Clinical Improvement Opportunity

Charter Outline- exhibit 7.2 example 9-4-18 screen shots

The exhibits ( Team Charter outline and either Gnatt Chart or Timeline) only need to be 1 page in length at the most. I included an extra page to the total in case more is needed. The research portion needs to be 4 pages.
I have includes examples or Gnatt Chart and Timeline- choose which ever is easiest.


You are the director of quality in a 200-bed hospital. The organization has identified three clinical improvement opportunities: reduce surgical site infections, reduce patient falls, and improve compliance with congestive heart failure clinical guidelines.

For this assignment, select one of these clinical improvement opportunities. Your task, as sponsor and team facilitator, is to develop a robust team charter (see exhibit 7.2 in our textbook).

  • First, research the opportunity you selected to understand how progressive organizations have addressed the challenge.
  • Next, determine and justify the size of the team and identify the specific positions (to include physicians) that you would include as members. Describe the role of each member.
  • Then, craft a robust problem statement and team charter.
  • Finally, create a draft agenda and Gantt Chart or timeline (select just one) for the first meeting of the team.

The paper should be well-written and meet the following requirements:

  • Be four pages in length (excluding title page, reference list, and exhibits)
  • The team charter, Draft Agenda, and Gantt Chart / timeline should be included as exhibits in the paper, but thoroughly discussed and justified in the body of the paper.
  • Includes at least three references from the peer-reviewed articles.

Extra info:

Charter A written declaration of an improvement team’s purpose. (An example of an improvement project charter is found in Exhibit 7.2.)

Sponsor An individual or a group that supports, guides, and mentors an improvement project team; serves as a link to the organization’s leadership; removes barriers; and acquires the resources a team needs to achieve successful outcomes.

Sponsor – Charters the improvement team, provides initial improvement goals, monitors team progress, and supports the team.

Team leader- Coordinates project assignments and communication with external parties, removes barriers, and keeps the project on track.

 Facilitator- Helps manage discussions about the process during team meetings, usually by asking questions (e.g., How do we want to make this decision? What points can we agree on?).

 Recorder- Captures ideas, decisions, action items, and assignments on a flip chart or whiteboard for later transcription into a written summary of the project.

 Timekeeper- Keeps track of time during project meetings Participates in discussions, decision making, and other team tasks such as gathering data, analyzing information, assisting with documentation, and sharing results

The facilitator supports the team leader. The facilitator assists with team-building activities, keeps meeting discussions and the entire project on track, and ensures deadlines are met. The facilitator should be an objective team resource and detached from the process being improved. As a neutral party, the facilitator is particularly effective at engaging everyone on the team and helping the group reach consensus on controversial issues. The facilitator works with the leader to plan meetings, structure tasks and assignments, and incorporate quality improvement tools into the project. The facilitator knows what data to gather, how to gather the data, and how to present the results in a meaningful graphic or tabular form. In cases where the project is not overly complex, one person may assume the dual role of team leader and facilitator. Research suggests, however, that multifaceted health- care improvement projects involving several departments and professions benefit from having a facilitator who is not also responsible for leading the project.

Team members share responsibility for achieving the improvement goal. Members participate in discussions, decision making, and other team tasks such as data collection. Each team member should represent a program, department, or work unit significantly affected by the process to be improved or the problem to be solved. Ideally, team members should have a basic understanding of quality improvement principles, but familiarity with this topic is not a prerequisite for team membership. Inclusion of one or two independents—members with little or no knowledge of the process—can also be useful. Because independents have no vested interest in the problem, they may provide a fresh and creative perspective. Some healthcare improvement projects also benefit from customer input. For example, if a hospital team is working to improve security in the newborns nursery, a woman who recently delivered a baby in the facility can be included as a team member. The recent patient may be made a permanent member of the team or serve part time by attending meetings only when her input is needed.

The sponsor clearly defines the performance problem that needs to be solved by writing a problem statement—a description of the situation. The problem statement influences many aspects of the project, including the makeup of the team and improvement expectations. In addition, a clearly communicated problem statement establishes project boundaries so that problem-solving activities do not escalate into larger issues or wander into unrelated topics. The project goal should include measurable performance expectations. For instance, the manager at Community Hospital hoped to achieve an 80 percent reduction in staff complaints about patient identification bands by making some process changes. The project sponsor sets these expectations and defines the time frame for achieving them. An explicit project goal with clearly stated, measurable expectations and time frames focuses the improvement efforts. Once the goal is clear, the sponsor identifies people who need to be included in the project. If the sponsor already has someone in mind to serve as the team leader, that person may help the sponsor select these key people. The following questions can guide their selection: 

◆ Where is the problem occurring? 

◆ What tasks are involved? 

◆ Who carries out these tasks? 

◆ Who determines how the tasks should be done? 

◆ Who provides the inputs to these tasks? 

◆ Who uses the outputs of these tasks? 

The people chosen for the team should have detailed knowledge through experience with some part of the performance problem. They also must be willing and able to attend team meetings and make time for project work that may need to be done between meetings. Once the project is under way, the team may ask additional members to participate if critical expertise is needed or a key group is not represented. The team should be capped at five to ten members. To keep the team from expanding beyond the preferred size, some individuals may serve as consultants and attend meetings only when their expertise is needed. In an ideal project initiation, the sponsor creates a written charter incorporating all the aforementioned elements: the project goal, a description of the system or process to be improved, the time frame for project completion, deliverables, measures, project scope, and team members. Exhibit 7.2 is a charter for a project aimed at improving the employee hiring process in a county-operated emergency medical service (ambulance) company.

When expectations are unclear or too broad, an improvement project can flounder. At one hospital, for example, staff members voiced concerns about the safety of the process of ordering, dispensing, and administering chemotherapy medications. An interdisciplinary team was chartered, which included representatives from the hospital’s inpatient, out- patient, adult, and pediatric areas (physicians, nurses, pharmacists, and laboratory staff). Over a four-month period, the team developed a top-down flowchart of the process, which ultimately was diagrammed as 21 steps, each with multiple sub-steps. On review, the team realized the enormousness of the project and discovered that each area had its own way of executing tasks. The charter the team developed at the outset of the project was too broad and was stalling the project. The team decided it would address only the adult outpatient population and limited the project to the medication administration phase, where most of the problems were occurring. Once the project scope and focus were better defined, the improvement initiative proceeded more quickly. Charters keep teams focused and on track during projects. Team members may want to revisit the charter periodically to remind themselves of the project’s boundaries and the objectives of the improvement effort. If the team receives new information during the project or if situations change, it may need to renegotiate its objectives or boundaries. The sponsor supports the team throughout the project, monitoring progress and clearing obstacles that may arise. The sponsor acts as a sounding board for improvement ideas but does not become overly involved in the details of the team’s work. At the end of the project, the sponsor reviews the team’s improvement actions and ensures the solutions are effectively implemented.

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