3 1 Gap Analysis and Project Charter: Patient Teach Back Method Project

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Gap Analysis and Project Charter: Patient Teach Back Method
Project Charter
Patient teach-back method adoption
Montefiore medical center outpatient clinic
Hannah Fraser
Project Plan
Project description/scope.
This project’s aim is to improve the awareness and understanding of the importance of the use of patient teach-back in improving home care and patient satisfaction of the staff at Montefiore medical center outpatient clinic for its patients. The project seeks to implement other aspects of this evidence-based practice that ensure that patient quality of care post discharge. The patient teach-back method, as understood through research, involves providers asking patients to explain the given information on their own terms. This will provide the nursing staff with the opportunity to ensure that the patients, 100% of those that visit Montefiore medical center outpatient clinic, understand their home-care processes. The plan involves ensuring that the nursing staff is taught and buy-in the steps involved in the teach-back method: Chunk and check; ensuring that the misunderstandings realized due to patient teach-back are clarified using other means; using the teach-back approach consistently; adopting the show-me method when communicating with patients; using handouts when communicating with patients about medication regimens; and asking questions to ensure that the patients understand instructions. At the end of the project, the staff at the Montefiore medical center outpatient clinic will not only be aware of the patient teach-back method but start to practice it consistently. The project will be implemented only at the Montefiore medical center outpatient clinic and will be compulsory for all the nursing staff.
Case for change (potential ROI).
Based on the review of the processes at the Montefiore medical center outpatient clinic, it is evident that the staff at the institution has adopted aspects of the teach-back method by communicating with patients to repeat in their own words what was taught to ensure that medical information is delivered to patients and their families in a clear and understandable manner, which has helped improve patient outcomes. However, there are aspects of the patient teach-back that are still yet to be implemented (practices mentioned). About 17 to 42% of the patients discharged are recorded to have insufficient information about their medication regimen and other home-care directions. In addition, medical errors are reported that significantly affect the health outcome. Results from research show that the teach-back method will improve the quality of care offered at the Montefiore medical center outpatient clinic significantly. For instance, in Iran, a study showed improved quality of life among mothers after postpartum after the implementation of the patient teach-back method. Another study shows that patients exposed to the teach-back method improve in their understanding of self-management after kidney transplant, better adherence to the drug regimen, and other health interventions not limited to physical exercise and dieting.
Performance measures
Performance measures description
Baseline
Goal
Explanation of the process of chunk and chuck as a best practice of patient teach-back method
Most staff at Montefiore medical center outpatient clinic have little information about chunk and chuck practice
Staff are aware of chunk and chuck practice and use it in their patient teach-back approach with patients.
Identification of the skills of show-me together with handouts as an essential practice of the teach-back method
More than half of the healthcare practitioners at Montefiore medical center outpatient clinic do not use the skill of show me nor provide handouts in their patient teach-back approach
Staff members master the use of show-me techniques and buy in the idea of complementing the teach-back approach with handouts where necessary.
Identification of ways of asking questions to ensure proper teach-back method
Some staff members, the healthcare providers at Montefiore medical center outpatient clinic, have little understanding of how to ask questions that ensure the best teach-back method
Staff members can describe at least three ways to enhance patient teach-back using indirect and direct questions.
Explanation of strategies to remain consistent in using the teach-back approach
Staff members who currently use the teach-back approach do not use it consistently with everybody, more so with the learned patients
Those who have who use the teach-back approach understand the importance of remaining consistent for the benefit of all patients.
 
 
 
 
 
 
 
 
Performance milestones
Milestone description
Evaluation date
Completing the teaching on the various skills and strategies for the teach-back method like the chuck and chunk; Continuous and consistent application of the teach-back method by nurses
7/25/2022
Adoption and use of the show-me methods as teach-back practice; use of resources like handouts by staff to help in the teach-back method
7/25/2021
Complete awareness of the use of questions to help in the patient teach-back; Use of different styles of questions (direct and indirect) to help in patient teach-back
7/25/2021
 
Potential barriers to success
Stakeholders buy-in challenge.
The success of the project will squarely depend on the buy-in of the stakeholders, not limited to the nursing staff at Montefiore medical center outpatient clinic. It will also need the buy-in of the leadership, the patients, and the families that rely on the institution. Approval by all the stakeholders might take time, interfering with the implementation schedule.
Time limitations.
Time plays a significant role in the practice of nursing at an outpatient clinic because of working with a huge population. Time constraints can prevent the full adoption of the best practices of the patient teach-back method. Some nurses might find it difficult to conduct their day-to-day operations while also adopting all the best practices. In addition, the time frame for evaluation might not be enough to ensure complete buy-in by the nursing staff at Montefiore medical center outpatient clinic.
Resistance to change.
Most staff members at Montefiore medical center outpatient clinic are used to patient teach-back that does not entail other accompaniments, might not buy into the idea of chunk and check, use of the show-me method, and adding handouts.
Stakeholders. List the individuals or groups who will be affected by these strategies.
The nursing staff
Patients
Families
Leadership at the institution
Team members. Consider including representatives from the stakeholder groups noted above.
Montefiore medical center outpatient clinic administrator
Healthcare information manager at the institution
Director of Nursing department
CNO
Additional resources needed
Incentives for nurses that fully adopt the best practices of patient teach-back
Resources are not limited to materials that help promote teach-back by the nursing staff
Computers to track the progress of teaching and application of the best practices
 
Project Scope Statement
 
Scope Description:
Patient teach-back methods, as understood through research, involve providers asking patients to explain the given information on their own terms. The teach-back method adoption will allow the nursing staff at the Montefiore medical center outpatient clinic to ensure that the patients and families understand the best home-care practice not limited to medication regimens, dieting, physical exercise, home management of chronic illness, and home care after surgeries and other forms of treatment. It will solve medical errors among the patients.
Acceptance Criteria: Among the acceptance criteria of the project are:
Achieving 100% adoption of the patient teach-back method as a culture at the Montefiore medical center outpatient clinic by all the stakeholders, more so the nursing staff.  
Improved patient satisfaction to about 95% and awareness by the nursing staff about the importance of using the teach-back method to 100%
Consistent use of the patient teach-back method by the nursing staff and understanding of the best practices for the patient teach-back method.
Deliverables: Among the deliverables of the project are:
Strategies to enhance chunk and chuck practice
Approaches to enhance show-me and use of handouts when carrying out patient teach-back method
Various strategies to use when asking questions to ensure the patients have understood the given information on their own terms.
Project Exclusions: Some elements to be excluded from the project will include
Patients and families will not be taught about the various strategies involving the teach-back method
Supply of the materials needed for the project like computers and handouts
Constraints:  Some of the constraints to the project might be;
Limited buy-in by the entire staff at the institution
Time, resources, and personnel limitations
Funding for the recommended processes
Assumptions: Some of the assumptions when conducting the project include;
100% buy-in by the entire stakeholders, not limited to the nursing staff.
The time frame will be enough for the implementation and evaluation of the project
Needed resources will be made available