Quality Improvement

A research paper on QI in Royal medical nursing home

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Table of Contents

Executive Summary…………………………………………….3




The Nursing home structure……………………………………..7

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Methodology and tools used in assessment……………………..8


Executive Summary

If somebody asks you where you would like stay when you need medical care when you become old, what would be your answer? Every would say that they would like to be in their homes. The intention of Royal medical nursing home is to be part of that home. The home is in a process of improving its quality of services. The home will hold 25 full assisted residents, offer nursing care that is respectful and skilled. The home would bring innovations to the field of medical care to our people. This development will make the home to be a home that will take care of the elderly using the modern models of medical care. We shall offer the services with the knowledge that the elderly people have the full human potential. We hope that you would assist us to realise our goal.


This will be a nursing home that will be unique. The home will endeavour on the promotion of dignity and the self worthiness of our beneficiariers.We shall concentrate on providing these people with quality life. We shall make the home not just a care giving place but also make it to be their home and also make them feel that this is their community. The other thing that we shall concentrate on is the opinions that we shall be receiving from various quarters and also from our staff. We have the commitment to the provision of wages that are fair and affordable to all the residents. We shall also have clear defined duties for our staff and also plan our work in a schedule that will favour each and every person who will be involved in the work of the home.

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Staff of the home will be delegated duties that they have training on and also we shall be holding trainings to sharpen their skills in the care giving tasks. The jobs that we shall provide will not only make the workers be in a position to support their families but will also give an opportunity to make at least some differences in their localities in caring for the members of the localities who are vulnerable. The nursing care department will be the one that will be affected most by the quality improvement process. All its programs will also be affected as the changes will be done in a more wholesome way.


Our objectives are divided into two categories. We have the financial objectives and the non financial objectives. Our financial objective include to solicit enough capital to start the project and also to a well developed implemented plan for the funding of the funding needs for third year to the seventh year. We have other, non-financial objectives as well. The non financial objectives include provision of quality home services for up to 20 permanent residents in the home. To find out about the progress that we shall be making we shall form a resident house team that will be providing feedbacks on weekly basis. The other objective will be provision of medical care in an atmosphere that will be conducive to all residents who will be receiving temporary medical care and the third objective would be provision of adequate training and development to our workers so that we can attain job satisfaction.


Our activities will be categorised into two Areas. One of the areas will be the assisted living and the other activities will dwell on skilled nursing care. The assisted living will be those who will be living in the home. Here they will be expected to do daily activities that would be of their own choice but not the choice of the director of activities. (Siegler 2003). This will help them to have a feeling that they have the right to make their own choices in the home. There will be assistants who will be responsible for the provision of care to the residents. They will also be involved in other activities such as laundry work, cleaning and also in preparation of meals. These services will be offered to the residents so that they feel being respected and also make them to feel like they are in their homes. (Marquis & Houston 2008)

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We endeavour to make this a community by allowing other people to visit the residents. This will give an opportunity for socialisation, sharing of knowledge and share other life issues. This will also assist them not to feel like they are being denied their right of association. The time for the visits will be as from eight in the morning until ten in the night. The residents will be given opportunities to take outing sessions when they feel that they need to go out. They will also be given a chance to visit places that they would prefer. They are supposed to give feedback on their health ad other social welfare issues so that the home can know how to assist them. (Doran 2005).

The other activity will be for the skilled nursing care. This will be provided for those residents or the temporary residents who have problems with their health. We shall have a nursing care facility which will take care of these people by offering them a closely supervised and a lifestyle that is assisted. We shall have three full time and four part time licensed practical nurses who will have the responsibility of offering medical care. They will be assisted by elder assistants who will be engaged in offering the skilled nursing resident the same services that they usually provide to the assisted living residents. We shall have a medication schedule for the skilled nursing care which will be used in the provision of medications to them. (Marquis & Houston 2008) This schedule will be developed depending on the time that the residents joined the facility. It will be the responsibility of our nursing staff to undertake this. The medical director will have the responsibility of overseeing that all is running in an efficient way.Inorder for the residents to recover quickly they will be advise on how to engage with the Royal home social life so that they are in a position to have an improvement in their connection sense.

For those residents who are insured we shall be offering them care that is nurtured and respectful using the perspective which they will be viewed as whole persons. For those residents who require Medicare we shall offer them more human services but still the services will be medically qualified. We shall endeavour in providing their family members with peace of mind and giving them the assurance that their loved ones are receiving good care to help them move on with their lifestyle.

We have developed brochures that contain the descriptions of the services that we shall be offering. The brochures contain pictures which show our facilities. This will help more people to

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have information of our new developed facilities .The brochures have also been sent to our donors so that they can have well organised information of the services that we are planning to start offering in the home. (Barker 2008).

We shall also employ the use of modern technologies and modern medical equipments. We shall install computers which will help in having a medical records system that is computerised. This will make the accessing of individual records to be more efficient as even the residents will be in a position to view their own record s by use of a password. This will enhance the understanding of their own health situation and also they will also get information on how to improve their health. (VA field staff 2001) .We are collaborating with many technological companies to make sure that our technology system is of high standard. Standard. The staff will be educated about this plan in a two week programme which will take place in the home. They will be equipped on every aspect of the plan to make them well equipped. At the end of every year all the staff will go through staff appraisals which will be mutual. The medical director who will also act as the human resource manger will oversee the appraisals. He will be responsible of communicating the performance of the staff to the board members so that any issue that would need to be dealt with regarding staff performance would be discussed in that forum.

The Nursing home structure

In the home we have qualified people who will be responsible for overseeing the implementation of the activities and also who will be involved n seeing that everything runs efficiently. Our medical director Doctor Michael smith is one of the most respected professional in the country. As I had mentioned earlier he will be responsible for overseeing that all the staff members are performing their duties efficiently and according to the schedule. He will be assisted by three full time licensed nurses and four part time licensed nurses who will have the responsibility of offering the medical care services to the residents as required. Then we shall have fifteen elder assistants who will be responsible for taking care of the residents by preparing meals for them, assist in laundry work, cleaning and other daily duties as will be instructed. At the top of the structure will be the board of members who will oversee that every aspect of the home moving smoothly. All the elder assistants and the medical nurses will be answerable to the medical director who will also be delegating duties to them and also communicate any other issues that may arise. All the staff members of the home will be required to meet with the board twice per year for discussions concerning their welfare and also on issues pertaining to the home. (Walburg 2006).

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Methodology and tools used in assessment

The home will use the readiness assessment tool which will assist in assessing whether the home will be ready to start undertaking the implementation of the new strategy for the quality improvement. There will be a baseline assessment which will assist to gather information at all levels of the staff in the home. This baseline survey will make it possible to acquire in formation which will be used in making the home to be ready for changes that will come with the quality improvement. The readiness assessment tool in this case will help to gather all these information. The tool will also be used to in assessing the progress that the home will be making in development of a culture of quality improvement. (Marquis & Houston 2008)

The areas which the tool will be used to assess are commitment of the organization, level of teamwork, management and also in communication. In this assessment the home will be in a position to understand the areas which it has a weakness and which may hinder readiness and also hinder the home capacity bring the change imtended.This will help the home to put more strength to those aspects so that it can successfully undertake the implementation of QI and also be in a position to sustain it. Walburg, J. (2006).

All the members of staff of the organization are supposed to complete this tool. This will help the home to identify areas where the staff differs in the running of the home. If the tool shows disagreement this would mean that there is a weakness which need to be addressed as it shows that the organization is not ready for the implementation of change. (Walburg 2006).


We are hoping that Royal medical nursing home with bring a lot of improvement on the

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Medicare of the elderly in our area because this is what has been lacking. We would also wish to collaborate and network more with schools who can come and learn from our home so that we can teach them our ideology so that they can also practise it in their school work and also practise it when they finish school. All this is geared towards improving the life of the elder members of our society. We hope that the staff members will corporate in bringing the new changes and also adapt to the system as quickly as possible. Its also our hope that the technology we shall employ will make the performance be more efficient.


Barker, A. (2008).Advanced practise nursing, essential knowledge for the proffesion, Jones and Bartlet publishers, pg 344, ISBN0763748994, 9780763748999.

Doran, D. (2005).Nursing sensitive outcomes, Jones and Bartlet publishers, ISBN0763722871, 9780763722876.

Marquis, B. Houston, C. (2008) Leadership roles and management functions in nursing theory and application, Lipincott William and Wilkins ISBN078177246X, 9780781772464.

Siegler, E. (2003).An introduction to hospital inpatient care, Springer publishing, pg 337, ISBN0826121942, 9780826121943.

VA field staff (2001).Long term oversight of community nursing homes: needs strengthening, DIANE publishing, pg 21, ISBN1428949941, 9781428949942

Walburg, J. (2006). Performance management in health care: improving patient outcomes, Routledge, pg128 ISBN0415323983, 9780415323987.