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UNIVERSITY OF FLORIDA COLLEGE OF NURSING COURSE SYLLABUS Fall 2015

COURSE NUMBER NGR 6836 - Section 25FC

COURSE TITILE Leading Quality Improvement Practice Initiatives

CREDITS 3

PLACEMENT DNP Program

PREREQUISITIES NGR 6638 Health Promotion NGR 6101 Theory and Research for Advanced Nursing Practice

COREQUISTIES None

FACULTY OFFICE PHONE OFFICE HOURS Mary L. Fisher, PhD none 317-439-1507 Thursdays, 8-10PM and Clinical Professor by appointment via phone, [email protected] Skype or Facetime Skype name: mlfquilter

COURSE DESCRIPTION This course provides knowledge and skill necessary for evaluation activities that support the management of quality outcomes in nursing systems. Emphasis is on identification of critical variables that serve as catalysts for positive clinical outcomes. Focus is on qualitative and quantitative benchmarks derived from extant and emerging information systems.

COURSE OBJECTIVES Upon completion of this course, the student will be able to: 1. Analyze health indices relationship or health indices and resource utilization.

2. Evaluate quality indicators and their relevance for nursing systems.

3. Construct and analyze a plan that allows a nursing system to effectively meet complex health care needs.

4. Evaluate traditional and emerging approaches for measuring and using outcomes evidence

5. Utilize evidence for population-based clinical decision-making.

6. Evaluate selected outcomes research as a foundation for policy development and clinical practice guideline development.

NGR 6836 – Section 25FC – Fall 2015 – Fisher - Final COURSE SCHEDULE Canvas is the course management system that you will use for this course. Canvas is accessed by using your Gatorlink account name and password at http://lss.at.ufl.edu. There are several tutorials and student help links on the Canvas login site. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to [email protected].

It is important that you regularly check your Gatorlink account email for College and University wide information and the course E-Learning site for announcements and notifications.

Course websites are generally made available on the Friday before the first day of classes

TOPICAL OUTLINE 1. Quality in the context of the Affordable Care Act 2. Health indices and benchmarking 3. Health care disparities (inequities) and delivery of culturally competent care a. Value added outcomes 4. Best efficacy versus average effectiveness evidence Continuous quality improvement process a. PDSA model utility b. Evaluation frameworks 5. Sources, processes and expected outcomes of evaluation research 6. Process and outcome measurement a. domains b. indicators c. metrics 7. Quality indicators, outcomes and long-term impact 8. Interactions among structure, process and outcome

TEACHING METHODS Online mini lectures, web-based module discussions, presentations, individual and group assignments

LEARNING ACTIVITIES Online group presentations, module discussions, written assignments, research critique

EVALUATION METHODS/COURSE GRADE CALCULATION Outcome Evaluation plan 25% Case studies (3, at 9 points each) 27% Module participation (8, at 4 points each) 32% Peer Critique 6% Take home final 10%

NGR 6836 – Section 25FC – Fall 2015 – Fisher - Final MAKE UP POLICY Students must post completed assignments by the Assignment due date. Deductions of 5 points a day (beginning the day following the deadline) will occur for ALL late assignments. Please contact your faculty member prior to a due date if there is an emergency that will prevent you from turning in the assignment by the deadline.

GRADING SCALE/QUALITY POINTS A 95-100 (4.0) C 74-79* (2.0) A- 93-94 (3.67) C- 72-73 (1.67) B+ 91- 92 (3.33) D+ 70-71 (1.33) B 84-90 (3.0) D 64-69 (1.0) B- 82-83 (2.67) D- 62-63 (0.67) C+ 80-81 (2.33) E 61 or below (0.0) * 74 is the minimal passing grade For more information on grades and grading policies, please refer to University’s grading policies: https://catalog.ufl.edu/grad/current/regulations/info/grades.aspx.

UNIVERSITY AND COLLEGE OF NURSING POLICIES: Please see the College of Nursing website for a full explanation of each of the following policies - http://nursing.ufl.edu/students/student-policies-and-handbooks/course-policies/.

Attendance Academic Honesty UF Grading Policy Accommodations due to Disability Religious Holidays Counseling and Mental Health Services Student Handbook Faculty Evaluations Student Use of Social Media

REQUIRED TEXTBOOKS American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: American Psychological Association

Kleinpell, R. (2013). Outcome assessment for advanced practice nursing: Third edition. New York, NY: Springer Publishing Company.

RECOMMENDED TEXBOOKS Langley, G.J., Moen, R.D., Nolan, K.M., Nolan, T.W., Norman, C.L., & Provost, L.P. (2009). The improvement Guide: A practical approach to enhancing organizational performance, 2nd. Ed. San Francisco: Jossey-Bass. eISBN : 978-0-470-54903-2

NGR 6836 – Section 25FC – Fall 2015 – Fisher - Final Terry, A. (2015), Clinical research for the doctor of nursing practice. (2nd Ed.). Burlington, MA: Jones & Bartlett Learning.

WEEKLY CLASS SCHEDULE

WEEK TOPIC/EVALUATION ASSIGNMENT/READINGS ITEMS DUE 8/24-9/1 Introduction to course and class Introduction Assignment Complete Introduction Assignment by 9/1 11:59pm 9/1-6 Begin working on Module 1: Go to HHS.gov and search for Title III of the Affordable Care Act – reads parts 1-3.

Selected readings on the Affordable Care Act and Quality Outcomes 9/13-20 Module 1 – Quality in the Context Begin working on Module 2: Module 1 due by 9/20 of the ACA Kleinpell, Ch. 1, 3, 11 and pp. 134-158, 190 11:59pm 9/21-27 Module 2 – Measuring Outcomes in Begin working on Module 3: Module 2 due by 9/27 ARNP Practice/ Selected readings on Health disparities 11:59pm research Selected readings on levels of evidence models 9/28-10/4 Module 3 – Healthcare Disparities – Begin working on Module 4: Module 3 due by 10/4 looking at the Data Group assignment: Kleinpell, Table 6.6, pp. 159- 11:59pm 160, Table 6.2, pp. 144-146 10/5-11 10/12-18 Module 4 – CQI Models/Levels of Begin working on Module 5: Module 4 due by 10/18 Evidence – Group Assignment I Kleinpell, Ch. 5 11:59pm 10/19-25 Module 5 – Indices, Measures and Begin working on Module 6: Module 5 due by 10/25 and Benchmarking Kleinpell, Chapter 1 11:59pm

Donabedian, A. (2013). Evaluating the quality of medical care, Milbank Quarterly, 83(4), 691-729. Retrieved at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC26 90293/

Gardner G1, Gardner A, O'Connell J. (Jan., 2014). Using the Donabedian framework to examine the quality and safety of nursing service innovation. J. Clinical Nursing, 145-155. Retrieved at http://www.ncbi.nlm.nih.gov/pubmed/23834585 10/26- Outcome Evaluation 11/1 Plan drafts due for peer critique 11/2-8 Module 6 – Interactions of Begin working on Module 7: Module 6 due by 11/8 Structure, process and Kleinpell, Chapter 2; Exhibit 1.3, pp. 7-8. 11:59pm Outcomes: Domains, Indicators Peer Critiques due and Metrics 11/9-15 Module 7 – Efficacy versus Begin working on Module 8: Module 7 due by 11/15 Effectiveness Evidence Kleinpell, Ch. 11 11:59pm

NGR 6836 – Section 25FC – Fall 2015 – Fisher - Final Final Outcome Evaluation Plans due 11/16-22 Module 8 – Outcomes of DNP Module 8 due by 11/22 Practice 11:59pm

11/23-29 Thanksgiving week – no assignments! 11/30- Nearing the Finish Line! 12/6 Complete on line course and Take home final due instructor evaluations. December 3, 11:59 pm

Approved: Academic Affairs Committee: 03/15 Faculty: 03/15 UF Curriculum:

NGR 6836 – Section 25FC – Fall 2015 – Fisher - Final