NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Name

Capella university

NURS-FPX 8012 Nursing Technology and Health Care Information Systems

Prof. Name

Date

Quality Improvement Project Plan Using Informatics/Technology

Introduction

The quality improvement project focuses on enhancing patient care delivery by integrating telehealth online consultations at Kaiser Foundation Hospital. Previous assessments have identified risks and good performance areas related to telehealth adoption, workflow optimization, and patient outcomes throughout this program. This final assessment consolidates the insights and analyses from prior assessments incorporating leapfrog and Medicare Score alongside SAFER guides results to develop a comprehensive quality improvement plan.

The project aligns with DNP Essential IV, emphasizing the role of information systems and patient care technologies in transforming healthcare practices. By leveraging telehealth, the plan aims to address inefficiencies in care delivery, improve accessibility, and promote better health outcomes. This initiative underscores the importance of evidence-based strategies in addressing organizational needs and fostering sustainable change in healthcare practice.

Problem

The problem centers on inefficiencies and barriers in using telehealth services at Kaiser Permanente’s primary care settings. Despite its potential to improve patient access, reduce costs, and enhance chronic disease management, several challenges limit its optimal use. These include patient barriers, meaning poor technological savvy, owing to inadequate access among patients, often the elderly, and low-income earners slow down its adoption.

It also includes provider challenges, which entail client pressure, lack of preparedness before a visit, and call interferences during consultations alter care provision. Further, organizational barriers where integrated tools only cover numerous patient and clinic needs separately are incompatible with the (Electronic Health Record) EHR and are expensive in purchasing and subsequent support. Lastly, policy barriers where many states limit license use and variable reimbursement rates discourage its use (Gajarawala & Pelkowski, 2020).

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Telehealth offers transformative benefits such as improved accessibility, cost savings, and better chronic disease management (Ezeamii et al., 2024). However, without addressing these barriers, patients face limited access to care, providers experience burnout, and the organization struggles to realize the full potential of telehealth. Telehealth has multiple stakeholders with whom they interact differently due to their objectives. Due to telehealth’s cost-saving and efficacy benefits, managers are concerned with performance, efficiency, and improving the internal environment. According to the respondents, the care delivery function depends on telehealth in clinical departments and calls for optimized processes and integrated technology systems (Chen et al., 2020).

This requires a safe, easy-to-use solution that is well-integrated with the rest of the IT solutions provided by the IT department for patients and providers. Clinical personnel should have sufficient initial and continuous education to facilitate a transition to status and the means to excel during telehealth interactions while still being excellent at addressing workloads. On the other hand, legal advisors remain wary of conditions such as HIPAA; they always try to reduce risks and abide by regulatory rules. Therefore, it is imperative to understand and meet these stakeholders’ needs and expectations to promote the success of telehealth projects (Chen et al., 2020).

Data to Support the Problem and Trigger a Need for a Practice Change

To understand how efficient the Kaiser Foundation Hospital in Oakland is in delivering telehealth services, there is a safety grade from the Leapfrog group as shown below: Hospital staff’s responsiveness received a mean of 78, slightly lower than the national mean of 81.48, hence implying that patients might have to wait several hours before their calls or messages to their hospitals are responded to when using telehealth technology. On the other hand, the hospital practiced communication on medicines well and scored 100 against the national percentage of 79.04.

This augmented strong provider and patient communication. Further, MRSA infection rates were low at the hospital, demonstrating that the hospital was successful in infection control (Leapfrog Hospital Safety Grade, 2024). At the same time, telehealth is even safer than face-to-face visits to minimize the risks of infections. Observations from Medicare Compare extend the lessons about what is possible with telehealth even further. The patient experience scores affirm that telehealth positively affects the convenience factor, contributing to the patient satisfaction indices with an 8/8 score. 

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Further, the hospital’s low readmission rates also show the efficiency of telehealth in handling chronic ailments and averting avoidable hospitalization and mortalities that score 6/7 (Medicare, 2025). Regarding timely and coordinated care, the hospital scores really badly with a 4/12 score, showcasing that telehealth can effectively provide timely and continuous patient care through remote consultations.The comparison of Leapfrog and Medicare Compare data proves the importance of eliminating current obstacles to telehealth usage.

Addressing issues of staff operating Response time and technical interrupts is useful in the context of boosting patient satisfaction and involvement. Moreover, the enhancements in the organizational design of work also increase provider satisfaction and facilitate the implementation of telehealth systems. Enhancing clients’ participation in care, particularly low-income patients, is crucial in achieving the goal of universal health care. These findings underscore the need for practice modifications to drive advancement in telehealth, enhance patient outcomes, and address the needs of the main stakeholders (Talal et al., 2020).

Proposed Solution

The proposed solution seeks to increase and improve telehealth practice connected with EHRs at the Kaiser Foundation Hospital situated in Oakland, California, focusing on urgent issues – patient waiting time decrease, (Hospital Acquired Infections) HAI rates – such as MRSA (Methicillin-resistant Staphylococcus aureus) decrease, and care interprofessional practice among departments and external providers. The goal of this initiative is to explore how making the hospital a patient-centered organization through applying best practice technology for efficiency, safety, and result improvement can be achieved. Some goals may involve reducing the time patients get access to care, reducing HAIs, and increasing interoperability and data security within and outside the healthcare facility (Talal et al., 2020).

The proposed technology includes telehealth consultation tools, video conferencing, and home monitoring devices; all synergized with automated real-time EHR interaction during telehealth calls. The integration will transform the workflow and practice at the Kaiser Hospital in several ways. For instance, encryption in messages, timely alerts, and using HIPAA-compliant applications means that privacy is well guaranteed and productivity improves. This integration revolutionizes work processes by engaging patients through remote consultations for acute and chronic care management. It helps facilitate provider-to-provider information sharing and real-time access for better patient outcomes management through early identification of complications, hence low readmission rates (Anawade et al., 2024).

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

The telehealth solution implementation plan of the conceived scheme starts with step 1, Infrastructure Development, which is aimed at enhancing the compatibility of the hospital’s telehealth infrastructure with the current EHR systems and provides end-user security to the data by incorporating end-to-end encryption. In step 2, Training and Education, various sessions will be organized to sensitize the healthcare providers and the administrative staff on the mode of telehealth and functionalities of the EHR system, and multiple workshops will be conducted to revisit telephone consultations, identification of patients, and data management (Kobeissi & Hickey, 2023).

In Step 3, a Pilot Testing and Evaluation will also involve patients with chronic diseases to examine the system’s efficiency and provide the gaps in patient and provider feedback. Further, in the case of full-scale deployment, the telehealth solution is to be implemented across the hospital’s area, with proper procedures followed by the planning of backup procedures to guarantee the system’s functioning in case of potential system failures. Finally, in Step 5, Continuous Monitoring and Optimization of the system based on SAFER Guides will satisfy the needs and demands that could appear in further practice.

Implementation Challenges and Solutions for Telehealth Integration

Possible challenges that arise during the Kaiser Foundation Hospital telehealth integration implementation plan are presented as follows. Firstly, integrating the telehealth platform with hospital EHR and incorporating data from other providers or community hospitals can be challenging. This can lead to gaps in data sharing, incoherency in data, and long periods between care handoffs (Zhang & Saltman, 2021). To solve such challenges, the organization should acquire better and more efficient integrated technology systems and data security standards for correspondence and signaling and develop closer relationships with third-party providers for better information exchange. 

Another is the deficit in secure data management and HIPAA requirements, especially the encrypted messaging during telehealth (Ansarian & Baharlouei, 2023). To this, the hospital can ensure that the communication is encrypted end-to-end, safeguard the security audits done frequently, and educate the staff on the security of the healthcare data. Moreover, the unwillingness of staff to switch to new technology or alterations in working patterns may also be an issue. That means overcoming this challenge requires sufficient training and education to enable medical practitioners and administrative personnel to utilize the telehealth system (Kobeissi & Hickey, 2023). More practical experience, continuous support in terms of technology, and a proper explanation of how telehealth will be advantageous will reduce the chances of a smooth implementation.

Last but not least, patient involvement and accessibility might be an issue, especially when reaching those individuals who have no prior exposure to telehealth or do not have the appropriate tools. The hospital could offer patient support and teaching, thus preparing the patients independently to use telehealth equipment and knowledge (Vicente et al., 2022). Also, a wide variety of telehealth consultations through multiple devices, such as mobile devices and computers, could enhance the availability. By proactively addressing these challenges with targeted solutions, Kaiser Foundation Hospital can enhance the effectiveness and sustainability of its telehealth integration, ultimately improving patient care and hospital operations.

Role of Leaders in Change Management

The leaders are responsible for proposing and implementing the change strategy, particularly in integrating telehealth at Kaiser Foundation Hospital. This also requires the involvement of people because the change has to respect the hospital’s vision to mean something to the staff, patients, and others involved. Certainly, great leadership will ensure that the success of a particular organization is covered and that the factors that might slow down change implementation are covered (Casillas et al., 2022).

Telehealth implementation readiness is visible at Kaiser Foundation Hospital due to its existing EHRs, which can be reused when implementing this concept of change. Also, there is authorization from top management that supports improving the quality of patient care and safety, which enhances the stability of change. However, challenges that may hinder the implementation of telehealth include staff resistance precipitated by lack of experience with the tools, issues of security, and the need to ensure that staff are trained adequately on the same. Therefore, the following will be deemed important for leaders to help tackle the barriers highlighted below: Leaders need to explain the need for a new model, train employees on the new system, and allow them to see its advantages (Casillas et al., 2022).

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

The model selected for implementing change is Kotter’s Eight-Stage Process, which provides the right platform for effectively implementing change in an organization (Mayo, 2021). The initial strategy is to mobilize people’s emotions and present the need for telehealth integration due to the barriers encountered during care delays, high infections, and fragmentation of care. Thus, leaders should establish a guiding coalition involving a group of managers from different departments supporting the project. A vision and acts should be developed to achieve the objectives regarding Patient-centered care, effectiveness, and safety. Leadership must recruit people into the new behavior, rally others, especially in the healthcare facilities and the staff, and create interest by making examples from other early starters.

Leaders should also reduce resistance by offering all the required training and support to overcome resistance and practical difficulties. Therefore, the paper recommends the following strategies for gaining traction in the implementation process: The use of a telehealth platform for piloting and attainment of victories in the short run, for instance, a reduction in patient waiting time and increased patient satisfaction. As the project continues, it is important to build on successes, providing wider coverage of telehealth across the departments and using the feedback to amend the process further. Lastly, leaders must embed new solutions into the existing organizational context and make telehealth a permanent and integrated practice in a hospital.

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Communicating the change must be done professionally to effectively effect and manage this change. Policymakers should make it their duty to keep everyone in the internal communication loop by sharing the status of the company’s efforts to adopt the technology through emails, posters on internal pages, and departmental meetings. These communications should describe how the change will affect the respective department and seek to hear any concerns “?” Healthcare providers and staff should be trained periodically on the importance of telehealth systems and how they can raise their concerns (Kobeissi & Hickey, 2023). Furthermore, staff should be part of the planning and testing phase to get them committed.

Feedback should also be created for constant patient and staff feedback to ensure continuous improvement during telehealth integration. To garner support from executive Leadership and the board, it is critical to emphasize the strategic benefits of the telehealth initiative. Leaders shall present data that shows how telehealth can improve patient outcomes, increase operational efficiency, and reduce infection rates, ultimately aligning with the hospital’s mission and financial objectives. Furthermore, leaders highlight the benefits of compliance, including meeting regulatory requirements such as HIPAA and improving patient satisfaction. Sharing successful case studies from similar institutions can provide a solid rationale for investment and support. 

Workflow Analysis

The following analysis and visual depictions of the workflow examine the processes related to telehealth integration at Kaiser Foundation Hospital, comparing the current state with the proposed post-implementation state. This analysis identifies inefficiencies, breakdowns, and communication errors in the existing process and outlines how the proposed telehealth and EHR integration will address these challenges. The pre-implementation structural scenario entails appointment scheduling of patients through calls and paper diaries, manually entering patients’ history and test results, consultation done through physical meetings, and interaction between departments, which creates gaps, mistakes, and inefficiencies.

Telehealth and EHR systems were implemented after the study; they incorporate the scheduling portal for the convenience of customers and colleagues, the real-time patient database to reduce waiting for the preliminary meeting, and the vulnerability to HAIs. A free flow of communication between departments and timely access to patient information effectively coordinates care, avoids duplication, and achieves optimum results (Ezeamii et al., 2024).

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Before the implementation, surveillance at Kaiser Foundation Hospital had many constraints, including manual scheduling and data entry, which were ineffective, time-consuming, and full of errors. A face-to-face approach increased patients’ waiting times for an appointment and raised the possibility of HAIs. Further, silo working across the departments and the external providers led to staff miscommunication and delayed care to patients. Patient consultations, diagnoses, and treatment were value-added. At the same time, steps such as manual scheduling, data entry, and physical travel from clinic to clinic were not linked to the goal of improving patient care and were, therefore, non-value-adding steps.

After the implementation of telehealth and EHR systems, there was also a reduction in the work burden of the departments because the consultations were made through telehealth, whereby the data was synchronized in real-time across the departments (Zhang & Saltman, 2021). Scratch scheduling and data entry decreased administrative burdens from the acute care facility; the study concurred with this. This change improved patient care delivery, fixed broken communication flows, and ensured optimal patient and organizational outcomes.

Summary: Final Recommendations and Conclusions

Hence, integrating telehealth services at Kaiser Foundation Hospital can elevate the accomplishment of patient care objectives, minimize incidences of organizational delay, and increase the satisfaction levels of the providers. This stems from the utilization of telehealth platforms integrated into the new model of the EHR system as a proposed solution for overcoming key issues, which include patient waiting time, healthcare-associated infections, and lack of proper care coordination. From the teaching and learning perspective, the implementation plan focuses on infrastructure, developmental staff, and evaluation.

This paper identified some of the barriers to telehealth in the hospital, including data security, patient access, and staff resistance, among others, and addresses them, focusing on how the hospital can better incorporate and enhance telehealth practices, which will, in turn, improve the results of the patients, organizational flow and quality of healthcare delivery. Due to this, it will only be appropriate that professional leaders engage in the management of change, clarification of the benefits, and feedback for telehealth to become a permanent part of the care delivery model of the said hospital, as it supports the mission and vision of the health care facility for the long-term future.

References

Anawade, P. A., Sharma, D., & Gahane, S. (2024). A comprehensive review on exploring the impact of telemedicine on healthcare accessibility. Cureus, 16(3). https://doi.org/10.7759/cureus.55996 

Ansarian, M., & Baharlouei, Z. (2023). Applications and challenges of telemedicine: Privacy-Preservation as a case study. Archives of Iranian Medicine, 26(11), 654–661. https://doi.org/10.34172/aim.2023.96 

Casillas, A., Valdovinos, C., Wang, E., Abhat, A., Mendez, C., Gutierrez, G., Portz, J., Brown, A., & Lyles, C. R. (2022). Leadership and frontline staff perspectives on telehealth transitions in the Los Angeles safety net during the COVID-19 pandemic and beyond. Frontiers in Digital Health, 4, 944860. https://doi.org/10.3389/fdgth.2022.944860 

Chen, N., Spigarelli, F., & Lv, P. (2020). Stakeholder power analysis for telehealth solution implementation in China, facilitators, and barriers. JMIR Formative Research, 6(1). https://doi.org/10.2196/19448 

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Ezeamii, V. C., Okobi, O. E., Sani, H. W., Perera, G. S., Zaynieva, S., Okonkwo, C. C., Ohaiba, M. M., Enemali, P. C. W., Obodo, O. R., & Obiefuna, N. G. (2024). Revolutionizing healthcare: how telemedicine improves patient outcomes and expands care access. Cureus, 16(7). https://doi.org/10.7759/cureus.63881 

Gajarawala, S., & Pelkowski, J. (2020). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013 

Kobeissi, M. M., & Hickey, J. V. (2023). An infrastructure to provide safer, higher quality, and more equitable telehealth. The Joint Commission Journal on Quality and Patient Safety, 49(4), 213–222. https://doi.org/10.1016/j.jcjq.2023.01.006 

Leapfrog Hospital Safety Grade. (2024b). Kaiser Foundation Hospital – Oakland – CA. Hospitalsafetygrade.org. https://www.hospitalsafetygrade.org/h/kaiser-foundation-hospital-oakland 

Mayo, M. (2021). Pandemic preparation & response: A case study applying Kotter’s 8-step change management theory to improve pandemic response in an acute care setting. Medical University of South Carolina https://medica-musc.researchcommons.org/cgi/viewcontent.cgi?article=1559&context=theses 

Medicare. (2025). Kaiser Foundation Hospital – Oakland/Richmond. Medicare.gov. https://www.medicare.gov/care-compare/details/hospital/050075?id=386ad861-edb2-4f97-b731-5256a315de69&city=Oakland&state=CA&zipcode= 

Talal, A. H., Sofikitou, E. M., Jaanimägi, U., Zeremski, M., Tobin, J. N., & Markatou, M. (2020). A framework for patient-centered telemedicine: Application and lessons learned from vulnerable populations. Journal of Biomedical Informatics, 112(1), 103622. https://doi.org/10.1016/j.jbi.2020.103622 

NURS FPX 8012 Assessment 5 Quality Improvement Project Plan

Vicente, M. A., Fernández, C., Guilabert, M., Carrillo, I., Delgado, J. M., & Mira, J. J. (2022). Patient engagement using telemedicine in primary care during COVID-19 pandemic: A trial study. International Journal of Environmental Research and Public Health, 19(22), 14682. https://doi.org/10.3390/ijerph192214682 

Zhang, X., & Saltman, R. (2021). Impact of electronic health records interoperability on telehealth service outcomes. JMIR Medical Informatics, 10(1), e31837. https://doi.org/10.2196/31837