The Pennsylvania Patient Safety Authority has issued its 2010 Annual Report highlighting its Patient Safety Liaison program, educational activities and an announcement about reductions in healthcare-associated infections in hospitals and nursing homes.
"Specifically, catheter-associated urinary tract infections decreased by twenty-six percent, central-line associated bloodstream infections by forty-four percent and ventilator-associated pneumonia by twenty-seven percent," Dr. Stanton Smullens, acting chair of the Pennsylvania Patient Safety Authority, said
Click here for more information.
Friday, April 29, 2011
Thursday, April 28, 2011
Health Wonk Review: Spring Has Sprung & Mud Still Flung
Check out the latest edition of the Health Wonk Review, hosted by The Incidental Economist: The “Spring Has Sprung and Mud Still Flung” Edition.
Thanks to Don Taylor, Aaron Carroll, and Austin Frakt of The Incidental Economist for including a recent INQRI post in this edition.
Enjoy!
Thanks to Don Taylor, Aaron Carroll, and Austin Frakt of The Incidental Economist for including a recent INQRI post in this edition.
Enjoy!
INQRI Project Featured in Health Services Research
Health care experts often consider it a failure of the system when patients use emergency departments or are readmitted to the hospital within 30 days after being discharged. Patients who are inadequately prepared for being discharged are more likely to visit the emergency department or be readmitted than patients who are well-prepared. In many hospitals, the responsibility for discharge teaching and preparation lies with staff nurses.
A new study published in the current issue of Health Services Research, finds that having more registered nurses (R.N.s) working on a hospital unit and reducing the amount of R.N.s’ overtime hours are correlated with fewer patients being readmitted or visiting the emergency department within the first 30 days after hospital discharge, and also reduced costs. The study also found a positive correlation between the number of R.N. staffing hours and patients’ satisfaction with the quality of discharge teaching and subsequent readiness to go home.
Marianne Weiss, D.N.Sc., R.N., associate professor and Wheaton-Franciscan Healthcare/Sister Rosalie Klein professor of women’s health at Marquette University College of Nursing is one of the lead investigators of the study, which was funded by the INQRI program. She led an interdisciplinary team that included Olga Yakusheva, Ph.D., assistant professor in the Department of Economics at the Marquette University College of Business Administration and Kathleen Bobay, Ph.D., R.N., N.E.A.-B.C., associate professor at Marquette University College of Nursing and Research Scientist at Aurora Health Care. The team studied nurse staffing levels, patients’ reports on quality of the discharge teaching process and their readiness for discharge, along with post-discharge readmissions and emergency department visits for sixteen medical surgical units at four hospitals in a single Midwestern health care system. The final sample included 1,892 patients.
Researchers found that when R.N. non-overtime staffing was higher, the odds of patient readmission were lower and when R.N. overtime hours were higher, emergency department use was also higher. In addition, a cost-benefit analysis estimated that increasing non-overtime staffing by .75 hours per patient per day increased hospitals’ cost by $197.92 per hospitalized patient but saved payers $607.51 per patient. Reducing R.N. overtime staffing by .07 hours per patient day resulted in hospital savings of $8.18 per hospitalized patient and $10.98 in savings per hospitalized patient to payers. Using a cost analysis projection for the 16 nursing units in the study, the researchers estimated an annual net savings of $11.64 million associated with increasing non-overtime hours and an annual net savings of $544,000 associated with decreasing overtime hours. However, in current payment models, payer savings accruing from reduction in readmissions or Emergency Department use would not be applied to offset hospital costs for increased nurse staffing.
“We know that patients who aren’t properly prepared to be discharged are more likely to be readmitted to the hospital and we also know that if nurses have more hours allocated to work with patients, they have more time to perform critical functions that require R.N.- level expertise, like discharge teaching,” said Weiss. “This study shows us that investing in nursing care hours could potentially be offset by the savings that could be realized in reductions in readmission and emergency department use.”
The study’s authors write that their findings support recommendations to: monitor and manage unit-level nurse staffing to ensure optimal post-discharge results; implement assessment of the quality of discharge teaching and patients’ readiness for discharge as part of the discharge procedure; and realign payment structures so that the cost of nurse staffing is offset by the savings that result from reductions in unplanned readmissions and Emergency Department visits after discharge.
A new study published in the current issue of Health Services Research, finds that having more registered nurses (R.N.s) working on a hospital unit and reducing the amount of R.N.s’ overtime hours are correlated with fewer patients being readmitted or visiting the emergency department within the first 30 days after hospital discharge, and also reduced costs. The study also found a positive correlation between the number of R.N. staffing hours and patients’ satisfaction with the quality of discharge teaching and subsequent readiness to go home.
Marianne Weiss, D.N.Sc., R.N., associate professor and Wheaton-Franciscan Healthcare/Sister Rosalie Klein professor of women’s health at Marquette University College of Nursing is one of the lead investigators of the study, which was funded by the INQRI program. She led an interdisciplinary team that included Olga Yakusheva, Ph.D., assistant professor in the Department of Economics at the Marquette University College of Business Administration and Kathleen Bobay, Ph.D., R.N., N.E.A.-B.C., associate professor at Marquette University College of Nursing and Research Scientist at Aurora Health Care. The team studied nurse staffing levels, patients’ reports on quality of the discharge teaching process and their readiness for discharge, along with post-discharge readmissions and emergency department visits for sixteen medical surgical units at four hospitals in a single Midwestern health care system. The final sample included 1,892 patients.
Researchers found that when R.N. non-overtime staffing was higher, the odds of patient readmission were lower and when R.N. overtime hours were higher, emergency department use was also higher. In addition, a cost-benefit analysis estimated that increasing non-overtime staffing by .75 hours per patient per day increased hospitals’ cost by $197.92 per hospitalized patient but saved payers $607.51 per patient. Reducing R.N. overtime staffing by .07 hours per patient day resulted in hospital savings of $8.18 per hospitalized patient and $10.98 in savings per hospitalized patient to payers. Using a cost analysis projection for the 16 nursing units in the study, the researchers estimated an annual net savings of $11.64 million associated with increasing non-overtime hours and an annual net savings of $544,000 associated with decreasing overtime hours. However, in current payment models, payer savings accruing from reduction in readmissions or Emergency Department use would not be applied to offset hospital costs for increased nurse staffing.
“We know that patients who aren’t properly prepared to be discharged are more likely to be readmitted to the hospital and we also know that if nurses have more hours allocated to work with patients, they have more time to perform critical functions that require R.N.- level expertise, like discharge teaching,” said Weiss. “This study shows us that investing in nursing care hours could potentially be offset by the savings that could be realized in reductions in readmission and emergency department use.”
The study’s authors write that their findings support recommendations to: monitor and manage unit-level nurse staffing to ensure optimal post-discharge results; implement assessment of the quality of discharge teaching and patients’ readiness for discharge as part of the discharge procedure; and realign payment structures so that the cost of nurse staffing is offset by the savings that result from reductions in unplanned readmissions and Emergency Department visits after discharge.
Coverage of the study:
Wednesday, April 27, 2011
Opinion: Nurse Practitioners Could Alleviate Primary Care Shortage in Maine
Check out last week's opinion piece in the Portland Press Herald, "Rx for Maine's primary-care shortage is nurse practitioners." Written by Michael Hiltz, RN, BSN, a nurse practitioner student at the University of Southern Maine, the piece suggests that "a divide should not be widened or exacerbated between the nurse practitioners and physicians," explaining that expanding nurse practioners' roles could help solve Maine's shortage of primary care physicians.
Tuesday, April 26, 2011
Nurse Staffing - Different Models, Different Results
Last week it was announced that the Henry Mayo Newhall Memorial Hospital in Santa Clarita, CA, is abandoning the “team nursing” program they initiated last year (to a "rocky reception"). Instead, they will replace it with a more intimate model which will allow nurses to focus more of their time on fewer patients. The California Nurses Association has welcomed this change, believing that the team nursing model could be detrimental to patient safety.
This is just one example in which nurses are contributing to the discussion revolving around increasing patient care quality. All across the country, nurses are leading efforts to understand what drives better nursing care to keep patients safe and the environments that are crucial to making that happen. For example, an INQRI team at the University of California examined the extent to which nurse staffing levels affected the incidence of complications and the failure to rescue from those complications, (i.e. death following complications). Their examination showed that nursing hours per patient day were strongly associated with lower rates of pressure ulcers and hospital acquired infections, and fewer deaths from complications. Further, more RN hours in the mix had additional benefit with still lower rates of failure to rescue and hospital acquired infections. Their work shows that higher levels of nursing hours per patient day and RN skill mix will lead to better patient outcomes.
Another INQRI team at the University of Pennsylvania conducted the first study to look at the link between nursing and very low birthweight infants in the neonatal intensive care unit (NICU). Researchers examined care in more than 100 NICUs around the U.S. and found that when babies are treated in units where nurses have less support and less frontline experience they are at higher risk of developing infections. Babies in hospitals where nurses are supported and have more experience are less likely to have medical complications such as bleeding in the brain, which leads to costly complications. The team has found that higher levels of nurse staffing and the proportion of nurses with bachelor’s degrees in nursing and NICU experience are associated with better infant outcomes. The study results could guide decisions related to setting standards for all hospitals to follow when creating and staffing a neonatal intensive care unit where infants thrive.
This is just one example in which nurses are contributing to the discussion revolving around increasing patient care quality. All across the country, nurses are leading efforts to understand what drives better nursing care to keep patients safe and the environments that are crucial to making that happen. For example, an INQRI team at the University of California examined the extent to which nurse staffing levels affected the incidence of complications and the failure to rescue from those complications, (i.e. death following complications). Their examination showed that nursing hours per patient day were strongly associated with lower rates of pressure ulcers and hospital acquired infections, and fewer deaths from complications. Further, more RN hours in the mix had additional benefit with still lower rates of failure to rescue and hospital acquired infections. Their work shows that higher levels of nursing hours per patient day and RN skill mix will lead to better patient outcomes.
Another INQRI team at the University of Pennsylvania conducted the first study to look at the link between nursing and very low birthweight infants in the neonatal intensive care unit (NICU). Researchers examined care in more than 100 NICUs around the U.S. and found that when babies are treated in units where nurses have less support and less frontline experience they are at higher risk of developing infections. Babies in hospitals where nurses are supported and have more experience are less likely to have medical complications such as bleeding in the brain, which leads to costly complications. The team has found that higher levels of nurse staffing and the proportion of nurses with bachelor’s degrees in nursing and NICU experience are associated with better infant outcomes. The study results could guide decisions related to setting standards for all hospitals to follow when creating and staffing a neonatal intensive care unit where infants thrive.
Monday, April 25, 2011
New Brief Highlights that Higher Health Care Costs Do Not Necessarily Equal Higher Quality
Although the U.S. spends more per person on health care than any other nation, the quality of that care frequently falls far short of what it should. A new policy brief from Health Affairs and the Robert Wood Johnson Foundation (RWJF) examines major efforts undertaken across the country in recent years to better define health care quality, identify the most meaningful ways to measure it, and determine how best to improve and increase access to it.
A 2001 Institute of Medicine (IOM) report found that U.S. health care was insufficiently safe, effective, patient-centered, efficient, timely, or equitable. It also noted that preventable medical errors caused an estimated 44,000 – 98,000 inpatient hospital deaths per year.
The latest research reveals that while some progress has been made, there is still a considerable distance to go. The cost in human life or reduced health exacted by medical errors and quality shortfalls is the most pressing reason to push forward, but the need to control ever-escalating health costs adds urgency. The brief’s authors outline how the Affordable Care Act’s quality-related provisions—including hospital pay-for-performance programs and other “value-based” strategies—are expected to jumpstart quality improvement efforts over the next several years.
Read the policy brief.
A 2001 Institute of Medicine (IOM) report found that U.S. health care was insufficiently safe, effective, patient-centered, efficient, timely, or equitable. It also noted that preventable medical errors caused an estimated 44,000 – 98,000 inpatient hospital deaths per year.
The latest research reveals that while some progress has been made, there is still a considerable distance to go. The cost in human life or reduced health exacted by medical errors and quality shortfalls is the most pressing reason to push forward, but the need to control ever-escalating health costs adds urgency. The brief’s authors outline how the Affordable Care Act’s quality-related provisions—including hospital pay-for-performance programs and other “value-based” strategies—are expected to jumpstart quality improvement efforts over the next several years.
Read the policy brief.
Friday, April 22, 2011
New Edition Focuses on Reducing Errors, Improving Safety
Check out this newly released edition focused on reducing health care errors:
Error Reduction in Health Care: A Systems Approach to Improving Patient Safety, 2nd Edition
Patrice L. Spath (Editor)
Completely revised and updated, this second edition of Error Reduction in Health Care offers a step-by-step guide for implementing the recommendations of the Institute of Medicine to reduce the frequency of errors in health care services and to mitigate the impact of errors when they do occur. With contributions from noted leaders in health safety, Error Reduction in Health Care provides information on analyzing accidents and shows how systematic methods can be used to understand hazards before accidents occur. In the chapters, authors explore how to prioritize risks to accurately focus efforts in a systems redesign, including performance measures and human factors. This expanded edition covers contemporary material on innovative patient safety topics such as applying Lean principles to reduce mistakes, opportunity analysis, deductive adverse event investigation, improving safety through collaboration with patients and families, using technology for patient safety improvements, medication safety, and high reliability organizations.
Error Reduction in Health Care: A Systems Approach to Improving Patient Safety, 2nd Edition
Patrice L. Spath (Editor)
Completely revised and updated, this second edition of Error Reduction in Health Care offers a step-by-step guide for implementing the recommendations of the Institute of Medicine to reduce the frequency of errors in health care services and to mitigate the impact of errors when they do occur. With contributions from noted leaders in health safety, Error Reduction in Health Care provides information on analyzing accidents and shows how systematic methods can be used to understand hazards before accidents occur. In the chapters, authors explore how to prioritize risks to accurately focus efforts in a systems redesign, including performance measures and human factors. This expanded edition covers contemporary material on innovative patient safety topics such as applying Lean principles to reduce mistakes, opportunity analysis, deductive adverse event investigation, improving safety through collaboration with patients and families, using technology for patient safety improvements, medication safety, and high reliability organizations.
Thursday, April 21, 2011
IHI Seminar Invitation: Reengineering the OR
Nurse understaffing can have a significant impact on many aspects of patient care, including time at the bedside, communication with patients and families, patient safety, and clinical outcomes. A recent study by Needleman, et al. in the New England Journal of Medicine adds to growing literature suggesting that suboptimal staffing levels even are associated with a higher rate of inpatient mortality, especially when patient turnover is high. Flexible staffing that matches capacity to demand is essential to addressing this critical clinical and safety issue.
Learn how to match capacity to demand — and much more — by joining the Institute for Healthcare Improvement (IHI) for Reengineering the Operating Room to Improve Hospital-Wide Efficiency and Quality on June 9-10, 2011, in Boston, MA.
For more information, please click here.
Learn how to match capacity to demand — and much more — by joining the Institute for Healthcare Improvement (IHI) for Reengineering the Operating Room to Improve Hospital-Wide Efficiency and Quality on June 9-10, 2011, in Boston, MA.
For more information, please click here.
Wednesday, April 20, 2011
Voices of Quality: AF4Q
The April edition of the Robert Wood Johnson Foundation's monthly e-newsletter, "The Quality Report" features a video depicting recent work from the Aligning Forces for Quality (AF4Q) program.
To improve the quality of health care, we need better information about the performance of doctors and hospitals. You cannot improve what you do not measure. Across the country, Aligning Forces for Quality communities are developing online public reports to make that information available to those who get care, give care and pay for care. This video tells their stories.
If you would like to receive future editions of "The Quality Report" monthly e-newsletter, sign up here.
To improve the quality of health care, we need better information about the performance of doctors and hospitals. You cannot improve what you do not measure. Across the country, Aligning Forces for Quality communities are developing online public reports to make that information available to those who get care, give care and pay for care. This video tells their stories.
If you would like to receive future editions of "The Quality Report" monthly e-newsletter, sign up here.
Monday, April 18, 2011
WIHI Session: Palliative Care = Quality Care
This week, WIHI's "talk show" will focus on Jennifer Temel's article on palliative care from last August's edition of the New England Journal of Medicine. The session will discuss Temel's research and the impact her work has had on clinicians.
INQRI is committed to the delivery of high quality patient care, including palliative care. In fact, our researchers at Oregon Health Science University are currently examining nursing's contributions to quality palliative care. Very little is known about the relationships between quality palliative nursing care delivered in intensive care units (ICUs) and patient and family outcomes or how to measure and improve these outcomes. Led by Lissi Hansen, Ph.D., R.N. and Richard Mularski, M.D., an interdisciplinary team of researchers will identify the role that nurses play in the delivery of high quality palliative care provided both to patients and their families. The team will be presenting their findings at the upcoming annual INQRI meeting in July.
Palliative Care = Quality Care
Thursday, April 21, 2011, 2:00 PM – 3:00 PM Eastern Time
Guests:
- Jennifer Temel, MD, Director, Fellowship Program at Massachusetts General Hospital; Clinical Director, Thoracic Oncology, MGH; Assistant Professor in Medicine, Harvard Medical School
- Daniel Ray, MD, Fellowship Director, Hospice and Palliative Medicine, Lehigh Valley Health Network
- Allan Ramsay, MD, Medical Director, Palliative Care Service, Fletcher Allen Health Care; Professor and Associate Chair, Department of Family Medicine, University of Vermont College of Medicine
To enroll, please click here.
INQRI is committed to the delivery of high quality patient care, including palliative care. In fact, our researchers at Oregon Health Science University are currently examining nursing's contributions to quality palliative care. Very little is known about the relationships between quality palliative nursing care delivered in intensive care units (ICUs) and patient and family outcomes or how to measure and improve these outcomes. Led by Lissi Hansen, Ph.D., R.N. and Richard Mularski, M.D., an interdisciplinary team of researchers will identify the role that nurses play in the delivery of high quality palliative care provided both to patients and their families. The team will be presenting their findings at the upcoming annual INQRI meeting in July.
Friday, April 15, 2011
Health Affairs Article: "The Quality ‘Journey’ At Ascension Health: How We’ve Prevented At Least 1,500 Avoidable Deaths A Year—And Aim To Do Even Better"
This week, we'll be highlighting papers published in the new edition of Health Affairs, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
"The Quality ‘Journey’ At Ascension Health: How We’ve Prevented At Least 1,500 Avoidable Deaths A Year—And Aim To Do Even Better"
Authors: David Pryor, Ann Hendrich, Robert J. Henkel, James K. Beckmann and Anthony R. Tersigni
In 2008, Ascension Health set the goal of reducing preventable deaths in their system by 900 each year. By the 2010 fiscal year, they had surpassed this goal, reducing preventable deaths by more than 1,500 a year. In this article, the authors share the health system's "quality journey" and their plans for the future.
Click here to read the piece.
"The Quality ‘Journey’ At Ascension Health: How We’ve Prevented At Least 1,500 Avoidable Deaths A Year—And Aim To Do Even Better"
Authors: David Pryor, Ann Hendrich, Robert J. Henkel, James K. Beckmann and Anthony R. Tersigni
In 2008, Ascension Health set the goal of reducing preventable deaths in their system by 900 each year. By the 2010 fiscal year, they had surpassed this goal, reducing preventable deaths by more than 1,500 a year. In this article, the authors share the health system's "quality journey" and their plans for the future.
Click here to read the piece.
Thursday, April 14, 2011
Health Affairs Article: "A Road Map For Improving The Performance Of Performance Measures"
This week, we'll be highlighting papers published in the new edition of Health Affairs, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
"A Road Map For Improving The Performance Of Performance Measures"
Authors: Peter J. Pronovost and Richard Lilford
Although use of performance measures has increased as efforts to improve health care quality have also increased, there is much debate over their effectiveness. The public wants proof of improved performance and researchers want to ensure that measures have validity. In this article, the authors discuss the "deadlock" present in the field of quality measurement.
Click here to read the piece.
Click here to read about INQRI teams whose work focused on quality measurement.
"A Road Map For Improving The Performance Of Performance Measures"
Authors: Peter J. Pronovost and Richard Lilford
Although use of performance measures has increased as efforts to improve health care quality have also increased, there is much debate over their effectiveness. The public wants proof of improved performance and researchers want to ensure that measures have validity. In this article, the authors discuss the "deadlock" present in the field of quality measurement.
Click here to read the piece.
Click here to read about INQRI teams whose work focused on quality measurement.
Wednesday, April 13, 2011
Health Affairs Article: "The Trade-Off Among Quality, Quantity, And Cost: How To Make It—If We Must"
This week, we'll be highlighting papers published in the new edition of Health Affairs, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
"The Trade-Off Among Quality, Quantity, And Cost: How To Make It—If We Must"
Author: Mark V. Pauly
In this analysis and commentary, INQRI co-director Mark Pauly shares his concern that the Affordable Care Act may "lead to a lot of talk about quality but necessarily much improvement." Pauly suggests that "disruptive innovation" (a market-driven approach that balances cost and quality) might be able to facilitate improvements in health care as it has improved quality in other industries.
Click here to read the piece.
"The Trade-Off Among Quality, Quantity, And Cost: How To Make It—If We Must"
Author: Mark V. Pauly
In this analysis and commentary, INQRI co-director Mark Pauly shares his concern that the Affordable Care Act may "lead to a lot of talk about quality but necessarily much improvement." Pauly suggests that "disruptive innovation" (a market-driven approach that balances cost and quality) might be able to facilitate improvements in health care as it has improved quality in other industries.
Click here to read the piece.
Tuesday, April 12, 2011
HHS Partnership for Patients Initiative
Today, the Department of Health and Human Services announced their commitment to use $1 billion in new funding from the Affordable Care Act to meet two important patient safety goals:
As Administrator Berwick said, we have the best trained and best equipped health workforce. The safety issues facing our health care system are indeed system-oriented. As we work to develop new processes and improved systems, we believe that nurses can and should be at the forefront of the discussion.
As recently articulated in the Institute of Medicine report on “The Future of Nursing: Leading Change, Advancing Health,” nurses are integral to promoting health and preventing medical errors in hospitals, clinics and everywhere patients are treated. The recommendations in the report are a testament to the value of nurses in ensuring patient safety. The recommendations encourage interprofessional collaboration and patient-centered teams that incorporate the skills and talents of all health professionals.
- Reduce preventable hospital injuries by 40% by 2013; and
- Cut preventable hospital readmissions by 20% by 2013.
As Administrator Berwick said, we have the best trained and best equipped health workforce. The safety issues facing our health care system are indeed system-oriented. As we work to develop new processes and improved systems, we believe that nurses can and should be at the forefront of the discussion.
As recently articulated in the Institute of Medicine report on “The Future of Nursing: Leading Change, Advancing Health,” nurses are integral to promoting health and preventing medical errors in hospitals, clinics and everywhere patients are treated. The recommendations in the report are a testament to the value of nurses in ensuring patient safety. The recommendations encourage interprofessional collaboration and patient-centered teams that incorporate the skills and talents of all health professionals.
Health Affairs Article: "Creating A Framework For Getting Quality Into The Public Health System"
This week, we'll be highlighting papers published in the new edition of Health Affairs, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
"Creating A Framework For Getting Quality Into The Public Health System"
Authors: Peggy A. Honoré, Donald Wright, Donald M. Berwick, Carolyn M. Clancy, Peter Lee, Juleigh Nowinski and Howard K. Koh
In this piece, the authors discuss two reports from the Department of Health and Human Services: Priority Areas for Improvement of Quality in Public Health and Consensus Statement on Quality in the Public Health System and how they relate to the Affordable Care Act, serving "as a call to action for ensuring a better future for population health."
Click here to read the piece.
Click here to download Priority Areas for Improvement of Quality in Public Health.
Click here to download Consensus Statement on Quality in the Public Health System.
"Creating A Framework For Getting Quality Into The Public Health System"
Authors: Peggy A. Honoré, Donald Wright, Donald M. Berwick, Carolyn M. Clancy, Peter Lee, Juleigh Nowinski and Howard K. Koh
In this piece, the authors discuss two reports from the Department of Health and Human Services: Priority Areas for Improvement of Quality in Public Health and Consensus Statement on Quality in the Public Health System and how they relate to the Affordable Care Act, serving "as a call to action for ensuring a better future for population health."
Click here to read the piece.
Click here to download Priority Areas for Improvement of Quality in Public Health.
Click here to download Consensus Statement on Quality in the Public Health System.
Monday, April 11, 2011
Health Affairs Article: "Preventing Bloodstream Infections: A Measurable National Success Story in Quality Improvement"
This week, we'll be highlighting papers published in the new edition of Health Affairs, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
"Preventing Bloodstream Infections: A Measurable National Success Story In Quality Improvement"
Authors: Peter J. Pronovost, Jill A. Marsteller and Christine A. Goeschel
The authors discuss the collaborative efforts undertaken to successfully reduce and end central line-associated bloodstream infections (CLABSIs) in a 45 state initiative. This program has demonstrated continual results in reducing hospital-associated infections and deaths.
Click here to read the piece.
Click here to read about the team's INQRI-funded project, a nurse-led initiative to reduce CLABSIs.
"Preventing Bloodstream Infections: A Measurable National Success Story In Quality Improvement"
Authors: Peter J. Pronovost, Jill A. Marsteller and Christine A. Goeschel
The authors discuss the collaborative efforts undertaken to successfully reduce and end central line-associated bloodstream infections (CLABSIs) in a 45 state initiative. This program has demonstrated continual results in reducing hospital-associated infections and deaths.
Click here to read the piece.
Click here to read about the team's INQRI-funded project, a nurse-led initiative to reduce CLABSIs.
Friday, April 8, 2011
Health Affairs Explores the Quality Chasm
A new edition of Health Affairs was published yesterday, entitled "Still Crossing the Quality Chasm." This edition explores the question of quality as raised in the 2001 Institute of Medicine report, Crossing the Quality Chasm, and explores how far we have come since its publication... while also anticipating the road ahead.
For the next week, we will highlight pieces from this edition on our blog. Please share your comments with us as related to the Quality Chasm.
First up: "The Importance of Transitional Care in Achieving Health Reform," authored by INQRI program director Mary Naylor and her colleagues Linda Aiken, Ellen Kurtzman, Danielle Olds and Karen Hirschman.
Currently, one in five elderly patients discharged from a hospital is readmitted within a month. Seeking to address the human and substantial financial burden of revolving door hospital readmissions, the Affordable Care Act proposes a number of initiatives to improve care and health outcomes and reduce costs for the growing population of chronically ill people in the U.S. While transitional care is a central theme in these provisions, there is little information available to guide those responsible for implementing these important opportunities.
To bridge the gap, Naylor and her team reviewed existing programs in order to determine what works, for whom and for how long. They discovered “a robust body of evidence” that transitional care can improve health outcomes and reduce hospital readmissions. This paper highlights a range of solutions to reduce avoidable hospitalizations and health care costs.
Click here to read more.
For the next week, we will highlight pieces from this edition on our blog. Please share your comments with us as related to the Quality Chasm.
First up: "The Importance of Transitional Care in Achieving Health Reform," authored by INQRI program director Mary Naylor and her colleagues Linda Aiken, Ellen Kurtzman, Danielle Olds and Karen Hirschman.
Currently, one in five elderly patients discharged from a hospital is readmitted within a month. Seeking to address the human and substantial financial burden of revolving door hospital readmissions, the Affordable Care Act proposes a number of initiatives to improve care and health outcomes and reduce costs for the growing population of chronically ill people in the U.S. While transitional care is a central theme in these provisions, there is little information available to guide those responsible for implementing these important opportunities.
To bridge the gap, Naylor and her team reviewed existing programs in order to determine what works, for whom and for how long. They discovered “a robust body of evidence” that transitional care can improve health outcomes and reduce hospital readmissions. This paper highlights a range of solutions to reduce avoidable hospitalizations and health care costs.
Click here to read more.
Thursday, April 7, 2011
Free Event: Safer Designs for Safer Injections
The Premier healthcare alliance and the Safe Injection Practices Coalition are collaborating to host an open meeting, Safer Designs for Safer Injections: Innovations in Process, Products and Practices, on Tuesday, April 26, 2011, at the Omni Shoreham in Washington, DC. There is no registration fee.
More information and registration is located at the conference website.
For more information regarding safe injection practices:
More information and registration is located at the conference website.
For more information regarding safe injection practices:
Wednesday, April 6, 2011
INQRI Study on Staffing is Making the News
Recently, Medical Care featured an INQRI study which shows that higher nurse staffing levels in hospitals can reduce infection rates and improve outcomes for patients. The study, completed by Mary Blegen and her team, is generating a lot of buzz in the media... check out some recent stories:
Tuesday, April 5, 2011
Joint Commission: New Advanced Certification for Palliative Care
The Joint Commission has announced that their new Advanced Certification Program for Palliative Care will be available as of September 1, 2011. This program was created to "recognize hospitals that demonstrate exceptional patient and family-centered care in order to optimize the quality of life for patients with life-limiting illnesses."
The dependable delivery of high quality palliative care is incredibly important. In fact, INQRI researchers at Oregon Health Science University are currently examining nursing's contributions to quality palliative care. Very little is known about the relationships between quality palliative nursing care delivered in intensive care units (ICUs) and patient and family outcomes or how to measure and improve these outcomes. Led by Lissi Hansen, Ph.D., R.N. and Richard Mularski, M.D., an interdisciplinary team of researchers will identify the role that nurses play in the delivery of high quality palliative care provided both to patients and their families.
Learn more about the Joint Commission's Advanced Certification Program for Palliative Care.
The dependable delivery of high quality palliative care is incredibly important. In fact, INQRI researchers at Oregon Health Science University are currently examining nursing's contributions to quality palliative care. Very little is known about the relationships between quality palliative nursing care delivered in intensive care units (ICUs) and patient and family outcomes or how to measure and improve these outcomes. Led by Lissi Hansen, Ph.D., R.N. and Richard Mularski, M.D., an interdisciplinary team of researchers will identify the role that nurses play in the delivery of high quality palliative care provided both to patients and their families.
Learn more about the Joint Commission's Advanced Certification Program for Palliative Care.
Monday, April 4, 2011
The Future is Now for Nurse Practitioners
Laura Raines of the Atlanta Journal-Constitution has a new piece detailing the expanding role of nurse practitioners. As she writes, "born out of the physician shortage of the 1960s, the nurse practitioner role seems to have come full circle with the recommendations of the Institute of Medicine and Robert Wood Johnson Foundation’s 2010 report on the future of nursing... By continuously expanding their roles, proving their competency and pushing the barriers of acceptance and authority for more than 45 years, nurse practitioners have not only earned a place at the leadership table, they have found more ways to practice."
Click here to read the article in the Atlanta Journal-Constitution.
Click here to read the report on the Future of Nursing.
Click here to read the article in the Atlanta Journal-Constitution.
Click here to read the report on the Future of Nursing.
Friday, April 1, 2011
AAACN Releases Statement About Role of Nurses in Outpatient Settings
Recently, the American Academy of Ambulatory Care Nursing released a statement advocating for registered nurses' role in outpatients settings, explaining that the care provided by nurses in these settings is just as important as that provided in hospitals.
This statement supports the themes presented in the Future of Nursing report, which include recommendations that are targeted at utilizing the benefits of nurse-led models of care throughout the health care system.
Click here to read the statement, "The Role of the Registered Nurse in Ambulatory Care."
This statement supports the themes presented in the Future of Nursing report, which include recommendations that are targeted at utilizing the benefits of nurse-led models of care throughout the health care system.
Click here to read the statement, "The Role of the Registered Nurse in Ambulatory Care."
Eh, I think we'll hang it up
Nursing... quality... eh. I think we'll take a break and go on vacation.
APRIL FOOLS!!!!!!!!!!
APRIL FOOLS!!!!!!!!!!
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