Syllabus

Schedule

Course learning modules are divided into weeks. Each week starts on Wednesday at 12:00 am Eastern Time (ET) and closes on Wednesday at 11:59 pm ET, with the exception of Week 8, which ends on Sunday. All assignments must be submitted by 11:59 pm ET on the due date.

Course Schedule at a Glance

Learning Modules	Topics	Assignments and Due Dates
Week 1 1/3 – 1/10	Fundamentals of Quality	Introductory Discussion Discussion – Initial post by Sunday 1/7, responses by Wednesday 1/10
Week 2 1/10 – 1/17	It’s All About the Customer	Discussion – Initial post by Sunday 1/14, responses by Wednesday 1/17
Week 3 1/17 – 1/24	Practice Variation and its Implications for Quality	Discussion – Initial post by Sunday 1/21, responses by Wednesday 1/24
Week 4 1/24 – 1/31	The role of Leadership and Collaboration in Healthcare Improvement	Discussion – Initial post by Sunday 1/28, responses by Wednesday 1/31 Article Critique – Wednesday 1/31
Week 5 1/31 – 2/7	Paying for Value	Discussion – Initial post by Sunday 2/4, responses by Wednesday 2/7
Week 6 2/7 – 2/14	Role of IT and Quality	Discussion – Initial post by Sunday 2/11, responses by Wednesday 2/14 Research Paper – Wednesday 2/14
Week 7 2/14 – 2/21	QI Landscape and the Future	Final Project Slide Presentation – Wednesday 2/21
Week 8 2/21 – 2/25	Culture of Safety and Medical Errors	Discussion – Initial post by Friday 2/23, responses by Sunday 2/25

Weekly Course Schedule

Week 1 – Fundamentals of Quality

Learning Outcomes:

• Analyze customer service practices to determine what constitutes high quality in the service industry
• Reflect on recent healthcare service to identify good and poor service within the healthcare field

Course Materials:

• Read chapters 1 and 2 in Spath (2013)
• Read chapter 1 in Strome (2013)
• Watch video – TheNewAltons. (2010, January 10). If air travel worked like health care [Video file]. Retrieved from https://www.youtube.com/watch?v=5J67xJKpB6c

Assignment:

Discussion Question: After doing this week’s readings and watching the video, If Air Travel Worked Like Healthcare, please respond to the following items:

• In your opinion, which service industry companies provide superior customer service? Which companies provide average or mediocre customer service? List and briefly describe the factors most important to you when judging the quality of a company’s customer service.
• Think about your most recent healthcare encounter. Without disclosing the nature of the encounter, what aspects of care or service were you pleased with? What could have been done better, and how could it have been improved?

Week 2 – It’s All About the Customer

Learning Outcomes:

• Analyze performance measures of healthcare service providers to determine the quality of care available
• Critique the manner in which performance measures are presented on a healthcare website to determine the usefulness of the site

Course Materials: Read chapters 3 and 4 in Spath (2013)

Assignment:

Discussion Question: Explore the CMS Hospital Compare website (www.medicare.gov/hospitalcompare/search.html?). Choose 3 hospitals within 100 miles of your location. Review the data for each of the following broad measurement categories:

• Process of care measures
• Outcome of care measures
• Patients’ hospital experiences

Which hospital rates highest in each of the above categories? As a consumer, would you consider using the data on CMS Hospital Compare website to select a hospital? Why or why not? Do you know of family, friends, or coworkers who have use this website? If so, what was their experience like? If not, what you would you tell them to persuade them to use it?

Week 3 – Practice Variation and its Implications for Quality

Learning Outcomes:

• Employ an improvement model to resolve a performance problem

Course Materials: Read chapters 5 and 6 in Spath (2013).

Assignment:

Discussion Question: This week’s reading introduced you to a number of improvement models which are in current use. In this discussion you will choose a performance problem and select an appropriate improvement model to address the problem. In your initial post, provide a detailed plan for how you will use your selected improvement model to resolve the performance problem.

First, choose one of the following problems:

• More than 25 percent of the insurance claims submitted by a clinic are rejected because of mistakes made by the clinic’s billing clerks.
• Patients experience long wait times and delays for outpatient diagnostic services.
• A large number of hospitalized patients develop a wound infection following surgery.
• Labor costs are too high in the radiology department.
• Patients’ overall satisfaction with the emotional support provided by nurses is lower than the satisfaction levels reported for other hospitals.

Then, select an improvement model to address the problem you chose:

• PDSA
• RCI
• FOCUS-PDCA
• FADE
• Lean
• Six Sigma

Here are some helpful websites where improvement project descriptions may be found:

• Institute for Healthcare Improvement (www.ihi.org)
• Clinical Microsystems, The Dartmouth Institute (http://clinicalmicrosystem.org/)
• Individual website of the Quality Improvement Organizations. A list of sites is available at www.qualitynet.org

Week 4 – The Role of Leadership and Collaboration in Healthcare Improvement

Learning Outcomes:

• Evaluate team strategies for improvement projects to determine which are most useful
• Discuss leadership skills required to manage effective teams
• Critique a quality improvement article to determine its strengths and weaknesses

Course Materials:

• Read chapter 7 in Spath (2013)
• Read Godlock, G., Christiansen, M., & Feider, L. (2016). Implementation of an evidence-based patient safety team to prevent falls in inpatient medical units. Medsurg Nursing, 25(1), 17-23.
• Sendelbach, S., Wahl, S., Anthony, A., & Shotts, P. (2015). Stop the noise: A quality improvement project to decrease electrocardiographic nuisance alarms. Critical Care Nurse, 35(4), 15-22.
• Watch video – Gawande, A. (2012, April 16). Atul Gawande: How do we heal medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=L3QkaS249Bc

Assignments:

Discussion Question: This week’s discussion has 2 distinct parts.

1) Consider the ground rules listed in Spath (2013) Critical Concept 7.1 (pp. 165-171). Which three do you think are most important for a team to adopt, and why? To help you decide which three are most important, consider your past experiences working with a team or a decision-making group. Explain your decision using concrete examples from your past experiences

2) Imagine you are the team leader of the group described in the scenario below.

Scenario: When members were recruited for an improvement project, they were told that the team’s work would be in addition to their regular work responsibilities. Furthermore, they were instructed to treat team activities as a high priority. They were expected to complete team assignments on time and were required to attend meetings. Despite these clear expectations, by the third week of the project problems have arisen. Team members have begun to arrive late to meetings, have not completed their assigned tasks, and have neglected to return your phone calls.

How might you refocus and motivate the team to achieve the improvement goal they are charged with implementing?

Article Critique: Read and critique ONE of the following articles:

• Godlock, G., Christiansen, M., & Feider, L. (2016). Implementation of an evidence-based patient safety team to prevent falls in inpatient medical units. Medsurg Nursing, 25(1), 17-23.
• Sendelbach, S., Wahl, S., Anthony, A., & Shotts, P. (2015). Stop the noise: A quality improvement project to decrease electrocardiographic nuisance alarms. Critical Care Nurse, 35(4), 15-22.

To prepare your critique, follow these guidelines for critiquing an article, which were prepared by RPI (n.d.). Since this is a professional paper, you will need to pay attention both to the quality of your critique and to the professional statement of your critique, using proper grammar and mechanics. Paper length: 3 to 5 pages. Use APA formatting. Refer to the Article Critique Rubric for submission guidelines.

Week 5 – Paying for Value

Learning Outcomes:

• Apply a value-added analysis of a healthcare visit to make recommendations for improvement

Course Materials: Read chapters 2 and 4 in Strome (2013).

Assignment:

Discussion Question: As a general rule of thumb, somewhere between 5% and 20% of activity in healthcare can be considered value-added; the remainder is considered non-value-added (Strome, 2013, p. 54). Considering this statement and your most recent experiences with healthcare services:

• What did you consider to be value-added? Non-value-added?
• What recommendations for improvement would you suggest to leadership at that particular healthcare organization?

Week 6 – Role of IT and Quality

Learning Outcomes:

• Analyze quality improvement data to assess how it relates to the improvement process
• Investigate a quality improvement organization to determine its potential applicability in healthcare improvement

Course Materials: Read chapters 5 and 6 (pp. 91-95 only) in Strome (2013).

Assignments:

Discussion Question: In your initial post, consider a current quality improvement issue at your place of employment, and answer the above questions. You may need to consult with other people in your organization in order to get the information you need. It is important to obtain a clear understanding of the context of data and how it relates to improvement processes. When developing analytics around quality or performance improvement, required information includes:

• What does the data represent? What process, workflow, outcome, or structural component does the data correspond to?
• How is the data stored? What kind of storage is the data in (such as an enterprise data warehouse, Access software computer database, file cabinet), how is the data physically stored, and how might that storage format constrict what can be done with the data? Also, how good is the quality of the data; are there missing values that might bias analysis, and are there invalid entries that need to be cleaned and/or addressed?
• What is the data type? Regardless of how data might be physically store in a database, what kind of data do the values represent in “real life”?
• What can logically be done with the data? Given the type of data and how it is stored, what kind of database and mathematical operations can be performed on the data in meaningful ways?
• How can the data be turned into useful information? How can the data drive decision making and enable leaders and quality stakeholders to take appropriate and necessary action?

Research Paper: Many methods of systematic, evidence based, goal driven, and shared processes have been used for decades in industry to improve product and service quality. In this paper, investigate a quality-focused organization such as The Joint Commission, Institute for Healthcare Improvement, Leapfrog Group, National Committee for Quality Assurance, or Agency for Healthcare Research and Quality, etc. Analyze the following components as they might apply to healthcare improvement and their potential application to a healthcare system:

• History of the organization
• Purpose
• Data repositories
• Tools
• Initiatives

Paper length: 5 to 7 pages, not including cover page and reference page.

Remember, this is a professional paper. You will need to draw upon your course readings as well as conduct additional research in your investigation. Use conventional grammar, punctuation, mechanics and APA formatting. Your paper should flow well and be organized to effectively guide the reader in learning about the topic. Refer to the Research Paper Rubric for submission guidelines.

Week 7 – QI Landscape and the Future

Learning Outcomes:

• Describe the steps necessary to develop a quality improvement plan

Course Materials: Read chapter 12 in Strome (2013).

Assignment:

Final Project Slide Presentation: This is the culminating project for the course.

Imagine that you have to give a presentation on quality improvement to a group of stakeholders. Use PowerPoint or a similar tool to create your presentation. Create 20-25 slides. Your slides should include text and graphic images. Be careful not to put too much information on any one slide. You can either use the note section of the tool to write down additional comments for each slide (what you would say aloud in your presentation) or you can record yourself speaking these comments. (Powerpoint, Knovio, and other slidedeck programs will allow you to make audio recordings to accompany your slides.) Refer to the Final Project Slide Presentation Rubric for submission guidelines.

Topic: You may choose between a quality improvement project with your employer OR you may use the case study below.

Choice 1 – Quality Improvement Project (student choice – employer based):

Describe what steps you would take to solve this problem. In your presentation include:

• Which specific QI methodology design (PDCA, FOCUS-PDCS, FADE, RI, Lean, Six Sigma, see Spath (2013), chapter 5).
• Will you need team meetings? if so, who would be invited and why?
• What other steps would be taken to resolve the issue?

Your presentation should also include answers to the following questions:

• What improvement tool would you use to identify possible reasons for the identified problem in your department?
• What improvement tool would you use to gather data to confirm the reasons for identified problem in your department?
• Based on the above bullet point, what is your hypothesis as to why the problem continues to occur. What improvement tool would you use to analyze this theory?
• What improvement tool would you use to prioritize the problems?
• What improvement tool would you use to define the current process surrounding this issue?
• To whom would you assign the task of defining roles and responsibilities for staff involved in this issue?
• After redesigning the process, you need to monitor the effectiveness of your actions. What improvement tool would you use to determine whether resolution of the issue has occurred?

Choice 2 – Case Study:

Imagine you are the supervisor of the health information management (HIM) department in a large outpatient clinic. This department manages patient records. Complaints about your department are becoming more frequent and intense than in the past. Some clinic employees have complained that the HIM department takes too long to retrieve patient records. Others have expressed dismay over the rudeness of HIM staff. You decide to talk to employees throughout the clinic about the problems. The clinic’s receptionists respond to you defensively. They tell you that the HIM staff won’t answer the phone and that they want some backup when they are busy with patients. You talk to the HIM staff and they say they are being charged with more responsibilities but have no additional help. They also complain that the receptionists transfer calls that they should be handling. The clinic’s nurses are also upset with the HIM staff; they claim the department does not help them locate patient charts, causing long wait times for patients. The clinic’s physicians say they cannot assume additional tasks to alleviate the situation because their days are already chaotic.

Describe what steps you would take to solve this problem. In your presentation include:

• Which specific QI methodology design (PDCA, FOCUS-PDCS, FADE, RI, Lean, Six Sigma, see Spath (2013), chapter 5).
• Will you need team meetings? If so, who would be invited and why?
• What other steps would be taken to resolve the issue?

Your presentation should also include answers to the following questions:

• What improvement tool would you use to identify possible reasons for the the increase in complaints about the HIM department?
• What improvement tool would you use to gather data to confirm the reasons for the complaints about the HIM department?
• You hypothesize that complaints spike on certain days of the week. What improvement tool would you use to analyze this theory?
• The HIM staff tallies information about the causes of complaints. What improvement tool would you use to prioritize the problems?
• What improvement tool would you use to define the current process for retrieving patient records?
• You believe that cooperation between the clinic receptionists and HIM staff would improve if phone responsibilities were more clearly defined. To whom would you assign the task of defining roles and responsibilities for staff involved in this issue?
• After redesigning the process, you need to monitor the effectiveness of your actions. What improvement tool would you use to determine whether the number of complaints has decreased?

Week 8 – Culture of Safety and Medical Errors

Learning Outcomes:

• Identify ways to prevent or mitigate patient harm

Course Materials:

• Read chapters 8 and 9 in Spath (2013)
• Read pages 173-179 in Strome (2013)
• Read Waterson (2014) Patient safety culture: Theory, methods, and application

Assignment:

Discussion Question: Provide an example of an error that can occur in a healthcare process and result in patient harm. Then describe at least one strategy that could accomplish each of the following objectives:

• Prevent the error from resulting in patient harm
• Detect the error when it occurs and before the patient is harmed
• Mitigate the amount of harm to the patient

Student Resources

Online Student Support

Your Student Support Specialist is a resource for you. Please don't hesitate to contact them for assistance, including, but not limited to course planning, current problems or issues in a course, technology concerns, or personal emergencies.

Questions? Visit the Student Support Health Informatics page

APA Style Guide

• https://www.apastyle.org

UNE Libraries:

• Library Access for all students: Your library login ID and password are the same as the ones you use to log into Blackboard/Brightspace.
• MSIN Databases: https://library.une.edu/library-materials/find/research-by-subject/health-informatics/
• Library Tutorial: Find an article
• Library Questions: Ask a librarian or phone library staff at (207) 602-2361 or (207) 221-4330.

UNE Student Academic Success Center

The Student Academic Success Center (SASC) offers a range of services to support your academic achievement, including tutoring, writing support, test prep and studying strategies, learning style consultations, and many online resources. To make an appointment for tutoring, writing support, or a learning specialist consultation, go to une.tutortrac.com. To access our online resources, including links, guides, and video tutorials, please visit:

• UNE Student Academic Success Center

Accommodations

Any student who would like to request, or ask any questions regarding, academic adjustments or accommodations must contact the Student Access Center at (207) 221-4438 or pcstudentaccess@une.edu. Student Access Center staff will evaluate the student's documentation and determine eligibility of accommodation(s) through the Student Access Center registration procedure.

Policies

Technology Requirements

Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements

Turnitin Originality Check and Plagiarism Detection Tool

The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.

Make sure to cite your sources appropriately as well as use your own words in synthesizing information from published literature. Webinars and workshops, included early in your coursework, will help guide best practices in APA citation and academic writing.

You can learn more about Turnitin in the Turnitin Student quick start guide.

Information Technology Services (ITS)

ITS Contact: Toll Free Help Desk 24 hours/7 days per week at 1-877-518-4673

Course Evaluation Policy

Course surveys are one of the most important tools that University of New England uses for evaluating the quality of your education, and for providing meaningful feedback to instructors on their teaching. In order to assure that the feedback is both comprehensive and precise, we need to receive it from each student for each course. Evaluation access is distributed via UNE email at the beginning of the last week of the course.

Attendance Policy

Online students are required to submit a graded assignment/discussion prior to Sunday evening at 11:59 pm ET of the first week of the term. If a student does not submit a posting to the graded assignment/discussion prior to Sunday evening at 11:59 pm ET, the student will be automatically dropped from the course for non-participation. Review the full attendance policy.

Late Policy

Assignments: Late assignments will be accepted up to 3 days late; however, there is a 10% grade reduction (from the total points) for the late submission. After three days the assignment will not be accepted.

Discussion posts: If the initial post is submitted late, but still within the discussion board week, there will be a 10% grade reduction from the total discussion grade (e.g., a 3 point discussion will be reduced by 0.3 points). Any posts submitted after the end of the Discussion Board week will not be graded.

Please make every effort ahead of time to contact your instructor and your student support specialist if you are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.

Student Handbook Online - Policies and Procedures

The policies contained within this document apply to all students in the College of Graduate and Professional Studies. It is each student's responsibility to know the contents of this handbook.

UNE Online Student Handbook

UNE Course Withdrawal

Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.

Academic Integrity

The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.

Academic dishonesty includes, but is not limited to the following:

1. Cheating, copying, or the offering or receiving of unauthorized assistance or information.
2. Fabrication or falsification of data, results, or sources for papers or reports.
3. Action which destroys or alters the work of another student.
4. Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
5. Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.

Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations.  Appeal of a decision may be made to the Dean whose decision will be final.  Student appeals will take place through the grievance process outlined in the student handbook.