Contemporary Nursing Issues & Management

Continuous improvement plan

The quality improvement plan is intended for application by Glendale Memorial Hospital and Health Center (GMHHC) with regards to two Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores that were significantly lower than the federal and state scores. The first area is quietness at night around the patients’ rooms where the patients noted high noise levels that interfered with their night rest and healing progression. The second area is discharge education and instructions whereby the patients reported that they did not understand the home care needs and requirements even as they left the facility Contemporary Nursing Issues & Management.

Determine and explain who the key stakeholders are.

A stakeholder analysis of GMHHC shows that the medical facility has five key stakeholders; identified on the basis of their influence and response with no reference to their priority address. The first group of stakeholders are the facility owners and shareholders who own the stock and are paid dividends. The shareholders and owners have the most influence in the facility since their ownership allows them to veto key decisions that may include appointment of top management, expansion and so on. The facility responds to the shareholders and owners by regularly updating them on the facility’s performance and paying out dividends at regular intervals. The shareholders consider the response satisfactory when the facility performs well against its competitors and they are paid their dividends even as the value of their shares rises. In addition, they are influenced by the facility in that they expect the management to inform them of what is going on in the facility. It becomes evident that the shareholders are the owners of GMHHC and have a share of the facility’s profits that are presented to them as dividends (Friedman & Miles, 2006; Weiss, 2014).

The second group of stakeholders are the patients and the community that receives medical services from the facility. Similar to the facility shareholders and owners, the patients and community are a high influence and response group. This is because the facility is designed to serve them and their dissatisfaction with any aspect of the facility’s performance will translate to them to present negative reviews even as they switch and patronize other medical facilities. In essence, failure by the facility to closely manage its patients and community will cause its revenues to dip (Friedman & Miles, 2006; Weiss, 2014). Therefore, patients and the community are a high influence and response group who must be closely managed by the facility to ensure that their revenues do not dip.

The third group of stakeholders are the suppliers who include all firms and enterprises that supply the medical equipment and other consumables used at the facility. The suppliers are a low influence but high response group. This is because the facility can easily switch suppliers thereby determining them as low influence, although their failure to meet set terms could translate to low performance by facility thereby identifying them as a high response group. Despite the fact that suppliers are unable to influence facility management direction, they are influenced by being informed of what is going on in the facility and setting succinct contractual terms that clearly state their obligations and penalties for failure to meet them (Friedman & Miles, 2006; Weiss, 2014). In this respect, GMHHC suppliers are identified as low influence and high response stakeholders.

The fourth group of stakeholders are the medical personnel and other employees who are concerned with the daily running of the facility operations and ensuring that the set policies are implemented. Similar to the suppliers, they are a low interest and high influence group of stakeholders. This is because they are not concerned with formulating the facility policies, but are concerned with how the policies will influence the overall facility performance. In fact, the facility’s management informs its employees of any happenings in the facility to ensure they respond favorably (Friedman & Miles, 2006; Weiss, 2014). As a result, GMHHC employees are a low influence and high response stakeholders.

The final group of stakeholders is the government and regulators who include all agencies who give permits and licenses as per the set legislation. As a stakeholder group, the government and other regulators are concerned with licensing the facility as an organization, legitimizing its operations and facilitating business-oriented operations through operational oversight, monetary policies and taxes. They have a lot of influence and response since they can easily alter or even halt the facility’s operations. It becomes clear that their recommendations must be considered by the facility and whatever response they mount be anticipated and preempted (Friedman & Miles, 2006; Weiss, 2014) Contemporary Nursing Issues & Management.

Determine and explain who the participants and recipients are.

Five groups of stakeholders were identified on the basis of interest and influence. Additional review of the stakeholders determines that they can be demarcated as either participants or recipients in the quality improvement project. With regards to participants, the facility owners and shareholders, suppliers, medical personnel and other employees, and government and regulators would be identified as such. That is because they directly contribute to the project. Firstly, the facility owners and shareholders must release funds for the project to proceed, particularly the high cost responses that include purchasing new medical equipment. Secondly, suppliers are responsible for availing the equipment and other consumables used in the project. Thirdly, medical personnel and other employees are responsible for implementing the project in the facility. Finally, the government and regulators are responsible for ensuring that the project with the existing regulations and legislations in mind. With regards to recipients, the patients and community are the recipients since the anticipated changes brought about by the project are intended to change their opinion about the facility and improve their reviews and feedback (Kloppenborg, 2015).

What are the key performance indicators?

It must be noted that the initial quality problems were identified through HCAHPS scores that were gleaned from feedback provided by the patients. As such, the key performance indicator will be how the patients rate the facility in terms of the changes brought about by the quality improvement project. Other performance indicators will be the reviews provided by other stakeholders who are able to objectively evaluate the changes and provided professional opinions devoid of personal influences (Cherry & Jacob, 2013; Marquis & Huston, 2017). For instance, medical personnel and other employees can offer an opinion on how the patients respond to the changes and how the medical statistics have been influenced in terms of re-hospitalization and medication errors.

Determine what the internal and external benchmarks are.

Internal benchmarking refers to how the performance of the different individuals, teams and departments compare within the facility. This is important since it makes it easier to identify the best procedures and practices that would then be disseminated and adopted within the whole facility (Penner, 2013). For instance, if the emergency department reports the best pain management results among its patients then these results would be considered as the benchmark that other departments would be encouraged to similarly achieve. On the other hand, external benchmarking compared the performance of the facility against the performance of other facilities. The facility that reports the best statistical data would then be considered as the benchmark with its practices targeted for adoption by other lower performing facilities (Penner, 2013) Contemporary Nursing Issues & Management.

Identify areas that fall above or below the benchmark level.

A review of HCAHPS scores determined that the GMHHC had three goals of which it achieved one goal but failed to achieve two goals. With regards to the service line quality composite goal, the facility achieved its objective of 60%. Concerning HCAHPS total points goals, and listening and responding to patients’ goal, the facility failed to achieve the desired goals of 37 and 88.70 by scoring 16 and 86.96 respectively. The implication is that of the three benchmarks that the facility had set, it was only able to achieve two of them.

What is the role of the dashboard in achieving the organization’s goal?

A dashboard is a graphic that offers condensed figures for key performance indicators that can be identified at a glance and reviewed in terms of set goals. In terms of achieving the facility goals, the dashboard would offer at-a-glance view of how the facility is currently performing in relation to the benchmarks thus pointing out the specific areas that can be changed to achieve the desired goals (Penner, 2013).


Cherry, B. & Jacob, S. (2013). Contemporary nursing, issues, trends, & management (6th ed.). Amsterdam: Elsevier Health Sciences.

Friedman, A. & Miles, S. (2006). Stakeholders: theory and practice. Oxford: Oxford University Press.

Kloppenborg, T. (2015). Contemporary project management (3rd ed.). Stamford, CT: Cengage Learning.

Marquis, B. & Huston, C. (2017). Leadership roles and management functions in nursing: theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Penner, S. (2013). Economics and financial management for nurses and nurse leaders (2nd ed.). New York, NY: Springer Publishing Company, LLC.

Weiss, J. (2014). Business ethics: a stakeholder and issues management approach (6th ed.). San Francisco, CA: Berrett-Koehler Publishers, Inc Contemporary Nursing Issues & Management.



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