Question

Identify and describe two quality indicators or core measures, such as those utilized by AHRQ, NDNQI, or CMS. Be sure to discuss how nursing care can impact the two indicators you have selected. Additionally, you will describe two evidence-based strategies to improve each quality indicator or core measure.

Answer 1

Answer:

The following are two quality indicators of AHRQ:

1) Inpatient quality indicator:

The Inpatient Quality Indicators (IQIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on quality. Provider-level volume indicators are proxy, or indirect, measures of quality. They are based on evidence. suggesting that hospitals performing more of certain.

2) Pediatric Quality Indicators Overview:

The Pediatric Quality Indicators (PDIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on the quality of pediatric healthcare. Specifically, PDIs screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the system or provider level.

Development of quality indicators for the pediatric population involves many of the same challenges associated with the development of quality indicators for the adult population. These challenges include the need to carefully define indicators using administrative data, establish validity and reliability, detect bias and design appropriate risk adjustment, and overcome challenges of implementation and use. However, the special population of children invokes additional, special challenges. Four factors—differential epidemiology of child healthcare relative to adult healthcare, dependency, demographics, and development—can pervade all aspects of children’s healthcare; simply applying adult indicators to younger age ranges is insufficient.

This PDIs focus on potentially preventable complications and iatrogenic events for pediatric patients treated in hospitals, and on preventable hospitalizations among pediatric patients.

The PDIs apply to the special characteristics of the pediatric population; screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the provider level or area level; and, help to evaluate preventive care for children in an outpatient setting, and most children are rarely hospitalized.

The impact of nursing care for the quality indicators:

Quality improvement: the nurse's role:

Continuous quality improvement is a concept which includes: Quality assurance--the provision of services that meet an appropriate standard. Problem resolution--including all departments involved in the issue at hand. Quality improvement--a continuous process involving all levels of the organization working together across departmental lines to produce better services for health care clients.

Deming (1982b) and others have espoused total system reform to achieve quality improvement--not merely altering the current system, but radically changing it. It must be assumed that those who provide services at the staff level are acting in good faith and are not willfully failing to do what is correct (Berwick, 1991).

Those who perform direct services are in an excellent position to identify the need for change in service delivery processes. Based on this premise, the staff nurse--who is at the heart of the system--is the best person to assess the status of health care services and to work toward improving the processes by which these services are provided to clients in the health care setting.

The nurse manager must structure the work setting to facilitate the staff nurse's ability to undertake constructive action for improving care. The use of quality circles, quality councils, or quality improvement forums to facilitate the coordination of quality improvement efforts is an effective way to achieve success.

The QA coordinator assists departments in documenting that the quality improvement efforts are effective across all departments of the organization, and aggregates data to demonstrate that they meet the requirements of external regulatory agencies, insurers, and professional standards.

The nurse executive provides the vision and secures the necessary resources to ensure that the organization's quality improvement efforts are successful. By inspiring and empowering the staff in their efforts to improve the process by which health care is provided, nurse managers participate in reshaping the health care environment.

The professional nurse plays a vital role in the quality improvement of health care services. However, nurses cannot make these improvements in a vacuum; they must include other professionals and ancillary personnel in their efforts.

Total quality commitment must include all levels of an organization's structure. Quality patient care services will be achieved as the result of positive interactions among departments working together to build a dynamic mechanism that continuously improves the processes and outcomes of health care services.

Evidence based practice for improving the quality indicators:

the 3 components of evidence based practice

Evidence based practice (EBP) is 'the integration of best research evidence with clinical expertise and patient values' which when applied by practitioners will ultimately lead to improved patient outcome. In the original model there are three fundamental components of evidence based practice.

The EBP are:

Four categories of external supports, which can be used alone or in combination, can assist practices with QI:

• Data feedback and benchmarking provide practices with information on their performance, as compared to external benchmarks (such as regional or national averages), and help target areas for improvement.
• Practice facilitation (or coaching) by external organizations helps practices develop skills and organize their approach to QI, provides QI tools and expertise, and helps them troubleshoot challenges or barriers.
• Expert consultation (also called peer-to-peer mentoring) provides practices with specific evidence-based knowledge from clinicians and staff outside the practice.
• Shared learning or learning collaboratives provide a community in which practices can share challenges, lessons learned, and best practices and draw motivation and inspiration