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Academic Integrity
Inpatient Quality Indicators
Emily Jones
Walden University
NURS 3100 Section 01, Issues and Trends
September 23rd, 2017
Inpatient Quality Indicators
Inpatient quality indicators are a set of measurements used around the world for hospitals to measure inpatient stays and improve patient’s overall health. Hospitals are using patient stays as ‘makers’ to help guide mortality and improve disease process and decrease deaths around the globe. The purpose of this paper is to describe inpatient quality indicators.
Quality Indicators
Inpatient quality indicators help guide hospital administration on ways to improve procedures, decrease mortality, misused, underused and help improve patient
John Hopkins Hospital was founded by John Hopkins a philanthropist and a Quaker by faith in 1867 and endowed in 1873. He dedicated his life and finances approximately $7,000,000 in cash to building a teaching hospital and a university named after him with designations of uniting functions of patient care with education and research. The John Hopkins hospital was officially opened on May 7, 1889. Before Mr. Hopkins died in 1973, he had committed himself to the principle of “united we stand and divided we fall” and selected board of trustees for the hospital and the university whom he entrusted with tasks and responsibilities to carry out his vision. On March 10, 1873, he put in black and white that the hospital must provide for “the indigent sick of the city of Baltimore without regard to sex, age, or color who may need surgical or medical treatment”. In his letter he also specified that the school of nursing and medicine must be established in conjunction with the hospital. Looking at it today, the John Hopkins hospital has evolved into one of the largest teaching hospital in the country. It includes more than 12 smaller hospitals and medical centers affiliated to the main hospital in Baltimore 226 clinical services 977 licensed beds and 37 building in the State of Maryland. The John Hopkins Hospital and School of Medicine are the founding institutions of modern American Medicine and the birthplace of so many traditions of medicine including ward rounds, residency programs, and house staff. Many medical specialties including neuroscience by Harvey, cardiac surgery by Blalock, urology, endocrinology pediatrics, and child psychiatry by Kanner were founded at this hospital....
If patients constantly have to wait an excessive amount of time they will either leave before they receive care or could end up becoming sicker as a result. Donabedian’s three-element model structure, process and outcome have become the gold standard for defining quality measurement (Varkey, 2010). Structure relates to the health care setting, which includes the hospital policies, procedures and design. Process evaluates if the right actions were taken for an intended outcome and how well the actions were executed to achieve the outcome. Outcome focuses on the patient, it measures the patient’s condition, behavior, and response to or satisfaction with care (Varkey, 2010). Although each of these measures focus on different areas, they indicate areas that need improvement. Also, the measurement from structure and process plays an important role in the patient’s outcome. If the hospital has the right staff, equipment and
Dimension1.2- “Clinical Effectiveness” takes part in better resource utilization; attempt to accomplish “more for less” through evidence based practice to improve the care. Providing effective and safe care is necessary in achieving the best clinical care outcome especially in an acute care hospital, and will help provide the best possible patient experience
The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan...
According to the Centers for Disease Control and Prevention (CDC) (2012), the average time patients spend in the U.S. emergency department (ER) before they can see a doctor has increased to 25% between 2003-2009. The main cause of longer wait times (WT) in the ER is overcrowding. Overcrowding has been found to be closely related to both subjective and objective patient satisfaction (Miro’ et al, 2003). Longer wait times in the ED is such an important issue because its consequences are detrimental not only to the ER patients, but also to providers. As a health care provider, decreasing patients’ WT in the ED is essential, although challenging, to improve patient’s health outcomes and increase patients’ satisfaction. Although it is a very challenging issue to tackle, hospitals that have initiated some quality improvement (QI) strategies are experiencing some positive outcomes in that area of care. The outcomes are measured by decreased waiting times, improved patients’ clinical outcomes and increased patients’ satisfaction.
Nurses are pivotal in hospital efforts to improve quality because they are in the best position to affect the care patients receive during their hospitalization. Data collection and analysis is the core of quality improvement assisting in understanding how the system work, identifying potential areas in need for improvement, monitoring the effectiveness of change and outcome. Nurses are also the eyes and ears of the hospital to positively influence patient outcome. For example, nurses are the ones catching medication errors, falls, and identifying barriers to delivering care. In this nurse’s facility, in order to minimize patient falls the hospital implemented a falls risk assessment tool called, “The Humpty Dumpty Scale” upon admission
For the purposes of this quality improvement effort, the measures will be aimed at improving the wait time for a patient after the check in at a facility. Wait time is defined as time spent between checking in and the actual encounter. The encounter includes when the patient is seen by a medical professional. This will potentially increase patients’ satisfaction but could jeopardize patients that will come in with more critical conditions.
This paper will show how assessment is a core part of the client’s treatment. It will show how assessment is done at the beginning of the treatment process but, will allow you to see that assessment is a continuing process. It results from a combination of focused interviews, testing, and record reviews. Assessments give the social worker a framework of reference to understand the strengths, weaknesses, problems, and needs of the client for the development of the treatment plan. It provides the social worker with a theory-based framework for generating hypotheses about the client’s experience and behaviors, which in turn helps prepare the basis for a specific treatment intervention. This paper will discuss the assessment tools
All three quality improvement interventions that Fielder Medical Center staffs have been working on adhere closely to the CMS Quality Strategy guidelines. The hospital has been applying plans to assist patients and their families in ensuring the steady care processes before and after discharges to reduce the readmission rate. Additionally, the Center creates various research professional teams and mandated educating programs for all staffs in the efforts to reduce the hospital-acquired infections related to central line catheters and urinary catheters. These activities have helped Fielder Medical Center in raising the quality of provided cares to all of their patients and eliminating preventable errors, which give the patients the best experience during their stay and reducing the unfavorable addition costs to overall
In the healthcare system, quality is a major driving compartment for patient outcomes. The quality of care reflects the outcomes in a patient’s care. According to Feeley, Fly, Walters and Burke (2010), “quality equ...
An example of a quality improvement initiative that could be proposed would be to reduce medical errors by improving communication and teamwork. Medical errors usually occur when there is a breakdown in teamwork and communication. The first thing that I would propose is to have all medical staff members follow a routine daily round schedule. During the daily rounding, the teams will be encouraged to collaborate and discuss the patient plan of care. A performance improvement dashboard should be implemented. Medical staff should be encouraged to use the patient's bedside whiteboards to document and keep track of daily goals. Also, patients and family members should be encouraged to ask questions and collaborate on the plan of care.
Quality improvement (QI) involves the regular and constant actions that enable measurable improvement in health care. QI results in enhanced health services, organizational efficiency, quality and safe care to patients, and desired health outcomes for individuals and patient populations (U. S. Department of Health and Human Service, 2011). A successful quality improvement program is patient-centered, a collaboration of teams, and uses data in systems. QI helps to develop a culture of excellence in nursing, identify and prioritize areas of improvement, promote communication and collaboration, collect and analyze data, and encourage continuous evaluation of systems and processes (American Academy
Another factor being looked at in quality of care is patient satisfaction. There has been some debate as to whether the patient’s perception of their care truly reflects the quality of care. I feel like this can be looked at from both angles. The nurse to patient ratio certainly factors into this as well as the acuity of the patients which can vary dramatically. Just stepping onto the floor we have a long list of “to do’s” for our patients; doctors to call, test results to look for, protoco...
Understanding quality measurement is essential in improving quality. Teams need to be able to understand whether the changes being made are actually leading to improved care and improved outcomes. For data to have an impact on an improvement initiative, providers and staff must understand it, trust it, and use it. Health care organization must understand the measurement of quality provided by the Institute of Medicine (patient outcomes, patient satisfaction, compliance, efficiency, safe, timely, patient centered, and equitable. An organization cannot improve its performance if it does not know how it is performing. Measuring quality improvements is essential as it reflects the quality of care given by the providers and that by comparing performance
Maintenance and promotion of quality improvement initiatives are essential for the successful growth and development of the health care industry. Nurses are key to all quality improvement initiatives as they are in the frontlines and have the most contact with the healthcare consumers. Therefore, nursing professionals are good at putting in their valuable inputs for quality improvement efforts. On a daily basis nursing professionals strive to deliver safe, efficient, effective, patient-centered care in a timely manner. With the growth and development in the health care industry, there is an increased need to provide competent and high quality services. Nurses are equipped with distinctive proficiency required for delivery of patient care