NURS 4220 Week 3 DISCUSSION: Applying Performance Improvement Tools

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In the healthcare industry, patient satisfaction is a crucial measure for identifying areas of improvement and developing effective strategies for enhancing the quality of care. Patient satisfaction surveys provide valuable qualitative and quantitative data regarding the effectiveness of healthcare services and the level of empathy provided. Higher patient satisfaction scores indicate better overall performance for healthcare organizations. This discussion focuses on a hypothetical scenario in which efforts were made to improve patient satisfaction scores in pain management within a geriatric medical nursing unit.

Upon analyzing the Patient Satisfaction with Pain Management Run Chart and the implemented Strategies and Interventions, several conclusions can be drawn. The year began with staff training on the significance of patient satisfaction monitoring, which resulted in a significant improvement in satisfaction scores for a few months. However, there was a sudden drop in satisfaction percentages in March 2014, leading to a pain and pain management lecture, which proved to be ineffective. An interim improvement occurred after the adoption of a comprehensive pain assessment tool following a team meeting on 6/12/2014.

NURS 4220 Week 3 DISCUSSION: Applying Performance Improvement Tools

Further strategies were discussed during a team meeting on 8/2/2014, including a Journal club review and an examination of electronic medical record (EMR) data on pain assessment by the Quality Improvement (QI) team. However, these interventions did not produce consistent results, as patient satisfaction scores continued to fluctuate throughout 2014. A meeting on 3/1/2015, focusing on the effectiveness of pain medication and generating new improvement ideas, led to a significant increase in patient satisfaction. For the first time, the scores surpassed the national benchmark for similar medical surgical units.

Unfortunately, the satisfaction scores declined after two months. On 5/15/2015, the QI team met with staff to strategize, opting to implement the IHI rapid cycle improvement model with iterative Plan-Do-Study-Act (PDSA) cycles. This model facilitates faster changes and continuous measurement for ongoing improvements. The adoption of this model resulted in a considerable increase in patient satisfaction scores with pain management, surpassing the national benchmark. Subsequent team meetings aimed to refine and enhance current strategies, leading to sustained improvement in patient satisfaction scores on the run chart. On 3/1/2016, the nursing unit celebrated the achievement of improved patient satisfaction with pain management.

NURS 4220 Week 3 DISCUSSION: Applying Performance Improvement Tools

Based on this analysis, it can be inferred that the continuous adaptation of strategies and interventions proved effective in creating a sustainable change within the nursing unit. The run chart demonstrated predictive abilities by objectively reflecting the impact of process and system changes over time. With the current performance trajectory, the nurse manager and Chief Nursing Officer (CNO) can anticipate the unit to remain above the national benchmark in the upcoming quarter and year. The data from the run charts support this optimism, validating the decision to celebrate. The comprehensive training, education on pain management, and the collaborative efforts of the team, supported by the QI team, provide confidence that the positive trend will continue. With ongoing training and teamwork, accompanied by QI support, the nursing unit aims to achieve 100 percent patient satisfaction.


Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: a simple analytical tool for learning from variation in healthcare processes. BMJ quality & safety, 20(1), 46–51. Spath, P. (2018). Introduction to healthcare quality management (3rd ed.). Chicago, IL: Health Administration Press.