• April 3rd, 2016

Case Discussion

Paper, Order, or Assignment Requirements

Three questions including one on short topics. Your answers should make generous use of references and articles related to each topic in order to support your discussions. Please start each of the three answer sections on a new page. 

  • Please note your name and course number on your answers document.
  • Insert Page Numbers in the document.
  • List references you may have used at the end of each answer.
  • If submitting electronically, please submit all your answers in one combined document.
  • Please submit hard copies on Monday April 11, 2016 in class.


  1. SCENARIO ONE: You have been appointed as Director Quality Improvement in a large Skilled Nursing Facility. Recent data has shown an increase incidence of bed sores or pressure ulcers in patients admitted to your facility for long term care. The rate is now 12% of your Nursing Home Residents developing Bedsores.

Bed sores are injuries to the skin and underlying tissue resulting from prolonged pressure on the skin. Most often occurs on skin covering bony areas of the body such as heels, ankles hips and tail bones. Approximately 11% of Nursing home residents have pressure ulcers in the U.S.

It is now your responsibility to proceed with improving the Quality within your organization. How will you proceed with reducing the pressure ulcer rates? Please use examples and references in support of the steps you would take. You may also include pertinent information from the lectures, text book and your discussion papers. Discuss and focus on the tools and strategies you may use. Please do not spend time in discussing pressure ulcers and its pathology at any great length. You may mention importance of improving pressure ulcer rates very briefly. Please focus more on the Quality Improvement strategies. This scenario may be written in two double spaced pages.





  1. Answer the following 3 questions (Each Question about ¾ to 1 page): (Please note Improvement strategies requested below may include FOCUS PDSA, Six Sigma, Lean Principles. Within the improvement strategies components also include other tools such as Root Cause Analysis, DMAIC that goes with Six Sigma etc). Explain your choices with references :
    1. Wait times for patients visiting the Eastwood Hospital ER are on an average 4 hours. With the result hospital is losing clients and revenues. What strategy would you consider to improve the wait times?
    2. Below is a chart analyzing and tracking Medication errors over a period of 12 months. These errors need to be reduced and eliminated since they are responsible for creating safety issues for patients. Interventions are noted at various times on this chart. Please explain the type of chart and describe components of this chart. In addition also discuss what happened in December 1998? Please note the interrupted line (dashes) below is the goal line. What improvement strategy may have been used here?


  1. Below is a chart analyzing and tracking defects over a period of 20 weeks. These defects need to be reduced and eliminated since they are responsible for creating safety issues for patients. Please describe the components of this chart. In addition also discuss what happened at week 11 and onwards? What strategy may have been used in reducing the defects?




  1. SCENARIO TWO: Admission Process- Description


Current Process for patient being admitted as an inpatient:

  • Upon arrival, the patient reports to the hospital registration or admitting area.


  • The patient completes paperwork and provides proof of insurance, if insured.


  • An identification bracelet including patient’s name and doctor’s name is placed around the patient’s wrist.


  • Patient is requested to sign a consent form before any services are provided. If patient is not feeling well a family member or care giver may help patient complete the admission process.


  • Patient then waits to be admitted. Wait time is based on bed availability in the unit patient needs to be admitted


The hospital Quality Improvement professional has been requested to explore any areas of improvement in this process. This requires the professional to develop two aims and select two measures that would help with analyzing and making improvements to the admission process described above.


(Hint: Please focus on this process above as written and not any admission process in general)


Answer all three issues listed below based on this scenario:


  1. What are the two Aims you would select for improving process above?


  1. Select only two specific measures you have identified to evaluate the AIMs from this particular admission process only as described above.


  1. Describe each measure providing the Numerator and Denominator etc as applicable. If measure does not require a numerator or denominator explain why.


  1. Draw a run chart or control chart tracking progress for only one of the admission process measures you have selected above. The chart must show the baseline and then results after intervention. You may use fictitious data for your chart. Be sure to describe your chart.

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