Quality Management Plan
A quality management plan describes the activities to be applied throughout the life cycle of a project to meet the quality objectives. The paper aims to develop a quality management plan outlining the activities to be implemented in a quality improvement project addressing a problem in a hospital department. The sections of the paper will include a description of the organization, its environment, the selected program, the nature and scope of the problem, a SWOT analysis, and a quality management plan using the Shewhart cycle.
Description of the Environment, the Organization, and the Department or Program
The selected organization is a 350-bed community acute care setting that offers various services, including trauma care, emergency care, critical care, urgent care, and intensive care. The hospital has spacious patient wards, waiting for area sections, and offices. It is fitted with sound-absorbing tiles making rooms quieter, bathrooms near the patient beds to reduce fall risk, and standardized rooms for healthcare providers. It is also equipped with advanced technology, including an electronic health record system, clinical decision support system, tablets, and computers, implemented to improve the quality of care and increase patient safety in the facility. The organization offers healthcare services to community members across lifespans.
Healthcare providers in the facility include nurses, nurse practitioners, physicians, pharmacists, nurse leaders, and managers. The department of focus is the facility’s general ward. Care provided to patients in a general ward is essential as it impacts patient recovery. For many patients, moving from the ICU to the general ward is usually a significant milestone in their recovery. Patients would be less satisfied with the care offered if they suffered harm. The improvement project will focus on the strengths and weaknesses of the facility.

Description of the Scope and Nature of the Problem
There has been a growing concern in the facility about the high rates of medication errors reported. As a result, the facility has been reporting decreased patient satisfaction, poor patient outcomes, and patient experience. The hospital administration has been concerned with the rising medical care costs due to increased hospital length and hospital-related complications. Medication errors are a growing concern in the healthcare system due to the burden on hospitals, patients, and families. Medication errors also increase morbidity and mortality rates. According to Tariq et al. (2021), about 7000 to 9000 deaths are reported annually in the United States due to medication errors. They are associated with decreased patient satisfaction, psychological and physical pain, lack of trust in the healthcare system, increased costs, and decreased morale for healthcare professionals (Tariq et al., 2021). Patient dissatisfaction with the care delivered in the acute setting has been reflected in patient ratings. Medication errors threaten the safety and quality of healthcare offered in the facility due to the risk of patient harm. They negatively impact outcomes, leading to poor patient and health outcomes. Therefore, the facility is concerned with the increasing medication errors as they threaten patient safety, and the negative impact may affect the hospital’s reputation and image.
SWOT Analysis
The stakeholders interviewed include the nurses, the physicians, the nurse leaders, the nurse managers, the patients, and the administrative team. These are the major individuals involved in delivering care facilitating care, and others, such as patients, are impacted by the care delivered. Each category of stakeholders provided insightful contributions to the organization. Open-ended questions were used in the interview. The collected responses were used to generate the SWOT analysis. The following table is a summary of the results.
Strengths
-Strong leadership
-Effective communication and collaboration
-Use of electronic health records
-Strong patient-provider relationships
-Patient-centered care
-Funds availability Weaknesses
-Lack of technology to support medication administration
-Outdated practices
– Medication errors
-Lack of training
-Lack of nurses’ involvement in quality improvement
Opportunities
-Technological upgrade
-Increase nurses’ involvement and participation Threats
-Competition
-Decreased patient satisfaction

Strengths identified included strong leadership, effective communication, strong patient-provider relationships, patient-centered care, availability of financial resources, and use of electronic health records. The facility has strong leadership that makes an appropriate and informed decisions. The hospital can deliver patient-centered care with the providers maintaining strong relationships with the patients. Weaknesses highlighted include lack of training, outdated practices, medication errors, supportive technology to support medication administration, and lack of nurses’ involvement in quality improvement projects. The facility does not have a training program for nurses. It also lacks a technological support system for providers to administer medication. The practices used in certain areas, especially in medication administration, are outdated and have many flaws. Threats identified include competition from other nearby hospitals and decreased patient satisfaction. The focus of the facility should be on the threats to the sustainability of the hospital. The opportunities identified included the technological upgrade and increasing nurses’ involvement in quality improvement projects. The opportunities can be utilized to address the threats. For example, the facility can implement technological interventions to improve medication administration, reducing medication errors. Medication error reduction would increase patient satisfaction, increasing the hospital’s competitive advantage.
A Plan for Improvement
As stated earlier, the weaknesses highlighted include lack of training, outdated practices, supportive technology to support medication administration, medication errors, and lack of nurses’ involvement in quality improvement projects. Based on the problem discussed earlier, the hospital should focus on the weakness that impacts mediation errors. Based on the views provided during the interview, the facility lacks a supportive technology to promote efficiencies and effectiveness of the medication administration process, increasing the risk of medication errors. According to Di Simone et al. (2018), most medication errors occur during administration. Errors committed at the administration errors pose a greater risk as they have a high likelihood of impacting the patient, including causing adverse events. The improvement plan involves utilizing one opportunity to address the weakness. The opportunity to be utilized involves technological upgrades.
The Improvement Plan using the Shewhart Cycle
The Shewhart cycle, which involves four steps: planning, doing, checking, and acting, will be utilized to implement the improvement plan. The cycle stimulates a continuous improvement process and allows testing possible solutions on a small scale, providing a standardized method to achieve continuous improvement.
Plan
The planning face involves problem identification using a root cause analysis. At this stage, important questions that are answered include the problem that needs to be solved, resources needed, the best solution that can be utilized to address the problem based on available resources, and conditions that must be met to consider the plan successful. The identified weakness representing a problem in the facility is medication errors. Medication errors are attributed to various factors, including communication failure, illegible handwriting, and inadequate knowledge about medications and their dosage. The causes are linked to human errors; hence a solution that minimizes human errors is required to address the issue.
Evidence suggests using barcodes to reduce human errors as the technology ensures the five rights of patients, including the right patient, the right drug, dose, time, and the right route (Thompson et al., 2018). The technology involves the patient being issued a wristband upon admission. The healthcare providers are supposed to scan the barcode on the medication and the wristband to confirm that the healthcare provider is administering the correct medication to the correct patient. If there are any errors related to the five patient rights, an alert is issued, and the mistake is corrected. Therefore, the barcode medication administration technology will be an effective intervention to prevent and reduce medication errors in the acute setting.
The improvement plan will require various resources, including computers and software. Finances will be required to facilitate the installation of the necessary infrastructure supporting the technology. To increase interoperability, the facility will be required to upgrade various techniques used to increase the effectiveness and efficiencies of the new barcode technology. A team comprising of the nurses, the nurse managers and the nurse leaders, the physicians, and the psychiatrist will be put in place to ensure the inclusion of all the relevant stakeholders. Studies show that the involvement of all the stakeholders increases the success rate of the improvement project involving barcode technology (Thompson et al., 2018).
The Do Stage
Since planning has already been done, the do stage will entail implementing the project in small steps. The project will be implemented in one of the wards of the acute setting to determine the effectiveness of the proposed technology in addressing the problem of mediation errors. Steps to be taken during the stage include designing the software to be adopted, determining the barcode technology to be adopted, assessing whether any technological upgrades are required and making the necessary upgrades, determining any needs of the healthcare providers, for example, a knowledge gap that needs to be addressed or any concerns that may lead to resistance. The last step will involve the integration of the technology into clinical practice. It will involve nurses scanning patients before administering any medication. The expectation is that the nurse will receive an alert, like an alarm, to indicate that there is an error. The nurses are expected to act upon the alerts by identifying and correcting the errors. Therefore, a new practice of issuing the patient with a wristband upon admission will be introduced. Healthcare providers at all points will be required to collaborate to ensure that the steps are taken into account.
The Check Stage
The stage will involve determining the effectiveness of the intervention by comparing the results obtained and the objectives set at the beginning of the improvement project. The project will be analyzed critically to determine what went well and as expected and what was different. The identified problems will be seen as improvement opportunities during the project implementation. Outcome measures to be utilized include a significant reduction in medication errors involving administration of the wrong drug, dosage, administration to the wrong patient, through the wrong route, and during the wrong time. Such events are expected to reduce significantly. The project is also expected to determine the cost-effectiveness of the project based on its ability to reduce medical costs incurred by the hospital. The project will also be assessed on the ability to increase patient satisfaction by improving patient experience. The objective of the improvement project is to increase patient safety, which should improve the patient experience with the care provided in the health facility. The clinical efficiency of the technology will also be analyzed to ensure that the healthcare providers have a better experience. The data to be used in the analysis will be collected from the medical records and from the stakeholders, including the nurses and the patients.
The Act Stage
Now that the problems have been identified, a possible solution has been identified, and the improvement plan will be fully implemented. The implementation will be conducted after all the weaknesses have been addressed and upgraded effectively. Possible challenges encountered in the previous stage include negative perspectives from the healthcare providers, limited interoperability with the rest of the technology, and lack of support by the administrative team resulting in limited effectiveness in reducing medication errors. Some strategies that can be used to address the listed challenges include staff training and increased involvement in the project implementation, technology upgrades, and addressing the specific concerns raised by the providers. Limited interoperability will require upgrading the current infrastructure. Healthcare providers, especially nurses, may require training to ensure they are well-equipped to utilize the technology, reducing reluctance to integrate it into clinical practice. The role of the administrative team may also be made clearer and more concise, linking it to the project outcomes. Healthcare providers require the support of the leaders, such as the nurse leaders and managers, regarding resources needed and addressing their concerns. Some of the strategies, such as support from leadership, upgrade of the infrastructure, and staff training, are essential for the project’s sustainability.
Conclusion
The selected organization is an acute hospital. The identified problem in the facility in the facility is medication errors. Medication errors have also been identified as a major weakness of the organization. Medication errors’ impacts on the facility include decreased patient experience and satisfaction, increased medical costs, and poor patient outcomes. The proposed improvement project involves implementing a barcode medication technology. The Shewhart cycle will be adopted for the implementation of the project. Project analysis after the do stage will be based on the ability of the technology to reduce medication errors, decrease medical costs, increase patient experience and satisfaction, and improve patient outcomes.

References
Di Simone, E., Giannetta, N., Auddino, F., Cicotto, A., Grilli, D., & Di Muzio, M. (2018). Medication errors in the emergency department: knowledge, attitude, behavior, and training needs of nurses. Indian Journal of Critical Care Medicine, 22(5). https://search.proquest.com/openview/bdb87cb7fe14c888f21e14bdd9b37f52/1?pq-origsite=gscholar&cbl=28428
Salar, A., Kiani, F., & Rezaee, N. (2020). Preventing the medication errors in hospitals: A qualitative study. International Journal of Africa Nursing Sciences, 13, 100235. https://www.sciencedirect.com/science/article/pii/S2214139120301128
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication Dispensing Errors and Prevention. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065
Thompson, K. M., Swanson, K. M., Cox, D. L., Kirchner, R. B., Russell, J. J., Wermers, R. A., … & Naessens, J. M. (2018). Implementation of barcode medication administration to reduce patient harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342-351.
https://www.sciencedirect.com/science/article/pii/S2542454818301012