Nurse Staffing, Nurse Human Capital and the Quality of Hospital Care

Last week, three INQRI teams presented a panel together at the American Society of Health Economists meeting. Abstracts are now available online for their panel, "Nurse Staffing, Nurse Human Capital and the Quality of Hospital Care."

A Longitudinal Study of the Effects of Nurse Staffing Levels, Nurse Human Capital, and Nursing Teams on Patient Outcomes for VA Inpatient Care
Presenter: Ciaran Phibbs (Veterans Affairs Palo Alto and Stanford University)

Nurse Staffing, Nurse Education and Experience, and Patient Outcomes in Neonatal Intensive Care
Presenter: Jeannette Rogowski (University of Medicine and Dentistry of New Jersey)

Does Public Reporting of Process of Care Lead to Improvements in Outcomes?
Presenter: Richard Lindrooth (University of Colorado, Denver)

INQRI Grantee to be Recognized at 2010 AcademyHealth Meeting

Congratulations to INQRI grantee Douglas R. Wholey, Ph.D., M.B.A., who will be recognized this afternoon by RWJF and AcademyHealth at the Annual Research Meeting on his research “Public Health Systems: A Social Networks Perspective” (published in Health Services Research) which will be recognized as the year’s best scientific work in the field of public health services and systems research (PHSSR).

The RWJF Public Health team will be covering this session (as well as a variety of others) via text and podcast updates to the RWJF public health home page, the RWJF Twitter feed @RWJF_PubHealth (hashtag #ARM10), and daily guest blog posts on Scutch’s Blog, a PHSSR blog hosted by Douglas Scutchfield, professor of health services research and policy at the University of Kentucky.

Aligning Forces for Quality

Back in 2006, the Robert Wood Johnson Foundation began a four-site pilot program called Aligning Forces for Quality (aka AF4Q), a multi-faceted laboratory for reform, active in 17 very different communities, home to 38 million people.  Bruce Siegel, AF4Q's director was recently interviewed for an article about the program for New America.  In the piece, writer Joanne Kenen asserts, "Quality -- attaining it, improving it -- is at the heart of health reform."

Check out the article.

The National Quality Forum needs your help!

The National Quality Forum (NQF) is accepting public comments through July 1, 2010 on their Quality Data Set. This set is an ‘information model' that defines concepts used in quality measures and clinical care and is intended to enable automation of electronic health record use.

Click here to read more about the Quality Data Set.
Click here to go to the comment page.
Click here to read more about NQF.

Video Advice Columns from AHRQ Director

The Agency for Healthcare Research and Quality (AHRQ) has a wonderful new resource available online: a series of videos featuring Director Carolyn M. Clancy, M.D. which provides advice to patients.  Topics include questions to ask of doctors, tips for safe medication practices and how to avoid medical errors.

Check out the series on the AHRQ website.

INQRI Grantees at AcademyHealth 2010

We are pleased to share with you the schedule of INQRI grantees who will be presenting at the AcademyHealth meeting this year. These sessions provide a wonderful representation of INQRI’s work. If you are attending the Annual Research Meeting, we encourage you to attend these sessions.

Robyn Cheung (University of Pennsylvania) will chair a panel entitled, “The Interdisciplinary Health Workforce – Needs, Work Environments, and Supply.”
Sunday, 4:15 p.m. – 5:45 p.m. – Room 203

R. Adams Dudley (University of California, San Francisco) is a panelist for a session entitled, “Measuring Clinical Performance: The Path Forward.”
Monday, 9:45 a.m. – 11:15 a.m. – Room 210

Robin Newhouse (University of Maryland School of Nursing) will chair a panel entitled, “Hospital-Based Systems Redesign.”
Monday, 9:45 a.m. – 11:15 a.m. – Room 202

Jack Needleman (University of California, Los Angeles) will chair a panel entitled, “Missing Data in Longitudinal Studies: Models and Sensitivity Analyses.”
Monday, 11:30 a.m. – 1:00 p.m. – Room 202

Ying Xue (University of Rochester) will chair a panel entitled, “Nursing Process of Care and Job Experiences.” Joining her on the panel will be fellow INQRI grantee Olga Yakusheva (Marquette University).
Monday, 11:30 a.m. – 1:00 p.m. – Room 313

Dennis Scanlon (Pennsylvania State University) will chair a panel entitled, “Realistic Evaluation of Complex Programs: Using Mixed Methods to Uncover Lessons for Health Policy and Practice.”
Tuesday, 8:00 a.m. – 9:30 a.m. – Room 304

R. Adams Dudley (University of California, San Francisco) will chair a panel entitled, “Incentives for Providers: Long-Term Impact and Unintended Consequences.”
Tuesday, 8:00 a.m. – 9:30 a.m. – Room 202

Douglas Wholey (University of Minnesota) is a panelist for a session entitled, “Health Reform and Delivery System Organization.”
Tuesday, 11:30 a.m. – 1:00 p.m. – Room 311

Thank You, Mr. President

As guest speaker at the June 16 Biennial American Nurses Association House of Delegates, President Barack Obama reminded the crowd of 1,000 that "nurses are the beating heart of our health care system," and thanked nurses for their conversations contributed during the health care debate.

Read more at Advance for Nurses: "Nurses 'Beating Heart of Health Care' Obama Tells ANA Delegates."

It's Working!

The American Medical News is reporting that more than 1,500 hospitals in 17 states have shown 18% fewer central-line associated bloodstream infections (CLABSIs) than they expected. 

Click here to read the story, "Central-Line Infections Declining, CDC Reports."

INQRI researchers at Johns Hopkins University have found that substantial reductions in central line associated blood stream infections can be widely achieved with nurses leading the infection control efforts. Hospitals that followed their well defined ICU safety program and fostered nurse involvement in quality improvement efforts reduced, and in some cases completely eliminated, bloodstream infections for several months at a time. 

Click here to learn more about their INQRI project, "Linking Blood Stream Infection Rates to Intensive Care."

PA Governor Knows Nurses are Key to Patient Safety

This week, Pennsylvania Governor Ed Rendell signed a bill into law to ensure patient safety in the OR. Rep. Mauree Gingrich, R-Lebanon, sponsored the bill which makes it mandatory for hospitals to have a circulating nurse present in surgeries requiring deep sedation or general anesthesia. Circulating nurses ensure that all OR equipment is available, clean and working properly. In addition, they are trained to look for signs of distress in sedated patients.

Click here to read the story on the ABC-27 website.

Thank you to the Sebastian Ferrero Foundation

Thank you to Horst and Luisa Ferrero for sharing the story of their beloved son, Sebastian, during yesterday's webinar, "A Vision for Transformative Change." This presentation focused on the preventable medical errors that led to three year old Sebastian's death and his parents' commitment to bringing a state of the art children's hospital to Gainesville, Florida in the hopes that this tragedy will not be repeated in their community.

If you missed yesterday's webinar, you can still access the materials online:

PowerPoint Presentation
Audio Recording
The Sebastian Ferrero Foundation's Vision Video

***

This webinar concludes our spring series. Keep an eye on the INQRI website for information about the fall series. Special thanks to the Gordon and Betty Moore Foundation who co-sponsored the medication management webinar series and to SRA, International for all their assistance.

INQRI Grantee in the Inaugural Class of HPNA Research Scholars

Congratulations to INQRI grantee Gail Towsley, PhD, NHA, who was one of five scholars recently selected by the Hospice and Palliative Nurses Association as the inaugural class of HPNA Research Scholars.

The HPNA Research Scholars Program supports funding to participate in the 4th Annual Kathleen Foley Palliative Care Retreat and Research Symposium of the National Palliative Care Research Center, co-sponsored by AAHPM, American Cancer Society, and HPNA. The Retreat will be held October 12-14, 2010 in Sundance, Utah. The goal of the Retreat is to advance the scientific endeavors of those who are or will become independent investigators actively involved in palliative care research through development of attendees' individual works in progress and improvement of specific competencies and core methodologies essential to conducting palliative care research.

Dr. Towsley was a member of the INQRI team at the University of Utah whose project was entitled, "Measuring Nursing Care Quality Related to Pain Management."  Led by principal investigator Susan Beck, the team developed and tested a questionnaire that can be used to measure opinions of patients about how their nurses manage their pain. The information from this project will provide researchers with an understanding of how patients with pain understand and interpret questions related to the quality of their nursing care. This measure is likely to prove salient to consumers interested in selecting hospitals that can best address their care needs, as well as to hospital administrators and policy makers interested in improving the quality of nursing-related care.


Click here to learn more about the HPNA.

Still Time to Register for Tomorrow's Webinar

There is still time to register for tomorrow's webinar, "A Vision for Transformative Change." This webinar will be our last until the fall and will conclude our medication management series, co-sponsored by the Gordon and Betty Moore Foundation.

June 16, 2010 - 3:30 p.m. - 4:30 p.m. ET

Three year old Sebastian Ferrero died in October, 2007 due to a series of preventable medical errors including a medication overdose. Please join us as we welcome his parents, Horst and Luisa Ferrero, who will share their son's story and the efforts they have taken in his memory.

Click here to register.

Click here to learn more about the Sebastian Ferrero Foundation.

Contact Heather Kelley with any questions.
Visit the INQRI website to view previous presentations.

More News about Reducing Blood Stream Infections

As readers of this blog know, INQRI researchers at Johns Hopkins University have conducted the first randomized-control trial to reduce central line associated blood stream infections (CLABSIs) among ICU patients. This study, conducted in ICUs in 12 states, has shown in preliminary analysis that substantial reductions in infections can be widely achieved and this project did so with nurses leading the infection control efforts.

With a growing cultural emphasis on patient safety and increased quality, this work comes at a very important time. However, although the goal of reducing infections is widely held, it is not always easily accomplished. In Delaware, Wilmington Hospital has (for a year) had the highest rate of mostly preventable infections, with a rate among the highest in the nation. Click here to read about this hospital's struggle to reduce infections.

Around the Blogosphere...

Take a look at some of the things we're reading this week...

• Check out this week's "killer edition" of the Health Wonk Review, hosted by Tinker Ready at Boston Health News.

• Over at the John A. Hartford Foundation blog, Health AGEnda, Chris Langston discusses patient engagement in health care and a team-based approach to care management in his post "Sailing the Ship of Health Care."

• The Health Care for All blog provides the latest action on a series of patient safety bills being considered by the Massachusetts legislature in the post, "Patient Safety Bill Moving." 

Reminder - Webinar Next Week

Don't forget to register for INQRI's last webinar until fall: "A Vision for Transformative Change."

June 16, 2010 - 3:30 p.m. - 4:30 p.m. ET

Three year old Sebastian Ferrero died in October, 2007 due to a series of preventable medical errors including a medication overdose. Please join us as we welcome his parents, Horst and Luisa Ferrero, who will share their son's story and the efforts they have taken in his memory.

This webinar will serve as a poignant conclusion to our medication management series, co-sponsored by the Gordon and Betty Moore Foundation.

Click here to register.

Click here to learn more about the Sebastian Ferrero Foundation.

Contact Heather Kelley with any questions.

Visit the INQRI website to view previous presentations.

National Time Out Day - Next Wednesday

With the support of the World Health Organization and the Joint Commission, the Association of periOperative Registered Nurses (AORN) has organized the Time Out Commitment Campaign, creating several tools in support of National Time Out Day.  This year, the event will be held on June 16 and reminds the entire surgical team how much Time Out matters to them and their patients. Each year, the AORN promotes National Time Out Day to emphasize the importance of surgical teams taking a time out before every operation to confirm correct patient, correct procedure, correct surgical site, and other important information to ensure patient safety.

Please comment below to share your experiences with National Time Out Day.

The Association of periOperative Registered Nurses (AORN) is the national association committed to improving patient safety in the surgical setting. AORN is the premier resource for perioperative nurses, advancing the profession and the professional with valuable guidance as well as networking and resource-sharing opportunities. AORN promotes safe patient care and is recognized as an authority for safe operating room practices and a definitive source for information and guiding principles that support day-to-day perioperative nursing practice.

INQRI Projects Featured in Geriatric Nursing

The INQRI program is pleased to report that the latest edition of Geriatric Nursing features all INQRI projects in their selection of featured articles.

Please click here to read the letter from editor Barbara Resnick (also an INQRI grantee), "The Difference Nurses Are Making to Improve Quality of Care to Older Adults through the Interdisciplinary Nursing Quality Research Initiative."

Featured Articles:

The Impact of Worker Health on Long Term Care: Implications for Nursing Managers
Susan Letvak, Christopher J. Ruhm

SPEACS-2: Intensive Care Unit “Communication Rounds” with Speech Language Pathology Mary Beth Happ, Brooke M. Baumann, Jennifer Sawicki, Judith A. Tate, Elisabeth L. George, Amber E. Barnato

Age-Related Differences in Perception of Quality of Discharge Teaching and Readiness for Hospital Discharge
Kathleen L. Bobay, Teresa A. Jerofke, Marianne E. Weiss, Olga Yakusheva

Nurse Identified Hospital to Home Medication Discrepancies: Implications for Improving Transitional Care
Cynthia F. Corbett, Stephen M. Setter, Kenn B. Daratha, Joshua J. Neumiller, Lindy D. Wood

Satisfaction with Assisted Living: The Unexplored Role of Physical Activity
Barbara Resnick, Elizabeth Galik, Ann L. Gruber-Baldini, Sheryl Zimmerman

Geriatric Nursing

Volume 31, Issue 3, Pages 153-238, e1-e2 (May-June 2010)

RWJF's Quality Stories

Each month, the Robert Wood Johnson Foundation releases "The Quality Report," an e-newsletter which provides a monthly report from their Quality/Equality program area. One of the highlights each month is the "Voices of Quality" segment - an opportunity to hear from a health care provider about what works.

This month's segment actually featured a video: Learn how the team at Memorial Hospital in Broward County, Florida, reduced emergency department door-to-balloon time for heart attack patients and saved lives while participating in an RWJF-sponsored quality improvement initiative. In the first year of the program, door-to-balloon time improved by 60 percent. Now the hospital routinely hits the 90-minute target for 100 percent of heart attack patients.

Click here.

Initiative on the Future of Nursing Releases Workshop Summary

Yesterday, the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine released a summary document encapsulating the presentations and discussions from the Forum on the Future of Nursing: Community Health, Public Health, Long-term Care and Primary Care held in December 2009.

The Initiative on the Future of Nursing seeks to transform nursing as part of larger efforts to reform the health care system. As part of this Initiative, three forums were held to explore challenges and opportunities in nursing. The second forum, on December 3, 2009, was held in Philadelphia, Pa. More than 600 health care leaders attended this forum in person and via webcast. Speakers, including Pennsylvania Gov. Ed Rendell, discussed opportunities in which nurses—who are key front-line providers of care—can play a role in ensuring patients in all settings receive the best possible care.

The IOM will use the perspectives and ideas summarized in this document to inform a final report on the future of nursing, expected to be released in October 2010.

To download a copy of the summary, please visit www.iom.edu/nursing.

A Vision for Transformative Change

Please join us...

"A Vision for Transformative Change"

June 16, 2010 - 3:30 p.m. - 4:30 p.m. ET

Three year old Sebastian Ferrero died in October, 2007 due to a series of preventable medical errors including a medication overdose. Please join us as we welcome his parents, Horst and Luisa Ferrero, who will share their son's story and the efforts they have taken in his memory.

This webinar will serve as a poignant conclusion to our medication management series, co-sponsored by the Gordon and Betty Moore Foundation.

Click here to register.

Click here to learn more about the Sebastian Ferrero Foundation.

Please contact Heather Kelley with any questions.
Please visit the INQRI website to view previous presentations.

The Medication Management Webinar Series is a year-long initiative, co-sponsored by the Interdisciplinary Nursing Quality Research Initiative (INQRI) program and the Gordon and Betty Moore Foundation.

A Web Event Series on Improvement Science

Please join INQRI grantees Kathleen Stevens and Jack Needleman for the first web event presented by the Improvement Science Research Network (ISRN).  This session will introduce improvement science and showcase the activities of the ISRN as a catalyst for change:

The Way Forward: An Introduction to Improvement Science
Monday, June 14, 2010, 2:00 pm EDT

Click here to register.

Co-Presenters:

Jack Needleman, PhD, FAAN
Professor and Director,
Health Services PhD and MSHS Programs
Department of Health Services
UCLA School of Public Health

Kathleen R. Stevens, EdD, RN, ANEF, FAAN
Professor and Director
Academic Center for Evidence-Based Practice
The University of Texas Health Science Center at San Antonio

For more information, contact: ImprovementScienceResearch@isrn.net.

The Nurse in Your Health Care Future

Check out this commentary in last week's Oregonian: "The Nurse in Your Health Care Future." Guest columnist Thomas Aschenbrener discusses the impact that the new health care bill will have on the delivery of care considering the new demand for services and the fact that some 300,000 doctors will be retiring in the next ten years. Aschenbrener challenges us to consider expanding what is already successful:

"We need to ask what's required to meet the future needs of our population and look at what's already working. One area of great success: nurse-run clinics. Why can't this model become widespread?"

We couldn't agree more.
Comment below and tell us what you think.