Centers for Medicare & Medicaid Services, Capstone Project Example

Introduction

The achievement of successful results relative to healthcare quality requires an examination of the key principles that influence how nurses achieve high-level performance in the practice environment. This process requires nurses to be mindful of their responsibilities to perform their duties consistently at a high level and to be effective in meeting the demands of the practice setting in this regard. Quality-based standards must be established within each organization and promote an environment where change may occur as warranted and flexibility supports nurses’ ability to protect their patients when new regulations have been created. A number of organizations have been created to accommodate the ever-changing landscape of quality improvement throughout the nursing profession and provide a basis for exploring problematic areas that impact nursing practice methods. As a result, quality improvement standards remain a critical component of the nursing profession and require all nurses to be mindful of the challenges related to achieving optimal patient safety at all times.

Body

Organizations which operate independently of many healthcare organizations provide a basis for the development of measures regarding quality improvement that govern many activities within the nursing profession. For example, The American Health Quality Association (AHQA) (2015) has established a number of criteria that impact quality improvement, including but not limited to improving patient safety, reducing waste, expanding patient-centered care, and expanding the learning potential of nurses at all stages of their careers. These criteria represent a means of understanding how healthcare organizations must work across different areas to ensure that patients are the critical priority of nurses and are positively impacted by the decisions that are made (AHQA, 2015). This is essential to the discovery of new ideas and approaches to positively impact how patients are treated and what steps are required to facilitate new practices to improve safety and quality of care at all times (AHQA, 2015).

The Centers for Medicare and Medicaid Services (CMS) established a Nursing Home Quality Initiative (NHQI) in 2002 to address issues regarding quality of care in today’s nursing homes (2015). This program has been largely instrumental in establishing optimal standards for nursing homes and the work that nurses perform within these settings, including initiatives such as the Medicare Learning Network and the AHRQ Nursing Home Consumer Assessment of Healthcare Providers and Systems (CAHPS), which evaluate quality-based standards of care in nursing homes to improve patient outcomes (CMS, 2015). These and other performance-based initiatives are critical to the success of the nursing practice environment and in supporting a culture where patient safety is a critical priority and a strength of a given healthcare organization (CMS, 2015).

Alliant/GCMF of Georgia has established standards to identify quality improvement criteria for implementation using teamwork and an empowering presence to identify problems and support action plans to impact patient safety and quality of care. This report demonstrates that quality improvement is based upon a number of key principles that influence decision-making in the practice setting, such as data analysis and utilization, team-based decision-making, and system improvements as necessary to improve quality-based standards of care for patients (Alliant/GCMF). In addition, nurse-level preparedness is also essential to the discovery of systems-based improvement that involves individual nursing performance (Alliant/GCMF). This reflects the importance of new strategies as necessary to improve patient care quality and to address any deficiencies that exist through quality-based improvements throughout the organization (Alliant/GCMF).

In general, quality improvements must be identified on a routine basis in order to make changes as required to address any limitations or complications related to patient safety. Nursing-based knowledge must be current and timely in order to address the needs of the populations which are served and must include methods to minimize risk and harm to patients (Hughes, 2008). This reflects a need to evaluate the conditions under which a patient is able to receive high quality care and treatment that is consistent and appropriate to meet his or her needs and which supports a dynamic where patient care is an essential priority of nursing practice (Hughes, 2008). My organization emphasizes quality improvement with key performance standards and also supports quality with respect to high quality care at the bedside. The organization is congruent with similar organizations and strives to improve its performance with each evaluation that is conducted. Our management team is focused on quality improvement; therefore, it is addressed during our individual evaluations and in other areas as trends change and other needs require flexibility in the nursing work environment. Therefore, it is important to identify these changes and to make adjustments as required to ensure that patient care quality is optimized.

Conclusion

Quality-based improvements in nursing practice must demonstrate the importance of developing new techniques and strategies to address patient care outcomes and to minimize any risks to patient safety. It is important for nurses to be responsible in this regard and to identify any areas where there is room for improvement and to be cognizant of the challenges of improving patient care quality and outcomes. In addition, they must be aware of their own actions and aim to be proactive in recognizing areas where performance could be improved to accommodate patients and their needs, using efficient means and quality-based variables to achieve the intended objectives.

References

Alliant/GMCF. Guide to implementing quality improvement principles. Retrieved from http://www.gmcf.org/AlliantWeb/Files/QIOFiles/Nursing%20Homes/Implementing%20QI%20Principles%2010SOW-GA-IIPC-12-237.pdf

The American Health Quality Association (2015). Transforming health care delivery. Retrieved from http://www.ahqa.org/quality-improvement-organizations/transforming-health-care-delivery

Centers for Medicare & Medicaid Services. Nursing home quality initiative. Retrieved from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html?redirect=/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp

Hughes, R.G. (2008). Patient safety and quality: an evidence-based handbook for nurses. Rockville: Agency for Healthcare Research and Quality.