Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 131

Performance and quality measurement is an essential component of health care improvement efforts. Performance and quality are measured to determine resource allocation, organize care delivery, assess clinician competency, and improve health care delivery processes. Hospitals and practitioners have been given past and present financial incentives to score well on measures of quality from both public and private health care payers. When the quality of care is measured, it improves (Brook, Kamberg, & McGlynn, 1996; Chassin & Galvin, 1998). possibly largely due to the Hawthorne effect, which has illustrated that observed activity shows improvement. Ramirez (2019) reports that more people receive evidence‐based care (EBC) for heart attack when they arrive at a hospital, hospital‐acquired conditions decreased from 2014 to 2017, that medicare 30‐day hospital readmission rates have declined, and that mortality rates within 30 days after hospital admission for heart attack, stroke, and pneumonia have decreased.

From 2003 to 2013, the mortality rate for deaths amenable to health care in the U.S. declined by about 17%. More recently, the rate has increased slightly.

Nursing leaders have also recognized the need to establish classifications that can be used to measure nursing care. Selected classifications are listed in Table 2.9.

Table 2.9 Selected Classification Systems (List compiled by R. Hughes).

North American Nursing Diagnosis Association (NANDA): www.nanda.org

Home Health Care Classification (HHCC): www.sabacare.com

PeriOperative Nursing Data Set: www.aorn.org

National Quality Forum‐Endorsed Nursing‐Sensitive Consensus Standards: www.qualityforum.org

Omaha System: www.omahasystem.org

ABC Codes: www.alternativelink.com

Logical Observation Identifiers Names and Codes: www.loinc.org

Nursing Interventions Classification: www.nursing.uiowa.edu

Nursing Outcomes Classification: www.nursing.uiowa.edu

National Database of Nursing Quality Indicators (NDNQI): www.nursingworld.org. (Search for NDNQI.)

SNOMED CT: www.snomed.org

International Classification of Nursing Practice: www.icn.ch

Note that setting standards for appropriate care and guideline development should have a basis in validated measures of quality, using reliable performance data, and making appropriate adjustments in care delivery. Reliable methods and measures need to be developed and tested. Some practitioners have been resistant to their care delivery being measured because they have believed that it would interfere with their professionalism and autonomy. If this belief persists, the majority of health care delivery will not be measured.