1. 2017 QSEN National Forum Using QI to Leverage Academic Practice Partnerships
Chito A. Belchez, MSN, RN-BC
David Martin, MN, RN
Amanda Gartner, MSN, RN, CPHQ
The University of Kansas Hospital
University of Kansas School of Nursing
Contact:

2. Session Objectives
Identify strategies in a BSN program that promote quality improvement and change management with students.
Describe how students apply quality improvement process in the classroom setting.
Describe the outcomes of establishing a collaborative partnership between a Magnet hospital and an NLN Center for Excellence school of nursing.

3. The University of Kansas Hospital
The Setting
The University of Kansas Hospital
University of Kansas
School of Nursing
Traditional RN pre-licensure and RN-BSN Program
New “Partnership Program” with area Community Colleges
Total enrolment in 2017 – 300+
NCLEX Pass rate above National Average
Magnet Prepared Generalist Nurse Emphasis
Concept Based Curriculum in an Active Learning Environment

4. QI Course QI Project “The Pot”
Kumm, S. & Fletcher, K.A. (2012). From Daunting Task to New Beginnings: Bachelor of Science in Nursing Curriculum Revision using the New Essentials. Journal of Professional Nursing, 28 (2):

5. SON Goals of the Project
Foster knowledge and skills about chart auditing, quality outcomes, and big data
Provide students with “real life” chart audit experience
Develop initial PDSA plan
Shared audit information and PDSA plan with Hospital Nursing QI Department

6. TUKH Nursing Goals of the Project
Support the hospital’s Magnet culture
Quality of Care
Quality Improvement
Nurses as Teachers
Provide baseline or ongoing process measurement for quality improvement
Value added contribution by students to the improvement process

7. Structure/Process Hospital Preparation: Nursing School Preparation:
HIS Training and System Requirement
EMR Access
Developed definitions and audit tools for performance measures
Nursing School Preparation:
Knowledge of QI process: PDCA/PDSA
Skills in data mining and chart audit
Active Learning Environment

8. Process Senior Nursing students
Class divided into 14 Teams of 7-8 students
Students accessed TUKH EMR electronically during the 2 hour class period
Audit tools provided by TUKH Nursing QI Department
TUKH mentors available during class

9. Process
Audits performed were related to National Patient Safety Goals and Magnet Empirical Outcomes (nursing sensitive indicators)
Critical Results Follow Up
Blood Administration Vital Signs
CAUTI/CLABSI Process Measures
HAPU Screening and Staging
Sepsis Screening
Pain Management Documentation

10. Outcomes
Over 90 students participated in the course each of the four years (2013 – 2016)
Approximately 1,500 audits conducted each year during the course
Used audit results to develop PDSA QI Projects
14 PDSA developed, shared, reviewed and presented to TUKH quality improvement teams
Potential cost savings: $10/audit = $15,000/year

11. Outcomes: Shared Experiences
The University of Kansas Hospital
KU School of Nursing
Identifies gaps in the system and opportunities
Redirection of resources within the system
Shared Experiences and Interprofessional collaboration
Project potential evolution – partnership with Lean Promotion Office and Getting to the Gemba
Application of QI knowledge and skills (QSEN, 2012)
Introduced students to Big Data Science
Enhance partnership with KU Nursing
Aided career and professional development
The key lesson of Stone Soup is that interprofessional cooperation between clinical and academic community amidst scarcity of resources (healthcare cost) can lead to the generation of new perspectives (nourishing soup) on quality improvement compared to one person or department could od on their own.

12. Student Feedback
Discuss what skills your team have gained from this activity and how would you apply it in the practice setting.
“From this activity, we gained skills that will be implemented into our practice. The skills we learned specifically were how to perform a chart audit, compiling data, and analyzing data. For the most part, we have only been given data and used it to make changes. This activity showed us how to actually gather our own data to analyze a specific compliance rate. We then had to brainstorm as a group how to create a new way to raise our compliance rate. ……“
The key lesson of Stone Soup is that interprofessional cooperation between clinical and academic community amidst scarcity of resources (healthcare cost) can lead to the generation of new perspectives (nourishing soup) on quality improvement compared to one person or department could od on their own.

13. Student Feedback
“…….Our skills have to be completely nursing based and clinically applicable. We acquired new skills on our ways of thinking. We had to implement an intervention that would actually make a difference and be seen by the necessary people. For our critical result documentation, we had to think like a nurse and take on the perspective of how something would make a difference in our thought process. Altogether, this activity furthered our nursing knowledge and increased our nursing thought process.”

14. Student Feedback
“We found how to navigate through databases in order to find adequate and proper information. We learned how to incorporate other profession als into our PDCA form to make our implementation more holistic - it doesn’t just focus on nursing tasks it focuses on interprofessional contribution. In regards to implementing a project of this magnitude in our future practice setting, we have learned how to effectively get information to a large amount of people and how to analyze and access literature effectively to see if it is relevant.”
The key lesson of Stone Soup is that interprofessional cooperation between clinical and academic community amidst scarcity of resources (healthcare cost) can lead to the generation of new perspectives (nourishing soup) on quality improvement compared to one person or department could of on their own.

15. Conclusion
Chart audit project yielded mutual benefits to KU School of Nursing, students, TUKH Nursing QI Department.
Students are capable of doing continuous quality improvement with real life parameters.
Considerable thought and planning is needed from all parties.

16. References
Berkow, S., Virsktis, K., Stewart, J., & Conway, L. (2008). Assessing new graduate nurse performance. Journal of Nursing Administration. 38(11)
Kumm, S. & Fletcher, K.A. (2012). From Daunting Task to New Beginnings: Bachelor of Science in Nursing Curriculum Revision using the New Essentials. Journal of Professional Nursing, 28 (2):
Sherwood, G., & Barnsteiner, J. (2012). Quality and Safety in Nursing: A competency approach to improving outcomes. John Wiley & Sons. West Sussex, UK.
Quality and Safety Education for Nurses (QSEN). Competencies: Pre-licensure KSAs. Retrieved from: