Teri A. Kaneski, RN, BSN, Clinical Excellence, Edward Hospital, 801 South Washington Street, Naperville, IL 60540
- Objectives
- Describe the value of nursing sensitive outcome measurement, benchmarking and reporting at a unit level.
- Define the relationship between unit level performance improvement activity and the Nursing Scorecard.
- Purpose
In an effort to promote performance improvement at the unit level and promote staff nurse involvement, a nursing scorecard was developed to track nursing sensitive measures at the unit level. These unit specific scorecards are distributed to the units quarterly and are reviewed by staff, management team, and the unit quality council for improvement opportunities which can be planned and implemented at a unit level.
- Provide relevant and current knowledge
The nursing scorecards are a means for transforming nursing data into quality outcomes in our organization. These scorecards have driven performance improvement efforts which resulted in improved nursing sensitive outcome and satisfaction measures.
Our organization recognized the critical role nurses play in the delivery of care to our patients and the ideal position the nurses were in to identify opportunities for improvement as well as methods to improve this care. Nursing sensitive data was being measured and reported through many sources. These data were being reviewed by nursing administration and nurse managers; however, there was no consistent vehicle for communication with staff regarding the measures. Based on this, and the organization’s desire to include bedside nurses in the performance improvement process, the Chief Nursing Officer tasked the Performance Improvement Department with the development of a scorecard which would be unit specific and nursing sensitive. The PI team met with the management team for each nursing unit and identified nursing sensitive measures for their specific department. From these discussions, the Nursing Scorecard evolved and was first distributed with the 3rd quarter 2004 outcome data. The scorecards continue to evolve and are very unit specific. However, patient and employee satisfaction and employee turnover are found on all scorecards, with the inpatient units including measures such as nursing hours/skill mix, pressure ulcer prevalence, patient falls, length of stay, restraint use, pneumococcal vaccination, infection control, and cardiac arrest data. Improvement efforts that have been driven by or monitored through the nursing scorecards include OB patient satisfaction, hospital acquired pressure ulcers, patient falls, reduction in codes outside the ICU, and reduction in average length of stay. Today, the nursing scorecard has become a vital tool for the nurse manager, the unit quality council and unit staff. The scorecards are shared with all staff and are used as a means of communication as well as a performance improvement tool. The poster presentation will include examples of nursing scorecards, several performance improvement projects identified through the use of the scorecard, and the project outcomes.
- Implications for practice
Development of a Nursing Scorecard provides a vehicle to disseminate unit level nursing sensitive outcome data. The scorecard provides one document for reporting outcome data from multiple sources, which can be easily understood and referenced by all unit level staff giving them concise information about nursing practice on their unit.
See more of Using Quality Indicators to Achieve Quality Improvement
See more of The NDNQI Data Use Conference (January 29-31, 2007)
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