C983
Quality Improvement in Healthcare
TASK 2
Pilot Plan Template
(Passed First Attempt)
Western Governors University
, Task 2
A. Perform a root-cause analysis by doing the following:
1. Critique the continuous quality improvement (CQI) team’s five whys analysis by
explaining how it could have been conducted more effectively.
The initial 5 why analysis focuses too specifically on the emergency
department without taking into consideration of other entities that impact the
patient satisfaction of emergency medicine. This is too narrow of a scope and
focus which will bring some analysis back, but not enough to make a large
scale change necessary to impact patient satisfaction. The questions asked
were valid, but the problem requires much more than just the 5 proposed
questions in the 5 Why analysis- digging deeper and asking a set of 5 whys to
lead and direct the quality improvement is necessary in this situation (Lighter,
2011).
a. Discuss whether the “why” cycle has been performed to a logical end in
which additional questions would not change the response.
The “why” cycle here would not lead to a logical end; additional questions
would surely change the responses. As we dig deeper into the 5 Why analysis,
more and more is uncovered with each set of questions. This is a simple
technique to determine cause, and a cause can be detected early in the
questions, but here there are more than one cause and many potential
solutions paired with each cause. By further evaluating and preforming more
questioning we can figure out what cause has the highest impact and change
the process to alter patient satisfaction (Lighter, 2011).
2. Using the attached template, create an Ishikawa
diagram using the information from the process flowchart,
SIPOC map (from Task 1), and the five whys analysis.
a. Explain the effectiveness of using the Ishikawa diagram to synthesize the
results from multiple information sources.
Ishikawa diagram, like the SIPOC diagram, allow analysis of each part of a
process to evaluate effectiveness, limitation, and opportunity within each
section of the process and outcomes. It spreads the process out to be able to
visualize every step and help identify the clear gaps in the process
management. By using this it can be easier to decide what areas need
improvement and where the direct patient impact sections exist. Since the
process is spread out, we can implement changes to involve more processes
or tool to help perfect the process where opportunities exist.
This study source was downloaded by 100000902171055 from CourseHero.com on 11-13-2025 21:45:20 GMT -06:00
https://www.coursehero.com/file/73033695/C983-Task-2-Jdocx/
Quality Improvement in Healthcare
TASK 2
Pilot Plan Template
(Passed First Attempt)
Western Governors University
, Task 2
A. Perform a root-cause analysis by doing the following:
1. Critique the continuous quality improvement (CQI) team’s five whys analysis by
explaining how it could have been conducted more effectively.
The initial 5 why analysis focuses too specifically on the emergency
department without taking into consideration of other entities that impact the
patient satisfaction of emergency medicine. This is too narrow of a scope and
focus which will bring some analysis back, but not enough to make a large
scale change necessary to impact patient satisfaction. The questions asked
were valid, but the problem requires much more than just the 5 proposed
questions in the 5 Why analysis- digging deeper and asking a set of 5 whys to
lead and direct the quality improvement is necessary in this situation (Lighter,
2011).
a. Discuss whether the “why” cycle has been performed to a logical end in
which additional questions would not change the response.
The “why” cycle here would not lead to a logical end; additional questions
would surely change the responses. As we dig deeper into the 5 Why analysis,
more and more is uncovered with each set of questions. This is a simple
technique to determine cause, and a cause can be detected early in the
questions, but here there are more than one cause and many potential
solutions paired with each cause. By further evaluating and preforming more
questioning we can figure out what cause has the highest impact and change
the process to alter patient satisfaction (Lighter, 2011).
2. Using the attached template, create an Ishikawa
diagram using the information from the process flowchart,
SIPOC map (from Task 1), and the five whys analysis.
a. Explain the effectiveness of using the Ishikawa diagram to synthesize the
results from multiple information sources.
Ishikawa diagram, like the SIPOC diagram, allow analysis of each part of a
process to evaluate effectiveness, limitation, and opportunity within each
section of the process and outcomes. It spreads the process out to be able to
visualize every step and help identify the clear gaps in the process
management. By using this it can be easier to decide what areas need
improvement and where the direct patient impact sections exist. Since the
process is spread out, we can implement changes to involve more processes
or tool to help perfect the process where opportunities exist.
This study source was downloaded by 100000902171055 from CourseHero.com on 11-13-2025 21:45:20 GMT -06:00
https://www.coursehero.com/file/73033695/C983-Task-2-Jdocx/
