NKF-CQI Clinical Practice

HEDIS is list of health care process measures and intermediate outcome measures based on administrative data, claims and patient records and is utilized by insurance agencies and CMS (Martino, Weinick, Kanouse, Brown, Haviland, Goldstein &… Elliott, 2013). The HEDIS measures include coronary artery disease, diabetes (and its complications), congestive heart failure, stroke, hypertension, obesity, smoking, metabolic syndrome, medication adherence and derive the best quality outcomes from trials and preventive medicine (Eddy, Pawlson, Schaaf, Peskin, Shcheprov, Dziuba & …Eng (2008). In 2005, these HEDIS measures targeted a study of 3.3 million and improvement in performance to those imply prevention of 1.9 million myocardial infractions, 0.8 million strokes, and 0.1 million cases of end-stage renal disease, however if performance would have been 100 percent 1.4 million myocardial infractions could have been prevented because the control of blood pressure has the largest potential effect on quality at a national level (Eddy, Pawlson, Schaaf, Peskin, Schcheprov, Dziuba & …Eng, 2008). These measures follow the best practice guidelines for improving the health of the

As we further our education to become advanced practice nurses (APNs), it is crucial that we understand the behaviors or core competencies expected of all APNs. For the purpose of this discussion, I will evaluate the core competency of quality and how I will integrate this behavior into my daily practice.

QSEN consists of six competencies: patient centered care, quality improvement, teamwork and collaboration, safety, informatics, and evidence based practice. To provide patient-centered care, I had to educate the patient when administering medications on why the patient was taking the medication and side effects. Care had to be individualized with each patient and it included providing respect with his or her decisions in their care. An example includes respecting the decision when a patient refused to take lactulose because it made him have frequent bowel movements. In EPIC, we would chart patient refused the medicine resulting in providing patient-centered care. For quality improvement, the unit has data on how many infections have occurred with central lines and utilize benchmarks and evidence-based practice guidelines to prevent infections. For instance, I had to perform proper hand washing and scrub the hub for at least 30 seconds with alcohol pads to prevent infections in patients who have intravenous lines.

As an integral part of the healthcare team, nursing has evolved tremendously. In Nurse of the Future Nursing Core Competencies a picture was painted of what the future of nursing looks like. From my own opinion I do feel that a reform or evolution in nursing education is required to create competent nurses of the future. Current nursing school programs are academic heavy with an emphasis on skills. While growing competency in clinical skills is necessary, there is much more to the future of nursing than being highly skilled. It is time to distinguish not just skills, but characteristics of a successful nurse of the future. This is a nurse who will be well rounded with the tools and resources to help guide healthcare and the patient experience

Lewis, Stephens, and Ciak (2016) confirmed that the Quality and Safety Education for Nurses (QSEN) initiative was developed to determine competencies for nursing students based upon Institute of Medicine (IOM) recommendations with the main goal of QSEN is to establish a cultural change toward quality and safety. According to QSEN (2014), addresses the challenge of preparing future nurses with the knowledge, skills, and attitudes (KSAs) are essential components of improving the quality and safety of the healthcare systems. Furthermore, the QSEN six competencies for nursing that targets the KSA to guarantee future graduates to develop competencies in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement,

The CQC uses and monitors services continuously, it is also the entity responsible for gathering and analysing information, then publish their findings to give consumers clear information when making choices and to help services improve. The kind of information they use is inclusive of: information collected directly from care providers, information about people’s experiences and vies from their families and carers and lastly data used to plan inspection

Since the addition of Crossing the Quality Chasm six aims of quality patient care was created by the Institute of Medicine (IOM), there has been a significant change in the effectiveness and condition of patient care. Before this report came out in 2001, health care providers did not realize that they were not providing proper care to patients in addition to disorganization and complexity of standards of care. The IOM was able to determine that, “failure of system processes, poor communication, and unhealthy work environments contribute to medical errors, ineffective delivery of care, and stress among health professionals” (Winterbottom 2012). It is essential for patients to feel

Why is Accountability so important in the health care industry? Even though a situation may be positive or negative, every aspect of health care needs to be credited to something or someone, with accountability, errors can be fixed and then prevented and helps keep costs down. An employee accountability is measured by customer satisfaction, results of performance, and the cost and impacts of the employee over time, and affects an organization’s working culture by their values, integrity and work ethics. A successful organization follows the checks and balance process, maintains a positive working culture, and stays clear from blame.

Quality improvement efforts and risk management are complementary, and together are key modules of clinical governance. Risk management reinforces quality management in healthcare. This leads to:

Prior to the implementation of the Affordable Care Act (ACA), few people anticipated employer-provided health care would disappear as a major player in the United State healthcare arena. However, ACA adoption and has put more than 169 million employees at risk for losing their workplace coverage. Several studies indicate employer-based coverage will decline rapidly over the next decade as the traditional US system is displaced by the healthcare exchange system. While consumers grapple with finding affordable coverage options and providers adjust to the new norms, there is another wrinkle in the mix. In January, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced the agency's push toward value-based and alternative reimbursement models. HHS expects 90% of Medicare payments to be directly tied to quality measures by 2018. It is imperative that hospitals, urgent care clinics and frontline providers align their

The American Nurses Association estimates that up to 80% of serious medical errors involve miscommunication between caregivers when patients are transferred or handed off during shift report (ANA 2012). In the nursing profession change of shifts require the successful transfer of information from nurse to nurse to prevent medical errors and adverse events (Sullivan, 2010). Research shows that when patients are included and engaged in their health care there is greater potential to lead to measurable improvements in safety and quality of care. The purpose of this paper is to report results of an organized review of the literature which studied bedside reporting in the hospital

To evaluate the change, results were monitored on a monthly basis which was not sufficient to reach the goal of 100% compliance. The initial change was effective in increasing the compliance rate from 68% to 95.6%. An additional PDSA is needed to meet the goal of 100% compliance. This can be achieved with additional reporting on a weekly basis, with a focus on individual staff or primary care teams. This will allow for individual coaching. Without coaching, individual barrier or gaps cannot be identified.

CMS`s Medicare and Medicaid program might one those heading to failure because of the financial constraints the government has been imposing on this program. Also, public reporting on how the hospitals, providers and nursing homes are faring. They are also more current and projected like “Quality Improvement Organizations, Post- Acute Care Reform Plan and Development of Quality Indicators for Inpatient Rehabilitation Facilities (IRFs) which is, an overall goal of this project was to assist CMS in developing appropriate measures to monitor and evaluate the quality of rehabilitation services provided to Medicare beneficiaries in IRFs”, (CMS, 2017, p. 10). As for The Joint Commission, the current and projected initiatives are “Performance Measures for Acute Stroke Ready Hospital Certification which all currently certified acute stroke ready hospitals, as well as those hospitals seeking initial certification, will be required to implement data collection for five standardized measures effective with discharges on and after January 1, 2018”, (TJC,2017, p.1). In 2016, an advanced certification was launched for Total Hip and Total Replacement Knee and in 2017, advanced certification for Palliative Care program was launched. All these initiatives which has been launched or not yet will bring change to our

Under state law, a patient may pursue a civil claim against physicians or other health care providers, called medical liability or medical malpractice, if the health care provider causes injury or death to the patient through a negligent act or omission (Malloy, 2015). In North Carolina, The Nurse Practitioner has different risks and premiums. The recommendations are to obtain as much coverage as the provider can afford, but no less than one million (Krauss, 2004). Some employers will carry the liability insurance but they strongly recommend obtaining one 's own policy for additional coverage. For family practitioners with no obstetric practice: a 115-percent increase to $9,000 per

Bus Éireann is presently progressing towards a competency- based approach to HRM, this approach recognises that employees are an organisation’s most valued asset and they focus on improving employee’s skills, attitude and knowledge in order to make the most of their influence or contribution to the achievement of the company. By so doing it improves Bus Éireann’s capability to retain valued staffs.