Developing and Testing Nursing Quality Measures with Consumers and Patients

The INQRI-supported work of Shoshanna Sofaer, Jean Johnson and colleagues at Baruch College and The George Washington University has helped shed light on whether some of the National Quality Forum's (NQF) nursing sensitive measures are perceived as meaningful by consumers. The team designed and conducted focus groups with recently hospitalized patients to understand their perception of the nursing sensitive measures. Consumers found several patient safety measures to be very compelling, and clearly believed that nurses had a significant role in hospital quality. On the other hand, consumers didn't think nurses should be advising patients to quit smoking, arguing that nurses have better things to do with their time. They also found measures of nurse skill mix and turnover rates confusing. The team learned that overall, the public, while valuing nurses highly, has an incomplete understanding of what they do, including what they do based on their own assessments, and to whom they are accountable. Researchers performed a thorough literature review regarding the actions of nurses in care coordination and conducted interviews with nurses in four hospitals and held nine focus groups with recent patients. They found that while consumers clearly recognize the importance of care coordination, their perceptions of the nurses' role differed from the perspective of the nurses. The team found that there are limits to the patients' ability to truly observe many aspects of care coordination, which may explain why nurses see their role as broader and more central than do the patients. This research provides great weight to the importance of seeking public views when creating measures of nurse quality and showed that the public has much to contribute to the process. Findings could influence the process by which NQF endorses measures. In part because of this research, NQF recently dropped smoking cessation counseling for myocardial infarction, heart failure and pneumonia from the nursing sensitive measures.

The project findings are presented in a research brief on the Robert Wood Johnson Foundation's website.

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Interprofessional collaboration (R2)
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