How is it measured? How is it defined? Quality Nursing Care How is it measured? How is it defined?

Defining “quality” Definition of quality may depend upon stakeholder perspective. IOM definition:  The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. http://www.iom.edu/Global/News%20Announcements/Crossing-the-Quality-Chasm-The-IOM-Health-Care-Quality-Initiative.aspx. Accessed June 8, 2011

Nursing Sensitive Quality Indicators (ANA) Staffing mix Total nursing care hours/patient day Pressure Ulcers Patient falls Patient satisfaction with: pain management Educational information Overall care Nursing care Nosocomial infection rate Nursing staff satisfaction

National Database of Nursing Quality Indicators Initiated in 1998 The goals: to promote and facilitate the standardization of information submitted by hospitals across the United States on nursing quality and patient outcomes. Data on the 10 Nursing-sensitive Quality Indicators for Acute Care Settings are collected. 60 hospitals participate. Quarterly reports

Review link for more information American Nurses Association | Nursing Facts: Nursing-Sensitive Quality Indicators for Acute Care Settings and ANA's Safety & Quality Initiative

Quality education American Association of Colleges of Nursing National League for Nursing

Why is the plethora of definitions concerning? Lack of consistency affects measurement and standardization Computerization is hindered. Nursing nomenclature for reimbursement is affected. International Council of Nurses International Classification for Nursing Practice (Ehealth) http://www.icn.ch/pillarsprograms/international-classification-for-nursing-practicer/

National Quality Forum National Quality Forum Home WEBINAR: http://www.myeventpartner.com/WebConference/RecordingDefault.aspx?c_psrid=E053DB8781 The National Quality Forum is a private, not-for-profit membership organization created to develop and implement a national strategy for healthcare quality measurement and reporting. The mission of the NQF is to improve American healthcare through endorsement of consensus-based national standards for measurement and public reporting of healthcare performance data that provide meaningful information about whether care is safe, timely, beneficial, patient-centered, equitable and efficient.

Nursing Performance Indicators Suggests 15 national voluntary consensus standards.

HCAHPS Pronounced H-Caps National Quality Forum endorses the use of this instrument 27 item survey to solicit standardized information about how patients perceived their care Developed by CMS and AHRQ http://www.hcahpsonline.org/home.aspx

Payment as Incentive for Quality? NQF conducting meetings to explore possible mechanism for rewarding healthcare providers based upon performance. “Pay for Performance” aligning performance to pay structures. Conversations beginning—wave of the future? Risks?