Practice Gaps for Quality Improvement Identification and Assessment

IDENTIFYING PRACTICE GAPS FOR QUALITY IMPROVEMENT

Discussion: Identifying Practice Gaps for Quality Improvement

Identification of practice gaps in healthcare organizations is essential for quality improvement. This is more so the case given that identification of gaps helps in assessing and examining the performance of an organization so as to identify differences between what should be happening and what is happening in practice. From the gap analysis, healthcare organizations are then able to come up with actions or projects that could be implemented so as to close the gaps and improve quality of care. Essentially, identifying gaps initiates the implementation of knowledge in practice (Kitson and Straus, 2010). There are various approaches which can be used to identify quality improvement practice gaps. For instance, there may be need to carry out a gap analysis at the hospital level. According to Kitson and Straus (2010), a needs assessment determines the nature and the size of the gap in practice and the desired behaviors and outcomes, attitudes, skills, and knowledge. Further, the authors suggest that the strategy used for the needs assessment is dependent upon the resources available, the type of data, and the purpose of the said assessment. For instance, to identify information gaps on use of restraints, mortality, and control of infection, I would use information that had been collected with regard to the said cases as it is required by bodies such as the Joint Commission on the Accreditation of Health Care Organizations.

A potential quality improvement practice gap that I might use for my DNP project relates to the management of cardiovascular disease risk. According to Heeley et al (2010), cardiovascular disease happens to be a major cause of disability and death in the world. A research study conducted in 2005 in Australia showed that cardiovascular disease was accountable for approximately 1.4 million disabilities and 35% of deaths. In addition, eighty five percent of Australians visit general practitioners to seek care for the said disease. At present, there appears to be little knowledge on how the said evidence can be deployed to improve outcomes in clinical settings. One problem could be the failure of general practitioners to perform cardiovascular disease risk assessment. Essentially, Heeley et al (2010) suggest that general practitioners fail to perform the said assessment owing to lack of incorporation of risk tools into practice software, poor understanding of how the said tools are used, and lack of understanding of the difference between relative and absolute risk. Therefore, it is important to note that if the said barriers are addressed, then we would be able to see significant improvements on the preventive and management fronts.

There are various tools and/or methods that can be used by general practitioners so as to address the gap in the management of cardiovascular disease. For instance, a tool such as the chart audit could come in handy in this regard. For instance, a chart audit could be done on cardiovascular disease whereby health records are assessed using data contained in the electronic health records. The said records would facilitate the process of capturing data on diagnostic tests and medications. Apart from chart audits, another tool that could be used to address the said gap happens to be the decision support tools. According to Buchbinder and Shanks (2016), decision support tools of literacy could be of great relevance on this front given that they help patients better understand certain crucial aspects of disease. The said decision support tools are generated from computers and can be used by patients at home to access their assessment (Buchbinder and Shanks, 2016). Other methods such as explanations, personal stories, and narratives could also be utilized so as to communicate cardiovascular risk numerically.