1. From the Joint Commission website, select a QI/QM initiative that has been implemented in your place of employment (mount sinai hospital). Discuss the effects that it has made in your organization. If you do not have a place of employment, select a QI/QM initiative that has been implemented in healthcare and discuss the effects of this initiative.Support your initial post by including two references: 1) one reference from an English-titled, peer-reviewed nursing journal (less than 5 years old) and 2) one from the course textbook.2. Review existing posts and reply to at least one of your colleague’s ideas or feedback. Support your response by including: 1) one reference from an English-titled, peer-reviewed nursing journal (less than 5 years old). This article must be different from the one used for the initial post.Additional peer-reviewed journal articles, textbooks and professional, governmental, or educational organizations websites (.org, .gov, or .edu) may be used as supplemental references for the initial post and the response.APA format required. See criteria and grading rubric for discussions prior to submission.Reply to this peer discussion :Quality Improvement InitiativeA quality improvement (QI) initiative directs its efforts towards the improvement of healthcare outcomes amongst patients after correct identification of a problem and implementation of a counteractive solution. This discussion covers a QI initiative of the actualization of an enhanced recovery after surgery (ERAS) program amongst patients undergoing elective cesarean delivery with corresponding measurement and assessment of change in care outcomes.Precisely, the QI initiative involved here consists of elective cesarean delivery patients over two 12-month periods before and after implementation of the initiative and the measurement criterion is based on the measurement of the opioid exposure of the patient. Each of the 12-month observation period involve 4689 and 4624 patients respectively, spread across 15 hospitals (Hedderson et al., 2019). The specific outcome improvement measurement tenets included an improvement on the management of pain after the surgery, early capability to move, good nutrition and enhanced engagement with patients. As expected, the results of the study indicate a reduction in morphine equivalents which can be interpreted as reduced morphine use, an improvement in the management of pain, improved nutrition and increase in number of patients showcasing stable mobility earlier.Additional measures of assessment for the study included observation of period of hospital stay, readmission rates, breastfeeding statistics and infections contracted at surgical sites. Improvement observed based on such measures indicates the functionality of the QI initiative implemented (Kathy & Janice, 2016). Overall, the observation that opioid use is controllable without a negative effect of the initiative on after surgery pain management reinforces the purpose of a QI initiative.ReferencesHedderson, M., Lee, D., Hunt, E., Lee, K., Xu, F., & Mustille, A. et al. (2019). Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery. Obstetrics & Gynecology, 134(3), 511-519. doi: 10.1097/aog.0000000000003406Kathy, B., & Janice, H. (2016). Professional Nursing Practice: Concepts and Perspectives (7th ed.). New York: Pearson.

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