Introduction
It may be useful to think of the introduction as a signpost to what is coming up next in the essay. It is usually about 5-10% of the word count (approx. 500 words ).
Some things you might do in an intro:
- Introduce the purpose of the essay: what are you attempting to do, and why? (NB: this may be unnecessary to write explicitly in the introduction, but it is always helpful to clarify it in your own mind).
- Set the scene or provide relevant background.
- Define QI
- Explain why QI is important e.g. consider the size or scope of the problem or its implications.
- Set out the argument or position you are taking in response to the topic, brief or issue. How are you going to answer the question?
- Give an outline of the structure to explain your logic in the main body (e.g. ‘This essay will first present……)
Tips – Back up with evidence E.g The NHS faces the challenge of improving quality of care while coping with the biggest funding squeeze in its history . Plans for what should change The NHS five year forward view (Forward View) is the national plan for improving servi-ces in the NHS in England (NHS England et al 2014). Plans for how change will happen
Main body of your essay-
- The main body of the essay should be used to develop your central ideas.
- Paragraphs, parts, and links are needed. Try dividing them into maybe three or four key parts, followed by paragraphs. It is important it is to link ideas from one section to the next and refer back to points you made earlier.
Consider the following:
- What do I need to know in order to respond to the question? Make a list.
- How do I address these issues in a more logical rather than descriptive manner? What are the common threads that run through all of the topics?
What is the best way for me to separate each subject or problem? What are the various dimensions or aspects of it?
- Paragraphs: Each paragraph focuses on a single key concept or point. These points should be closely related to your assignment’s overall argument or theme.Support these central concepts or “claims” with proof from your reading. Referencing
- Make ties and clarify relations between various concepts to keep the flow between sections and paragraphs.
- Be critical , for example one side of an argument may be presented , but you can also present the opposing perspective in the next. .
Some suggestions for the Body
- Introduce the clinical setting , the topic or problem. Remember your formative assignment. What was the SI that led to you introducing the QI? ( Brief description if not included in the intro) Remember the focus of the assignment in the QI , not the SI
- Who was involved : Staff , service users , chief executive , clinical directors, other partners etc (strong emphasis on co-production and service user involvement)
- Was this work influenced by anything else : organisational change, policy , improvement work, new strategy to improve care quality
- How did the QI journey start ? For example : The trust’s quality assurance journey began with board members, senior clinical staff, and managers working together to define the trust’s vision for providing the highest possible level of treatment. The emphasis on productivity rather than performance was seen as critical to retaining employees and service users. It was recognized from the start that quality enhancement would be a long-term process that would require everybody in the confidence to commit to it.
- Risk Assessment
- Describe QI implementation
- Describe any challenges or ethical dilemmas and how this was overcome -e.g How were staff / patients / SU supported during any changes or implementation ? (e.g coaching conversations to encourage improvement thinking based on the trust’s priorities, training and development etc.
How were people held accountable for their work? ( e.g Maybe the trust has a statement of values and behaviours, which includes a commitment to quality. The behaviours that demonstrate this commitment include: seeking and acting on feedback from service users, carers and staff about their experiences, improving standards through training, experience, audit , evidence-based Practice and learning from mistakes when things go wrong and building on successes and producing and sharing information that meets the needs of all individuals and their circumstances.
How was success measured ?
What was the outcome ?(list improvements – Some examples might include : strengthened collaborative working with service users and carers; employs people with lived experience of mental health problems to work alongside staff because of its quality improvement activities. Leaders and administrators set an example of quality management by critically evaluating their own nonclinical jobs ( list any models or methods) As a result, they devote less time to monthly meetings and more to regular or weekly “huddles” to discuss problems as they arise. The trust has also made performance data more accessible to staff and service users (through the use of “visual control boards”) so that everyone can see what is happening in real time (rather than looking back over the previous month). The goal is for leaders and managers to be more mindful of pressures at the service level, allowing for faster decision-making.
- How was this QI shared to other parts of the Trust?
- How were measures implemented sustained ?
Conclusion:
- Sum up
- Draw all parts together
- Reiterate main argument
- Explain why this is a useful conclusion
CASE Scenario
During one of my long day shift on my placement, At around 10:00am A patient known as Vivian (pseudonym) approach the nurse office and requested to use the patient phone to make a call to her care coordinator. The staff nurse said the office phone is not working but did not offer alternative which has been done in the past like asking patient to come and use one of the wards telephone in a supervised area. Vivian left and returned just 15 minutes after that and again request for the ward I Pad again She was told that they can not find it and again not offering her alternative or reassured her that staffs will look for it
At around 2 pm Vivian was observed to be pacing up and down the corridor and muttering to herself, after 10 minutes of pacing the corridors, Vivian charged unprovoked at the nurses office and banged on it aggressively. She began to throw objects at staffs and shouting really loudly and saying that ‘ I need to get out of here now!’ By this time the Nurse in charge had asked another staff to call the response team and whilst all the noise and chaos was going on the other patients begins to respond to the atmosphere by reacting aggressively. The teams arrived from their wards and was brief by the nurse in charge about the current situation on the ward, she said that the patient should basically be taken to seclusion. Vivian was approached by the team and was charging towards one of them, She was restraint in a prone position for a short while where she was tranquillised and taken into seclusion.
SUI meaning Serious untoward Incident
