VEGA Medical Center: DNP Research Proposal

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Setting

The proposed project is going to take place at the VEGA medical center, which is located in Miami, IL. It is a primary care center that focuses on Family Medicine and Internal Medicine provided in a variety of settings from offices to hospitals. The vision of the organization is to build healthier communities, and its mission is to provide high-quality and affordable care. The key values of the company include innovation, which is in line with the proposed project; the project is also aligned with the mission and vision because all of them aim at improving the quality of care.

The center celebrates diversity and promotes culturally competent care because VEGA serves a culturally and economically diverse community. The elderly population of both genders may be prevalent among the patients because of various chronic illnesses that are treated by the center, but other age groups are also served by it.

The key decision-makers of the institution include the owner, medical director, and the administrator and manager, who comprise the bulk of the organizational structure of the center. Nurses are also included in decision-making, which is shared. The organization welcomes change due to its innovation value, but there may be difficulties in introducing particular ideas, especially if they are not perceived as useful or necessary. The modification of the perceptions of nurses with respect to the change, for example, with the help of Rogers innovation diffusion theory (Hanrahan et al., 2015), can be the strategy to deal with this problem.

Organizational Need

The organizational needs assessment is based on discussions with the stakeholders of the project. The administrator and manager of the center and two of the nurses have agreed that the problem of the absence of direct guidelines on depression diagnosis may have detrimental effects on the quality of care. Also, one nurse suggested that it would be more convenient for the staff to have direct guidelines. Thus, the need for guidelines is recognized by the organization. Using the Iowa model terminology, this trigger is related to a problem (an absence of practice) (Brown, 2014).

Stakeholders

The primary stakeholders of the project are the nurses of the VEGA medical center, their patients, and the organization itself. The absence of the standardized guidelines may complicate the treatment of patients with depression (Petrosyan et al., 2017), which is especially problematic for vulnerable populations like older adults (Taylor, 2014). However, the introduction of standardized guidelines can improve the quality of depression treatment. The organization might benefit from the improved quality due to enhanced reputation. Moreover, the standardization of the guidelines improves the cost-effectiveness of service, which is beneficial for the organization (Duhoux, Fournier, Gauvin, & Roberge, 2012). Finally, the nurses of the center will enjoy improved guidance, which may enhance their confidence and ability to handle depression.

Organizational Support

A letter of support has been provided by the organization, which is ready to cooperate, but no financial assistance will be offered.

Sustainability

The project is aimed at a sustainable change because the center intends to adopt the standardized evidence-based guidelines. To monitor and improve the process of adoption and change routinization, the documentation of the guidelines use and feedback from nurses will be employed during and after the project (Hadorn, Comte, Foucault, Morin, & Hugli, 2016). After the project, the nursing leader will support the change; also, the management will sustain change with various approaches to enforcing the use of guidelines.

SWOT

Internal Forces (project) External Forces (organization or environment)
Strengths Opportunities
  • The intervention: based on evidence; developed and approved by a reputable healthcare organization.
  • Addresses an important and specific organizational problem.
  • Organizational culture (values and alignment).
  • Supportive stakeholders.
Weaknesses Threats
  • Restricted timeframe.
  • Restricted budget.
  • Possibility of resistance to change.
  • Possibility of inefficient employment of the guidelines in practice (affects outcomes).

Risks

Risks and unintended consequences you could potentially encounter associated with your project? What processes will you use to overcome any risks/unintended consequences?

No unexpected consequences are likely to occur because of the implementation of an EBP guideline, and it poses no danger. Still, some risks may be connected to the resistance to change or ineffective use of the guidelines, which might affect the outcomes. To resolve the problem, the project will employ the existing models of translating EBP into practice to modify the nurses perspectives and monitor the adoption process.

References

Brown, C. (2014). The Iowa Model of Evidence-Based Practice to promote quality care: An illustrated example in oncology nursing. Clinical Journal of Oncology Nursing, 18(2), 157-159. 

Duhoux, A., Fournier, L., Gauvin, L., & Roberge, P. (2012). Quality of care for major depression and its determinants: A multilevel analysis. BMC Psychiatry, 12(1), 1-15. 

Hadorn, F., Comte, P., Foucault, E., Morin, D., & Hugli, O. (2016). Task-shifting using a pain management protocol in an emergency care service: Nurses perception through the eye of Rogerss diffusion of innovation theory. Pain Management Nursing, 17(1), 80-87.

Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J.,& Williamson, A. (2015). Sacred cow gone to pasture: A systematic evaluation and integration of evidence-based practice. Worldviews on Evidence-Based Nursing, 12(1), 3-11. 

Petrosyan, Y., Sahakyan, Y., Barnsley, J., Kuluski, K., Liu, B., & Wodchis, W. (2017). Quality indicators for care of depression in primary care settings: A systematic review. Systematic Reviews, 6(1), 1-14. 

Taylor, W. (2014). Depression in the elderly. New England Journal of Medicine, 371(13), 1228-1236. 

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