Effectiveness of an Improvement Project Harvard Case Solution & Analysis

Effectiveness of an Improvement Project  Case Solution

Health Care Quality Management


Following are the four process measures that can be used for the evaluation of the improvement project and actions already taken to reduce the pulmonary complications by the management of the hospital.

First Process

Swallow and nutritional screening tests are performed on stroke patients for early diagnosis of dysphagia. The screening is performed before any oral food liquid or non-liquid is given to the patients. The process is measured to identify any symptoms and sign of dysphagia in the patients.The stroke survivors must be kept at NPO-(nil per os) nothing by mouth until an experienced trained physician or specialist assess the swallowing ability of the patient.
As per to remove pulmonary complications in the patients who suffered from dysphagia through aspiration, in the early phase there should be diagnosis of the patient and when the stroke patient has any of the following;an abnormal chest x-ray, subjective complaint of trouble swallowing as well as congested voice quality, a delay in discretionary initiation of the swallow reflex and also coughing during swallowing,then aspiration is more likely to be suspected in these patients.
It should be notified whetherthe screening tests are performed appropriately at the early stage by the physician.Moreover, it should also be identified whetherthe additional procedures are followed to verify the symptoms identified through various tests and procedures.

Second Process

Stroke patients are assessed for aspiration detection through Flexible endoscopic examination of swallowing (FEES), this process allows direct viewing of swallowing function.Patients with dysphagia remain under monitoring for at least one week to identify rapid recovery and swallow screening is conducted from time to time.
A simple water swallow test is performed on regular basis. Gag reflex test is conducted on admission of the stroke patient and if the patient has absent gag reflex then it shows potential risk of aspiration.Furthermore, the physician withholds oral foods and place client in side lying position. The physician or nurse performs tracheal suctioning and the patient is referred for chest-x-ray for further diagnosis.
The key consideration includes assessing the stroke patients before given any treatment and if the swallowing tests are performed on the patient on admission. Proper screening as well as subsequent monitoring was done by a designated trained nurse that shows no symptoms of dysphagia. If the patient is discharged after stroke treatment has been done and after such measures, then the patient would be free from pulmonary complications......................

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