Priority Quality Improvement Of A High Performing Health Care System

My second clinical day took place on September 24th, 2015 at Saint Barnabas Hospital in Livingston, New Jersey. My preceptor Maria Brilhante, MSN, RN, allowed me to observe the morning huddle that took place with all the nurse managers that are in the hospital. The purpose of this huddle was to keep the director of nursing informed about the census on each unit. I found this processed to be very uniformed and professional because the DON was engaged. The day went on with me attending meetings on how managers could implement plans to contain cost for the hospital. Maria did her daily rounds on her patients and her nursing staff. She has a folder that contains papers on how each nurse is progressing from the time they get off orientation. Her motto to the nurses is, “You are good at what you do, so when I coach don’t take offense. I am only trying to get you to be great”. This boost their confidence which I thought to be important.

Nurse mangers is the leader of a specific department or unit of a healthcare facility. The nurse manager is responsible for recruitment and retention of the nursing staff, collaborating with other health care providers on patient care, and assisting patients and their families when needed. The nurse manager works with administration communicating and interpreting the facility’s policies and procedures to the staff. Usually with other departments in the facility, the nurse managers develop quality improvement measures tracking the patient services and care. According to Espinoza et al (2009), the nurse manager plays a pivotal role in

What do you consider to be the key issues for quality improvements in the NHS quality-improvement program as it goes forward?

The Health Care System 's purpose is to meet the physical and mental health needs of the communities in which they serve, these systems operate using people working within heal care facilities as well as other health delivery resources. One group of individual that help with facility operations are nursing administrators. Nursing Administrators contribute in managing along with directing the nursing care delivery system. Their leadership style, characteristics, communication strategies, including the way that they negotiate as well as manage conflicts can determine the quality of the healthcare services treat the facility provide as well as help to develop a set of guidelines to standardize the type and quality of the nursing services. (Cipriano, 2011) Together the Nurse Mangers work toward the same goals along with guiding nurses in their practice and contribute to the facilities successes. (Frankel, 2011) The nursing leaders are advocates who directly affect the quality of the nursing care along with also having a positive impact on healthcare through leadership.

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

| Learning and Growth * Enhance knowledge and skills of staff * Learn health center risks * Educate patients on urgent care sites

With over three million nurses in the United States nurses play an important role in healthcare today. As the future of health care changes the nurses’ role will change as well. In 2008, The Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) combined partnership and put together a committee to assess nursing practices and make recommendations for the future transformations in the health care system. This report was released in 2010 and included four key components in which three will be discussed in this paper.

This paper seeks to expand upon the 2010 Institute of Medicine’s report on the future of nursing, leading change, advancing health and illustrating its impact on nursing education, practice and leadership. There is an ongoing transformation in the healthcare system necessitated by the need to achieve a patient centered care in the community, public, and primary care settings in contrast to previous times. Nurses occupying vital roles in the healthcare system, need improvements in the areas mentioned above to

“There are three basic dimensions to this: structure, process, and outcome. Structure represents the basic characteristics of physicians, hospitals, other professionals, and other facilities” (Clancy, 2009).

The American Nurses Association is leading the way by implementing countless initiatives to bring attention to the nurses’ essential role in care coordination. It is up to the nurse to step up and draw attention to the integral part they play in improving patient satisfaction, patient care quality, and the effective and efficient use of health care resources (American Nurses Association, 2012).

Healthcare changes occurring today along with shrinking budgets and reimbursement rates for hospitals has forced institution CEOs to do more with less. Changes and restructuring of various health facilities require nursing leaders with flexibility and adaptability. Nurse leaders must also consider budgetary constraints, cost effectiveness, patient safety, and quality care while maintaining focus on improved patient outcome. The responsibility of ensuring patients receive safe and high quality care belongs to every employee in the hospital, including support staff such as IV therapy. In this hospital, this led to the development of a nurse director position to oversee the

The nurse manager stated that her vision for her unit was to have her entire staff be clinically sound and function confidently under adverse client load. She expects upmost teamwork from her staff and expects the unit to operate efficiently with upmost regard for staff and client safety.

Several of the roles which I observed this morning were expected: the nurses took vitals for incoming patients, performed focused assessments, and were the main communicators between family, the patient, and the physician. I realized when the first patient came in around 10:00 am, the RN’s role in assessments, gathering blood work, and carrying out all the necessary steps to situate and stabilize the patient as soon as possible. It was incredible seeing the nurses work together, in sync, in those first moments when the patient was brought in. And though expected, I appreciated seeing just how much communication was held and information was gathered from the patient or family members by the nurse. Jessica asked the right questions from both parties, while still showing incredible empathy and not making the whole situation seem rushed and flustering. I understood this as another essential role of the nurse in the ED; he or she must maintain even in such a fast-paced environment empathy and focus in each interaction.

Health care systems are reporting and monitoring quality of care indicator data with increasing regularity.

-Examine at least three (3) examples of quality initiatives that could increase patient satisfaction and potentially reduce healthcare cost. Support your response with examples of the successful application your chosen quality initiatives.