DQ: Identify two quality metrics used in your clinical workplace
There are several quality measures used in healthcare. The measures used to assess and compare the quality of health care organizations are classified as either a structure, process, or outcome measure. “Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care. Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice. Outcome measures reflect the impact of the health care service or intervention on the health status of patients.” (Agency for Healthcare Quality and Research, 2021)
One quality metrics used in the VA is Mission Act Quality Standards comparison data. This allows consumers to examine VA and regional community provider performance on key clinical quality and experience metrics. This metric aids patients in understanding the quality of care available in their geographic region. The metrics included indicators of inpatient, outpatient, and patient experience performance that align with three central tenants of VA care. “Effective care is based on scientific knowledge of what is likely to provide benefit to veterans, Safe Care that avoids harm from the care that is intended to help veterans, and veteran -centered care that anticipates and responds to Veterans and their caregivers.” (United States Department of Veterans Affairs, 2021). The quality metrics are measured by surveys and evaluation of weekly incident reports. The information is shared with nurses via the monthly townhall meetings, electronic mail, and weekly news letters.
Another quality metric used at the VA is catheter associated urinary tract infection rates. The number of patients who contract UTI’s during their inpatient stay that have indwelling catheters is measured daily. The system keeps track of everyone in the facility that has a catheter and charts are audited daily to see if CHG baths were performed. Cultures and labs are consistently drawn to evaluate the range of WBC’s and possible signs of infection. The results are shared with staff on a monthly basis via e-mail and in monthly town hall meetings.
Overall, I think that having quality metrics is a benefit to the VA system. Quality metrics helps to keep us aware of areas of improvement as well as areas that are doing well. It is important to consistently perform evaluations to maintain a high level of quality service.
At our facility OR start times and other pertinent data are documented in the VISTA electronic health record. The perioperative nurse
manager is responsible for gathering, analyzing, and reporting this information monthly. Unfortunately, dissemination of this information is not always consistent. However, I believe everyone should be fully informed because it is critical in improving on-going processes and patient care.
SSIs are responsible for 20% of all hospital-acquired infections (Ban et al., 2017). Surgical site infections are tracked by the VA Surgical Quality Improvement Program (VASQIP) which is part of the VA National Surgery Office (NSO). This department is responsible for reviewing and reporting data on all patients who undergo surgery within the VA healthcare system including its significance and implications for patient care as well as the quality of the care provided. However, this information is reported to leadership, but not to nursing staff unless requested. This is a significant patient safety issue that requires a multidisciplinary approach and therefore, data should be routinely reported and readily accessible to nursing staff.
