NURS FPX 9100 Assessment 6 Project Charter

The quality improvement initiative titled Provider Inbox Management Optimization (PIMO): Creating the Optimal Inbox is being implemented at Adelante Healthcare – Adult and Family Medicine. The project is led by Dr. Robert Babyar, MD, the Chief Medical Officer, who serves as the site contact. Dr. Babyar can be reached via email at robert.babyar@adelantehealthcare.org or phone at 877-809-5092. The appointed preceptor for this initiative is Adita Flagg, who can be contacted through adita.flagg@adelantehealthcare.org. The project is sponsored at the executive level by the CEO of Adelante Healthcare. As the organizational leader, the CEO plays a pivotal role in securing political, financial, and collaborative support necessary to sustain the project’s goals and ensure alignment with strategic priorities.

A performance gap was uncovered in May 2022 when the Quality Department investigated patient complaints regarding untimely responses. A follow-up report from January 2023 found that 75% of patient messages had not been addressed within three days of receipt. The organization lacked a formal policy to guide provider inbox response times, leading to inefficiencies, workflow redundancies, and communication delays. A root cause analysis (Appendix A) highlighted time constraints and inadequate task delegation as key issues. These insights prompted approval of a structured improvement effort, aimed at implementing a standardized, evidence-based response time protocol.

NURS FPX 9100 Assessment 6 Project Charter

This project aligns with the Joint Commission’s 2023 National Patient Safety Goals, which underscore the need for effective caregiver communication. Research shows that streamlining inbox management can help alleviate provider burnout and enhance workplace satisfaction (Murphy et al., 2019). According to Lieu et al. (2019), establishing formal message response guidelines reduces avoidable delays and decreases patient callback rates, further justifying the project’s implementation.

Evidence and Strategic Implementation

Empirical findings support that developing and enforcing timely response policies significantly boosts patient satisfaction, provider efficiency, and overall care quality. Steitz et al. (2019) and Hefner et al. (2019) emphasize the importance of clearly defined communication policies and staff training. Similarly, Reynolds et al. (2021) advocate for improvements in virtual patient interactions, which are increasingly essential in digital health. Huang et al. (2022) highlight the necessity for inbox system upgrades to optimize workload distribution and provider performance.

The PIMO initiative will pursue three integrated strategies: enforcing a response-time policy, conducting staff development workshops, and upgrading the current patient portal system. These measures will collectively reduce care delays, ensure timely provider-patient communication, and support patient safety. The project will use the Plan-Do-Study-Act (PDSA) model developed by the Institute for Healthcare Improvement (IHI, 2019). Weekly PDSA cycles will allow real-time evaluations and data-informed adjustments. The project’s comparative outcomes will be benchmarked against baseline metrics gathered before the intervention begins.

PICOT Question:
For staff and providers (P), how does the implementation of a patient-provider response time policy (I), compared to the current state (C), affect response times (O) over a two-month period (T)?

Project Aim:
To reduce patient-provider message delays by achieving compliance with a standardized response time policy.

Stakeholder Engagement Table:

Project Team Table:

Communication Plan Table:

Measurement, Evaluation, and SWOT

The intervention involves implementing a policy defining response expectations, combined with staff education and technological upgrades. Measurement efforts will be guided by clearly defined metrics:

Outcome, Process, and Balancing Measures Table:

Key Performance Indicators (KPIs):

• Provider Responsiveness: Minimum 85% compliance with the 24-hour response policy.

• First-Touch Review Time: Clinical staff to review at least 90% of messages within 12 hours.

• Escalation Management: Urgent messages will be flagged for immediate provider action.

• Data Review: Weekly monitoring during implementation, followed by monthly performance audits.

Data Management Table:

SWOT Analysis Table:

References

Akbar, F., Mark, G., Prausnitz, S., Warton, E. M., East, J. A., Moeller, M. F., Reed, M. E., & Lieu, T. A. (2021). Physician stress during electronic health record inbox work: In situ measurement with wearable sensors. JMIR Medical Informatics, 9(4), e24014. https://doi.org/10.2196/24014

Akbar, F., Mark, G., Warton, E. M., Reed, M. E., Prausnitz, S., East, J. A., Moeller, M. F., & Lieu, T. A. (2021). Physicians’ electronic inbox work patterns and factors associated with high inbox work duration. Journal of the American Medical Informatics Association, 28(5), 923–930. https://doi.org/10.1093/jamia/ocaa229

NURS FPX 9100 Assessment 6 Project Charter

Arndt, B. G., Beasley, J. W., Watkinson, M. D., et al. (2018). Tethered to the EHR: Primary care physician workload assessment using EHR event log data and time-motion observations. Annals of Family Medicine, 15(5), 419–426.

Ehrler, F., Tuor, C., Trompier, R., Berger, A., Ramusi, M., Rey, R., & Siebert, J. N. (2022). Effectiveness of a mobile app in reducing therapeutic turnaround time and facilitating communication between caregivers in a pediatric emergency department: A randomized controlled pilot trial. Journal of Personalized Medicine, 12(3), 428. https://doi.org/10.3390/jpm12030428

Ghaleb, H., & Abdullah, A. A. (2021). A conceptual framework for the impact of project complexity on the success of railway construction projects: The moderating role of effective communications to all stakeholders. The Journal of Management Theory and Practice (JMTP), 2(1), 62–69. https://doi.org/10.37231/jmtp.2021.2.1.85

Institute for Health Care Improvement (IHI). (2019). How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Lanham, H. J., Leykum, L. K., & Pugh, J. A. (2018). Examining the complexity of patient-outpatient care team secure message communication: Qualitative analysis. Journal of Medical Internet Research, 20(7), e218. https://doi.org/10.2196/jmir.9269

Murphy, D. R., Satterly, T., Giardina, T. D., Sittig, D. F., & Singh, H. (2019). Practicing clinicians’ recommendations to reduce burden from the electronic health record inbox: A mixed-methods study. Journal of General Internal Medicine, 34(9), 1825–1832. https://doi.org/10.1007/s11606-019-05112-5

NURS FPX 9100 Assessment 6 Project Charter

Musheke, M. M., & Phiri, J. (2021). The effects of effective communication on organizational performance based on the systems theory. Open Journal of Business and Management, 9, 659–671. https://doi.org/10.4236/ojbm.2021.92034

Nguyen, T. S., & Mohamed, S. (2018). Stakeholder management in complex projects. The 7th World Construction Symposium. https://research-repository.griffith.edu.au/bitstream/handle/10072/385361/NGUYEN221601.pdf?sequence=1

Sinsky, C., Colligan, L., Li, L., Prgomet, M., Reynolds, S., Goeders, L., Westbrook, J., Tutty, M., & Blike, G. (2016). Allocation of physician time in ambulatory practice: A time and motion study in four specialties. Annals of Internal Medicine, 165(11), 753–760. https://doi.org/10.7326/M16-0961