Attached you will find a template that will guide you in your QI project. At this time we will be addressing the FOCUS part of our FOCUS PDSA cycle on the attached template.  We will be completing the PDSA portion at a later time.  You will also complete the attached fishbone diagram.

A quality improvement (QI) project is an essential aspect of healthcare management, aimed at improving patient outcomes and organizational performance. The FOCUS-PDSA (Find, Organize, Clarify, Understand, Select – Plan, Do, Study, Act) cycle is a widely used framework in QI projects to guide the systematic improvement process. The FOCUS part of the cycle is crucial as it helps identify and define the problem to be addressed. In this assignment, we will focus on the FOCUS portion of the QI project template provided, which entails completing the fishbone diagram.

The fishbone diagram, also known as the cause-and-effect diagram or Ishikawa diagram, is a visual tool that helps identify the potential causes of a problem or issue. It provides a systematic way to explore and understand the various dimensions and factors influencing the problem. By analyzing the diagram, it becomes easier to identify the key causes and prioritize improvement strategies.

To complete the fishbone diagram, we first need to identify the problem that we are addressing in our QI project. This problem should be specific, measurable, attainable, relevant, and time-bound (SMART). For example, if we are working in a hospital setting, a possible problem could be “high readmission rates for congestive heart failure (CHF) patients within 30 days of discharge.”

Once the problem is identified, we divide the fishbone diagram into categories representing different potential causes. The main categories typically used in healthcare settings include equipment, process, people, materials, environment, and management. These categories can be adjusted based on the specific context of the project.

Under each category, we brainstorm and list the potential causes or factors contributing to the problem. For instance, under the “process” category, potential causes for high CHF patient readmission rates could include inadequate discharge planning, lack of patient education, poor medication reconciliation process, or insufficient follow-up appointments. Similarly, under the “people” category, causes could involve a lack of coordination between healthcare providers, limited patient engagement, or inadequate communication.

As we list the potential causes, it is essential to maintain a non-biased perspective and encourage input from different stakeholders involved in the process. This helps ensure a comprehensive understanding of the problem and increases the likelihood of identifying meaningful solutions.

Once all the potential causes are identified, we can proceed to analyze the information presented in the fishbone diagram. Understanding the cause-and-effect relationships between the various factors is crucial for prioritizing improvement efforts. It is important to consider both direct causes (factors directly contributing to the problem) and root causes (underlying factors leading to the direct causes).

The next step in the QI project would involve selecting key causes from the fishbone diagram that have the highest impact on the identified problem. For instance, we may determine that inadequate discharge planning and poor medication reconciliation processes are crucial causes contributing to high CHF patient readmission rates. These causes would be prioritized for further investigation and improvement.

In conclusion, the FOCUS part of the FOCUS-PDSA cycle in a QI project involves completing the fishbone diagram to identify potential causes and factors influencing the problem. It is crucial to approach this task with a systematic and inclusive mindset, involving stakeholders from different levels and departments. By analyzing the fishbone diagram and identifying key causes, healthcare organizations can prioritize improvement efforts and work towards addressing the problem at hand. The completion of the attached template and fishbone diagram will provide a solid foundation for the subsequent steps of the PDSA cycle in your QI project.

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