line dialogue the week that you are on site. REQUIRED TEXT(s) Kavalier, F., & Spiegel, A. D. (2003). Risk management in health care institutions: A strategic approach. Sudbury, MA: Jones & Bartlett Publishers. ISBN # 0763723142 Nash, D. B., & Goldfarb, N. I. (2006). The quality solution: The stakeholder s guide to improving health care. Sudbury, MA: Jones & Bartlett Publishers. ISBN # 0763727482 If you have any questions regarding your course materials, please contact your academic advisor and/or our book vendor EdMap. You can reach EdMap by phone 1- (800)-274-9104 or website at http://www.edmapbookstore.com/storefront/index/stjsp

WRITTEN ASSIGNMENTS LESSON 1.1 An Overview of Quality Nash & Goldfarb text: Chapter 1 Discussion Board assignment: Go to the National Quality Forum website (http://www.qualityforum.org) and review one of the "active projects" listed on the left side of the home page. Choose a topic that dovetails with your current practice setting (if possible). The topics change periodically and focus on quality improvement in patient care. After completing this activity, post your thoughts in a well written reflective statement to the Discussion Board (250 words) A list of websites is provided below to assist you in answering one of the following questions. The questions focus on concepts that are pertinent to Quality Improvement. You only need to answer one of the following questions. http://www.jcaho.org [Joint Commission on Accreditation of Healthcare Organizations] http://www.ncqa.org/ [National Committee for Quality Assurance] http://www.ihi.org/ [Institute for Healthcare Improvement] http://www.ahrq.gov/ [Agency for Healthcare Research and Quality] http://www.webmm.ahrq.gov/ [Agency for Healthcare Research and Quality WebM&M] http://www.usatoday.com/ [Despeinges, P. Report: Medicare could go broke by 2019.] http://qhc.bmjjournals.com/ [Quality and Safety in Healthcare (journal)] http://www.ama-assn.org/go/quality [American Medical Association, Clinical Quality Improvement] http://www.healthypeople.gov/ [Healthy People 2010]

http://iom.edu/report.asp?id=4475 [IOM Report: Unequal Treatment] <http://www.aha.org/>http://www.aha.org/aha_app/index.jsp?sso_cookie_id= 0a2f011430e20b71eb72a6a84a78886a89651ae8f2ea [American Hospital Association] <http://www.hret.org> http://www.hret.org/hret_app/index.jsp [Health Research and Education Trust] 1. What are some potential quality crises facing the healthcare system if the status quo persists? 2. What are the factors that have contributed to the historical resistance to the quality improvement movement and how might these barriers be overcome in the future? 3. How are vulnerable populations defined, and what are the effects of poor quality on underserved communities? 4. How are principles of quality management applied to continuous process improvement in managing and improving the overall quality of healthcare? LESSON 1.2 Duty v. Interest Nash & Goldfarb Text: Chapters 2 & 3 Written Assignment Some ill patients get better despite nursing care, not as a result of it. The quality of nursing affects patient outcomes tremendously. Do you believe that quality nursing care makes a difference in patients lives? Identify five criteria you would use to define quality nursing care. These criteria should reflect what you believe nurses do that makes the difference in patient outcomes. Are the criteria you have selected measurable? How? Please write a well developed response and provide evidence from the literature to support your response and cite those references per APA format (minimum of 500 words required in your response). Lesson 2.1 Conceptualizing and Improving Quality

Nash & Goldfarb Text: Chapters 4 & 5 Written Assignment Describe selected qualitative measures of quality used in your facility. How is the data collected, analyzed, and then used in improving patient care? Does the quality of your patient care fall within the parameters established as a result? Is your patient care always as high as you would like it to be? What factors affect this quality? Which ones can you control? In your clinical experience what are the things that have affected the quality of care provided? How? Please write a well developed response and provide evidence from the literature to support your response and cite those references per APA format (minimum of 500words required in your response). Lesson 3.1 Providers, Employers & Patients Nash & Goldfarb Text: Chapters 8, 9 & 10 Discussion Board Assignment National Guideline Clearinghouse Click on the link below to find out about the National Guideline Clearinghouse (NGC). Once in the website, click on the Guidelines in Progress hyper link to learn about how guidelines are developed and then summarize your findings. Post your commentary to the National Guidelines Discussion Board (250 words). National Guideline Clearinghouse: http://www.guideline.gov Guidelines in Progress: http://www.guideline.gov/browse/workqueue.aspx LESSON 3.2 Federal and Private Nash & Goldfarb Text: Chapters 11 & 12 Competency demonstrated in on site activity LESSON 4.1 Identifying and Controlling Risk/ Risk Reducing Communication

Kavalier & Spiegel Text: Chapters 1, 3 & 4 Written Assignment One of the most crucial aspects of risk identification is communication. When communication breaks down, we find ourselves at the greatest potential for risk. One of the objectives of minimizing potential sources of risk is to improve the process of communication at all levels of care. Normally, when we communicate in our own language and with someone of our own culture we are not particularly conscious of the process of communication. However, in an intercultural context we are usually far more aware of the different elements of the process of communication because of the difficulties inherent in intercultural communication. Even persons with the best predisposition toward intercultural contacts know the difficulties that exist in communication between persons of different cultures. What are the essential elements of the communication process within the context of risk management? Please be sure to include intercultural competency in your discussion as well as the definition of effective communication in a well thought out response. Be aware that methods of communication are not just limited to verbal dialogue and exchange. Please write a well developed response and provide evidence from the literature to support your response and cite those references per APA format (minimum of 500 words required in your response). LESSON 4.2 Risk Management and the Law: Standards and Liability Reduction Kavalier & Spiegel Text: Chapters 9 & 10 Competency demonstrated in on site activity and in final assignment LESSON 5.1 Workplace Issues Kavalier & Spiegel Text: Chapters 2 & 8 Discussion Board Assignment The prevention of workplace violence has emerged as an important safety issue in and around hospitals and healthcare facilities. Workplace violence such as physical assaults, or threatening or violent behavior, is a growing problem in the workplace. The workplace may be any location either permanent or temporary where an employee performs any work-related duty. OSHA is the federal organization that strives to "assure safe and healthful working conditions" for

today's workers, and mandates that employers provide a safe work environment for employees. Click on the link provided to access a unique tool provided by OSHA for the purpose of education about workplace safety issues. Select an area of interest and work through that module. Then comment on its effectiveness as an education tool for occupational safety and health topics (250-500 words). Post your commentary to the OSHA Discussion Board. <http://www.osha.gov> http://www.osha.gov/sltc/etools/hospital/hazards/workplaceviolence/viol.html LESSON 5.2 Ethics & Risk Kavalier & Spiegel Text: Chapter 7 & 15 Competency demonstrated in on site activity LESSON 5.3 Quality Related to Risk Kavalier & Spiegel Text: Chapter 6 Written Assignment Review your organization s mission statement. Using the guide found in Box 6-3 (Kavalier & Spiegel, p. 143), answer the questions listed. How does your organization meet the expectations stated in its mission? Please write a well developed response and provide evidence from the literature to support your discussion of your understanding of how continuous process improvement relates to risk management. Cite those references per APA format (minimum of 500words required in your response). Final Assessment: Risk Management Plan The purpose of this assignment is to develop a risk management plan or program that can be utilized in any health care setting. This assignment is worth 25% of your grade so budget your time and effort accordingly. Identify the key elements in a risk management plan. Address elements that are crucial to the minimization of financial loss. Develop a program to reduce the incidence of preventable accidents and injuries.

Include a description of the interaction between quality and risk management. This may include, but not be limited to, a description of a process improvement goal or a quality improvement plan. The format of this project can be in a written paper, PowerPoint presentation or any other creative means by which the student can disseminate information. Multiple media formats are encouraged. The project should reflect scholarly research and writing. Please write a well developed response and provide evidence from the literature to support your rationale for your plan/ program. Please cite those references per APA format (Recommend a 5-7 page paper your response).

CLASS SCHEDULE PERIOD TOPIC ASSIGNMENT Week 1 Online July 9-13 Week 2 On-Campus July 16-20 Week 3 Online July 23-27 Week 4 Online July 30-31; August 1-3 Week 5 Online August 6-10 Week 6 August 13-17 Lesson 1.1 and 1.2 Overview of Quality, Duty v. Interest Onsite active learning topics to include: Quality Improvement and Patient Outcomes Data Collection & Patient Outcomes Obstacles and Opportunities of Health Promotion Plans in our Current Health Care Environment Discussion of Ethical Dilemma related to Continuous Program Improvement and Risk Management Lesson 2.1 Conceptualization and Improving Quality Lesson 3.1 Providers, Employers and Patients Lesson 3.2 Federal and Private Lesson 4.1 Identifying and Controlling Risk/Risk Reducing/Communication Lesson 4.2 Risk Management and the Law: Standards and Liability Reduction Lesson 5.1 Workplace issues Lesson 5.2 Ethics and Risk Lesson 5.3 Quality related to risk 250 word post Written Assignment Onsite participation 500 word Written Assignment 250 word post 500 word Written Assignment 250 word post 500 word Written Assignment Final Assignment

COURSE POLICIES AND PROCEDURES Current information regarding College policies affecting your course can be found on the Resources/Policy section of the course homepage. On this page, you will find vital information, including the following: Current Student Handbook, outlining course-specific policies Access to support resources, including advising and online tutorial services Student Success Guides SUBMITTING ASSIGNMENTS Assignments should be submitted via the Assignment Submission Form on your ANGEL course site. EVALUATION Unit 1 15% (5% post, 10% written assignment) Unit 2 10% (written assignment) Unit 3 10% post) Unit 4 10% (written assignment) Unit 5 15% (5% post, 10% written assignment) Final Assessment 25% written assignment Onsite participation 15% Final Assessment: Risk Management Plan The purpose of this assignment is to develop a risk management plan or program that can be utilized in any health care setting. This assignment is worth 25% of your grade so budget your time and effort accordingly. Identify the key elements in a risk management plan. Address elements that are crucial to the minimization of financial loss. Develop a program to reduce the incidence of preventable accidents and injuries.

Include a description of the interaction between quality and risk management. This may include, but not be limited to, a description of a process improvement goal or a quality improvement plan. The format of this project can be in a written paper, PowerPoint presentation or any other creative means by which the student can disseminate information. Multiple media formats are encouraged. The project should reflect scholarly research and writing. Grading Criteria Thorough discussion of the legal requirements of an internal risk management program including a description of the program s self-assessment method of evaluation. Identification of method's for reducing liability exposure and property loss. Description of risk management's relationship to other departments and external agencies. Description of a process improvement goal or quality improvement plan. Submission of annotated references. Scholarly writing. Points 20 points 20 points 20 points 20 points 10 points 10 points PLEASE NOTE: If life gets in the way of your online classroom responsibilities, you must notify your instructor as soon as you aware that events may occur that may inhibit you from participating at the required level.

YOUR INSTRUCTOR Experience: I have been part of the adjunct graduate faculty at Saint Joseph s College for 27 years, and have taught online as well as summer courses for most of that time. I have a diploma in nursing from Lawrence General Hospital School of Nursing, a B.S. from St. Anselm College, Masters in Community/Community Mental Health from Boston College, and a Doctorate in Nursing Science from Boston University. My areas of practice have included Mental Health Nursing, Home Care, Occupational Health and School Health. My favorite focus in terms of teaching and practice include research and Evidence Based Practice (EBP). These two areas are intimately connected to one another, and also to the quality of care available to the consumers of health care who are our patients. They can guide us in improving the quality of care in any nursing endeavor, as they are essential components of professional and ethical practice. Getting to know you: I know each student brings a unique perspective to his/ her academic activities. It is valuable for me to better understand your background and what you bring to the course in terms of training, education and experience. Please send me an e-mail or brief note of introduction and interest before you submit your first assignment. Getting to know me: After many decades of teaching at Boston University, Boston College and UMass Lowell, I retired from UMass in 2000, but have maintained my teaching role in Maine since we have moved here. I live in Otisfield (a small town in the foothills of the White Mountains), with my husband and two cats. Our two children and three grandchildren remain in Massachusetts, but we visit often. My hobbies include writing and gardening (mostly vegetables which I enjoy preserving for the rest of the year once they are harvested), as well as travel. We just returned from almost seven weeks in the South Pacific and New Zealand. Getting in touch: If I can be of assistance please feel free to contact me by e-mail or phone.

If your question or concern necessitates immediate assistance feel free to contact me at my home phone at 207-637-7075. I usually prefer email correspondence, as you are sure to reach me that way but I will return telephone calls if you leave a message if I m not near the phone when you call. Assignments: Please send assignments to me as an e-mail attachment using the guidelines in your Student Handbook. When submitting an assignment by e-mail include the following information: Your name Course Code and name Assignment/ Unit # Notation of which APA edition was used to write the paper Send all e-mail assignments to me at jdouglass@sjcme.edu When you submit an assignment it is helpful for you to turn on your e-mail feature that allows you to see when someone has opened their e-mail. It is called the read receipt. This will allow you an automatic confirmation that I have in fact received their assignment I look forward to the opportunity to work with you. Sincerely, Janet B. Douglass, RN, DNSc