In our article, “Measuring Nurses’ Impact on Health Care Quality:Progress, Challenges and Future Directions,” we summarized the research generated by four INQRI teams and reflected on the challenges and future directions related to improving quality measurement. INQRI researchers have addressed the need for quality measures that are useful across populations including pain, falls, pressure ulcers, restraint use, medication administration accuracy, bloodstream infections, discharge preparation and perceptions of daily nursing care. These teams tested new ways to model the relationships between structure, process, and outcome; addressed the continuum from hospital to home, measuring the role of discharge preparation on readmissions and emergency department visits. Most of the measures tested focused on the positive aspects of what nurses do: believing the patient’s pain, providing daily comfort care, and preparing patients to go home after a hospitalization. We found that several challenges exist relative to quality measurement, including measuring care delivery from multiple perspectives, determining the dose of care delivered, and measuring the entire care process. Future work should focus on the development of simple, feasible, affordable measures that can be integrated in the care delivery system.
This post is part of our week-long blog carnival focused on the Medical Care supplement. Click here to access all posts in this carnival.