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Leaderships Role in the Implementation of Quality Indicators and Development of a Change

5 pages
1221 words
Carnegie Mellon University
Type of paper: 
Research proposal
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This milestone project will focus on a healthcare organization concerning the improvement of the quality patient indicator. Quality healthcare is the extent to which healthcare services are aimed at increasing the likelihood of the expected health outcomes for individuals or populations and are consistent with current practice. There are various quality indicators concerning patient safety that include prevention quality indicators, inpatient quality indicators, patient safety indicators, and the Paediatric quality indicators (Hughes, United States & Robert Wood Johnson Foundation 2008). The above quality indicators are used for different initiatives that range from internal quality improvement to pay for performance. The pay for performance initiative regarding the quality of healthcare services aims at improving their quality as well as their efficiency. The overall goal of implementing the initiative is to have a reasonable value of health care.


When strategizing plans for change and implementation of quality indicator proposals, various consideration must be put in place that include leadership, organizational values, and the present organizational culture. Leadership plays a vital role regarding the implementation of quality indicators and development of a change. They have both legal and moral obligations to make sure there is high quality regarding patient care. The leaders again determine the state of the organizational climate thus influencing the implementation process. Concerning the organizational values that determine implementation of quality indicators, they include integrity, teamwork and collaboration, and excellence. The above values act as the guiding tools for leaders and other practitioners in the healthcare. For instance, teamwork and collaboration is a critical value that should be considered before implementing any change because it influences togetherness and adherence to mission and goals. Another consideration is the current organizational culture that determines how the healthcare professionals are prepared in adhering to the evidence-based practice. Following a successful identification of the key characteristics of the organization, the next thing is to locate the key issue(s) involving quality of services that will require improvement.

Improvement opportunity

The issues involving patient safety and financial considerations identified in the healthcare organization include the postoperative deep vein thrombosis, respiratory failure, and postoperative sepsis. The postoperative complications are associated with higher cost of healthcare services. The above issues were identified using the Agency for Healthcare Research and Quality (AHRQ) quality indicators where patient safety indicators were used to identify the various problems experienced by patients while in contact with the healthcare providers (Hughes, United States & Robert Wood Johnson Foundation, 2008). According to AHRQ guidelines, the problems experienced by patients while in the healthcare system have a likeliness of prevention through implementation of changes. The identified issues are categorized under provider level indicators thus providing insights that if the care providers used an evidence-based practice, the better patient outcome would be achieved. Regarding the patient safety, the professionals have a responsibility for ensuring quality outcomes.

Patient safety as observed in the healthcare also depends on the financial state of the organization. Availability of funds is an opportunity for curbing the risk of postoperative complications. One of the benefits regarding this opportunity is the adequate training of professionals and availability of the competent human resource. To reduce the risk of postoperative complication, the organization must invest in providing better services without increasing the cost of services. Patient quality is significantly influenced by the value of service thus making financial consideration a key factor when implementing changes in the organization. Again, concerning the profitability of the services provided by the organization, improvement of the quality of services will require an additional cost. To reduce the postoperative complications, therefore, the healthcare needs to invest in evidence-based programmes.


The purpose of this project is to minimize postoperative complications through the implementation of evidence-based practice in the healthcare organization. According to Liunggvist, Scott, and Fearon, (2017), Enhanced Recovery After Surgery (ERAS) program was found to significantly improve the clinical outcomes and cost-effective for patients receiving surgical care. The proposal regarding this project is the implementation of ERAS program that is aimed at improving the quality of services given to surgical patients. This program applies a multidisciplinary approach where there is a team consisting of nurses, surgeons, and anesthetists. Additionally, this implementation is also aimed at reducing the hospital stay thus cutting the cost of services concerning financial considerations.

Proposal Initiative

The initiative regarding this proposal is to improve quality of healthcare outcomes specifically for the surgical patients by reducing postoperative complications. Through a strategic literature review, ERAS programme is the appropriate approach that can be implemented to ensure the issue is successfully fixed. This program is essential to the organization because it has two dimensions regarding its achievements. The first achievement is improving the patient outcome thus ensuring their safety upon admission into the healthcare. Secondly, this programme has the potential to reduce hospital stay thus improving the cost of healthcare services. Financial considerations are a key determinant of quality outcomes as much as patient safety is concerned.

Postoperative complications are also associated with increased morbidity and mortality. For instance, poor outcomes that are related to extended hospital stay contribute to other unhealthy states such as nosocomial infections. The postoperative complications, on the other hand, add to most deaths following the surgical procedures. By improving the patient outcome through quality care, this project will significantly improve patient safety and therefore making it relevant for implementation. Additionally, many healthcare organizations have also implemented the ERAS program and found it useful. According to Dai, Jiang, and Fu, (2017), this programme was used to curb postoperative complications as well as improving clinical outcome following pancreaticoduodenectomy where it was effective in reducing cases of pancreatic fistula. This programme is again appropriate for the organization because it will facilitate patient safety without affecting much the financial state of the organization.


Concerning the leadership of the organization, the leaders have played a very critical role in ensuring teamwork and collaboration among various professionals. Leaders have a positive perception regarding the goals and objectives of the organization and therefore, they play a critical role in ensuring every practitioner is committed to achieving the goals. In the organization, the leaders are very much aware of evidence-based leadership that facilitates their responsibility to develop evidence-based practice. Concerning the issue of postoperative complications, the leaders have significantly played a role in identifying the opportunities and strengths as well as the weaknesses and threats to the organization before implementation of the ERAS evidence-based programme. The above step is essential for the sustainability of the EBP programme. The available opportunities and strengths in the organization will be used in the implementation of the ERAS project and therefore make it easy for its establishment. Again, the identified strengths of the leaders will be used to address the various weaknesses and threats to the organization. The above contribution by the leaders in attempting to address the issue is essential concerning the implementation process of the EBP proposal.


Dai, J., Jiang, Y. and Fu, D. (2017). Reducing postoperative complications and improving clinical outcome: Enhanced recovery after surgery in pancreaticoduodenectomy - A retrospective case study. - PubMed - NCBI. [online]

Hughes, R., United States., & Robert Wood Johnson Foundation. (2008). Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality.

Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced recovery after surgery a review. Jama Surgery, 152, 3, 292-298.


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