REDUCTION AND PREVENTION OF FALLS AMONG PATIENTS WITH DEMENTIA AT KNIDRED HOSPITAL PAPER

TASK 1: ASSESSMENT

Stakeholder Identification

Stakeholders refer to individuals or organizations likely to be affected by the change, decision, or project outcome. They have an interest or are affected by the project or an initiative. Stakeholder identification is vital in project management, as it facilitates efficiency and enhanced realization of the project objectives (Slabá et al., 2019).

The identification of stakeholders for the project was to utilize interventions that included brainstorming and interviewing influential individuals in the organization. There was brainstorming with team members as well as experts in nursing.

The brainstorming aimed to identify individuals who were most likely to be affected or benefit from the project (Gregory et al., 2020).

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The brainstorming sessions aimed to answer questions related to individuals, directly and indirectly, involved and affected by the project, losers and gainers from the project, individuals to facilitate the successful implementation of the project, and individuals that may cause the project failure. (Gregory et al., 2020)

The second strategy utilized to identify the stakeholders was interviewing influential people. They included Nurse Leaders, Managers, and Team Leaders. The interview provided critical information about individuals who were likely to benefit and be disadvantaged with the project implementation.

The interview also provided insights into the success strategies needed for the project’s success.

The next step after stakeholder identification was stakeholder prioritization. Stakeholder prioritization was done based on the power and interest towards the project. The power-interest grid was adopted where stakeholders with high power and high interest in the selection process (Slabá et al., 2019).

Stakeholders with high power, low interest, and low power were not selected, as they could drag the successful realization of the desired project objectives.

Stakeholder identification and prioritization led to selecting three individuals, including the Nurse Manager, Nurse Leader, and Unit Preceptor. The individuals to have high interest and high power, which meant that they could contribute significantly to the project’s success. They also had extensive experience in project implementation and initiating change in healthcare settings.

The Nurse Manager has extensive experience and skills in managing change projects in the organization. For the last five years, she has been a Nurse Manager and has received awards for her ability to drive excellence in the organization.

She also has an adept understanding of the systems and processes needed for the successful implementation of the project.

The Nurse Leader is highly influential in the organization. She knows how to lead and motivate the employees to embrace the desired actions and behaviors for organizational success.

The Preceptor has extensive experience in leading interprofessional teams in implementing best practices in healthcare. As a result, he is well-positioned to lead the implementation of the project.

Roles of the Consulted Individuals

The identified stakeholders will play critical roles in supporting the proposed healthcare improvement project.

For example, the Nurse Manager will coordinate the entire project activities. She will utilize her experience in project management to ensure the realization of the project deliverables as planned in the proposal.

The Nurse Leader will use her influential power to motivate the staff to adopt the proposed change. The leader will also guide the implementation the best practices needed for the project’s success.

The Preceptor will lead the inter-professional teams in implementing the project (Boaz et al., 2018). He will also provide assessment data on the strategies needed to ensure enhanced outcomes in the healthcare improvement project.

Needs Assessment Using Affinity Analysis

The need for the healthcare improvement project was determined using affinity analysis. Affinity analysis refers to a method of determining the co-occurrence of relationships in ideas and activities undertaken by groups or individuals.

Affinity analysis represents the output from brainstorming ideas by groups of individuals. The process generates, organizes, and consolidates information related to the interest issue. Some processes were utilized in the affinity analysis approach to determine the need for the healthcare improvement project.

One of the processes was brainstorming ideas of the stakeholders on issues affecting dementia patients in the setting. The stakeholders wrote their ideas on stick notes to analyze their perceived critical issues affecting dementia patients in the institution (Stern, 2020). The stakeholders posted their ideas on the chart pack randomly for team analysis.

The second step in the process was examining the ideas by the stakeholders to identify interrelated ideas. The stakeholders examined and grouped ideas closely related to preventing falls among dementia patients in the setting. The grouping process also led to identifying lone ideas that did not share any similarities.

The third step entailed the discussion of the grouped ideas with the stakeholders. The discussion focused on defining categories of ideas and creating summaries for each group of ideas (Mizuno & Bodek, 2020). The stakeholders also reached a consensus on eliminating any controversial ideas and making changes or improvements when deemed necessary.

Sub-themes represent the grouped ideas to capture the meaning of the entire group. The purpose of developing the sub-themes was to identify best practice interventions adopted to address patients with dementia in the setting.

The last step was combining the sub-themes into main themes. Combining the sub-themes ensured that the stakeholders agreed on the best approach to guide the healthcare improvement project (Stern, 2020).

The stakeholders reached a consensus by discussing the developed ideas, subthemes, and themes. They discussed the relevance, similarities, and differences that brainstormed ideas, sub-themes and themes had.

They also discussed the overall implications of the adopted themes on understanding the clinical issue. They agreed on the best practice intervention relevant to the healthcare improvement project.

Feasibility Assessment

Feasibility of the Healthcare Improvement Project

The feasibility assessment of the healthcare improvement project showed that the project could be in the practice site. The project will benefit patients with dementia due to enhanced care safety and improved efficiency in inpatient care.

It is also an improvement n care safety as it reduces the risk and rates of falls among patients with dementia. The reduction in the rate and risks of falls translates into enhanced quality and safety of care.

It strengthens the adoption of models of care that promote patient-centeredness. Patient-centeredness promotes safety in the care and patient empowerment and satisfaction with their care.

The feasibility analysis revealed low impact risks that may arise due to project implementation. Some of the identified low-impact risks include an increase in the provider workload, reluctance, costs incurred by the organization, and the possibility of project failure.

However, the risks pose minimal threat to the healthcare improvement project since a positive impact on calculating the impact ratio. An impact ratio of three translates into the enhanced possibility of the healthcare improvement project with positive outcomes for patients and healthcare organizations.

Therefore, the project should drive excellent inpatient provision in the setting.

Organizational Readiness and SWOT Analysis

SWOT analysis is a tool utilized to determine the factors that are likely to affect the success of the healthcare improvement project. The analysis assesses the readiness of the organization to support change.

Identify ways of optimizing their strengths and opportunities in their environment to minimize the potential impact of threats and organizational weaknesses on the successful implementation of the project.

There was serious discussion among the stakeholder in the SWOT Analysis. The stakeholder tabled various criteria that may impact the implementation of the HIP into two criteria: internal and external criteria.

The stakeholders enumerated the following internal criteria: participation norms, defined roles, resources, funding, commitment, collective capabilities, people, experience, knowledge, data, innovative aspects, collaboration stools, processes systems, IT, and communication; include the development of knowledge, dissemination of knowledge or best practices, political, legislative, economic environment technology development, and innovation as the external criteria.

After serious brainstorming by the stakeholders about the criteria, weaknesses, and strengths, by unanimous decisions of the stakeholders agreed that the below table of SWOT Analysis is approved.

SWOT Analysis

Please refer to appendix C to review the SWOT analysis.

The Internal and External criteria were a consensus among the stakeholders.

The approach to SWOT analysis by Stern (2020) in this project, SWOT analysis begins with the examination of the strengths of the organization.

The strengths focus on the positive internal factors that provide the organization a competitive advantage in the industry. In this step, the team members explored collective capabilities, commitment, service quality and efficiency, morale, leadership, governance, culture, customer goodwill, participation norms, and financial resources.

Stern (2020) also asserts that the SWOT analysis process examines organizational weaknesses.

The weaknesses are internal and are negative organizational factors. The factors place the organization at a disadvantage compared to other healthcare organizations.

They also hinder its ability to influence its performance and achieve its desired core goal of growth. Also, the weaknesses are continuous staff turnover due to overwork and low staff morale due to improper motivation.

The team members utilized knowledge from their experience with the organization to identify weaknesses by focusing on market image, costs of care, resource distribution, management, leadership styles, and the competency level of the employees.

The third step in undertaking the SWOT analysis process, as stated by Stern (2020), was examining the organizational opportunities. Opportunities refer to the factors that will enhance the organization’s market prosperity.

The factors comprise the organizational existence in its markets. The team members explored external opportunities from their research and experience, including changes in consumer preferences, innovation, technologies, government regulations, and complacence of competitors.

The last step in the process entailed the examination of threats to the hospital. Threats refer to external damaging factors that are likely to affect the organization’s performance.

They are beyond the control of the organization. The team members explored external threats to an organization, such as competitiveness, technology changes, government regulations, and how they likely affect organizational performance (Mizuno & Bodek, 2020).

The team members ranked the factors to determine the severity of their effect to guide the implementation of responsive interventions to address them.

The SWOT analysis performed on the organization revealed some strengths, weaknesses, threats, and opportunities.

One of the strengths identified from the SWOT analysis is a supportive, committed, and devoted management team. The organization’s leaders are ready to implement change initiatives that would contribute to safety, efficiency, and quality of patient care.

The support can achieve the outcomes of the project. The other identified strength is productivity, scientific and guidance used in inpatient care.

The healthcare providers have the competencies of using different technologies, which would enhance the project’s outcomes.

The SWOT analysis also showed several weaknesses in the organization.

One of the weaknesses is the continuous staff turnover due to overwork. Covid19 pandemic has placed immense pressure on the organization’s workforce. The healthcare providers are inadequate to meet the high care needs of the large influx of patients to the organization.

The other weakness is poor staffing; they do not feel leadership understands their work demands, working much overtime, and having a poor work-life balance.

The SWOT analysis revealed the minimal involvement of the employees in making critical organizational decisions, lack of open communication, and inefficient use of reward mechanisms to enhance the performance and motivation of the staff.

The SWOT analysis also revealed several threats to the organization.

One of them is the high costs associated with acquiring new technologies. New technologies are expensive to acquire, maintain, and equip healthcare providers with the knowledge and skills needed to operate the systems.

The other threat is competition from the leading providers of care in the region that has embraced health information technologies to prevent and reduce patient falls.

The other threats include changing trends in healthcare and the emergence of new health problems that affect the sustainability of the adopted organizational interventions.

The organization can overcome the above issues and challenges by focusing on its opportunities. They include adopting novel technologies for sustained performance in terms of quality, safety, and efficiency, training its staff on technologies in healthcare, and encouraging evidence-based interventions.

It can also tap into the highly informed consumer base by providing solutions such as remote care using digital technologies in healthcare.

One of the regulations that will facilitate the implementation of the healthcare improvement project is the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA is a regulation adopted to promote the safe use of health information technologies. The regulation requires healthcare organizations to ensure data integrity in health information technologies.

It also protects patients from the adverse effects of data breaches in healthcare organizations.

HIPAA provisions also require healthcare organizations to develop strict policies that will guide access and use of private and confidential data of the patients.

HIPAA will facilitate the implementation of the proposed healthcare improvement project by ensuring that safe and efficient systems are adopted to prevent patient falls in the organization (Shuaib et al., 2021).

It will also guide the development of processes to implement health information technologies to prevent and minimize patient falls in healthcare.

SMART+C Goal and Outcome Statement

The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.

The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.

Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.

The proposed project is highly feasible in the organization. It entails using best practice interventions to reduce and prevent patient falls. It also entails using relevant practices to nursing that would enhance the safety and quality of patient care.

The project is relevant to the organization because of the recent increase in inpatient falls. The relevance can also be from the organization’s focus on achieving care outcomes such as safety, quality, and efficiency.

Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.

The project will start in October and end in July next year. Some of the anticipated challenges to the project may include getting adequate institutional and provider support, sustaining the project interventions, and effective implementation of health information systems to prevent and reduce the risk of falls in the organization.

SMART + C Goal

Please refer to appendix D to view the SMART + C Goal Questionnaire. This project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program. Please refer to the appendix.

Goal Outcome

The project’s outcome is the reduction in the rate of falls among patients with dementia.

The secondary outcomes include the reduction in the costs incurred by patients with dementia, hospital stay, and improvement in the overall efficiency in the institution.

The project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program.

The staff has significant roles to play to fulfill all the set goals.

TASK 2: INTRODUCTION FOR HEALTH IMPROVEMENT PROJECT.

INTRODUCTION
Problem Background

Promoting safety, quality, and efficiency in patient care is essential for their health and wellbeing. However, patient falls adversely affect the safety and quality of care that patients receive. Patients of a specific category, such as those with dementia, have an increased risk of falls.

Patients who have dementia have an increased risk of falls due to factors such as impaired judgment, visual-spatial perception, gait, and the ability to identify and avoid hazards that relate to falls (Peek et al., 2018).

The risk for falls in patients with dementia in the US is twice higher than those without the disorder (Fernando et al., 2017). Dementia is associated with adverse effects on the patients’ health and their careers. As a result, falls in these patients predispose them to worse health outcomes and poorer quality of life (Wheatley et al., 2019).

Falls in patients with dementia cause adverse effects, including injuries, increased care costs, and mortality (Peek et al., 2018). Nurses and other healthcare providers have a critical role in preventing falls in patients with dementia.

They utilize evidence-based interventions in inpatient care to optimize the care outcomes in patients with dementia (Oki et al., 2021). In addition, they explore inter-professional interventions that can be adopted to reduce and prevent falls in patients with dementia (Rajagopalan et al., 2017).

Health information technologies such as wearable sensors and motion detectors effectively reduce the risk and prevent falls in patients with dementia. The technologies enhance the ability of healthcare providers to respond promptly to patients’ vulnerability to falls in their settings, thereby promoting the patients’ health (Baig et al., 2019).

Despite the efficacy of the systems, the practice site has not implemented its use, leading to a high rate of falls among patients with dementia. Therefore, the project’s focus is on using health information technologies such as wearable sensors to predict, prevent and reduce the rates of falls among patients with dementia.

The project is significant as it enhances the safety and quality of care. The reduction in the risk and prevention of falls promote safety and quality in care by preventing the predisposition of patients with dementia to outcomes such as injuries, prolonged hospital stays, and mortality (Wheatley et al., 2019).

The project also promotes cost-efficiency in care. Falls increase the costs incurred by patients due to prolonged hospital stays, and complex care needs to manage the effects of falls. The reduction in the risks and rates of falls in patients with dementia promotes cost-efficiency inpatient care (Fernando et al., 2017).

The project also informs evidence-based practice in nursing. It guides the introduction of evidence-based interventions that can be adopted to prevent falls in dementia patients and acute care settings.

Through the project, nurses know about efficient and effective ways of incorporating technology into dementia care to promote safety and quality in their settings (Peek et al., 2018).

Description of the Problem

Dementia is one of the global health problems with adverse effects on the affected populations. Dementia is a term that encompasses a range of conditions associated with alteration in multiple high functions such as cognition, memory, communication, behavior, and the ability to perform the activities of daily living.

Patients with dementia are highly predisposed to falls compared to those without it. The risk and rate of falls annually are almost twice in patients with dementia compared to those without (Peek et al., 2018).

People with dementia have a history of falls five times and an increased risk of falls than those without any history of falls. Falls have adverse health effects on patients. Accordingly, it predisposes patients to fall-related injuries that include hip fractures.

It also increases mortality risk due to its complications (Fernando et al., 2017). Falls also predispose patients with dementia to health problems that include long-term disability, premature institutionalization, functional dependence, and traumatic brain injury.

Patients with a history of falls also develop a fear of falling, leading to anxiety and a decline in the quality of their lives (Stark et al., 2021).

Patients with dementia are increasingly predisposed to falls due to risk factors such as cognitive impairment and altered gait, balance, vision, and functional health status (Oki et al., 2021).

The medications that patients with dementia use also predispose them to falls due to their side effects, such as hypotension, confusion, and increased irritability (Wheatley et al., 2019).

Falls are associated with adverse economic effects to patients with dementia, healthcare institutions, and the state. For example, statistics estimates from the US show that about $30 billion is used annually for treating falls among elderly adults (Stark et al., 2021).

The costs incurred in the state for managing fatal falls in the US are estimated to be US $637.1 million and the US $31.3 billion for non-fatal falls. Due to the increased risk of falls in patients with dementia, its related hospitalizations to be 26% of all the hospitalizations in the US (Bayen et al., 2017).

The costs of treating dementia alone are significantly high for patients and their families. For example, Jutkowitz et al. (2017) found in their study that the cost of care for a person with dementia is $321,780 from the time of diagnosis until its optimum management or death due to its associated complications.

Families and patients incur 70% of the total cost burden from the above amount, while Medicaid and Medicare account for 14% and 15% of the costs, respectively.

The costs incurred by a family with a patient with dementia in healthcare are 86% higher than those without a dementia case (Jutkowitz et al., 2017).

Considering the above economic burden of dementia alone, a patient fall worsens the economic status of the patients and their families significantly, hence, the need for responsive interventions to address the problem.

Early detection and prevention of falls among patients with dementia are critical to promoting their health and wellbeing.

Early detection and prevention have the potential of reducing the morbidity as well as mortality associated with falls. Most of the elderly fallers (50-75%) experience recurrent falls in their lives irrespective of their disease states, making it imperative to take preventive measures to reduce fall-related injuries and fall risks at large (Bayen et al., 2017).

The implementation of rapid fall detection and prevention systems limits the risk of ling-lie, a predictor of worse health outcomes, reduced walking capacity, and prolonged hospital stay (Rajagopalan et al., 2017).

Rapid detection and prevention of falls also enhance the accuracy of care directed to injuries related to patient falls.

It also lowers the short-term indirect effects of falls such as hypothermia, phlebitis, and pressure sores alongside long-term fall-related effects such as fear of subsequent falls, loss of autonomy, and social isolation (Baig et al., 2019; Bayen et al., 2017).

Consequently, healthcare providers and institutions should embrace responsive interventions that promote early detection and prevention of falls among patients with dementia to enhance their health and wellbeing.

Purpose Statement

This healthcare improvement project aims to examine the effectiveness of healthcare technologies such as wearable devices in reducing and preventing falls among patients with dementia.

Through its implementation, the cost, safety, and quality of care given to patients with dementia will improve significantly.

(a) Project Management Lifecycle

Project management lifecycle is a model that organizations use to guide the implementation of their projects. The lifecycle comprises steps for optimum outcomes to be achieved in project implementation.

The steps include initiation, planning, execution, and closure. Initiation is the first step in the cycle where the project stakeholders identify an organizational need, problem, or opportunity for enhanced performance and productivity.

The stakeholders also develop the objectives of the project and its feasibility. They also develop deliverables that will guide the project implementation process.

The activity in this phase of the cycle in the proposed project will be the development of project objectives and deliverables (Clegg et al., 2020). The objectives and deliverables will guide the implementation process of the project.

The second step to be noted in the project management lifecycle is planning. Planning is when the stakeholders break down the more significant project deliverables into smaller, achievable tasks.

The stakeholders also develop an inter-professional team that will be held responsible for overseeing the implementation of the project.

They also develop timelines for completing the project tasks. At this phase, the project stakeholders must develop smaller goals that will underpin the project’s main objective, vision, and mission.

During the implementation of the healthcare improvement project, the activity in this step is creating a project plan (Clegg et al., 2020). A project plan comprising project timelines, phases, tasks, resources, and budget will guide the implementation of the process.

The third step in the project management lifecycle is execution. Execution is when the developed strategies in the planning phase are in practice. The stakeholders turn the project plan into action.

The project management leaders ensure that the project activities are on track in this phase. They organize the team members, assign roles and responsibilities, manage the project timelines, and ensure the implementation according to the developed plan.

One of the activities that will occur in this phase during the implementation of the healthcare improvement project will be creating tasks for teams and organizing workflows. The project leaders will assign tasks to the appropriate team members and ensure efficiency in the project’s implementation (Clegg et al., 2020).

The leaders will also coordinate project activities to ensure execution aligns with the developed plan.

The last step in the project management lifecycle is closure. The closure is when the project stakeholders provide the end deliverables of the project, release resources of the project and evaluate the success of the project in achieving its outcomes.

The closure provides an opportunity to reflect on the project successes, weaknesses, and opportunities that should achieve optimum outcomes in similar projects in the future.

One of the activities undertaken in this phase during the closure of the healthcare improvement project will be evaluating the project’s effectiveness. Process and outcome measures will determine whether the desired objectives of the project were achieved or not (Clegg et al., 2020).

In addition, feedback to the team members involved in the project to inform their practice.

4 (b). Project Guidance Initiation to Closure

The project management lifecycle will guide the project from its initiation to closure. It will provide the stakeholders with insights into the project objectives and deliverables.

It will also guide the development of an inter-professional team to implement the project.

The lifecycle will also guide the development of project strategies that would achieve the expected outcomes.

The project management lifecycle will also provide the desired structure for delivering the project.

It will provide a framework for enhancing project activities such as scheduling, communication, and collaboration.

The cycle will also guide the progressive evaluation of the project at different stages of its implementation.

The evaluation will inform the implementation of interventions that improve the project outcomes.

Lastly, the model will guide progress throughout the project implementation, evaluation, and termination processes (Institute, 2019). The tracking will eliminate potential issues such as task duplication and infective use of resources for the desired result to be achieved in the organization.

Review of Relevant Scholarly Sources.
Scholarly Review Purpose

A scholarly review of sources on the selected healthcare improvement project with some aims was to determine the credibility and reliability of evidence supporting the use of the intervention in addressing the clinical issue.

The sources of evidence should have valid, reliable, and credible evidence to inform the clinical practice in nursing.

The other purpose of the scholarly source review was to identify gaps in practice. Identifying gaps in practice informed the need for the healthcare improvement project. It also strengthened its relevance to the organization and its ability to address its needs.

The third aim of the scholarly review in the healthcare improvement project was to learn about the project’s practical ways. Accordingly, the sources of scholarly evidence inform the strategies utilized in the translation of evidence into practice (Dingwall & Staniland, 2020). Therefore, a scholarly review of sources of evidence must inform the need and relevance of healthcare improvement projects

Table of Scholarly Sources

First Author and (Publication Year)	Scholarly Source Title	Type of Scholarly Source	Relevance
1. Behera et al. (2021)	State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review	Peer-reviewed journal	This article is relevant to the proposed project, as it explores the benefits of using health information technologies in promoting safe inpatient care. It explores the benefits of technology use in detecting and preventing patient falls. It also provides insights into the factors for the effective use of health information systems of patients with dementia.
2. Bezold et al. (2021)	Sensor-based fall risk assessment in older and aged adults with or without cognitive impairment: A systematic review	Peer-reviewed journal	This article is relevant to the proposed project as it shows the efficiency associated with technologies used in detecting, preventing, and reducing falls among elderly patients. The article shows that sensor technologies have a high level of accuracy in fall detection. The results also show that the technology reduces the workload for healthcare providers. It also shows that the use of sensor technologies for fall prevention is a feasible project in acute care settings, including those involved in the care of patients with dementia.
3. Boutella et al. (2019)	Covariance matrix-based fall detection from multiple wearable sensors	Peer-reviewed journal	This article is relevant to the proposed project, as it shows that health information technologies are effective in fall detection and prevention. The article shows that automatic fall detection systems are easy to use and provide highly accurate data that can aid the promotion of safety in healthcare by preventing falls.
4. Gettel et al. (2021)	Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review	Peer-reviewed journal	This article relates to the healthcare improvement project by showing the effectiveness of healthcare technologies in fall prevention in elderly patients with dementia. The article shows that the technologies improve function, cognitive status, psychosocial status, caregiver burden, and home safety.
5 Potter et al. (2017)	Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.	Peer-reviewed journal	This article relates to the project, as it explored the effectiveness of sensor technologies in preventing falls in acute care settings. The article shows that sensor technologies have enhanced efficiency over fall alert systems. It also shows that healthcare technologies in fall prevention are viable in healthcare settings.
6 Subermaniam et al. (2017)	The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients.	Peer-reviewed journal	The article relates to the project by examining healthcare technologies in fall prevention among elderly patients. The article shows that technologies have enhanced effectiveness in accurately detecting bed absence episodes. The technologies also reduced workload scores. The rate of acceptability of the technologies is high among nurses.
7 Sun & Sosnoff (2018)	Novel sensing technology in fall risk assessment in older adults: A systematic review	Peer-reviewed journal	The article relates to the project by showing that healthcare technologies such as sensors effectively reduce the risk of falls among older adults. The technologies provide accurate, inexpensive, and easy methods to prevent falls.

Scholarly Source Synthesis

All the selected articles for the synthesis recognize that falls in elderly patients and those with dementia are critical health concerns with adverse health effects.

The sources further identify that falls and related injuries are preventable and predictable. Falls can be detected and prevented using interventions that aim at modifiable risk factors that predispose patients to falls, such as mobility, balance, and muscle strength (Sun & Sosnoff, 2018).

Effective adoption of fall prevention programs promotes cost efficiency in healthcare and maximizes the quality of life of patients with dementia.

Most of the selected articles agree that healthcare technologies such as sensors, pressure sensors, ambient motion sensors, and low-cost depth cameras and videos are effective in fall detection and prevention.

For example, Sun and Sosnoff (2018) assert that technologies provide accurate data to determine fall’ risk assessment and alert nurses about the need for responsive actions to prevent falls.

Despite evidence about the effectiveness of technologies in fall prevention, minimal interventions have to examine their use in the acute care of elderly patients.

In addition, limited evidence exists on the use of the technologies in undertaking fall risk assessment (Sun & Sosnoff, 2018). Subermaniam et al. (2017) provide similar assertions in their study that wireless modular bed absence sensor devices accurately detected bed absence episodes in geriatric inpatients and alerted nurses accordingly.

The authors found that the technology had 100% sensitivity and a 68% positive predictive value.

The technology further reduced the workload score by the end of the intervention, with 83% of the nurses considering it an effective tool for fall prevention.

However, the difference between the study by Subermaniam et al. (2017) and Sun & Sosnoff (2018) lies in the methodologies where the former used a two-part, uncontrolled study design while the latter was a systematic review.

The study by Potter et al. (2017) evaluated the effectiveness of sensory technology in detecting a risk of falls and preventing falls in acute care.

The study showed themes that included reducing fall rates and total patient-bed days.

The study also revealed the theme of enhanced efficacy of the sensory systems over the standard fall alert systems in fall detection and prevention in acute care settings.

As a result, the researchers recommended adopting fall prevention systems, as they are viable in healthcare organizations.

The systematic review by Bezold et al. (2021) also revealed a similar theme. The use of healthcare technologies in fall detection and prevention was to have a high level of accuracy and feasibility in elderly adults, irrespective of their cognitive status.

Unlike Potter et al. (2017), Bezold et al. (2021) identified factors such as the location of the sensors, type, and attachment to affect the accuracy of detection and alerts by the adopted healthcare technologies.

Gettel et al. (2021) investigated the effectiveness of ambient-assisted living, fall detection, and dementia care technologies in promoting safety in dementia care.

The study revealed themes that included improved function, cognitive and psychosocial status, caregiver burden, and home safety using the technologies.

The others, however, noted the need to consider barriers to the use of technologies in fall detection and prevention, such as privacy concerns, willingness to accept assistance, and suboptimal user experience (Gettel et al., 2021).

D157 IZM 1 MANAGNG RESOURCES IN THE ERA OF DISRUPTION

Human Resource Management

The design and implementation of a health improvement project require a careful plan formulation that considers several aspects, such as management of the whole project. The implication is that a well-crafted document should be a guiding light (Scott et al., 2020).

This is a potential project to help decrease the incidents of patient falls among elderly individuals in the medical-surgical unit of Kindred Hospital. And this current write-up explores various aspects of this project, such as human resource management, project team member engagement, financial resource management, and project charter.

The human resource is an integral part of any project, and therefore appropriate staffing requirements should timeously be considered and addressed to ensure that the project is a success (Zaid et al., 2018).

Staffing: Therefore, this section discusses the staff requirements and strategies of allocating and assigning the human resource. This project is to be implemented among elderly patients with dementia to prevent them from falling or reduce the incidences of falls.

Therefore, various staff with specific specialization will be needed. The required staff includes a unit preceptor, nurse leader, and nurse manager. Since they have a higher leadership power and high interest, these staff can substantially contribute to the project’s success.

By their experience, these staffs have extensive experience in change initiation and project implementation in healthcare settings.

The chosen staff have various roles and expectations. The nurse manager uses the extensive skills and experience acquired in managing various change projects in nursing and the obtained understanding of the system to fulfill the responsibilities (Caramanica & Spiva, 2018).

The nurse manager has various roles, such as coordinating the whole project. The implication is that the nurse manager will ensure that the expected deliverables are within the projected time frame achieved by the team.

The nurse leader uses the influence held in the organization to motivate and lead the organization’s employees to accept and embrace the targeted behaviors and actions for the project’s success (Harvey et al., 2020).

Therefore, the primary responsibility of the nurse leader is to motivate every organization’s staff to adopt the desired change and lead everyone in implementing the necessary best practices that are key to the success of the project.

By their experience, preceptors have extensive knowledge in working with interprofessional teams in various healthcare initiatives, such as implementing best practices (Spiva et al., 2017).

The preceptor plays a vital role in the project’s implementation phase. The key responsibility of the preceptor is to lead the inter-professional teams during the project implementation.

In addition, the preceptor will avail the strategies assessment data to ensure that the team achieves the expected outcomes.

Costs:

There are costs associated with the health improvement project for the project’s success related to the roles, personnel, projected hours, and salaries. The project’s duration is to take six months for full implementation. The projected salary for the staff is $10,000 monthly, resulting in a total of $60000 for the whole duration.

Project Team Member Engagement

Recruitment Strategies

The engagement of the project team member is vital for the successful implementation of the project. Therefore, it is essential to timeously identify the project team members and develop appropriate strategies to engage them (Fischer et al., 2017).

Various strategies in recruiting additional project team members are as follows; One of the strategies is holding a consultative meeting with the current team members to identify roles that need the project’s success effectively.

Such meetings can be vital in ensuring that role overlap is eliminated and specialization for better outcomes is actualized. It is vital to undertake team-building with the team members in place. Therefore, various strategies for team building, such as coaching, entails using the expertise of a professional or a senior person in a particular role to train the staff on how to accomplish particular tasks (Shirley, 2020).

It is also essential to establish trust among the team members to ensure that everyone fulfills their roles accordingly. Collaboration is critical, and therefore, as part of team building, the staff will be encouraged and empowered to collaborate and accomplish tasks within the defined time frame.

As part of the project team member engagement, various team guidelines will be used and will form part of the project. For instance, decision-making will guide the team into making the right choices during the project implementation process.

Conflict management will also form part of the guidelines. For example, a clear channel of managing any potential conflict during the project implementation will be made clear and form part of the team guidelines (Sipes, 2019). For example, the nurse manager will only be involved in conflict management if the nurse leader has tried, and apparently, the conflicts remain unsolved. Again, it will be critical to keep communication channels active and open. The staff will know how to channel their communication and the steps they should take when communicating issues dealing with the organization and the project implementation.

D(i). Support for Team Members

The success of the project depends on various aspects. One of such aspects is ensuring that the work environment is healthy and that the members achieve a work-life balance.

Thus, it is necessary to support the project team members and staff during the implementation using evidence-based strategies.

One of the strategies includes asking for their views and implementing them if necessary. Their views into the project’s day-to-day running feel appreciated and experience a better work-life balance (Soomro et al., 2018).

Another strategy is a regular review of the workload as this will prevent various negative distractions such as burnout which can hinder the project’s progress (Okoroafor et al., 2019). In addition, it gives a chance to redistribute workloads and potentially hire a new member for better implementation.

They encouraged the team members to take a break where necessary is another crucial aspect of ensuring that they have a better work-life balance (Soomro et al., 2018). Creating and making open communication channels can also be critical in this regard.

The team member will effectively air out their concerns, thoughts, and grievances, which could be vital in implementing the whole project. The Health Improvement Project RACI chart is an essential document for this project as it shows the detailed roles and responsibilities of various team members; the chart is in the appendices.

D(ii).

RACI Chart (Please see Appendix E)

Financial Resource Management

Budget Methods and Requirements (F and F1)

It is essential to manage financial resources appropriately. The financial resource management section documents the financial methods applied in formulating the operating budget to plan the HIP’s control and implementation phases and the input from various project team members who helped influence the budgeting process.

The financial method used in creating the pro forma invoice is activity-based budgeting. This financial method entails a top-down approach where the team analyzes activities and uses the analysis to predict the future costs and operating budget (Jones et al., 2018).

So, it takes place in three different phases: identifying, determining, and estimating. One team member who dramatically influences the budgeting process is the nurse manager.

Nurse Managers have vast experience in project management and implementation and all the financial aspects involved. So, the nurse manager was vital in helping identify the key areas to spend the money and the line-item financial estimates to the pro forma budget.

The process used in the financial estimates was through thorough research on the current market prices of various items and services. There was also a collaboration with various staff and team members. The nurse preceptor was particularly crucial in this aspect, drawing from a vast experience of the market and the overall costs.

SME/Preceptor/Team used that hourly wage and combined the knowledge to determine how many hours each phase would take to determine the hours required for training to determine the cost of each staff member. The same team also collaborated through online market search to determine the costs of each line item. The purchasing department was tasked with buying all items needed to accomplish the project

The control phase is vital for the project as it shows how the project is to be sustained. It is important to note that activity-based budgeting was used in this phase too. The nurse leader was instrumental in coming up with financial estimates for the project’s control phase.

The project Pro Forma operating budget has been included as part of the appendix and explains various parts such as the budget items, amount for each item, and the description of each item.

Budget Variances

Budget variance can come with anxiety and threaten the successful completion of a project as it can either be unfavorable due to high cost or favorable, implying more revenue. Therefore, it is essential to track and manage such variance.

One way of tracking and managing the variance is regularly running a budget to report (Jones et al., 2018). This will ensures that the team keeps updated on the variance to spot trends and possible trouble spots timeously.

It will ensure that variance does not occur. Budget adjustment can also be essential. The implication is that the budget can be adjusted mid-way to ensure that the variance does not occur.

Project Charter

The project charter section focuses on various aspects such as justification for the project, the project summary, the project’s objectives and constraints, the high risks, budget overview, and the schedule of milestones summary (Sipes, 2019).

STRIDE Early Mobility program entails using a walking program among the patients at risk of falling. This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital. The project charter is in Appendix H.

Healthcare Improvement Project Charter (Appendix H)

Justification

This project STRIDE, Early Mobility program help, reduce the rates of falls among patients with dementia. Older individuals living with dementia are always at risk of fallings and ensuring consequences.

In addition, these patients with dementia experience twice the rates of falls experienced by cognitively intact individuals, and they have more injurious falls.

Elderly patient falls among patients with dementia can lead to enhanced institutionalization rates, mortality, and morbidity. Therefore, there is always a need to develop various strategies to prevent such falls.

While some interventions have been successful to a degree, there is a need to develop better methods of controlling these falls. Therefore, this project will focus on lowering the rates of falls among patients with dementia.

The targeted intervention is the STRIDE Early Mobility program.

STRIDE Early Mobility program entails using a walking program among the patients at risk of falling.

This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital.

Project Goal and Outcome Statement

The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.

The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.

Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.

Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.

The project will start in December and end in November next year. Some of the anticipated challenges to the project may include getting adequate institutional and provider support, sustaining the project interventions, and effective implementation of health information systems to prevent and reduce the risk of falls in the organization.

Project Milestones

The project is to start on October 2, 2021, and end by graduation date after September 30, 2022

Project Budget

For successful completion of the project, finance will be critical, hence formulating a budget with the main project expenses and the total anticipated expenses, as such, various budget items in this section.

One of the necessary budget items includes Research sources and preparation of interview questions and questionnaires, projected to cost $1000.

The other item is telephone expenses and transport allowance, which cost $700. It will ensure effective communication and collaboration between the stakeholders and the team members. The next item covered in the budget is teaching and educating staff on the STRIDE Early Mobility program. There will be a need to hire experts who can train the staff.

Therefore, the expected cost is $3000. Another $800 allowance for stakeholders working overtime and another $900 for Project monitoring and the total cost will be $6400.

Significant Risks

Risks While the project can give better outcomes among the participants, there are also possible risks; one of the possible risks is a possible injury to the participants caused by the STRIDE program as the participants will have to participate in the daily walks program. Such a walking requirement may prove challenging to individuals with dementia who are already frail.

Conclusion

In conclusion, the success of a health improvement project largely depends on the implementation plan put in place.

Therefore, a good plan is critical. Phase two of the project has mainly dealt with planning. Various aspects have been addressed and discussed, such as human resource management, project team member engagement, financial resource management, and project charter.

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Appendix “A”

Individuals Consulted

Nurse Manager

Nurse Leader

Unit Preceptor

Appendix” B”:

Impact Analysis

Benefits:

Category	Improvement Project Benefits	Rating
Patient Safety	1. Reduction in adverse events due to falls among patients with dementia. 2. Provision of patient-centered care that minimizes the risk of falls and other safety events in dementia care	3 3
Healthcare efficiency	3. Reduction in costs incurred by patients and healthcare institutions due to patient falls. 4. Reduction in resource utilization due to decreased hospital stay and demand for specialized care by dementia patients	3 3
	*Total Benefits Score*	12

Risks:

Category	Improvement Project Risks	Rating
Patient safety	1. The project may increase the workload for healthcare providers due to the increased need for additional care	1
	2. The project may cause reluctance among healthcare providers due to an increase in false-alarm rates for potential circumstances related to falls	1
Healthcare efficiency	3. The project may cause increased costs incurred by the hospital due to the need for additional purchases and hiring more staff. 4. The organization may incur losses should the project fail to achieve its objectives.	1 1

Total Risk Score 4

Impact Ratio

Impact Ratio = __3___ [Benefits Rating total score divided by Risks Rating]

Appendix “C”

SWOT Analysis

	Factors to Maintain	Factors to Address
Internal Criteria	Strengths	Weaknesses
I. Morale, Commitment, Leadership II. Experience, Knowledge, and Data	(i) Effective clinical and educational training/support. (ii) Dedicated, Collaborative, and devoted Leadership/Management team. (i) Evidenced-based research to support system processes. (ii) Mandatory in-service and continuous training to maintain staff competency	(i) Leadership appears not to address this with the staff worsening the problem. Communication from leadership needs to improve. (ii) Poor staffing: staff does not feel leadership understands their work demands, works much overtime, and has a poor work-life balance. (i) Inconsistency of all team players to consistently follow the bundle as taught. (ii) The staff are not aligning and complying with the training policy.
External Criteria	Opportunities	Threats
I. Stakeholder Involvement” II. Innovation and Development of Knowledge.	(i) Introduction of modern technology improve patient care, which encourages the Stakeholders (patients) (ii) Inputs from diverse stakeholders can provide data for continual improvement. (i) Variety of best practice suggestions from multiple stakeholders. (ii) Positive input of innovation in modern healthcare management	(i) The Stakeholders (patients) may be discouraged if the entire project fails. (ii) Monitoring agencies can sanction improper conduct, undermining patient trust and decreasing patronage. (i) Multiple stakeholders may lead to consistent disagreement on the data due to multiple studies that may conflict. (ii) Tasks/care may be delayed due to needed new equipment and training.

Appendix “D”

SMART+C Goal and Outcome Statement

SMART+C Criteria

Questions

SMART+C Criteria

Answers

Specific: What is the specific project?	Prevention and reduction of falls among patients with dementia through the implementation of the STRIDE program.
Measurable: What are the indicators or parameters that will be measured?	Rates of falls among patients with dementia Costs of care incurred by patients with dementia Average hospital stays by patients with dementia The medical-surgical fall rate is 12 per year, with a monthly average fall rate of 1 per month. The number of falls will be tracked and trended monthly after implementing the STRIDE program, hoping to reduce the falls by 30%.
Achievable: How feasible or realistic is the project?	Evidence-based data on the possible interventions for use exists. The interventions apply to any clinical setting. Yes, when connected to the Impact Analysis with an impact ratio of 1:50, this healthcare improvement project is good because the benefits outweigh the risks. The SWOT analysis supported the implementation of the project after comparing the strengths and opportunities that were advantageous towards the project. The need analysis highlighted that the number of falls continues to be a costly problem within the organization that needs addressing to reduce costs to the company and improve patient outcomes.
Relevant: How worthwhile is the project to the organization?	The project is worthwhile for the organization. It will reduce the rate of falls among patients with dementia It will also reduce the cost of care for patients with dementia It will also improve the safety, quality, and efficiency of care It will also heighten its market visibility
Time-Bound: What are the start and end dates of the project?	The project is expected to start on October 2, 2021, with the implementation occurring after my graduation date, which is after May 31, 2022. The end date will be September 30, 2022.
Challenging: What is challenging about the project?	To decrease elderly patient falls by 30% on the medical-surgical unit over the six months of data collection. Getting support from the healthcare providers Getting adequate support from the hospital Sustaining the use of the project interventions in the organization Implementation of health information systems to be used in detecting and preventing falls among hospitalized patients
SMART+C Project Goal:
This project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to JULY 30, 2022, through the implementation of the STRIDE Early Mobility program.
Goal Outcome Statement:
The project’s outcome is the reduction in the rate of falls among patients with dementia. The secondary outcomes include the reduction in the costs incurred by patients with dementia, hospital stay, and improvement in the overall efficiency in the institution. The project aims to decrease elderly patient falls on the Medical-Surgical Unit by 30%, beginning October 2, 2022, to July 30, 2022, through the implementation of the STRIDE Early Mobility program.

Appendix E

Table of Scholarly Sources

First Author and (Publication Year)	Scholarly Source Title	Type of Scholarly Source	Relevance
1. Behera et al. (2021)	State-of-the-Art Sensors for Remote Care of People with Dementia during a Pandemic: A Systematic Review	Peer-reviewed journal	This article is relevant to the proposed project, as it explores the benefits of using health information technologies in promoting safe inpatient care. It explores the benefits of technology use in detecting and preventing patient falls. It also provides insights into the factors for the effective use of health information systems of patients with dementia.
2. Bezold et al. (2021)	Sensor-based fall risk assessment in older and aged adults with or without cognitive impairment: A systematic review	Peer-reviewed journal	This article is relevant to the proposed project as it shows the efficiency associated with technologies used in detecting, preventing, and reducing falls among elderly patients. The article shows that sensor technologies have a high level of accuracy in fall detection. The results also show that the technology reduces the workload for healthcare providers. It also shows that the use of sensor technologies for fall prevention is a feasible project in acute care settings, including those involved in the care of patients with dementia.
3. Boutella et al. (2019)	Covariance matrix-based fall detection from multiple wearable sensors	Peer-reviewed journal	This article is relevant to the proposed project, as it shows that health information technologies are effective in fall detection and prevention. The article shows that automatic fall detection systems are easy to use and provide highly accurate data that can aid the promotion of safety in healthcare by preventing falls.
4. Gettel et al. (2021)	Dementia Care, Fall Detection, and Ambient-Assisted Living Technologies Help Older Adults Age in Place: A Scoping Review	Peer-reviewed journal	This article relates to the healthcare improvement project by showing the effectiveness of healthcare technologies in fall prevention in elderly patients with dementia. The article shows that the technologies improve function, cognitive status, psychosocial status, caregiver burden, and home safety.
5 Potter et al. (2017)	Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care.	Peer-reviewed journal	This article relates to the project, as it explored the effectiveness of sensor technologies in preventing falls in acute care settings. The article shows that sensor technologies have enhanced efficiency over fall alert systems. It also shows that healthcare technologies in fall prevention are viable in healthcare settings.
6 Subermaniam et al. (2017)	The Effectiveness of a Wireless Modular Bed Absence Sensor Device for Fall Prevention among Older Inpatients.	Peer-reviewed journal	The article relates to the project by examining healthcare technologies in fall prevention among elderly patients. The article shows that technologies have enhanced effectiveness in accurately detecting bed absence episodes. The technologies also reduced workload scores. The rate of acceptability of the technologies is high among nurses.

Appendix F

Healthcare Improvement Project

RACI Chart

HIP Roles & Responsibilities Matrix	ROLES
	Nurse Manager, DS	Nurse leader, GC	Unit Preceptor, BA	Nurse Educator, SA	Nurse, HF
Coordination of the whole project	AI	R	C	C	I
Review of research	AI	R	C	C	C
Presentation development	AI	R	C	C	C
Approval of the intervention plan	A	RA	C	C	CI
Reviewing of the information provided	R	R	A	I	C
Project implementation	RA	R	C	C	I
Presenting the health improvement project to the staff	A	R	R	R	R
Requesting feedback from staff	A	R	C	I	I
Verification of staff compliance	I	RA	I	C	I
Data review	R	R	R	I	I
*In the empty boxes above, enter the appropriate letter for the role that will be Responsible, Accountable, Consulted, or Informed for each deliverable/task using the letters below:*
R = Responsible for completion of task or deliverable
A = Accountable for completion and approval of the task
C = Consulted by those responsible for advice and expertise
I = Kept updated on progress and notified when tasks are completed

From <https://westerngovernorsuniversity-my.sharepoint.com/personal/makino2_student_wgu_edu/Documents/D157%20RACI%20Chart%20_Filled%20.docx>

Appendix G

Healthcare Improvement Project

Pro Forma Operating Budget

Budget Item	Budget Amount	Description	Comments
Research sources and preparation of interview questions and questionnaires	$1000	This budget item covers valuable literature research materials that need to be purchased. It will also help in preparing interview questions and questionnaires to be applied in project evaluation and assessment.	The sources will be valuable in offering evidence and the use of the STRIDE Early Mobility program. The questionnaires and interview questions will also offer valuable information regarding the study.
Telephone expenses and transport allowance	$700	This budget covers the travel and telephone costs for all the team members as they will need to travel to the practice site, meet each other, and conduct interviews.	Constant and frequent conversation and connection between the team members is critical for the project’s success, hence the transport and telephone call allowance.
Allowance for stakeholders working overtime	$800	This budget will cover the costs for working extra time or up to late hours if need be. They will need to get an allowance for fuel and motivation	This item is vital as it will show that these individuals are appreciated, hence enhanced motivation
Teaching and educating staff on the STRIDE Early Mobility program	$3000	This item will cover the training of the staff taking care of the dementia patients prone to falls for successful implementation of the program.	Training and education are key as it not only ensures that the staff are knowledgeable about the program but also makes them embrace it and feel confident using and following the program.
Project monitoring	$ 900	This will cover the monitoring phase of the project to determine sustainability.	Monitoring project after implementation is key as it ensures that the team can effectively determine how sustainable to project is

From <https://westerngovernorsuniversity-my.sharepoint.com/personal/makino2_student_wgu_edu/Documents/D157%20Pro%20Forma%20Operating%20Budget.docx>

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Healthcare Improvement Project Charter (Appendix H)

Justification

In addition, these patients with dementia experience twice the rates of falls experienced by cognitively intact individuals, and they have more injurious falls.

This patient falls among patients with dementia can lead to enhanced institutionalization rates, mortality, and morbidity. Therefore, there is always a need to develop various strategies to prevent the incidences of such falls.

The targeted intervention is the STRIDE Early Mobility program.

STRIDE Early Mobility program entails using a walking program among the patients identified to be at risk of falling.

This intervention is suitable for older individuals. It involves a one-time balance and gait assessment, accompanied by daily walks, usually supervised by specialists while in the hospital.

Project Goal and Outcome Statement

The specific project entails using health information technologies to prevent and reduce the rate of falls among patients with dementia.

The project aims at achieving measurable goals that include a reduction in the rate of falls among patients with dementia, costs incurred, and average hospital stay by these patients.

Evidence shows that adopting interventions to reduce and prevent patient falls enhances patient care safety, quality, and efficiency.

Patients with dementia are highly predisposed to falls. Therefore, the project is relevant, as seen from its focus on addressing the issue of falls among dementia patients.

Project Milestones

The project is to start on October 2, 2021, and end by graduation date after September 30, 2022

Project Budget

One of the necessary budget items includes Research sources and preparation of interview questions and questionnaires, projected to cost $1000.

Therefore, the expected cost is $3000. Another $800 allowance for stakeholders working overtime and another $900 for Project monitoring and the total cost will be $6400.

Significant Risks

Risks

While the project can give better outcomes among the participants, there are also possible risks; one of the possible risks is a possible injury to the participants caused by the STRIDE program as the participants will have to participate in the daily walks program. Such a walking requirement may prove challenging to individuals with dementia and are already frail.

MARIAN ADENIKE AKINOLA

IZM1 â€” IZM1 TASK 1: HEALTHCARE IMPROVEMENT PROJECT PHASE 2 – PROJECT PLANNING
MANAGING RESOURCES IN AN ERA OF DISRUPTION â€” D157

PRFA â€” IZM1

TASK OVERVIEWSUBMISSIONSEVALUATION REPORT
COMPETENCIES
INTRODUCTION
REQUIREMENTS
RUBRIC
SUPPORTING DOCUMENTS
COMPETENCIES
7073.3.1 : Workforce Development

The graduate promotes a healthy work environment by developing programs to mitigate workplace behavior problems and enhance work-life balance.

7073.3.2 : Team Building

The graduate designs team-building experiences that promote high-performance teams where members trust each other and have the synergy to work together toward common goals.

7073.3.3 : Fiscal Planning

The graduate collaborates with key stakeholders to plan for the use of available resources needed to achieve project aims and goals.

7073.3.4 : Human Resource Planning

The graduate applies human resource principles and practices when developing a project charter that includes planning for adequate human resources for a healthcare improvement project.

INTRODUCTION
Note: You must have completed and passed the performance assessment and clinical practice experience (CPE) for D156: Business Case for Healthcare Improvement prior to beginning this performance assessment.

After your first course, the remaining specialty courses through your capstone will have a summative assessment that consists of an authentic performance assessment that scaffolds the tasks of the healthcare improvement project (HIP) proposal through the project management lifecycle phases of project initiation, planning, implementation, and evaluation. Each performance assessment will focus on aspects of the proposal you will develop for a healthcare improvement project using a real-world approach to improving healthcare. Each phase will be described in different sections of a Healthcare Improvement Project (HIP) paper.

In D156, you initiated your healthcare improvement project (HIP) by completing a needs assessment and a business case analysis to determine the feasibility of your proposed HIP.

In this assessment, you will leverage your previous coursework and project activities while continuing to build on your project plan. Collaborate with your project team, specialized experts in your field of interest, or colleagues from your current or former organization to gain competence in key planning components, including identification of additional project team members, establishment of team member roles and responsibilities, attainment and allocation of financial resources required to support your project, and completion of a project charter.

This task requires the submission of your entire HIP paper template including the following section(s) of your HIP paper which you will be developing in this performance assessment:

â€¢ â€œHuman Resource Managementâ€

â€¢ â€œProject Team Member Engagementâ€

â€¢ â€œFinancial Resource Managementâ€

â€¢ â€œProject Charterâ€

The following templates should be completed and submitted as appendices to your HIP paper:

â€¢ â€œHealthcare Improvement Project RACI Chartâ€ (Appendix E)

â€¢ â€œHealthcare Improvement Project Pro Forma Operating Budgetâ€ (Appendix F)

â€¢ â€œHealthcare Improvement Project Charterâ€ (Appendix G)

During your clinical practice experience (CPE), you will be evaluated on whether the elements found within the â€œRACI Chartâ€, â€œProject Charterâ€, and â€œPro Forma Operating Budgetâ€ are completed. The CPE provides you an opportunity to practice and improve these items before including them in your performance assessment. In this task, these elements will be evaluated on content and quality of completion.

REQUIREMENTS
Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. The originality report that is provided when you submit your task can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Tasks may not be submitted as cloud links, such as links to Google Docs, Google Slides, OneDrive, etc., unless specified in the task requirements. All other submissions must be file types that are uploaded and submitted as attachments (e.g., .docx, .pdf, .ppt).

Complete the â€œHealthcare Improvement Project (HIP) Planningâ€ section of your healthcare improvement project (HIP) paper by completing the following:

Human Resource Management

A. Discuss how you projected staffing requirements and the process that would be used for assigning and allocating personnel for the project. Include the following in your discussion:

â€¢ number of staff

â€¢ justification for number of staff

â€¢ staff roles and expectations

B. Provide a projection of personnel costs related to the HIP that include roles, number of personnel, number of projected hours, and salaries

Project Team Member Engagement

C. Describe the strategies that could be used to recruit additional project team members, including the following elements:

â€¢ team-building strategies (collaboration, establishing trust, coaching)

â€¢ team guidelines (communication, conflict management, decision-making)

D. Explain how you could support project team members and staff during implementation, using evidence-based initiatives, to promote a healthy work environment and work-life balance.
E. Submit the completed â€œHealthcare Improvement Project RACI Chartâ€ supporting document, which should include the following elements:

â€¢ all the major deliverables that must be completed before implementing the project

â€¢ the role titles of project team members as column headers

â€¢ the role each member has for these tasks using the initial of the RACI definitions (i.e., responsible, accountable, consulted, and informed)

Financial Resource Management

F. Describe the financial methods used to create a pro forma operating budget for planning the implementation and the control phase of your HIP, and include any input from project team members who influenced the budgeting process.

1. Explain the process used to procure the line-item financial estimates for your pro forma budget, including examples of collaboration with project team members who were essential for identifying expense items and estimating the needed financial resources.

G. Submit the completed â€œHealthcare Improvement Project Pro Forma Operating Budgetâ€ supporting document, which should include the following elements:

â€¢ 5 budget items

â€¢ amount for each item

â€¢ description of each item
H. Discuss how budget variances would be tracked and managed.
Project Charter

I. Submit the completed â€œHealthcare Improvement Project Charterâ€ supporting document, which must include the following elements:

â€¢ justification for the project

â€¢ summary of the project

â€¢ objectives and constraints of the project

â€¢ identified high risks

â€¢ budget overview

â€¢ summary schedule of milestones

J. Incorporate the following components of APA style and formatting into your paper:

â€¢ bias-free language

â€¢ objectivity, credibility of sources, and evidence-based approach

â€¢ APA-specific rules regarding verb tense, voice, and perspective

â€¢ a title page and headers

â€¢ APA-specific formatting rules for in-text citations and references, margins, spacing, numbering, and indentation for the title page, main body, and appendices of your paper, including headers, bulleted and numbered lists, and tables and figures

K. Demonstrate professional communication in the content and presentation of your submission.
File Restrictions
File name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRIC
A:PROJECTED STAFFING REQUIREMENTS
NOT EVIDENT

A discussion of how the candidate projected staffing requirements were determined is not provided.

APPROACHING COMPETENCE

The discussion addresses how the candidate projected staffing requirements, but the discussion does not accurately detail the process that would be used to assign or allocate personnel for the project. Or the discussion does not include 1 or more of the given elements.

COMPETENT

The discussion addresses how the candidate projected staffing requirements and accurately details the process that would be used to assign and allocate personnel for the project. The discussion includes all the given elements.

B:PERSONNEL COSTS
NOT EVIDENT

A projection of personnel costs related to the proposed HIP is not provided.

APPROACHING COMPETENCE

The projection of personnel costs related to the proposed HIP is provided, but the costs are inflated, far too low, or otherwise impractical. Or the submission does not clearly define costs, including roles, number of personnel, number of projected hours, or salaries.

COMPETENT

The projection of personnel costs related to the proposed HIP contains practical and clearly defined costs, including roles, number of personnel, number of projected hours, and salaries.

C:RECRUITMENT STRATEGIES
NOT EVIDENT

A description of strategies that could be used to recruit additional project team members is not provided.

APPROACHING COMPETENCE

The description of the strategies that could be used to recruit additional project team members is illogical, or 1 or more of the given elements are not addressed or not appropriate.

COMPETENT

The description of the strategies that could be used to recruit additional project team members is logical and appropriately addresses all the given elements.

D:PROJECT TEAM SUPPORT
NOT EVIDENT

An explanation of how the project team could be supported during implementation is not provided.

APPROACHING COMPETENCE

The explanation of how the project team could be supported during implementation is not well supported using evidence-based initiatives or will not contribute to a healthy work environment or work-life balance.

COMPETENT

The explanation of how the project team could be supported during implementation is well-supported using evidence-based initiatives that will contribute to a healthy work environment and work-life balance.

E:RACI CHART
NOT EVIDENT

A RACI Chart is not submitted.

APPROACHING COMPETENCE

The RACI Chart is submitted, but 1 or more of the elements of the RACI Chart are either missing or irrelevant to either the organization or the HIP.

COMPETENT

A completed RACI Chart is submitted, and all elements of the RACI chart are relevant to the organization and the HIP.

F:OPERATING BUDGET METHODS
NOT EVIDENT

A description of the financial methods used to create a pro forma operating budget for the planning of the implementation and control phase of the proposed HIP is not provided.

APPROACHING COMPETENCE

The description of the financial methods used to create a pro forma operating budget for the planning of the implementation and control phase of the proposed HIP is not rational. or does not include input from project team members who influenced the budgeting process.

COMPETENT

The description of the financial methods used to create a pro forma operating budget for planning of the implementation and control phase of the proposed HIP is rational and includes input from project team members who influenced the budgeting process.

F1:BUDGETARY REQUIREMENTS
NOT EVIDENT

An explanation of the process used to procure the line-item financial estimates for the pro forma budget is not provided or does not include examples of collaboration with project team members.

APPROACHING COMPETENCE

The explanation of the process used to procure the line-item financial estimates for the candidateâ€™s pro forma budget is missing important details, or any of the examples of collaboration with project team members are with team members who are not relevant or critical to identifying expense items and estimating the needed financial resources.

COMPETENT

The explanation of the process used to procure the line-item financial estimates for the candidateâ€™s pro forma budget includes important details, and all examples of collaboration with project team members are with team members who are relevant and essential to identifying expense items and estimating the needed financial resources.

G:PRO FORMA OPERATING BUDGET
NOT EVIDENT

A â€œHealthcare Improvement Project Pro Forma Operating Budgetâ€ is not submitted.

APPROACHING COMPETENCE

The â€œHealthcare Improvement Project Pro Forma Operating Budgetâ€ is submitted, but 1 or more required elements are either missing or irrelevant to either the organization or the HIP.

COMPETENT

A â€œPro Forma Operating Budgetâ€ is submitted, and all elements are relevant to the organization and the HIP.

H:BUDGET VARIANCES
NOT EVIDENT

A discussion of how budget variances would be tracked and managed is not provided.

APPROACHING COMPETENCE

The discussion of how budget variances would be tracked and managed does not use best budgeting practices.

COMPETENT

The discussion of how budget variances would be tracked and managed using best budgeting practices.

I:PROJECT CHARTER
NOT EVIDENT

A â€œHealthcare Improvement Project Charterâ€ is not submitted.

APPROACHING COMPETENCE

The â€œHealthcare Improvement Project Charterâ€ is submitted, but 1 or more required elements are missing from the document or are not relevant to the candidateâ€™s HIP.

COMPETENT

A â€œHealthcare Improvement Project Charterâ€ is submitted, and all elements are relevant to the candidateâ€™s HIP.

J:APA STYLE AND FORMAT
NOT EVIDENT

The submission does not incorporate the given APA style and format components as described in the current APA manual.

APPROACHING COMPETENCE

The submission does not accurately or consistently incorporate 1 or more of the given APA style and format components as described in the current APA manual.

COMPETENT

The submission accurately and consistently incorporates all of the given APA style and format components as described in the current APA manual.

K:PROFESSIONAL COMMUNICATION
NOT EVIDENT

Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.

APPROACHING COMPETENCE

Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.

COMPETENT

Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.

SUPPORTING DOCUMENTS
HIP Paper Template â€“ Implementation Version.docx
HIP Paper Template â€“ MCA Version.docx

Title of Healthcare Improvement Project

Author Name (First, Middle Initial, Last)
Western Governors University
College of Health Profession
Name of Instructor
Month, Day, Year

Note: This document should be used as a template for your healthcare improvement project (HIP) academic paper. This paper should adhere to the formatting and style standards of the current edition of the American Psychological Association (APA) style manual. Refer to the performance assessment tasks and rubrics for specific instructions on submitting each section of your HIP paper. â€ƒ
D156: Business Case Analysis for Healthcare Improvement
Task 1: Healthcare Improvement Project – Introduction and Project Initiation
Stakeholder Identification
Needs Assessment
Problem Identification
Problem Description
Impact Analysis
SWOT Analysis

Task 2: Healthcare Improvement Project – Project Purpose and Review of Scholarly Sources
Purpose Statement
Review of Relevant Scholarly Sources and Table of Scholarly Sources Template
SMART+C Goal Worksheet (Appendix D)
Project Management Life Cycle
â€ƒ
D157: Managing Resources in an Era of Disruption
Human Resource Management
Staffing
Costs
Project Team Member Engagement
Recruitment Strategies
Support for Team Members
RACI Chart
Financial Resource Management
Budget Methods and Requirements
Pro Forma Operating Budget
Budget Variances
Project Charter
â€ƒ
D158: Strategically Planning the Execution of a HIP
Meetings and Organizational Policies
Action Plan Development
SDOH and Target Population
Force Field Analysis
Gantt Chart Information
Scope Statement
Communication Management Plan

â€ƒ
D159: Evidenced Based Measures for Evaluating Healthcare Improvement
Team Member Collaboration
Data Elements
Data Source
KPI and Benchmarks
Data Collection Method and Parameters
Data Analysis
Results Dissemination Plan
Project Closure Plan
â€ƒ
D160: Nursing Leadership and Management Field Experience
Kick Off Process
Communication Plan Implementation
Training Plan
Training Plan Implementation
Testing of Workflow
Implementation and Control Field Experience
Project Journal
HIP Management
HIP Monitoring
Project Status Meetings
Project Status Alignment

â€ƒ
D161: Nursing Leadership and Management Capstone
Evaluation
Final Status Report
Project Closure and Celebration
Wrap Up Session
Conclusion
â€ƒ
References

â€ƒ
Appendix A

Impact Analysis Template (D156)

Benefits: Identify two categories and two benefits for each category that will be positively impacted by implementing your improvement project. Use a norms-based scale, as a method of quantifying the impact that the benefits will have. Give a â€œ1â€ rating for Low Impact, a â€œ2â€ rating for Moderate Impact, and a â€œ3â€ rating for High Impact. Total these benefit ratings and enter the sum in the â€œTotal Benefits Scoreâ€ cell.

Category Improvement Project Benefits Rating
1
2
3
4
Total Benefits Score

Risks: Using the same categories identified above in the â€œBenefitsâ€ section, identify two risks for each of the two categories that may be negatively impacted by implementing your improvement project. As you did in the â€œBenefitsâ€ section, rate the risks using the norms-based scale of â€œ1â€ meaning Low Impact, â€œ2â€ meaning Moderate Impact, and â€œ3â€ meaning High Impact. Total these ratings and enter the sum in the â€œTotal Risks Scoreâ€ cell.

Category Improvement Project Risks Rating
(copy from above)1
2
(copy from above)3
4
Total Risks Score

Calculate the impact ratio by dividing the benefits total score by the risks total score, then enter that ratio into the table below. Use the criteria in the table below to determine if the benefits outweigh the risks.

Impact Ratio = ______ [Benefits Rating total score divided by Risks Rating total score]

If the ratio is > 1, the benefits outweigh the risks.
If the ratio = 1, there is no difference between the benefits and the risks.
If the ratio is < 1, the risks outweigh the benefits.

Appendix B
SWOT Analysis Template (D156)

A SWOT analysis will help you identify internal and external factors in an organization that may impact the readiness of the organization for an improvement project. At a minimum, identify two internal criteria and two external criteria. Then for the internal criteria, identify two Strengths and two Weaknesses for each of the criteria. For the external criteria, identify two Opportunities and two Threats for each of the criteria. The presence of weaknesses and threats are gaps to be addressed in planning, while the absence of strengths or opportunities clarifies the need for further planning or development before implementation. Click in the following boxes to enter your SWOT factors.

Factors to maintain Factors to address
*Internal Criteria Strengths Weaknesses
I.

II.

What does the organization do well that will help the implementation of the project?

I â€“ A
I â€“ B

II â€“ A
II – B
What does the organization lack that may hinder implementation of the project?

I â€“ A
I â€“ B

II â€“ A
II – B
*External Criteria Opportunities Threats
I.

II.

What external factors help facilitate implementation of your project?

I â€“ A
I â€“ B

II â€“ A
II – B
What external factors hinder implementation of your project?

I â€“ A
I â€“ B

II â€“ A
II – B

*Internal Criteria Examples: collective capabilities; morale, commitment, leadership; governance, participation norms, and defined roles; resources, funding, assets, people; experience, knowledge, data; innovative aspects; collaboration tools; processes, systems, IT, and communications; cultural, attitudinal, behavioral norms; etc.

*External Criteria Examples: Political, legislative, and financial environment; stakeholder involvement; technology development and innovation; development of knowledge; uptake in disseminated knowledge or best practices; etc.

Appendix C
Table of Relevant Scholarly Sources Template (D156)

In-text citation
Scholarly Source Title
Type of Scholarly Source
Relevance

In-text citation to include publication year in parentheses. Title of the journal article, book, or webpage. Peer-reviewed journal article, book, electronic source, etc. Explain how the source is similar and relevant to your proposed project.
â€ƒ
Appendix D

SMART+C Goal Worksheet (D156)

This worksheet is designed to help you create a SMART+C (specific, measurable, achievable, relevant, time-bound, and challenge) goal for your healthcare improvement project (HIP). Answer the following SMART+C criteria questions about your project. Next, synthesize your answers into a SMART+C goal for your project and enter it into the project goal box. Finally, state what the expected outcome will be for your goal.

SMART+C Criteria
Questions SMART+C Criteria
Answers
Specific: What is the specific project?
Measurable: What are the indicators or parameters that will be measured?
Achievable: How feasible or realistic is the project supported by your Impact Analysis and SWOT Analysis?
Relevant: How worthwhile is the project to the organization?
Time-Bound: What are the start and end dates of the project?
Challenge: What is the challenge or stretch goal for your HIP?

SMART+C Project Goal:

Outcome Statement: (What will be the larger outcome for your organization once the HIP has been implemented?)

Appendix E
RACI Chart (D157)
HIP Roles & Responsibilities Matrix ROLES
Role Title Role Title Role Title Role Title Role Title
Deliverable/Task #1
Deliverable/Task #2
Deliverable/Task #3
Deliverable/Task #4
Deliverable/Task #5
Deliverable/Task #6
Deliverable/Task #7
Deliverable/Task #8
Deliverable/Task #9
Deliverable/Task #10
In the empty boxes above, enter the appropriate letter for the role that will be Responsible, Accountable, Consulted, or Informed (based on the following definitions) for each deliverable/task.
R = Responsible for completion of task or deliverable
A = Accountable for completion and approval of the task
C = Consulted by those responsible for advice and expertise
I = Kept updated on progress and notified when tasks are completed

Appendix F

Pro Forma Operating Budget (D157)
Budget Item Budget Amount Description Comments

â€ƒ
Appendix G
Healthcare Improvement Project Charter (D157)

Background
[Why is the project being undertaken? Justify the need for this project and describe the issue or opportunity that the project is to address. Include summary details of the project.]

Project Goal and Outcome Statement
[Insert your SMART+C goal and project outcome statement]

Project Milestones
[Identify the significant project milestones: start date, end date.]

Project Budget
[Describe the main project expenses and total anticipated expenses. If there is funding for the project, identify the source.]

Significant Risks
Risks [What are the most significant risks? What must happen before the project is delivered?]

Appendix H
Action Plan Template (D158)
Action Item Owner Role or Title Five Action Items
(specific, high-level) Phase When Action Item Will Be Completed (e.g., pre-, during, or post-implementation) Target Due Date
1.
2.
3.
4.
5.

â€ƒ
Appendix I
Healthcare Improvement Project
Force Field Analysis Template (D158)

FORCE FIELD ANALYSIS
A force field analysis will help you identify the driving and restraining forces for the implementation of your healthcare improvement project (HIP). In the following table, list three positive forces that may drive the implementation of your project and three negative forces that may restrain it.
3 Positive (Driving) Forces 3 Negative (Restraining) Forces
1.
1.
2.
2.

3.
3.

â€ƒ
Appendix J
Gantt Chart (D158)

â€ƒ
Appendix K
Healthcare Improvement Project
Final Status Report (D161)
PROJECT SUMMARY

REPORT DATE
PROJECT NAME
PREPARED BY

Date Project
Name

PROJECT DESCRIPTION

PROJECT MILESTONES

MILESTONES MAJOR TASKS AND ACCOMPLISHMENTS
Initiation Phase
Planning Phase
Implementation & Control Phase
Evaluation & Closure Phase
BUDGET OVERVIEW

TOTAL BUDGET TOTAL SPENT DIFFERENCE (IF ANY) REASON FOR RESULTS

PROJECT OUTCOME

PROJECT KEY PERFORMANCE INDICATORS

KPIs SUMMARY OF PROJECT PERFORMANCE IN MEETING KPIs