Here is an article about patient safety and who owns the indices. This article is good, in that it talks about how top-down changes never stick and that you have to involve and empower the hands-on staff if you want to make lasting changes. That I like. What I was not too keen on, and I could be way off target here, is it also felt that nurses not taking ownership because of administrations policy and ways of dealing with the problem, was somehow to blame for there still being a problem.
After reading the article, I felt “there’s just another thing to throw on the nurse’s plate” when nurses everywhere are already struggling to stay current and afloat with all the healthcare changes that are in the works. Nurses just want to nurse. Period. Let them do what they became nurses to do and maybe some of these problelms would disappear. However, you would have to have enough nurses first so that each nurse could actually do the nursing she/he went to school to do. What a concept! I’m being sarcastic, in case that does not translate well in print.
Here’s the article from HealthLeadersMedia.com so you can read it and decide for yourself how it makes you think and feel. Let me know, won’t you?
Rebecca Hendren, for HealthLeaders Media , October 25, 2011
Who owns the quality measure and patient outcome scores in your hospital? Most hospitals have quality, safety, and infection prevention professionals devoted solely to these statistics and ways to improve them.
All their efforts are meaningless unless nurses and other clinical staff are engaged in the process. Too often, they are not. Most staff nurses don’t know what value-based purchasing is or why they should care about it. All they know is that when Administration or “Quality” has a new scheme it will take nurses more time to do their jobs.
Nurses may fully support the changes because they will benefit patients, but they don’t own them and they don’t own those scores.
As the people who actually touch patients, all members of the nursing staff need to feel directly responsible for patient safety. Quality improvement becomes one more meaningless directive from “above” unless nurses feel engaged in the process, involved in the plans, and accountable for the results.
“Culture eats strategy for lunch,” says Mary J. Voutt-Goos, MSN, RN, CCRN, director, Patient Safety Initiatives and Clinical Care Design at Henry Ford Health System in Detroit. “If frontline staff aren’t in agreement and actively engaged in the process, it won’t happen. Top-down approaches to culture change are typically unsuccessful.”
This is one reason why scores can start creeping downward after a successful quality improvement effort has come and gone. If nurses aren’t engaged in the process, they have less inclination to remain on a directed path.
“All frontline staff, not just nurses, should be engaged, as well as empowered to act, if we really want to see a change in our culture of safety,” says Voutt-Goos.
One way to build a feeling of accountability in nurses is to empower them to solve the problems themselves—in conjunction with quality and patient safety professionals, of course. New procedures or processes are more likely to be met with acceptance and to become part of everyday practice when the caregivers themselves are involved in the design.
At Henry Ford Health System, the organization studied aviation industry principles of safety cultures and safety climate literature and identified global indicators of safety culture.
“We use these global indicators as a guiding framework for our culture of safety efforts,” said Voutt-Goos. “One of the global indicators is employee empowerment.”
Empowering employees involves giving them a level of responsibility and knowledge, which sometimes they may not want, but is vital to achieving an end result of quality patient care in a financially healthy organization.
One common practice to reduce outcomes-related to issues such as patient falls or CAUTIs is to pit units against each other in competition and reward the winner with a pizza or ice cream. While it’s appropriate to celebrate success and recognize hard work, I think it’s a mistake to rely too heavily on competition.
Rewarding the unit that most improves its customer satisfaction scores or reduces patient falls by the greatest percentage is great at building enthusiasm and recognizing hard work, but it’s not an effective long-term strategy. Nurses should be treated like adults and involved in the imperatives behind process improvement, both those related to patient care and those related to the organization’s bottom line.
Just as the hospital should treat nurses as adults, nursing staff should be more interested in quality outcomes. They must seek out and embrace their level of ownership in these metrics. In today’s financial reality, it is no longer acceptable to not take an active role in quality improvement efforts. Organizations should engage nurses in frank and honest communication.
The financial imperative is such that hospitals can’t afford…[read more]
- Welcome to the New & Improved Nursing Notes (thenursingnotes.net)
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- What Can You Do With a Nurse’s License? (thenursingnotes.net)