NURS FPX 9901 Assessment 2 : Quality and Performance Improvement
Quality and Performance Improvement Framework
Current mental health interventions reveal various gaps, especially in the diagnosis and treatment of adult ADHD. The analysis of the EHR chart from September 2023 to September 2024 reveals that a basic rate is insignificant for 12 cases out of 2,500; merely 0.48 percent. Present approaches largely involve subjective assessment based on clinical data and interviews; no use is made of standardized diagnostic instruments, nor are there well-defined, empirically supported assessment procedures (Adamis et al., 2024).
NURS FPX 9901 Assessment 2 : Quality and Performance Improvement Framework Some areas of concern noticed are 288 patients (11.52%) with reported executive dysfunction, and no further workup; 195 medication management visits (7.8%) with no validated screening, 165 intake records (6.6%) with reported attention issues but no formal evaluation; 142 patients (5.68%) who requested but did not get evidence-based ADHD evaluation (French et al., 2024). Many of these weaknesses can be attributed to the utilization of unformatted clinical management, lack of set screening modalities, and low implementation of care outcome measures.
Data from the Centers for Disease Control and Prevention
The self-report analysis of the CDC provided evidence that ADHD of 6% found in the clinical population means the detection gap of approximately 138 cases or 5.52% in the adult population. It is evident that untreated ADHD comes with adverse consequences, 68% lose their jobs, 65% have poor academic performance that affects parenting capacity, and 55% have co-occurring disorders that require emergency care. Research also shows that clinics with no structured screening fail to identify 82% of adult ADHD patients with the help of a combined adult ADHD Rating Scale screener resulting in delays of an average of 6.7 years in the treatment of patients and a 47% increase in emergency visits (Adamis et al., 2024). Closing them through more data-driven screening programs is critical to enhancing detection and subsequent management.
Implementing a Quality Improvement Framework
The PDSA cycle is useful as a formal process for the rolling implementation of adult ADHD screening protocols over 12 weeks. During the planning phase, staff undergo extensive training on the usage of the ASRS tool, identifying how screening can be integrated into the initial assessment and subsequent medication reconciliation processes, and modifying EMR forms for documentation that is consistent with the project requirements (Lui et al., 2023). In the implementation phase, six psychiatric nurse practitioners will implement screening protocols, create measurement-based care processes for 195 medication management visits, and monitor protocol compliance with assistance from eight documentation coordinators (Adamis et al., 2024).
Assessment indicators will include monitoring of screening; assessing the level of staff conformity with the recommended guideline; increasing the detection rates from 0.48% to 4% using standard instruments within twelve weeks. From the previous information: daily completion audits, adherence reviews, and monthly data analysis will contribute to this progress. Key points that are part of the organizational protocol will be discussed during the morning team meetings, with both current levels of patient activity, numbering approximately 250 weekly appointments, and defined organizational best practices in mind (Adamis et al., 2024). This approach allows fixed intervals of assessment and modification to enhance strategic fit and facilitates organizational goal delivery.
Data Collection and Analytical Strategy
Measures to be collected will be those items associated with the process and effects of screening for ADHD. The clinical quality manager will be responsible for follow-up and collection of the ASRS scores during psychiatric evaluation and medicine visits while the medical assistant team lead will be in charge of Frontline documentation. Imminent data points consist of initial detection rates, the number of finished screenings of 195 medication visits, the overall rates of compliance throughout 12 providers, and the follow-up on referrals for the medication ASRS score greater than 17. HIPAA-compliant eSystems will capture and report this data safely (Shaheen et al., 2023). Graphs and frequencies will describe how detection rates are improving, when and how screening is being completed, and the degree of variation in adherence. Monthly monitoring will determine the monthly progress toward the shift from a baseline figure of 0.48% to 4% through the use of bar and line graphs. Such understanding will inform change and confirm enhancement.
Proposed Interventions and Anticipated Outcomes
Primary interventions address the implementation of the ASRS into first assessments and medication reconciliation visits to ensure consistent identification and assessment of symptoms. The goals include the need to raise the detection rates to 4% within 12 Weeks, increase medication adherence by 40% through systematic monitoring, and make 90% of the staffers adhere to the regimen. Structured assessments will be used to measure progress and to identify improvement needs. Outcome enablers include support from executive management, the EMR system, and the availability of ADHD-skilled providers (Adamis et al., 2024). Challenges include extended visits, the community’s reluctance to provide more documentation, and communication barriers. Other possible predictors include resource constraints, for example, authorization of pharmacy benefits and shortage of mental health care workers.
Evaluation Framework for Quality and Performance
Evaluation will involve the conscious use of standard assessment tools to check on the competency of the developed ADHD screening protocol. The WHO’s ASRS tool, with high reliability and validity, will be used in measuring the symptoms and or responses to treatment. Measures of performance will focus on the degree to which the screenings have been completed, the documentation of assessments being accurate, and clinical outcomes, which will be visible on live monitoring panels (Young et al., 2023). The percentage levels regarding the achievement of detection and compliance objectives will be checked monthly for conformity with broader organizational objectives. This approach makes it possible to achieve steady and gradual improvement and the consequent great importance for improving the quality of care offered.
Conclusion
The use of an assertive improvement system as the Plan-Do-Study-Act (PDSA) cycle is vital to address huge gaps in the identification and treatment of adult ADHD. When implemented in clinical settings, such screening tools help healthcare organizations establish the gold standards for diagnosing and increasing the detection rates of cases such as the one outlined in the ASRS study. Enhanced staff management, proper collection of data, and subsequent actionable evaluation guarantees protocol efficiency and longevity. These barriers can include limited resources and staff reluctance but addressing them by having specific interventions and strong leadership possible. In a nutshell, this approach enhances the quality of practice, integrated with the goals of organizational services that aim to provide timely, equal, and evidence-based mental health services.
References
Adamis, D., Singh, J., Coada, I., Wrigley, M., Gavin, B., & McNicholas, F. (2024). Measuring clinical outcomes in adult ADHD clinics: psychometrics of a new scale, the adult ADHD Clinical Outcome Scale. BJPsych Open, 10(6), e180. https://doi.org/10.1192/bjo.2024.739
French, B., Nalbant, G., Wright, H., Sayal, K., Daley, D., Groom, M. J., Cassidy, S., & Hall, C. L. (2024). The impacts associated with having ADHD: an umbrella review. Frontiers in Psychiatry, 15, 1343314. https://doi.org/10.3389/fpsyt.2024.1343314
Lui, L., Danko, C. M., Triece, T., et al. (2023). Screening for parent and child ADHD in urban pediatric primary care: pilot implementation and stakeholder perspectives. BMC Pediatrics, 23, 354. https://doi.org/10.1186/s12887-023-04082-2
