NURS FPX 9100 Assessment 6 Project Charter
Student Name
Capella University
NURS-FPX9100 Defining Nursing Doctoral Project
Prof. Name
Date
| Project Charter Information | Details |
|---|---|
| Project Name | Provider Inbox Management Optimization (PIMO): Creating the Optimal Inbox |
| Project Site | Adelante Healthcare – Adult and Family Medicine |
| Contact at Site | – Name with credentials: Robert Babyar, MD, Chief Medical Officer – Organizational Email: robert.babyar@adelantehealthcare.org – Phone Number: 877-809-5092 |
| Preceptor | – Name with credentials: Adita Flagg – Email: adita.flagg@adelantehealthcare.org – Phone Number: 877-809-5092 |
| Executive Sponsor | Chief Executive Officer (CEO) of Adelante Healthcare – The CEO is the key person responsible for the overall productivity and operation of the company. The CEO is instrumental in providing fiscal, political, and networking support. |
| Gap Analysis | Part 1 Project Charter Information |
| Evidence to Support the Need | Part 1 Project Charter Information |
| PICOT | Part 1 Project Charter Information |
| Stakeholders | Part II Stakeholders |
| Team Leader | Part 1 Project Charter Information |
Gap Analysis
| Gap Analysis | Details |
|---|---|
| Gap Analysis | A January 2023 report revealed 75% of patient messages are not reviewed or addressed in the first three days. The Quality Department identified this problem following an investigation into delayed patient responses. Currently, no response time policy, procedure, or guideline is in place. The practice gap was identified in May 2022, and a root cause analysis was conducted. Appendix A shows a Fishbone diagram for the practice gap. The desired state involves implementing an evidence-based intervention, a response time policy. The 2023 National Patient Safety Goals published by The Joint Commission focus on improving communication among caregivers. Organizations devoting time to optimizing provider inbox management is proven to lead to information overload and has been found to be a leading contributor to job dissatisfaction and provider burnout (Murphy, Satterly, Giardina et al., 2019). |
Evidence to Support the Need
| Evidence to Support the Need | Details |
|---|---|
| Evidence to Support the Need | Reviewing evidence-based interventions for inbox optimization, common themes emerged. Implementing a response-time policy demonstrated improved efficiency among clinical staff, higher patient engagement, increased involvement from nonprovider clinical staff, and timelier messaging and results sharing with patients engaged in portal messaging systems. It is imperative that appropriate policies and procedures are developed and then implemented for governing patient online portal use. The need for policy improvements is corroborated in the study by Hefner et al. (2019), as the researchers describe how policies need to be either revamped or established that require healthcare providers to undertake adequate training and education. Similarly, the findings of Lieu et al. (2019) also support the need for policy improvements that are used to oversee physician-to-physician training, as there are many different strategies that can be employed to improve how physicians manage their inboxes and respond to patients. Reynolds et al. (2021) found that patient portals must offer virtual patient-provider interactions and contextualized medical advice. NURS FPX 9100 Assessment 6 Project Charter Through these initiatives of response time policy creation and implementation, staff training of the organization’s inbox portal, and training on policy requirements, staff will learn how to better manage this patient portal secure messaging to ensure that patients are being responded to in a timely manner. Similarities are seen with Reynolds’ and Lieu’s findings that identify employee training as a crucial component to support policy implementation. Huang et al.’s (2022) study showed differential patient-provider communication patterns across various care settings and practice roles. Findings from this study indicate opportunities for care teams exist to optimize their inbox messaging system, helping to balance the workload and promote optimal efficiency. Securing and implementing policy changes within healthcare facilities focusing on provider training and integrating the latest patient portal messaging systems significantly improves patient safety, treatment delays, and patient satisfaction. Continued implementation and widespread use of response-time policy and adherence to time management expectations |
PICOT
| PICOT | Details |
|---|---|
| PICOT | For staff and providers (P), how does the implementation of a patient-provider response time policy (I) to respond to portal messages compared to the current state (C) affect response times (O) over a two-month period (T)? Project Aim: The aim of the PIMO project is to improve patient-provider response times, achieving or exceeding the time measures as dictated by the policy and decreasing delays in care as measured by the policy description. |
Stakeholders
| Stakeholder | Details |
|---|---|
| C.A. Director of Nursing & Nutrition Services | Project Lead Impact is had through direct involvement in the project to support implementation across both nursing and non-nursing disciplines. Project Lead. Will drive change, implementation, data collection, and analysis. Potential challenges may include scheduling conflicts with colleagues and additional stakeholders as well as potential staff resistance to change. |
| A.F. Director of Quality, Safety & Clinical Risk | Quality, Safety & Risk implications Impact is had through direct involvement in the project to support implementation. Support with implementation roll out in compliance with project site policies, procedures, and guidelines. A potential barrier to consider is increased workload or inability to prioritize another project. |
| S.A.L. Regional Medical Director | Advanced Practice Provider and Physician involvement Impact is had through direct involvement in the project to support implementation through the lens of medical providers. Support with implementation roll out in compliance with project site policies, procedures, and guidelines. A potential barrier to consider is increased workload or inability to prioritize another project. |
Team Leader
| Team Leader | Details |
|---|---|
| Team Leader | C.A. will be the team leader for the quality improvement DNP project. Successful project implementation requires participation from a multitude of departments, teams, and leaders. Effective collaboration and detailed communication are crucial to driving successful outcomes. Approaching the problem through different frames and perspectives is also necessary to facilitate high-level communication strategies and to keep the project on track. Exhibiting emotional intelligence, drive, and organization emotionally intelligent, organized, and driven, making C.A. the right leader to drive a quality improvement project of this size. C.A. has an extensive background in nursing and leadership over the past 14 years and currently serves as the Director of Nursing at the project site. Relationship building, technical skill, and change advocacy experience offer opportunities to garner additional project support and allocate necessary resources for project implementation. C.A.’s leadership style is a mix of servant and transformational leadership foundations in which the focus is to develop the team members and push them to reach their utmost potential (Manning & Curtis, 2019). Utilization of the servant leadership style supports team empowerment and offers authority by way of nurturing, and empathic listening to help team members achieve their goals (Reynolds, 2021). Choosing a leader with these leadership styles is crucial to successful project delivery. Leaders who cannavigate through challenges and lead with a transformational lens also adapt to the various changes and inspire team members to share and reach their utmost potential |
References
Akbar, F., Mark, G., Prausnitz, S., Warton, E. M., East, J. A., Moeller, M. F., Reed, M. E., & Lieu, T. A. (2021). Physician Stress During Electronic Health Record Inbox Work: In Situ Measurement With Wearable Sensors. JMIR Medical Informatics, 9(4), e24014. https://doi.org/10.2196/24014
Akbar, F., Mark, G., Warton, E. M., Reed, M. E., Prausnitz, S., East, J. A., Moeller, M. F., & Lieu, T. A. (2021). Physicians’ electronic inbox work patterns and factors associated with high inbox work duration. Journal of the American Medical Informatics Association, 28(5), 923-930. https://doi.org/10.1093/jamia/ocaa229
Arndt, B. G., Beasley, J. W., Watkinson, M. D., et al. (2018). Tethered to the EHR: Primary care physician workload assessment using EHR event log data and time-motion observations. Annals of Family Medicine, 15(5), 419–426.
Ehrler, F., Tuor, C., Trompier, R., Berger, A., Ramusi, M., Rey, R., & Siebert, J. N. (2022). Effectiveness of a mobile app in reducing therapeutic turnaround time and facilitating communication between caregivers in a pediatric emergency department: A randomized controlled pilot trial. Journal of Personalized Medicine, 12(3), 428. https://doi.org/10.3390/jpm12030428
Ghaleb, H., & Abdullah, A. A. (2021). A Conceptual Framework for Impact of Project Complexity on Success of Railway Construction Projects: The Moderating Role of Effective Communications to All Stakeholders. The Journal of Management Theory and Practice (JMTP), 2(1), 62-69. https://doi.org/10.37231/jmtp.2021.2.1.85
Institute for Healthcare Improvement (IHI). (2019). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx
Lanham, H. J., Leykum, L. K., & Pugh, J. A. (2018). Examining the complexity of patient-outpatient care team secure message communication: Qualitative analysis. Journal of Medical Internet Research, 20(7), e218-e218. https://doi.org/10.2196/jmir.9269
Manning, G., & Curtis, K. (2012). The art of leadership (4th ed.). New York, NY: McGraw-Hill.
Murphy, C. B. (2022, December 19). Pros and cons of stratified random sampling. Investopedia. Retrieved March 7, 2023, from https://www.investopedia.com/ask/answers/041615/what-are-advantages-and-disadvantages-stratified-random-sampling.asp
Murphy, D. R., Satterly, T., Giardina, T. D., Sittig, D. F., & Singh, H. (2019). Practicing Clinicians’ Recommendations to Reduce Burden from the Electronic Health Record Inbox: a Mixed-Methods Study. Journal of General Internal Medicine, 34(9), 1825-1832. https://doi.org/10.1007/s11606-019-05112-5
Musheke, M. M., & Phiri, J. (2021). The Effects of Effective Communication on Organizational Performance Based on the Systems Theory. Open Journal of Business and Management, 9, 659-671. https://doi.org/10.4236/ojbm.2021.92034
Nguyen, T. S., & Mohamed, S. (2018). Stakeholder Management in Complex Projects. The 7th World Construction Symposium 2018, (July). https://research-repository.griffith.edu.au/bitstream/handle/10072/385361/NGUYEN221601.pdf?sequence=1
Reynolds, H. (2021, July 7). Health Data Stewardship: What, why, who, how. NCVHS. Retrieved September 29, 2022, from https://www.ncvhs.hhs.gov/wp-content/uploads/2014/05/090930lt.pdf
Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties. Annals of Internal Medicine, 165(11), 753–760. https://doi.org/10.7326/M16-0961
Szilagyi, P. G., Albertin, C. S., Casillas, A., Valderrama, R., Duru, O. K., Ong, M. K., Vangala, S., Tseng, C. H., Humiston, S. G., Evans, S., Sloyan, M., Bogard, J. E., Fox, C. R., & Lerner, C. (2022). Effect of Personalized Messages Sent by a Health System’s Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial. Journal of General Internal Medicine, 37(3), 615–623. https://doi.org/10.1007/s11606-021-07023-w
The Joint Commission Requirements. (2023). History and physical – update requirements. The Joint Commission. Retrieved from [https://
www.jointcommission.org/standards/standard-faqs/critical-access-hospital/provision-of-care-treatment-andservicespc/000002112/](https://www.jointcommission.org/standards/standard-faqs/critical-access-hospital/provision-of-care-treatment-andservicespc/000002112/)
NURS FPX 9100 Assessment 6 Project Charter
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