Understanding Quality Patient Care and the Role of the Practicing Nurse

Owens, Laura; Koch, Robert W.

doi:10.1016/j.cnur.2014.10.003

Cited by 9 publications

(4 citation statements)

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“…Evaluating presupposes issuing a value judgment according to a given historical, social, economic and cultural context, (4,5) which supports the interviewees' perception of the subjective nature of the self-assessment. Despite a recommendation, the Ministry of Health does not require the adoption of strict quality standards for scoring (1) and the score in the final ranking merely considers the execution or not of the self-assessment, which weakens its impact in the result.…”

Section: Discussionmentioning

confidence: 99%

Implementação do Programa de Melhoria do Acesso e Qualidade segundo gestores da Atenção Básica de São Paulo

et al. 2017

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Objective: To analyze the implementation of the National Improved Access and Quality Program according to Primary Health Care managers. Methods: The thematic oral history was used, through semistructured interviews with five managers from Primary Health Care Services who participated actively in the two cycles of the Program in an administrative district of São Paulo City. The subjects answered the question "How do you assess the implementation process of the National Improved Access and Quality Program at this Primary Health Care Service?", among others. The analysis of the testimonies revealed the categories "The managers' perception of the implementation of the National Improved Access and Quality Program" and "Changes in the work processes since the implementation of the National Improved Access and Quality Program". Results: The managers acknowledged the Program as a well-structured proposal, which permits a broader management view on the health services. The interviewees evidenced the use of the quality indicators, which was hardly addressed and understood in the managers and teams' daily reality though. The interviewees demonstrated that they do not understand the concepts of continuing education and institutional support. The external evaluation phase was considered subjective and without standardization, producing data that did not contribute to the assessment of the changes the teams made. Conclusion: The systematic incorporation process of the assessment culture to support the continuing quality improvement in Primary Health Care is incipient. Despite the continuing distance between the proposals of Primary Health Care and the practice at the Primary Health Care services studied, the Program favored the organization of the work processes and contributed to the managers' focus on the teams' practice and their own activities. ResumoObjetivo: Analisar a implementação do Programa Nacional de Melhoria do Acesso e da Qualidade segundo gerentes de Unidades Básicas de Saúde. Métodos: Utilizou-se a história oral temática, por meio de entrevistas semiestruturadas com cinco gerentes de Unidades Básicas de Saúde que participaram ativamente dos dois ciclos do Programa em um distrito administrativo do município de São Paulo. Os sujeitos responderam, dentre outras, à questão "Como você avalia o processo de implementação do Programa Nacional de Melhoria do Acesso e da Qualidade nesta Unidade Básica de Saúde?" e da análise dos depoimentos emergiram as categorias "Percepção dos gestores quanto à implementação do Programa Nacional de Melhoria do Acesso e da Qualidade" e "Mudanças nos processos de trabalho a partir da implementação do Programa Nacional de Melhoria do Acesso e da Qualidade". Resultados: Os gerentes reconheceram o Programa como uma proposta bem estruturada, que permite ampliar a visão gerencial nos serviços de saúde. O uso dos indicadores de qualidade foi evidenciado pelos entrevistados, mas pouco trabalhado e compreendido no cotidiano dos gestores e equipes. Os entrevistados demonstraram não compr...

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Section: Discussionmentioning

confidence: 99%

Implementação do Programa de Melhoria do Acesso e Qualidade segundo gestores da Atenção Básica de São Paulo

et al. 2017

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“…These programs have gone through revisions over the years including identifying quality indicators. For example, the Experimental Medical Care Review Organizations were established in 1972 to review quality and appropriateness of care delivered (Owens & Koch, 2015). In 2001, CMS instituted the Hospital Quality Initiative, making aggregated healthcare quality data publicly accessible.…”

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confidence: 99%

Quality Improvement Essentials

D’Eramo¹

2022

Quality and Safety Education for Nurses

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Undoubtedly, the most important single requisite is a commitment to quality: an unequivocal desire and determination to dedicate oneself to the best one is capable of, despite every obstacle. " -Donabedian, 2003, p. xxix Upon completion of this chapter, the reader should be able to:1. Define quality improvement (QI). 2.Describe the historical evolution of QI. Explain QI in nursing practice 4.Compare and contrast QI, evidence-based practice, and research. 5.Differentiate between QI models and methodologies, including Plan-Do-Study-Act (PDSA), Lean, and Six Sigma. 6.Describe reactive and proactive approaches to QI problems. 7.Explore the role of the nurse in QI projects. 8.Discuss the impact organizational leadership has on QI activities. CROSSWALKThis chapter addresses the following: QSEN Competency: Quality Improvement The American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. Domain 5: Quality and Safety 1. From an interprofessional perspective, who would the nurse initially contact based on this observation? 2. What regulation(s) is the nursing admission assessment policy that stipulates medication reconciliation be conducted on every home visit based on? 3. Is there opportunity to consider a quality improvement activity based on this scenario? DEFINING QUALITY IMPROVEMENT Quality improvement (QI) is defined the same for both prelicensure and graduate nursing education by the Quality and Safety Education for Nurses (QSEN) competency as "Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems" (QSEN Institute, n.d.-a, n.d.-b). The knowledge, skills, and attitudes (KSAs) differ, however, in that the prelicensure expectations focus on preparing the new nurse to participate in or lead small-scale QI activities while graduate students are expected to take a greater role and facilitate QI activities across the organization. QI is the process of collecting and analyzing data to determine the extent to which quality healthcare is being delivered 11: QUALITY IMPROVEMENT ESSENTIALS | 363 according to established standards. Standards may be internal, such as those created by the organization, or external, such as those created by regulatory bodies. QI can be considered as both an art and a science (McLaughlin et al., 2012). Indeed, the art of QI involves asking questions and coming up with creative ideas and visionary innovations of how to approach and consider improvement interventions. The science of QI, presented in Chapter 12, involves the ongoing process of testing improvement interventions, to measure if improvements lead to the intended outcomes, and to sustain intended outcomes.Triggers that may initiate a QI activity may include inconsistent patient outcomes, poor patient outcomes, patient outcomes that do not meet expectations related to evidence-based practice (EBP) or to standards, or patient/family complaints. Such outco...

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“…33 As hospitals continue to face demands to improve the quality and cost-effectiveness of care, critical care nurses can function as leaders modeling EBP that enhances patients' outcomes. 35 Transforming care at the bedside requires nurses to develop patient-centered goals and strive to meet those goals through individualized evidence-based interventions. 36 Success also requires nursing leaders who encourage a culture of inquiry and foster continual advancement of practice as the evidence evolves.…”

Section: Evidence-based Practice and Highreliability Organizations: Smentioning

confidence: 99%