Part 1

Project Overview

Project Name

Decreasing Mortality rates due to Skin Cancer In West Virginia University Hospital through Early

Prevention Strategies

Gap Analysis

In any hospital or healthcare facility, mortality rates can be caused by poor care, a pandemic, or untrained staff. Age, gender, diseases, hereditary factors, and access to medical care all affect mortality. There was a measurably critical expansion in the mortality rate in the US from 2019 to 2020. The number of resident deaths in the United States in 2020 was 3,383,800, more than in 2019 (Centers for Disease Control and Prevention, 2021). The death rate in West Virginia was 16600 per 100,000 people in 2022. The mortality rate increased by 3.84 percent annually in 2022 (The World Bank, 2022). Cancer will claim 609,400 lives in 2022, an average of 1,670 lives each day, with 1.9 million new cases diagnosed. The American Cancer Society estimates there will be 7870 estimated cancer cases and 2400 deaths per day in 2023 (American Cancer Society, 2020). The Centers for Disease Control and Prevention (2019) states that making healthy choices, getting vaccinated, and getting regular screenings can lower a state’s risk of contracting many common types of cancer. One of the leading causes of death in West Virginia is cancer, which should be controlled by taking appropriate safety precautions. The goal is to reduce the estimated daily death toll from 2400 to 1000.

According to Health and Human Resources (2022), skin cancer affects 7% of the adult population in West Virginia. Healthcare organizations must put more effort into the prevention of the disease because the majority of the population is unaware of the consequences of skin cancer. There are gaps in healthcare services related to skin cancer treatment, as the population is not completely acknowledged of the disease, and new staff is not experienced enough to cope with the adverse effects of a disease that later leads to death. The mortality rates are getting increased due, to it is necessary for the staff to learn about prevention measures (Aggarwal et al., 2021).

Skin cancer can be effectively prevented by avoiding excessive exposure, applying sunscreen with a sun protection factor of more than 15 regularly, and wearing protective clothing (World Health Organization,

2019). According to the National Cancer Institute (2022), approximately 22% of all cancer patients mostly

The staff is not well- trained

Evidence to Support the Need

Dietz et al. (2020) state that cancer treatment aims to reduce cancer patients’ deaths and allow them to live everyday lives. Depending on the circumstances, this might or might not be possible. A “Priority” classification for cancer patients was developed across disciplines after extensive multidisciplinary teleconference discussions and a literature review. The severity of each patient’s condition was used to determine priority categories. As a result, mortality rates decreased, and the number of cancer patients decreased.

Between 2015 and 2019, the risk of dying from cancer decreased by approximately 2% annually, compared to 1% annually in the 1990s. The power of screening tests, early diagnosis, and treatment have

the overall capacity to reduce skin cancer mortality rates (American Cancer Society, 2022a).

Problem Statement

The increased mortality rates in the west Virginia population due to skin cancer have become a major concern for healthcare providers. It can be resolved through different educational and secondary prevention strategies, such as awareness campaigns on certain types of cancers, primary prevention strategies of lifestyle and dietary modifications, and a focus on genetics and precision oncology. It will have a positive impact on patient outcomes and will result in high-quality care.

SMART

Objectives

The aims and objectives known as SMART goals can be used to assist cancer patients and healthcare providers in making necessary adjustments. The ambition and objectives should be relevant, precise, measurable, and faultless. Some recommendations for SMART goals that could lower cancer mortality rates are listed below.

Specific: The target population is skin cancer patients in West Virginia hospitals. Individuals prone to skin cancer and diseases will be specifically targeted. As a result of the project, there will be a progression in the betterment of the health of skin cancer patients. The death rate of the patients will decrease as it is currently at 7% and constantly increasing.

Measurable: The number of deaths caused due to cancer will be observed monthly using EHR or surveys. The data relating to skin care patients will be stored in the healthcare records of the oncology department that can be taken accessed by the authorities.

Achievable: This objective is realistic and can be accomplished by professionals collaborating with other

healthcare staff to ensure easy access to screening test tools and other strategies.

Relevance: The suggested interventions are relevant to the issue of increased mortality rates. The aim is to bring positive health-related outcomes. These interventions will result in positive outcomes and the project’s success by educating the patients and training staff to increase their expertise.

Time-bound: The goal will be accomplished in one year. It will start in 2023 and end in 2024.

·         These goals ensure that the aim will be accomplished and that individuals and the overall population will benefit. The time will be divided and managed properly so the project will be successfully accomplished in the given time frame.

Project AIM

Treatments and interventions for cancer can help lower the annual death toll. Additionally, these goals will contribute to an increase in a healthy and flourishing population. Additionally, it is anticipated that 2400 people will die from cancer each day by 2023 in West Virginia.

The purpose of the project is to encourage healthcare workers at West Virginia University Hospital to put in more effort to reduce mortality rates in the patients. The aim of the project is to reduce the skin cancer rate from 7% to 5% from the year 2023 to 2024 by implementing prevention and early detection strategies along with training healthcare workers.

The emphasis will be placed on the role that everyone can play in ensuring that every skin cancer patient receives equal treatment without bias. This can be done by collaborating with interdisciplinary staff, medical professionals, and the community. The healthcare professionals will offer the patients prompt and effective treatment. The goal of the project is to lower the mortality rate in skin cancer patients. The aim of the organization for skin cancer patients is to reduce their death rates by educating them and giving training to the staff that will help them to deliver appropriate services.

Additionally, the aim of the project for the rest of the population is to spread awareness about the disease, and it will result in a lower percentage of skin cancer patients in the future. Healthcare organizations in West Virginia aim to provide care to patients without discrimination and prevent them from adverse side effects of the disease.

To achieve the objectives, this entire procedure will take approximately one year.

Timeline

The following precise objectives and other tested interventions will determine the patient’s timetable.

Proof of setting goals for the entire procedure to lower cancer patient mortality rates can be found here.

Two months of Planning and Preparation

·         Identifying the goals and objectives

·           Evaluating the number of patients with cancer and those in danger of getting the disease

·         Discussing obstacles and problems in achieving goals and suggesting solutions

·         Possession of funds and sponsorship

Implementation:

·         Forwarding the plan through different sources

·         Promotion of primary and secondary prevention strategies for cancer

·         Increasing collaboration with healthcare experts from neighboring organizations

·         Arranging educational seminars to train the staff about cancer treatment.

·         Assessing the progression

According to research by Corso et al. (2023), it was evaluated that primary prevention strategies focusing on educational campaigns and secondary prevention strategies, including screening and early detection, are useful in cancer prevention.

Six months for evaluation of the goal

·         Evaluating information to elaborate on the success of the objective.

·         Identifying gaps to proceed with the plan in a better way.

The change will occur in West Virginia hospitals where patients are admitted with chronic conditions and who are at risk. It is essential to know that this plan can be changed if any changes are needed according to the circumstances. The authorities should keep in mind that the process should be flexible enough to be adopted by healthcare staff and patients.

Part 2

Project Team

Title

Department

Role

Executive Sponsor

Medical oncologist/ Cancer Specialist

Healthcare services in Oncology departments

An executive sponsor for lowering the mortality rate for skin cancer patients in West Virginia is typically a senior healthcare organization member overseeing the management and supporting the program’s progress. The executive sponsor’s primary responsibility is to contribute to the program’s successful completion (Indini et al., 2020). Justin is a well-known medical oncologist with more than 25 years of experience. Due to his professional approach, he has worked for several prestigious healthcare organizations and has had a very successful career in the treatment of skin care. He reduces the mortality rate of cancer patients by recommending various treatments and medications. Justin works with other staff to teach his patients, members of the health team, and the community. He has adequate access to resources and can deal with potential obstacles and challenges. He prioritizes oncology-related cases and will significantly contribute to the program’s success in lowering patient

mortality rates.

Team Members

Title/Departme nt and/or Affiliation

The rationale for Selection/Contribution to the Project

Registered oncology nurse

Anna has 12 years of experience as a registered oncology nurse and has vast experience in looking after skin cancer patients. She contributes to the direct nursing care of cancer patients by administering chemotherapy and other oncology treatments. She helps in providing appropriate supportive care too. Anna also helps in patient education and is a bridge for communication between doctors and patients. Anna is a minority, she is an African American, and she will definitely help in the progression of the communication between doctors and patients.

Psychiatrist

Simon is a psychiatrist who has worked for 14 years to lower cancer patients’ mortality rates. He is crucial in treating depression and other skin cancer-related side effects that occasionally hinder treatment. He addresses mental health and social aspects of cancer in patients. Simon is a local, and he can easily speak the native language, which helps to communicate with the staff and local patients effectively.

Registered dietitian

Mark has 18 years of experience and is a registered dietitian. He has passed a national board exam and is a nutrition and diet expert. He specializes in cancer care in areas like patient weight management. Mark collaborates with patients and the medical team to control the diet of skin cancer patients. Mark is a Christian and belongs to West Virginia. He knows about the religious beliefs and ethical concerns of the patients related to diet plans.

Patient Service Representative

Cristopher has been a patient representative for the past 17 years. When skin cancer patients arrive at the hospital, he is their first point of contact. He is an essential team member as he gathers patient data, aids with the mandatory paperwork, and performs administrative responsibilities. He has been to many countries and is aware of the ethical beliefs, norms, and values of the stakeholders.

Team Leader

Dermatologist

Maria has been a dermatologist in the oncology department for 12 years. She has received special training in procedures, finding out about the severity and stage of the disease, and identifying and treating cancer. She also removes cancerous growths through procedures like biopsies and surgery.

Innovative leadership

When tackling issues associated with a complex disease like skin cancer, innovative leadership typically emphasizes providing a fresh and innovative point of view and

assisting team members in developing alternative perspectives. According to Kremer et al. (2019), this leadership style helps to solve problems or make the most of limited resources.

Transformational leadership

Siangchokyoo et al. (2019) claim that a healthcare organization led by a transformational leader employs an interdisciplinary strategy to achieve its goals. A transformational leader seeks input from staff and the community and determines the need for organizational change based on health outcome data.

This leadership approaches help the leaders to perform their job appropriately and communicate with other team members in a more effective way that ensures the success of the program to decrease the mortality rate in cancer patients.

·         A leader must demonstrate the quality of emotional intelligence in a healthcare organization. A leader can use this skill to understand better and control their emotions and those of their team members. Communicating with team members effectively enables the team leader to comprehend team members’ aspirations. Leaders and their teams benefit from good empathy when they can communicate continuously. It promotes growth and increases productivity (Momeny & Gourgues, 2019).

Stakeholders

Title/Role or Affiliation

Connection to the

Project

How Affected/Impacted by

Project?

Contribution to the Project

Healthcare staff in Oncology department

Monitoring and screening cancer patients at regular intervals and educating the cancer patients

about the severity of

The participants effectively impact the project by communicating and discussing aspects of the program with a team.

They will guide patients, perform screening tests and allow direct communication between skin cancer patients and doctors.

their condition in

different ways.

Health Promotion Organizations/ American Association for Cancer Research

Prevention and cure of cancer to decrease the mortality rate

They promote funding that will boost cancer-related research

Their contribution can be through suggesting strategies to foster a professional work environment and financially supporting the project

Policymakers/ Warner, Kelly

Making new policies and skin cancer prevention strategies

They will practically get involved in the program. Policymakers will pass new policies and rules that will help

the process progress.

These participants help to boost the program by supporting the patients’ concerns like security, insurance, and confidentiality.

Communication Plan

The purpose of communication plan for an executive sponsor, stakeholders, and team members is to boost the procedure to accomplish the goals of program to decrease mortality rate in skin cancer patients. The communication will benefit the team members by bringing innovative ideas from professionals. Team participation will be increased by online means or through face-to-face discussions. They will communicate through round table discussions and conferences, where the important aspects related to the program such as barriers and opportunities, will be discussed. They can communicate whenever they want, no matter where they are. Meetings are held regularly to discuss the program’s progress and identify patients who require additional care. The project leader will provide daily reports to the sponsors, letting them know how the program is progressing.

According to Stellefson et al. (2020), the aim and objective of communication are to inform executive supporters of the difficulties and obstacles and then discuss ways to remove them. The executive sponsors will provide weekly updates on the program’s progress and outcomes to the Board of Directors. Chambers et al. (2022) claim that the project committee can use additional monthly graphs, such as a Gantt map, to visually represent the program’s progress. The primary goal of the communication will be to make sure the panel is aware of the initiative because they are involved in its success. Diversity, cultural competency, varying levels of knowledge, and inclusion may present all present communication challenges

(Concannon et al., 2018). CLAS standards are also applied to ensure that all the healthcare services for skin cancer patients

are culturally and linguistically respectful. Inequality and healthcare disparities are removed due to following these standards. These factors may impact communication between the executive sponsor, stakeholders, and team members.

References

Chambers, C., Dada, M., & Williams, K. (2022). Special issues in process analysis for health care: Visualization, & project management. Improving Processes for Health Care Delivery, 27–52. https://doi.org/10.1007/978-3-031-19043-8_2

Concannon, T. W., Grant, S., Welch, V., Petkovic, J., Selby, J., Crowe, S., Synnot, A., Greer-Smith, R., Mayo-Wilson, E., Tambor, E., & Tugwell, P. (2018). Practical guidance for involving stakeholders in health research. Journal of General Internal Medicine, 34(3), 458–463. https://doi.org/10.1007/s11606-018-4738-6

Indini, A., Aschele, C., Cavanna, L., Clerico, M., Daniele, B., Fiorentini, G., Fioretto, L., Giordano, M., Montesarchio, V., Ortega, C., Pinotti, G., Scanni, A., Zamagni, C., Blasi, L., & Grossi, F. (2020). Reorganisation of medical oncology departments during the novel coronavirus disease-19 pandemic: a nationwide Italian survey. European Journal of Cancer, 132, 17– 23. https://doi.org/10.1016/j.ejca.2020.03.024

Kremer, H., Villamor, I., & Aguinis, H. (2019). Innovation leadership: Best-practice recommendations for promoting

employee creativity, voice, and knowledge sharing. Business Horizons, 62(1), 65–74. https://doi.org/10.1016/j.bushor.2018.08.010

Part 3

Intervention

Planned Intervention

The aims and objectives of the program, which are to lower mortality rates of skin cancer in West Virginia hospital, can be met by focusing on various aspects. Focusing on these factors will help to boost the intervention plan. According to the study by Chen (2021), educational seminars were conducted by oncology professionals to educate healthcare staff and patients about skin cancer screening. This effort resulted in acknowledgment in related individuals which ultimately resulted in fewer skin cancer patients and low mortality rates. Staff became more educated while hesitancy in the skin cancer patients about screening tests was also decreased. The intervention plan will include the following components:

·         Training Staff

Giving training and awareness to the current and new staff to get more idea about the importance of the program could help in the accomplishment of the project. Nurses, physicians, and surgeons will be given the appropriate and necessary training in cultural competency and giving treatment without discrimination. The staff will be given proper training through educational seminars by professional experts. They will be acknowledged about skin cancer prevention strategies.

·         Identifying Barriers

Addressing the barriers to accomplishing the program will help boost the plan. Access of patients in rural areas to healthcare services can also be addressed.

·         Interdisciplinary Collaboration

Interdisciplinary collaboration can be promoted by communicating with healthcare staff and policymakers. It will foster empathy and harmony among staff, and they will develop innovative ideas.

·         Increasing Patient Knowledge

Increasing patient knowledge through campaigns and regular awareness sessions can help increase their involvement in the treatment process and increase their life span. The patients will be informed that they can reduce the severity of their disease by following prevention strategies. Multiple preventive methods can be followed by skin cancer patients as well as the local population to reduce

the risk of skin cancer. These strategies involve less exposure to sunlight, wearing clothes that cover

body parts, wearing a brim or hat to cover the face and head while going out, wearing sunscreens, and wearing sunglasses that resist Ultraviolet rays.

The planned intervention will help to bridge the gap. There is a lack of knowledge among the patients, and the staff is not well-trained. These issues are to be addressed by the authorities. As the percentage of patients suffering from skin cancer is 7%(Health and Human Resources, 2022), that has to be reduced to 5%. The gap between both percentages is 2%

Stakeholders, patient service representatives, Registered nurses, dietitians, and other healthcare staff will be involved in implementing the change. The implementation process will be started after getting access to all the important data auditors related to the patients from Electronic Health Records. The process will take place at the oncology department of West Virginia University Hospital. The data will be secured and safe in a password-protected EHR where it will be given the right of confidentiality through HIPAA. After accessing the data, staff will be given proper training about implementing the process to decrease the death rate in skin cancer patients.

Measurement: Proposed Outcomes

Develop outcome, process, and counter/balancing measures for your project.

Outcome Measure

What is the desired outcome in measurable terms?

Process Measure

State 1–2 process measures that address:

Counter/Balancing Measure

·         The desired outcome is a reduction in mortality rate due to skin cancer from 7% to 5% in the The West Virginia University Hopsital.

·         Hospital will achieve the expected average of 5% of skin cancer patients. This project will be completed in a year after proper training of the staff.

·         All the staff members who are related to this process will get complete training and after that learning sessions after regular intervals will also be given.

·         Staff will perform screening tests regularly for early

detection of the disease and

·         The staff will face burnout as they must manage duty hours and attend training sessions.

·         Patients may face an increase in appointment

availability because

·         The SMART objective is to decrease the death rate and incresae thelife span of population through different prevention strategies.

those who do not follow the protocol will be penalized

·         Patients will be acknowledged through educational campaigns and sessions by the healthcare staff when they visit the hospital.

most of the staff will be busy with the training

Data Collection & Management

Use the table below to develop a plan for the collection, management, and stewardship of the data you will collect for your Project Charter. Use at least one source/citation to support your data collection plan.

Data Collection

Data Collector

Collection Timeline

Data Storage/Protection

Diversity, Equity, and Inclusion

·         Opinions, experience, and awareness of the stakeholders related to skin cancer patients; assessments may be administered through questionnaires (Nicholson et al., 2020).

·         Surveys will be helpful in collecting data to measure

A proficient auditor will collect data from EHRs and through data analysis.

Staff will evaluate that the questionnaire is answered properly, and the collected data is useful in the project or not.

·           The data collection will be started from the first day when the program is started. It will end with the completion of the project.

·           Data collection on

·         All the data accessed will be stored in the EHR of the hospitals as it is confidential information that cannot be published or shown publicly.

·         Security, confidentialit y, and

·         Issues pertaining to cultural competence, and the quality of care will be addressed using demographic data.

·         Issues such as cultural differences and language barriers that affect data utilization will be addressed.

·         By ensuring that data collection tools are

decrease or increase in the number of patients

·         Data will be collected related to skin cancer patients as well as that part of population which is at risk of skin cancer to identify causes and risk factors

weekly and monthly basis will also be done by the auditor

anonymity will also be maintained. It will be accomplishe d by following regulations such as Health Insurance Portability and Accountabilit y Act (HIPAA)

(Wagner et al., 2022).

bias-tested, bias will be decreased or removed.

·         Multiple analysts interpret the data

Ethical Leadership

West Virginia University Hospital have a duty to provide equal and quality care to all the patients. As the staff will be given training, it will help them to get a better idea of cultural competency and diversity. The initiative aims to make it easier for skin cancer patients and patient who are at risk of skin cancer to access quality healthcare services and reduce mortality rates. This could lead to better medical outcomes, like fewer cancer patients dying and early detection. People need to be sufficiently educated about the plan’s significance and necessity and may harm themselves if they attempt to make unhealthy and inappropriate choices rather than following the plan (Rawla et al., 2018). The Quadruple Aim of the program ensures that the needs of the patients and healthcare providers are addressed, resulting in improving the health of the target population. The Quadruple Aim is an extended version of the Triple Aim that considers the patient experience, population health, lowering patient costs per capita, and staff satisfaction (Haverfield et al., 2020). The Quintuple Aim is the same as Quadruple Aim but also involves equity as the fifth component (Nundy et al., 2022). The staff will benefit from these frameworks in terms of improved treatment, efficient communication, comprehension of the

patient’s requirements, job satisfaction, and the provision of high-quality care.

Patients will feel more open to discussing their condition with healthcare professionals. As a result, we may better understand how to avoid skin cancer and the factors that contribute to it, which may result in lower costs and more accessible healthcare.

The initiative must be impartial and consider the ideas and points of view of marginalized groups and minorities. Those who live in rural areas, face financial instability, and are subject to racial discrimination are vulnerable groups that may face more significant obstacles to access. To better communicate with the team, the leader will employ credible leadership styles, such as transformational, innovative, or both. The leader will also consider the participants’ well-being as it will promote efficiency and efficacy in the services.

According to Ueda et al. (2020), staff training is essential to ensure patients receive accurate information about the disease and healthcare services. The leader must consider following the Quadruple/Quintuple aim as it will enhance performance. The team leader will follow ethical leadership and ensure the work environment follows an ethical code of conduct and principles. Additionally, ethical leadership will be promoted if the healthcare staff and community members work together to reduce healthcare inequity and disparities.

SWOT Analysis

Strengths

The West Virginia University Hospital has organizational and executive support for implementing the project. Assets of an organization such as funding, resources, and executive support are the assets of the organization. This includes community outreach to raise awareness and resources for staff training. Additionally, the organization is in good standing with community stakeholders, which will benefit the program’s success. Patients with skin cancer will benefit from it, and mortality rates will decrease. Unbiased behavior and non-discriminatory treatment delivered by healthcare staff are qualities of West Virginia University hospital that make it different from others.

Weaknesses

There are various obstacles and challenges that are considered as weaknesses in the program. Lack of training among staff is a major obstacle. Lack of adequate staff is a major issue that will directly result in an increase in mortality rates of skin cancer patients. Apart from that, some of the staff members may resist or be hesitant in taking training and implicit discrimination against patients. Another potential weakness is the lack of knowledge among the patients and other general populations about skin cancer, which results in an increase in their number.

Opportunities

Multiple factors play part in the likelihood of the project. The training sessions will be arranged for the staff members, which is an opportunity for the healthcare organization to train them properly. Moreover, the hospital may hire new staff to reduce staff burnout, which will benefit the project. Awareness about the disease among the local community will be helpful to make the project implication process easier. Organizations can have access to external resources as well as there are also training opportunities for the staff.

Threats

Less staff and more patients may result in a low quality of care for the patients. The staff’s lack of ability to implement the project’s initiatives to the fullest and put the training into practice is another potential threat. Another threat is an increase in competition in the organization. Additionally, there may be unexpected changes in the policies or regulations that could be unfavorable for the organization.

References

Chen, K. (2021). Efficacy of educational seminars in increasing skin cancer screening in Asian Americans. Yale School of Medicine Physician Associate Program Theses. https://elischolar.library.yale.edu/ysmpa_theses/97/

Haverfield, M. C., Tierney, A., Schwartz, R., Bass, M. B., Brown-Johnson, C., Zionts, D. L., Safaeinili, N., Fischer, M., Shaw, J. G., Thadaney, S., Piccininni, G., Lorenz, K. A., Asch, S. M., Verghese, A., & Zulman, D. M. (2020). Can patient– provider interpersonal interventions achieve the quadruple aim of healthcare? A systematic review. Journal of

General Internal Medicine, 35(7), 2107–2117. https://doi.org/10.1007/s11606-019-05525-2