| Principal Investigator: | Jean Dowling Dols, PhD, RN, CNAA-BC, FACHE |
| Co-Principal Investigator/Collaborator: | Shirley Stewart |
| Organization: | CHRISTUS Health |
Abstract
Problem
Timely access to accurate, consistent nursing-sensitive metrics was not readily available to provide nurse leaders with the information needed to measure a drive toward nursing excellence.
Evidence
Definitions of nursing-specific measures of clinical quality, service excellence, finances, and community value varied. National benchmarks and goals could not be consistently used. Nurse Leaders did not know how their areas ranked against best performers. Best nursing practice definitions and benchmarks were identified through a comprehensive review.
Strategy
Implemented a system-wide unit level nursing dashboard that enabled nursing leaders to see a monthly one-page analysis of the metrics for each unit, service, and facility. Provided the nurse leaders with the opportunity to discuss best practices with areas demonstrating measurable positive change in metrics.
Practice Change
Nurse Leaders in 23 rural, urban, and suburban facilities were able to access timely statistics, evaluate trends, and obtain assistance from nurse leaders with best practices.
Evaluation
Twenty metrics were measured monthly for 18 months, e.g. falls/1000 patient days, hospital acquired pressure ulcers, RN vacancy rate, RN turnover rate, satisfaction with nursing care, productivity index, supply costs/unit of service, RN% of skill mix, licensed agency as % of total nursing hours, salary expenditure/workload, and direct care hours/unit of service.
Results
Nurse Leaders were able to steadily increase positive results in the twenty metrics selected to appear on the one-page nursing dashboard.
Recommendations
Select metrics that can influence change. Limit the number of metrics to enable Nurse Leaders to focus. Recognize the detailed definitions required to assure comparable data. Avoid dashboard disasters including inaccessible data, information overload, data collection nightmares, and lack of leadership support. Automate the collection, calculations, entry, graphs/charts, and comparison of data to enable Nurse Leaders to focus on the analysis of the data.
Bibliography
- NDNQI National Database of Nursing Quality Indicators. NDNQI Transforming Data into Quality Care, http://www.nursingquality.org.
- Griffin, K. and B Swan. Linking Nursing Workload and Performance Indicators in Ambulatory Care. Nursing Economics. 2006;24(1):41–44.