Question

What major mechanisms, reports and strategies have shaped nurses engagement with the quality movement

Answer 1

In recent years, emphasis on improving the quality of care provided by the nation’s hospitals has increased significantly and continues to gain momentum. Nurses are integral to hospitalized patients’ care, and thus are pivotal in hospital efforts to improve quality. As hospitals face increasing demands to participate in a wide range of quality improvement activities, they are reliant on nurses to help address these demands.Gaining a more in-depth understanding of the role that nurses play in quality improvement and the challenges faced by them, can provide important insights about how Nurses play an integral part in the Quality movement in Healthcare domain.Specific domains that determine the integrity level of nurses engagement in the quality movement are as follows:

1.Key quality improvement activities in which the hospital participates;

2.Role of leadership in these activities;

3. Overcoming Factors affecting nurses’ involvement; and

4. Decision making Developments that may change the role of nurses in hospital quality improvement .

The nurses therefore are playing a pivotal role in bringing quality movement in the Hospital.Some of the trends that they are picking up to spread are jotted down below.

A) Leadership support: For any quality improvement project to be successful, the literature shows that support has to come down from the top ie the Board and CEO.

As per reports, the CEO of one hospital supported nurses in their efforts to address the prevalence of bedsores among patients, even though doing so required that the information be reported to a state agency. Despite the potential for negative attention for the hospital, the CEO encouraged nursing staff to take ownership of a quality problem where there was an opportunity to improve patient care.Some hospitals, have reportedly expanded their nursing leadership infrastructure in recent years and some have created new nursing positions for quality assurance (e.g., director of nursing quality,nursing officer).

B) Quality as evryones responsibility: While hospital heads stated that the role of nurses in quality improvement as crucial, they also emphasized that nursing involvement alone is insufficient.Evry staff is essential cause nurses are primary caregivers and are well occupied with their patient service. One hospital Chief Nursing Officer reported, “I wish quality improvement could be done in a more multidisciplinary fashion. We tend to hand off pieces to each other and work in silos. Nurses themselves are very involved, but a lot of what happens is beyond just the nurse. I would like to be able to get the entire group, from nurses to pharmacy to lab techs to medical records to physicians together in a multidisciplinary way to say, ‘Something happened. Let’s check what went wrong together.’” To confront this silo mentality, one hospital moved the reporting relationship of the quality improvement department to the CEO as a signal to staff that quality improvement was not just a nursing activity but a responsibility of all staff.

C)Individual Ownership and Accountability: Another component of a hospital culture conducive to quality improvement is encouraging individual ownership and accountability for patient safety and quality, according to respondents. In one hospital, as reported, there were delays in notifying physicians of critical lab results. According to the hospital quality improvement director, when nurses took ownership of the process and started collecting the data, they were able to determine the problem and address it.Hospitals have pursued various strategies to increase staff ownership and accountability. Like in a report a hospital CEO stated, “We are trying to drive it down further to the nursing staff on the floor, or in the unit, or in the ER, and say, it is part of your job requirements to help us improve patient care and improve patient satisfaction.”

Hospitals also use other types of rewards to encourage staff ownership and accountability like mementos ,gifts,performance awards and many others.

D) Strong physician and nurse bonding ensures patient well being.Recently more Hospital boards and CEOS have involved nurses in healthcare quality assurance.

Therefore, we can see nurses have come a long way in quality management in Healthcare domain and will continue to do so in future if not restricted so.