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Book/movie review
22/08/2022
Queensland is the first jurisdiction in Australia to use the VLAD methodology to aid in the monitoring of the quality of the services provided. Variable life adjustment display or VLAD is a type of indicator used to measure healthcare quality and patient outcomes. The statistical tool predicts the likelihood of a patient outcome, and then plots the difference between the predicted and actual outcome. The VLAD technique signals when further investigation of performance is warranted. Hospital staff can then investigate performance using The Pyramid Model of Investigation. This structured investigation approach assists staff to identify reasons for variations in clinical outcomes and to develop plans to improve performance. Analysis of VLAD data (Stroke In-Hospital Mortality VLAD, Jul 2011 – Nov 2014) and development of an action plan to improve performance Note: There are 3 parts to this task. Please make sure you attempt all parts How are VLAD graphs interpreted? Explain the important features/aspects of a VLAD graph? As an example what does the red line, blue line, black line indicate, what are the numbers, what does the y axis indicate, what are the level 1 to 3 limits for (Note: this is not an exhaustive list. There may be other features that you should explain-what they are and what is their purpose)? Two three paragraphs Describe the issues that are evident when you analyse this VLAD graph above. (What does the graph tell you)? Two paragraphs 3. Using the Pyramid of Investigation describe The possible underlying reasons for the change in patient outcomes over time what could be the causes of the performance changes evident in this chart?s One or two examples of actions that you would take to investigate each of the possible issues or problems that you have described in (a) above? One or two examples of actions you could take to address the possible issues or problems you identified inThe actions you could take to monitor improvements associated with these actions identified inAssessment 3 (40%) You are the Director of the Acute Stroke Unit of a large hospital. Your CEO has asked you to investigate the issues identified from the VLAD chart you analysed in Assessment 2 and to prepare a report and action plan to address the issues identified. From analysis of the VLAD data you and your team have identified the following issues that may have contributed to the recent poorer than expected outcomes for your patients: Casemix increase in transfers of acute stroke patients from regional hospitals; poorer outcomes for delayed presentations to the ED of patients with possible acute stroke; poorer outcomes for Aboriginal and Torres Strait Islander patients. Resources high rates of outliers associated with unavailability of beds in the Acute Stroke Unit due to delays in the discharge of patients; Process of care – long waits (> 48 hours) for CT scans on admission; delays in allied health assessment of patients admitted late in the week; inconsistent and incomplete documentation of physiological and neurological signs during the acute admission; failure to identify patients requiring palliative care and no palliative care pathway suitable for stroke patients in use. Think about how you would approach this task then develop a written proposal for improving the management of acute stroke patients at the hospital. The following information should be included in your proposal. The word count is provided as a guide. 1. A problem statement. (Brief) 2. Definition of the scope of the problem to be addressed. (Brief) 3. The desired changes or improvements and why these are required? This should be based on the scenario and background information provided and your own research about best practice) 4. What are the options for action (what needs improving and what strategies could be used?) ) 5. Choose one priority action for implementation and write a detailed plan using the IHI Model for Improvement (PDCA cycle).
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