Quality and Safety Gap Analysis
Quality and Safety Gap Analysis
Write an analysis, 4-pages in length, of the gap between current and desired performance, with respect to the provision of safe, high-quality patient care.
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.
As a nurse leader, you must be able to assess your organization’s ability to deliver safe, high-quality patient care. In so doing, you may be required to perform a gap analysis of a quality or safety issue as the first step in improving outcomes. Failure to meet benchmarks for safe and effective patient care can have reimbursement, regulatory, and legal consequences.
This assessment provides an opportunity to develop the knowledge, skills, and attitudes required to successfully implement changes that improve patient outcomes by:
- Evaluating the current culture of an organization.
- Performing an outcomes gap analysis.
- Determining what changes are needed to bridge the gap.
- Examining current thinking on this topic contained in the literature.
Quality and safety are everyone’s responsibility as a team of interprofessional care delivery partners. Together we develop policies that support quality and safe care delivery. As part of the interprofessional team, nurses are leaders in care and thus are responsible and accountable for leading and providing safe quality care.
Health care delivery is structured around evidenced-based information. Quality is defined by exploring proven, evidenced-based information. After reviewing and defining evidenced-based information, the interprofessional team applies this knowledge to assess the organization’s or the practice setting’s ability to provide evidenced-based care delivery. When a gap in care is identified, it is important to propose an evidenced-based change and to execute a plan for improved care.
Your quality and safety gap analysis will provide the basis for the remaining assessments in this course.
Conducting the Analysis
- Identify a systemic problem in your organization, practice setting, or area of interest that contributes to adverse quality and safety outcomes.
- Propose specific practice changes that will improve quality and safety outcomes and bridge the gap between current and desired performance.
- Prioritize proposed practice changes.
- Determine how proposed practice changes will foster a culture of quality and safety.
- Determine how a particular organizational culture or hierarchy might affect quality and safety outcomes.
- Justify necessary changes with respect to functions, processes, or behaviors, specific to your organization.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
- Competency 1: Analyze quality and safety outcomes from an administrative and systems perspective.
- Identify a systemic problem in an organization related to adverse quality and safety outcomes.
- Propose specific practice changes within an organization that will improve quality and safety outcomes and bridge the gap between current and desired performance.
- Prioritize proposed practice changes.
- Competency 2: Determine how outcome measures promote quality and safety processes within an organization
- Determine how proposed practice changes will foster a culture of quality and safety.
- Competency 3: Determine how specific organizational functions, policies, processes, procedures, norms, and behaviors can be used to build reliable and high-performing organizations.
- Determine how a particular organizational culture or hierarchy might affect or contribute to adverse quality and safety outcomes.
- Justify necessary changes to particular organizational functions, processes, and behaviors that correct or mitigate adverse quality and safety outcomes.
- Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
- Communicate analysis data and information clearly and accurately, using correct grammar and mechanics.
