News
Back to List
October 22, 2007
Nurses take up quality mantle; New initiatives move them into quality reporting
Melanie Evans
22 October 2007
Modern Healthcare, Volume 37; Number 42
(c) 2007 Crain Communications, Inc. All rights reserved.
Nurses, lauded as the front line of hospital care, are increasingly at the forefront of healthcare's push to improve quality.
In two states, Massachusetts and Maine, efforts are under way to expand hospitals' publicly reported quality measures to include those that research has linked to nurses' performance. In Massachusetts, hospitals last week voluntarily posted online statistics on patients' falls and falls that caused injuries, two of 15 measures identified by the National Quality Forum as "nurse sensitive." Bay State hospitals hope to post data for a third measure, bed sores, by January, officials said in announcing the effort. Meanwhile, Maine officials are expected to launch a Web site with a dozen such measures before year-end.
The push to wipe out costly and harmful medical errors has fueled closer scrutiny of providers' performance, though reporting efforts have largely focused on hospitals and physicians. Now the nation's estimated 2.4 million working nurses may share the spotlight.
The National Quality Forum, a not-for-profit, first endorsed 15 nurse-influenced quality measures in 2003. Among them are common but preventable illnesses and injuries, including three-bed sores, urinary catheter-associated urinary tract infections, and falls-that federal officials have said Medicare will no longer pay providers to treat in cases where the condition was avoidable, starting in 2009.
Mary Naylor, a University of Pennsylvania professor and director of a $10 million Robert Wood Johnson Foundation effort to study nursing and quality, called the 15 measures "the beginning" and said additional research is needed. Naylor said researchers should explore how nurses can best be educated and employed to boost quality, be held accountable for outcomes, and how such measures can be adopted into the industry's pay-for-performance efforts.
In Maine, lawmakers mandated such reporting in 2005, but the effort stalled amid struggles to clearly define measures and uniformly collect data. Maine worked with the American Nurses Association and the Joint Commission to set standards, but ultimately, trial and error ironed out confusion, said Sandra Parker, a vice president and general counsel for the Maine Hospital Association.
