HI595 Unit 6 Methodology Outline Example

No Phase Opens Until the Last One Passes: A Unit 6 Capstone Methodology Outline With Exit Tests Written in Advance

[Student Name]

Purdue University Global

HI595: Master's Capstone in Health Informatics

Unit 6 Methodology Outline

[Instructor Name]

[Date]

Carrowby Health, its staff, samples and every threshold are composite; the sources cited are real.

Design

This is a quality improvement project producing a specification, not a research study. Its method is a sequence of phases, each producing evidence the next depends on. The phase structure follows the logic of improvement work, which pairs a clear aim with measures and tests of change (Langley et al., 2009), adapted to a deliverable that will be configured after the term.

Phase 1: Baseline Audit

Sample: 150 consecutive outpatient MRI exams in which screening identified an implant, drawn from the six months ending ninety days before the audit begins, so that every exam's outcome, completed, delayed or canceled, is known. A consecutive sample is chosen over a random one because it preserves the seasonal and scheduling patterns of a real period and is easier to reproduce.

Data: a twelve-field abstraction form recording exam date, hospital, device type, whether manufacturer, model and labeling were in a structured field before the scan date, where the information was eventually found, whether the exam was delayed or canceled, the delay length, and whether the device was placed at Carrowby or elsewhere.

Reliability: a colleague re-abstracts a random 20 of the 150 exams. Exit test: the two abstractors agree on at least 90 percent of fields in the double-coded set; disagreements are resolved and the form revised before the rest is accepted.

Phase 2: Requirements Interviews

Seven people in five roles: two MRI technologists, two screening nurses, the MRI safety officer, the operating room materials manager and the health information management director. Each interview follows the same six questions and is summarized within a day. Exit test: every role has been interviewed, and every draft requirement traces to at least one speaker or to the audit.

Phase 3: Drafting

The author drafts the implant entry, worklist, exception rules, letter and card. Exit test: the imaging informatics manager confirms in writing that each field and rule can be configured in Carrowby's record, or names the component that cannot.

Phase 4: Tabletop Test

Every one of the 150 audited exams is run through the draft rules on paper: would the worklist have flagged it, would the exception rules have routed it correctly, and would the information have been available before the scan date? A screening nurse and the author run the cases together. Exit test: the rules handle at least 90 percent of cases without a manual decision, and every unhandled case is examined and either addressed in a revision or listed as a known limitation.

The tabletop test asks a simple question of each audited exam: had these rules existed, would this patient have waited?

Phase 5: Review and Revision

The MRI safety committee and the patient advisory representative review the revised draft. Exit test: no unresolved objection from the committee, and the patient representative confirms that the letter can be understood without help.

Analysis

The baseline is reported as the share of exams with structured implant details before the scan date, with a 95 percent confidence interval, broken down by hospital and by implant origin, Carrowby or outside. Delay and cancellation counts are reported as frequencies. Free-text interview notes are coded by requirement area. No statistical test is planned for the baseline, because there is no comparison group within the term.

Risks to the Method

The audit depends on the screening form recording that an implant was identified; patients whose implants were missed entirely at screening will not appear in the sample, so the baseline describes known implants only. The interviews depend on staff candor about workarounds, which is why they are held one to one and summarized without names. The tabletop test depends on the nurse's judgment of what the rules would have done, so a second nurse reviews a random ten of the 150 cases. Each risk is listed in the final report's limitations.

Alternatives Considered

1. Random sampling instead of consecutive: rejected for the reasons above.

2. A survey of technologists instead of interviews: rejected because the requirements depend on specific cases a survey cannot elicit.

3. A pilot configuration instead of a tabletop test: rejected because configuration is outside scope and approval; the tabletop test is the strongest test available without it.

Ethics and Data Handling

The quality improvement determination precedes the audit. Each abstraction form is identified only by a study code. The key linking study numbers to records stays in the privacy officer's secure folder and is destroyed when the final report is accepted. Reporting guidance for improvement projects asks that such arrangements be stated (Ogrinc et al., 2016).

What Each Phase Hands On

Phase 1 hands the baseline and the case list to Phase 4. Phase 2 hands requirements to Phase 3. Phase 3 hands the draft to Phase 4. Phase 4 hands revisions and limitations to Phase 5 and the final report. The evaluation plan in Unit 9 reuses Phase 1's definition and form, so that later measurement is comparable (Provost & Murray, 2011).

References

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.). Jossey-Bass.

Ogrinc, G., Davies, L., Goodman, D., Batalden, P., Davidoff, F., & Stevens, D. (2016). SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Quality & Safety, 25(12), 986-992. https://doi.org/10.1136/bmjqs-2015-004411

Provost, L. P., & Murray, S. K. (2011). The health care data guide: Learning from data for improvement. Jossey-Bass.