Annually 187,000 deaths happen because of
medical errors (Disch, 2012). This does not include injuries, which are a
result of hospitalization, to include, hospital acquired infections, falls, medication
side effects, bedsores, blood clots, re -hospitalization and ineffective pain
control. The national debt in the United States is in large part due to rising
health care costs (Dunham –Taylor, 2015). Despite these rising cost, the United
States falls behind all other industrial countries in the quality of health
care (Disch, 2012). Other industrial nations also spend less per citizen to
provide higher quality care (Disch, 2012). The reason for this phenomena, in
the United States, is healthcare in the past was a result of volume based care,
verses quality care (Dunham –Taylor, 2015). The United States is currently
changing health care reimbursement to reflect quality of care patients receive.
In this overhaul of the health care industry, within the United States, nurses
are finally being recognized for the impact they have of patient outcomes, cost
and quality (Dunham –Taylor, 2015).
Quality nursing care making a
difference in patients lives
Research demonstrates that nursing care
is valuable and affects the health outcome of patients (Disch, 2012). When the
business world defines quality it is characterized by being free of
imperfections, deficiencies and is consistently provided, in a timely manner
(Dunham –Taylor, 2015). The consumer defines what is meaningful to them through
purchasing power. Front line staffs in hospitals, have the greatest opportunity
to improve the value and safety of health care provided to patients. This can
only occur through the support, vision and guidance of hospital leadership
(Botting, 2011). If leaders in health care organization fail to improve, the
quality of care, through restructuring of health systems, their organizations
will become financially incapable of continuing business (Porter-O' Grady &
Malloch, 2013). In the past leaders have failed in healthcare restructuring,
because they did not take into account how healthcare structures effect nurses
and patient outcomes (QSEN,2016). Leaders will take a greater role as coaches,
visionaries, quality control managers and partners in maintaining
accountability (Botting, 2011).
Hospital leadership
that fails to empower front line clinical staff will jeopardize patient's health
and their own financial viability (QSEN, 2016). Research demonstrates, supportive
healthcare environments result in positive patient outcomes (QSEN, 2016).
Magnet and professional pathways. are health care organizational designs, which
have proven to improve the quality, safety and profits within hospitals (Dunham
–Taylor, 2015). Both of these organization designs are based on the premise of
empowering nursing staff. Studies have
proven that Magnet hospitals have lower patient mortality than non- Magnet hospitals,
higher patient satisfaction and lower staff turnover (QSEN, 2016). This is
proof that high quality nursing care, improves patient outcomes.
Nurse sensitive activities that
improve patient care
QSEN is responsible for the national initiative
to have evidence-based care, informatics, and value improvement part of the
standardized care received by all patients in the United States, health care
industry (Disch, 2012). The purpose of QSEN is to provide nurse with education
to improve the quality and safety of patient care and to provide measurable
outcomes to ensure continual improvement. This national effort has identified
nine main areas of nursing care, that have direct impact on patient health outcomes
(Disch, 2012). The nine areas identified are, safety, patient centered care,
communication, care coordination, prevention and treatment of chronic illness,
pain control, deep vein thrombosis protection, and prevention of hospital
acquired infection and decreased hospital readmission (Disch, 2012).
Ways to measure
Quality outcomes
To create high valued safe health care,
the United Stated government has set quality standards that hospitals must
measure, record and report (Porter-O' Grady & Malloch, 2013). In 2010, the
United States passed a bill called the affordable care act. This bill includes
the national quality strategy that measures the patients hospital experience
(Porter-O' Grady & Malloch, 2013). Research shows that a positive patient
experience has a direct relationship to the clinical quality of care (QSEN,
2016).Measuring the value of healthcare is necessary to improving safety and quality.
In order to protect citizens from poor quality health, hospitals that do not
meet recognized standards, will not receive financial reimbursement for care
from Medicaid and Medicare patients (Dunham –Taylor, 2015).
One effective way to measure patient experience
is through a customer quality survey. Press Ganey is a health management
company that collaborates with about half of the hospitals in the United States,
to collect data about a patients hospital experience (Dunham –Taylor, 2015).
The survey results are reported to the public, government and measured against
other hospitals scores. Through a survey method the patient is ask question
about quality indicators such as, how well they felt their nurse listen to them
during their hospital stay, how well was
their pain controlled, did they understand what medication they are taking and possible side effects (Porter-O' Grady
& Malloch, 2013). In addition, the government requires that hospitals
collect and report data on nurse influenced quality care predictors, such as
the use of preventable measures against; deep vein thrombosis protection,
falls, and hospital acquired infections, as well as re-hospitalization within
thirty days and pressure ulcers obtained during hospitalization (Porter-O'
Grady & Malloch, 2013). If a hospital fails to meet standardized
expectations, they do not receive reimbursement for care and the public is
aware of the quality of care provided. Consumers will take their healthcare
dollars to hospitals, which provide more valuable health care and poor
performing hospitals will go out of business. The transparency of quality
indicators provide consumers a way to gauge care provided, so they can better
manage their own health and spending.
Conclusion
Hospitals
must define what they do is valuable. The only way to improve the quality of
care
is by measurement (Dunham –Taylor, 2015). For this
measurement to be meaningful it must be
measured by a third party, such as press Ganey. The
mother of nursing Florence Nightingale,
proved the importance of statistics in improving
healthcare (Dunham –Taylor, 2015). If the
United States, wants to make significant changes in
health care today, they must go back to the
foundation of health care improvement (Dunham –Taylor,
2015).
References
Botting, Lucy. "Transformational change in action: as
the government's healthcare reforms begin
to take shape, Lucy Botting stresses
the importance of good leadership skills in improving productivity, quality and
efficiency." Nursing Management [Harrow] 17.9 (2011): 14+. Academic
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