Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Dianne Conrad

Second Advisor

Dianne Slager

Third Advisor

Laura VanderMolen

Fourth Advisor

Amy Manderscheid


The Patient Protection and Affordable Care Act of 2010 resulted in major changes to healthcare infrastructure in the United States, with two main areas of concentration: healthcare financing and population health management. Quality improvement programs focus on improving healthcare quality for populations with conscious efforts to decrease healthcareassociated expenditures. Quality improvement interventions can include patient-reported outcomes, clinical decision support systems, and clinical dashboards. The purpose of the Doctor of Nursing Practice project was to formally implement a quality improvement program for chronic disease management in a safety net clinic serving vulnerable populations. The Donabedian model served as the conceptual model to frame the formal quality improvement program. The Plan-Do-Study-Act model guided the implementation of the formal quality improvement program. Despite the lack of statistically significant differences between pre- and post-implementation outcome measures, the Doctor of Nursing Practice project established a standard documentation process for several chronic diseases supported by a procedure manual, volunteer education modules, and clinical dashboards. Limitations of the project included the brief evaluation period, the low daily volume of patients with the selected chronic diseases, and the inadequate volunteer survey response rate. Recommendations for sustainability and future iterations involve an investigation into the documentation process of underperforming outcome measures, the identification of an effective process to solicit volunteer feedback on training modules, and the continuation of the clinical dashboard process to generate monthly compliance data to monitor documentation variation over time. The formalization of the quality improvement program in the safety net clinic during this Plan-Do-Study-Act cycle provided a strong foundation from which to launch the next Plan-Do-Study-Act cycle focusing on improved volunteer involvement.

Included in

Nursing Commons