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    Advanced Directives/Plan-Do-Check-Act Quality Improvement

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    Task 1: Please help me address advance directives and cover the following:
    â?¢ What are advance directives?
    â?¢ Purpose
    â?¢ Positive aspects
    â?¢ Negative aspects

    Task 2: Please use the P-D-C-A Model (explained below) of process improvement to show what you would do to solve the problem in the case study below.

    Case Study
    The director of the outpatient specimen collection section is sitting in his office when the phone rings. It is the office of the hospital administrator telling him that there have been a number of complaints from patients that they had to wait too long to be seen. (Note: For this case study, put yourself in the role of the director).

    What is the Plan-Do-Check-Act (PDCA) Model of Quality Improvement?
    The P-D-C-A Model was advocated by the quality expert, W. Edwards Demming, as a systematic, comprehensive model of quality improvement. The model states that once you have identified the need for improvement, you do the following steps:
    Plan: Develop a sound plan for improvement.
    Do: Implement your plan on a trial basis.
    Check: Study your results to see whether the improvements actually work.
    Act: Build the improvement into your routines so that you can hold onto your gains you've achieved.

    Numerous adaptations of the original P-D-C-A model have been developed. There are also additional steps added into the original PDCA model: evaluate, data, process, implement, and evaluate. Steps in the P-D-C-A Model are thus:
    Evaluate: Assess why the output or outcome was not achieved or maintained.
    Data: Collect new data on the problem or situation.
    Process: Develop a new process for improving the situation.
    Implement: Carry out the new improvement strategy and build quality into routine.
    Evaluate: Determine whether the improvement has been maintained.
    The proposed P-D-C-A model uses the original steps in the Demming model and expands it to make it dynamic and cyclical. You will notice that the added steps begin and end with "evaluate." This expresses the continuous nature of process improvement, where the process is repeated if the change was not maintained or if the problem still exists.

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    Solution Preview

    Task 1: An advance directive, also called a living will or personal directive, is a legal document that allows an individual to convey decisions about his/her end of life care ahead of time. This document is used to provide direction to caregivers and family in the event the patient is no longer able to make decisions, due to physical or mental restraints.

    An advance directive lets an individual decide if he/she wants to be connected to life support machines, if he/she wants to be resuscitated if breathing or heartbeat stops, and if organ or tissue donation is requested. It also appoints an agent to make decisions on the individual's behalf, should the individual be unable to function due to illness or incapacity.

    In some states, the law requires that health care providers ask patients checking into hospitals if they have an advance directive on file, and if not, if they would like to fill one out. There are many Internet sites that allow individuals to print and fill out advance directives in planning their health care.

    A positive aspect of an advance directive is that it can protect the individual's wishes at the end of life, avoiding the unnecessary burden of expensive medical treatment for remaining family members and also relieving family members of difficult decisions. An advance ...

    Solution Summary

    This solution defines advance directives, gives their purpose as well as positive and negative aspects.
    It also uses the Plan-Do- Check- Act Model of process improvement to address a situation in which there have been a number of complaints and how to resolve bottleneck. APA reference is included.