Discussion Due July 28, 2022 S8.00 The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned. To support your work, use your course and text readings and also use outside sources. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Complete your participation for this assignment by the end of the week. Good Leadership Good leadership is important for quality improvement processes, customer relationships, employee retention, and overall organizational processes. A good leader has several characteristics, including balanced commitment, positive role model, communication skills, positive influence, and persuasiveness. However, each leader may have a personally distinct style of leadership. In this discussion, you will explore the importance of leadership and the various leadership styles. Respond to one of the following questions: Question 1: · Discuss each of the following characteristics as they relate to quality leadership: · Balanced commitment · Positive role model · Communication skills · Positive influence · Persuasiveness · Analyze and explain which of these characteristics will be the most difficult to achieve for good leadership. Support your rationale with research and your experience. Question 2: · Select any two of the following leadership styles and compare them in terms of effectiveness: · Participative · Goal oriented · Situational · Explain how leaders can (and should) influence the results of efforts to improve quality and explain how the leaders can be impacted by those efforts. As the final paragraph of your post, discuss your personal leadership style. Of the various characteristics discussed in your post, describe which attribute you would integrate in your behavior. Support your rationale with an example situation in which that attribute would be highly effective. NUR 634 SOAP Note Guide and Template Patient SOAP Note Charting Procedures S = Subjective O = Objective A = Assessment P = Plan Subjective: Information the patient tells the treating team or patient advocate. Symptoms, not signs. These are typically not measurable, such as pain, nausea, and tingling, hence the term “subjective” as opposed to “objective”. Normally, the practitioner is not aware of this information until the patient provides it. Objective: Information gathered by the treating team or provider which ...

1. Discussion Due July 28, 2022 S8.00
The discussion assignment provides a forum for discussing
relevant topics for this week based on the course competencies
covered.
For this assignment, make sure you post your initial response to
the Discussion Area by the due date assigned.
To support your work, use your course and text readings and
also use outside sources. As in all assignments, cite your
sources in your work and provide references for the citations in
APA format.
Start reviewing and responding to the postings of your
classmates as early in the week as possible. Respond to at least
two of your classmates. Participate in the discussion by asking a
question, providing a statement of clarification, providing a
point of view with a rationale, challenging an aspect of the
discussion, or indicating a relationship between two or more
lines of reasoning in the discussion. Complete your
participation for this assignment by the end of the week.
Good Leadership
Good leadership is important for quality improvement
processes, customer relationships, employee retention, and
overall organizational processes. A good leader has several
characteristics, including balanced commitment, positive role
model, communication skills, positive influence, and
persuasiveness. However, each leader may have a personally
distinct style of leadership. In this discussion, you will explore
the importance of leadership and the various leadership styles.
Respond to one of the following questions:
Question 1:
· Discuss each of the following characteristics as they relate to
quality leadership:
· Balanced commitment
· Positive role model
· Communication skills

2. · Positive influence
· Persuasiveness
· Analyze and explain which of these characteristics will be the
most difficult to achieve for good leadership. Support your
rationale with research and your experience.
Question 2:
· Select any two of the following leadership styles and compare
them in terms of effectiveness:
· Participative
· Goal oriented
· Situational
· Explain how leaders can (and should) influence the results of
efforts to improve quality and explain how the leaders can be
impacted by those efforts.
As the final paragraph of your post, discuss your personal
leadership style. Of the various characteristics discussed in your
post, describe which attribute you would integrate in your
behavior. Support your rationale with an example situation in
which that attribute would be highly effective.
NUR 634 SOAP Note Guide and Template
Patient SOAP Note Charting Procedures
S = Subjective
O = Objective
A = Assessment
P = Plan
Subjective: Information the patient tells the treating team or
patient advocate. Symptoms, not signs. These are typically not
measurable, such as pain, nausea, and tingling, hence the term
“subjective” as opposed to “objective”. Normally, the
practitioner is not aware of this information until the patient
provides it.
Objective: Information gathered by the treating team or
provider which is typically observable and measurable, hence
“objective” as opposed to “subjective”. Normally, the patient
is not aware of this information until the practitioner elicits it.

3. This might include, for example, ranges of motion, body
temperature, blood pressure, the presence of a skin rash or
wound, comments about the patient’s posture or gait, and the
results of examination procedures and testing.
Assessment: The diagnosis. This must be documented prior to
the rendering or delivery of any treatment. Symptom code can
be documented as assessment when pending final diagnosis such
as Chest pain vs. MI.
Plan: Based on the assessment or diagnosis, the treatment or
therapeutic plan must be outlined. This may include both short
and long term plans. It is important to record not only passive
therapy, such as an injection, a prescription, a spinal
manipulation or a massage, but also active therapy such as home
care advice, exercises or other recommendations. All treatment
planned or delivered must be recorded.
SOAP NOTE TEMPLATE
**Please delete the instructions in each section prior to
submitting the assignment
Student Name: Date:
Course:
Subjective:
Patient Demographics: (age, gender, gender identity, ethnicity,
etc.)
Chief Complaint: “quote patient”
History of Present illness: (Be sure to tell the “story” of the cc
using the 7 attributes or OLDCARTS)
PMH: dates in reverse chronological order.
PSH: surgery dates in reverse chronological order.
Allergies: medications, OTCs, supplements, &
environmental/seasonal/food allergies

4. Untoward Medication Reactions: include type of
reaction/severity/date
Immunization Status: e.g. Flu, COVID, TdaP, etc.
Screenings: In this section you will document any age-
appropriate screenings the patient had prior to the visit today.
For example, dental visits, PAP, colorectal screening,
microfilament, etc… (Indicate if results were normal or
abnormal)
FMH: document genetically relevant conditions of immediate
family members (parents, children, siblings, and grandparents).
If history is unknown then document “history unknown” for the
family member you inquired about.
Personal History/Social History: Occupation, home
environment, relationship status, nutrition, exercise, and
substance use (smoking, alcohol, illicit drug use)
Females: LMP and relevant OB/GYN history Gravida, Para,
Abortions, Living (G__P__A__L__)
If prior pregnancies document any pregnancy or postpartum
complications.
Sexual History: #of partners, sex of partner/s,
protected/unprotected sexual relations, contraception
Current Medications/OTCs/Supplements: indicate Dose, Route,
Frequency(write either class of medication or indications for
use in parentheses)
For Episodic Visit, only list ROS/PE that are pertinent to
CC/HPI. Complete a full ROS for a comprehensive/well exam
visit.
Review of Systems:
General:
Skin:
HEENT:

5. Head:
Eyes:
Ears:
Nose:
Throat:
Breasts:
Respiratory:
Cardiovascular:
Gastrointestinal:
Genitourinary:
Peripheral Vascular:
Musculoskeletal:
Neurologic:
Hematologic:
Lymphatic:
Endocrine:
Psychiatric:
Objective:
For Episodic Visit, only list ROS/PE that are pertinent to
CC/HPI. Complete a full PE for a comprehensive/well exam
visit.
Physical Exam:
Vital Signs: Blood Pressure- P- RR- T- Height- Weight-
BMI-
General:
Skin:
HEENT:
Head:
Eyes:
Ears:
Nose:
Throat:
Neck:
Breasts:
Lungs:

6. Heart:
Abdomen:
Genitourinary:
Rectal:
Peripheral Vascular:
Lymphatic:
Extremities: Musculoskeletal:
Neurological:
Assessment:
Differential Diagnosis Diagnostic Reasoning Exercise:
Minimum of 3 differential diagnoses/maximum of 5
differentials—the table will help with the narrative write-up
required below the table.
Differential Diagnoses
Pathophysiology
(include APA citations)
Pertinent Positives
Pertinent Negatives
1.
2.
3.
4.

7. 5.
In a narrative format explain how you arrived at your final
diagnosis or working diagnoses based on the CC/HPI, PMH,
PSH, ROS, & Physical Exam (pertinent +/– will guide this
process). This should be written using examples of how the
history/clinical presentation led to the final diagnosis or
working diagnosis (APA citations to your references must be
included – use resources with Evidence Based Guidelines)
Plan:
Include a brief summary of the visit here
(APA citations required in your plan)
In this section, you would list the diagnosis that you assessed
for your patient. The Diagnosis is your primary/working
diagnosis made at the time of the visit. If you have not made a
diagnosis, then you would use the ICD-10 code for the
symptomatology since r/o diagnoses are not billable. This
should be followed by a plan of care that is evidenced based.
Diagnosis ICD-10 (must be related to CC/HPI)
· Treatment
· Lab/test
· Referral
· Education
· Follow up
Health Maintenance: Required App for USPSTF screening
guidelines https://epss.ahrq.gov/PDA/index.jsp
Must list all screenings/lifestyle recommendations that are age
appropriate (e.g. seasonal flu vaccine, HIV screening; STI
screenings, obesity—nutritional/exercise counseling; smoker—
tobacco cessation program, etc. even though you may not

8. address in an episodic visit)
RTC: (Document disposition)
References (APA Format)
Quality Function Deployment
In previous lessons, you have learned the importance of
customer feedback in the process of implementing quality
management.
However, the previous discussions have mostly focused on
gathering customer feedback and making improvements to an
existing to
product or service. Quality Function Deployment (QFD), on the
other hand, focuses on designing each new product with
customer
input as a main aspect.
QFD is useful in analyzing, evaluating, and incorporating
customer needs in the process of designing a product or a
service. In other
words, QFD ensures an organization produces what its
customers want. The bene�ts of using QFD include customer
focus, time
ef�ciency, teamwork orientation, and documentation
orientation. The steps involved in implementing QFD include
forming the

9. project team, establishing monitoring procedures, selecting a
project, conducting a kickoff meeting, training the project team,
and
developing the matrices.
Tools for QFD
To help identify and incorporate customer inputs, QFD involves
the use of traditional quality tools as well as several specialized
tools,
such as the af�nity diagram, the interrelationship digraph, the
tree diagram, and the matrix diagram.
Af�nity Diagram
It is used to promote creative thinking and the �nding of new
and different approaches to continuous improvement.
Interrelationship Digraph
It is used to logically identify relationships among different
ideas.
Tree Diagram
It is used to identify all the tasks that must be completed in
order to solve a problem.
Matrix Diagram
It is used to identify and graphically represent connections
among such things as responsibilities, tasks, and functions.
The elements of QFD are somewhat complicated and
interrelated. Careful attention should be paid to each of the

10. four tools that
make up the QFD matrices. Search for and study example of
each of the �gures.
Statistical Process Control
Statistical process control (SPC) is a statistical method of
separating special-cause variation from natural variation to
eliminate the
special causes and to establish and maintain consistency in a
process. This consistency enables process improvement.
Special-cause
variation is a departure from the output that a process would
normally produce due to some unusual circumstances like a
broken
machine or a power outage (in the case of the provision of a
service like a car wash).
There is a normal degree of variation in every process. For
example, when you to go the bank and stand in line to see a
teller, some
days you wait for a very short time (or none at all), while on
other days the wait seems very long. Depending on how
customers arrive
at the bank, this variation is normal and is to be expected.
However, if the bank begins to experience computer problems
which cause

11. the tellers to be unable to complete the customers’ transactions
at their normal pace, then the wait time may become much
longer
than usual, and will likely not return to normal until the
computer issues are �xed and the tellers have been able to catch
up on the
job of completing the transactions of the customers.
The key contribution of SPC to the collection of quality tools is
the ability to distinguish the results of a special cause (an
extremely
long wait time due to the computer problems) from the normal,
day-to-day variation that is inherent in any process (short wait
time
one day, longer wait time the next day).
In order to understand how SPC works in improving processes,
it is helpful to look at an example that demonstrates the
importance
of the �ve key rationales of SPC. Please review the
Supplemental Media entitled “Five Key Rationales of SPC” in
order to see such an
example.
Additional Materials
View a PDF transcript of Five Key Rationales Of SPC
(media/week5/SUO_BUS4101%20W5%20L1%20Five%20Key%

12. 20Rationales%20Of%20SPC.pdf?
_&d2lSessionVal=G8yTd5fDEtOWhKGrLSjs64OmW&ou=9083
2)
https://myclasses.southuniversity.edu/content/enforced/90832-
17106883/media/week5/SUO_BUS4101%20W5%20L1%20Five
%20Key%20Rationales%20Of%20SPC.pdf?_&d2lSessionVal=G
8yTd5fDEtOWhKGrLSjs64OmW&ou=90832
Five Key Rationales of SPC
Inconsistencies at Elevate Accounting
The financial system used by each department in Elevate
Accounting is user friendly and customizable. In
other words, each department can customize the system as per
its particular requirements and work without
any coordination with the other departments. Although the
system works well during the year, it produces
inconsistent reports at the end of each financial year. Therefore,
the management of Elevate Accounting has
decided to modify the financial system, so the system has a
centralized database and works at integrating all
the departments.
Elevate Accounting can use the five rationales of SPC to make
the required modifications and create an
effective system.
Control Variation

13. The output of the new process should be as per the set limit.
Any variation to the output must be
documented and explained. This method helps control variation
and provides consistent output.
Continual Improvement
In this case, SPC will help all departments of Elevate
Accounting understand the process as a whole,
identify the external special causes of variation, and eliminate
the special causes, if any. This understanding
will allow different departments to collaborate and integrate and
help each other in completing financial
tasks, such as making payments to vendors and service
providers. As a result, the process will be
continually evolving and improving.
Predictability of Processes
When causes of variations are identified, the variations are
eliminated, and the process is continually
improved, then the output of the process becomes predictable.
For example, with SPC, all departments will
know such things as the dates and amounts of checks that need
to be paid, the vendors that need to be paid,
and the vendor data that needs to be recorded.
Elimination of Waste
In this case, the new process developed by using SPC will yield
predictable and consistent output.
Therefore, there will be less time, effort, and cost spent on
rework, coordination, and resolving confusion.
In other words, SPC will eliminate wasteful activities and
increase the quality of the output.
Product Inspection
SPC can help Elevate Accounting reduce costs and increase
competitiveness by regularly testing,

14. maintaining, and inspecting the new process.
© 2017 South University
Traditional Quality Tools
Quality management tools help businesses improve quality,
productivity, and customer satisfaction. The following are some
traditional quality tools:
A Pareto Chart is a bar graph in which the lengths of the bars
represent frequency or cost of a problem. This chart shows
problems
that are more signi�cant than others. Organizations can use
Pareto charts to analyze data to identify and focus on the most
frequent
or costly problem, allowing the organizations to decide where to
allocate limited resources.
A Cause-and-Effect (Fishbone) Diagram is used to identify the
possible causes for an effect, or problem. It can be successfully
used in
a brainstorming session to sort ideas into useful categories.
A Check Sheet is a structured form for collecting relevant data
and presenting it in an easy-to-understand format. Check sheets
are

15. useful for data that is observed and collected repeatedly by the
same person or at the same location, in order to analyze data on
the
frequency or patterns of problems.
A Histogram helps to identify the frequency of a particular set
of problems over speci�c time frames. Organizations can use
histograms to analyze numerical data, and to determine whether
the output of a process is distributed normally, can meet
customer
requirements, and is steady over time.
A Scatter Diagram is used to determine the correlation between
two variables. It can also be used when the dependent variable
may
have multiple values for each value of the independent variable.
For example, after brainstorming causes and effects, an
organization
can use the scatter diagram to determine whether a cause and an
effect are related.
A Run Chart is used to analyze the performance data of a
process over a time. However, the run chart does not help in
identifying
whether the variations in data are caused by special causes or
common causes.
A Control Chart is another traditional quality tool, but is the
only such tool that requires a certain level of familiarity with
statistics.

16. It is similar to a run chart, but it has a central line for
determining the average, an upper line for determining an
“upper control limit,”
and a lower line for determining a “lower control limit.” By
comparing current data to these lines, it is possible to identify
whether the
variations in data are caused by special causes or common
causes.
A control chart can be used when controlling ongoing processes,
when predicting the expected range of outcomes of a process, or
when determining the stability of a process. It is also useful in
analyzing patterns of process variation from special causes or
common
causes. Finally, it is useful in determining whether a quality
improvement project should aim to prevent speci�c problems or
to make
fundamental changes in the process.