DNP 835 Grand Canyon University Quality & Sustainability Program Paper The Quality and Sustainability Paper is a practice immersion assignment designed to

DNP 835 Grand Canyon University Quality & Sustainability Program Paper The Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part three of the assignment. Learners are required to provide a theoretical framework that supports the design and implementation of their evidence-based quality and/or safety program and discuss expected outcomes.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.

This assignment requires that you support your position by referencing at least six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Directions:

Write a 2,000-2,500 word paper that provides the following:

Identify a quality, change, or safety theory you will use to support the implementation of your quality and/or safety program. Provide evidence that supports the use of this theory within the program you designed.

Provide the design of your evidenced-based quality and/or safety program that can be implemented to improve quality or safety outcomes in your identified entity.

Discuss expected outcomes of your implementation and how to ensure their sustainability.

Support your position by referencing at least five to six to eight scholarly resources. At least three of your supporting references must be from scholarly sources other than the assigned readings. Course Code
DNP-835
Class Code
DNP-835-IO10310
Criteria
Content
Percentage
70.0%
Completed Changes and Corrected Errors to
Subsequent Paper, Including Transitions for a
Scholarly Paper
5.0%
Identification of Quality, Change, or Safety
Theory to Support Implementation of Quality or
Safety Program
10.0%
Design of Evidence-Based Quality or Safety
Program to Implement in Proposed Health Care
Entity
25.0%
Expected Outcomes and Sustainability
20.0%
Six to Eight Additional Scholarly Research
Sources With In-Text Citations
10.0%
Organization and Effectiveness
20.0%
Thesis Development and Purpose
7.0%
Argument Logic and Construction
8.0%
Mechanics of Writing (includes spelling,
punctuation, grammar, language use)
5.0%
Format
10.0%
Paper Format (use of appropriate style for the
major and assignment)
5.0%
Research Citations (in-text citations for
paraphrasing and direct quotes, and reference
page listing and formatting, as appropriate to
assignment and style)
5.0%
Total Weightage
100%
Assignment Title
Quality and Sustainability Part Three – Implementation and Evaluation
Unsatisfactory (0.00%)
Learner did not attach previous paper and did not make
changes as indicated.
A theory is not used to support implementation of the quality
and/or safety program.
Program design of quality and/or safety program is not
presented. The program does not utilize an evidence-based
design.
Expected outcomes and steps to ensure sustainability are not
discussed.
None of the required elements (minimum of six topic-related
scholarly research sources and six in-text citations) are
present.
Paper lacks any discernible overall purpose or organizing
claim.
Statement of purpose is not justified by the conclusion. The
conclusion does not support the claim made. Argument is
incoherent and uses noncredible sources.
Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice
and/or sentence construction are used.
Template is not used appropriately or documentation format
is rarely followed correctly.
No reference page is included. No citations are used.
Total Points
180.0
Less than Satisfactory (74.00%)
N/A
Theoretical support is discussed, but a specific theory is not
identified to support implementation of the quality and/or
safety program. Evidence that supports the use of this theory
in the proposed program is not presented.
Program design of quality and/or safety program is
referenced, but a clear description of the program is missing.
The program does not utilize an evidence-based design.
Expected outcomes and sustainability are referenced, but no
specific outcomes or steps to ensure sustainability are
discussed.
Not all required elements are present. One or more elements
are missing and/or included sources are not scholarly
research or topic-related.
Thesis and/or main claim are insufficiently developed and/or
vague; purpose is not clear.
Sufficient justification of claims is lacking. Argument lacks
consistent unity. There are obvious flaws in the logic. Some
sources have questionable credibility.
Frequent and repetitive mechanical errors distract the
reader. Inconsistencies in language choice (register) and/or
word choice are present. Sentence structure is correct but
not varied.
Appropriate template is used, but some elements are missing
or mistaken. A lack of control with formatting is apparent.
Reference page is present. Citations are inconsistently used.
Satisfactory (79.00%)
Learner attached previous paper and has made changes as
indicated. Learner needs to incorporate transitions to
connect the ideas between the papers.
Theoretical support is discussed that references a specific
theory. It is unclear how this theory supports implementation
of the quality and/or safety program. Evidence that supports
the use of this theory in the proposed program is not
presented.
Program design of quality and/or safety program is described,
but numerous details are missing. There is no substantiation
that the design can be implemented. The program partially
includes an evidence-based design.
Expected outcomes and sustainability are discussed, but the
projected outcomes lack support for claims, or the plan for
sustainability lacks specific steps.
All required elements are present. Scholarly research sources
are topic-related, but the source and quality of one or more
references is questionable.
Thesis and/or main claim are apparent and appropriate to
purpose.
Argument is orderly, but may have a few inconsistencies. The
argument presents minimal justification of claims. Argument
logically, but not thoroughly, supports the purpose. Sources
used are credible. Introduction and conclusion bracket the
thesis.
Some mechanical errors or typos are present, but are not
overly distracting to the reader. Correct and varied sentence
structure and audience-appropriate language are employed.
Appropriate template is used. Formatting is correct, although
some minor errors may be present.
Reference page is included and lists sources used in the
paper. Sources are appropriately documented, although
some errors may be present.
Good (87.00%)
Learner attached previous paper and has made changes as
indicated. Learner needs to incorporate better transitions to
connect the ideas between the papers.
Theoretical support is discussed using a specific theory. The
theory supports implementation of the quality and/or safety
program. General evidence that supports the use of this
theory in the proposed program is presented.
Program design of quality and/or safety program is generally
described and there is adequate substantiation that the
design can be implemented. The program utilizes an evidencebased design.
Expected outcomes and sustainability are discussed.
Projected outcomes are supported, and general steps to
ensure sustainability are presented.
All required elements are present. Scholarly research sources
are topic-related and obtained from reputable professional
sources.
Thesis and/or main claim are clear and forecast the
development of the paper. It is descriptive and reflective of
the arguments and appropriate to the purpose.
Argument shows logical progressions. Techniques of
argumentation are evident. There is a smooth progression of
claims from introduction to conclusion. Most sources are
authoritative.
Prose is largely free of mechanical errors, although a few may
be present. The writer uses a variety of effective sentence
structures and figures of speech.
Appropriate template is fully used. There are virtually no
errors in formatting style.
Reference page is present and fully inclusive of all cited
sources. Documentation is appropriate and citation style is
usually correct.
Excellent (100.00%)
Learner attached previous paper and has made changes as
indicated. Learner has includes all necessary transitions to
create a scholarly paper.
Theoretical support is thoroughly discussed using a specific
theory. The discussion provides insight in to successfully
implementing the quality and/or safety program. Strong
evidence that supports the use of this theory in the proposed
program is presented.
Program design of quality and/or safety program is clearly
described and substantiates that the design can be
implemented. The program utilizes an evidence-based design.
Strong evidence is provided to support the program design
and implementation.
Expected outcomes and sustainability are thoroughly
discussed. Projected outcomes are supported with clear
evidence, and very specific steps to ensure sustainability are
discussed.
All required elements are present. Scholarly research sources
are topic-related and obtained from highly respected,
professional, original sources.
Thesis and/or main claim are comprehensive. The essence of
the paper is contained within the thesis. Thesis statement
makes the purpose of the paper clear.
Comments
Clear and convincing argument that presents a persuasive
claim in a distinctive and compelling manner. All sources are
authoritative.
Writer is clearly in command of standard, written, academic
English.
All format elements are correct.
In-text citations and a reference page are complete and
correct. The documentation of cited sources is free of error.
Points Earned
Cheryl McKay
K. Lynn Wieck
Evaluation of a Collaborative Care
Model for Hospitalized Patients
EXECUTIVE SUMMARY
The current lack of collaborative care is contributing to higher mortality rates and longer
hospital stays in the United
States.
A method for improving collaboration among health professionals for patients with congestive
heart failure, the Clinical
Integration Model (CIM), was
implemented.
The CIM utilized a process tool
called the CareGraph® to prioritize care for the interdisciplinary
team.
The CareGraph was used to
focus communication and treatment strategies of health professionals on the patient rather
than the discipline or specific
task.
Hospitals who used the collaborative model demonstrated
shorter lengths of stay and cost
per case.
CHERYL McKAY, PhD, CNS, RN, completed this work as part of her doctoral
education at the University of Texas at
Tyler. She is presently Nurse Executive,
Healthier Populations, OrionHealth, Santa
Monica, CA.
K. LYNN WIECK, PhD, RN, FAAN, is Mary
Coulter Dowdy Distinguished Nursing
Professor, University of Texas at Tyler.
248
NTERDISCIPLINARY collaboration is an emerging mandate
to decrease fragmentation of
care delivery in U.S. hospitals. Higher mortality rates
(Estabrooks, Midodzi, Cummings,
Ricker, & Giovannetti, 2005) and
longer lengths of hospital stay
(Zwarenstein, Goldman, & Reeves,
2009) have been found in environments where collaboration is limited or not present. As many as
98,000 people die in hospitals
each year as a result of medical
errors which may be traced to lack
of collaboration and disjointed
care. Beyond the cost of human
lives, billions of dollars are spent
annually for additional care resulting from medical errors (Kohn,
Corrigan, & Donaldson, 2000). The
aim of this study was to determine
if a care delivery model based on
collaboration and coordination of
care using the CareGraph® would
improve patient outcomes.
To provide high-quality care
and meet public expectations with
limited resources, collaboration
has become a necessity. In a landmark study, Knaus, Draper, Wagner,
and Zimmerman (1986) found that
hospitals where collaboration was
present reported a mortality rate
41% lower than the predicted
number of deaths. Hospitals where
there was little to no collaboration
exceeded predicted mortality by
as much as 58%. Collaborative
I
relationships have also been tied
to reduced costs for the health
care system (Zwarenstein et al.,
2009). Although empirical evidence in support of collaboration
in the health care environment is
available in the literature, there is
little evidence on how to create
this environment (Tschannen,
2004). The main structural elements necessary for collaboration
in an acute care environment include a culture where relationships are valued, health care professionals communicate effectively, and respect is shared among all
parties. A model of care delivery
consistent with these cultural values and focused on patient safety
is paramount.
A Midwestern health care system designed an innovative model
of care delivery where collaboration was purposefully woven into
the structures and processes to
effect positive change in patient
and organizational outcomes.
Called the Clinical Integration
Model (CIM) (Zander, 2007), several of the health system hospitals
adopted it while others chose to
stay with a traditional primary
care model. Comparing hospitals
within the health system provides
an opportunity to determine if
there is a difference in survival,
length of stay (LOS), and cost for
patients receiving care in facilities
utilizing the CIM and those receiv-
NURSING ECONOMIC$/September-October 2014/Vol. 32/No. 5
ing care in facilities utilizing a primary care model.
Collaboration in Health Care
Collaboration, as defined by
the American Nurses’ Association
(ANA) (2010), is a partnership
based on trust with shared power,
recognition, and acceptance of
separate and combined practice
spheres of activity and responsibility. Collaboration also includes
mutual safeguarding of the legitimate interests of each party and a
commonality of goals. The key
components of shared power,
recognition and acceptance, and
common goals are relevant to
many of the definitions found in
the literature (Fewster-Thuente &
Velsor-Friedrich, 2008; Petri, 2010).
These components are essential for
a collaborative process and can be
operationalized in an acute care
setting.
A number of factors have
affected the ability of health care
organizations to provide a collaborative environment including the
educational system and professionalization of health care practitioners. Studying determinants of
successful collaboration, San MartinRodriguez, Beaulieu, D’Amour, and
Ferrada-Videla (2005) found health
care practitioners develop a strong
professional identification through
education. This strong professional identification often limits knowledge of other professionals within
the team and is considered a main
obstacle to collaboration. The
dynamics of professionalization lead
to further differentiation of health
care professionals (D’Amour &
Oandasan, 2005) and potential
conflict hindering the development of true collaborative relationships.
Collaboration in health care
affects patient survival and decreases adverse patient outcomes.
Knaus and colleagues (1986)
found hospitals where collaboration was present reported a significant decrease in mortality rates
(Chi square=62.9, df 12; p3 times/day
4
4
4
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