1. Discuss the use of an NDNQI dissemination framework to drive quality improvement

2. Share strategies for integrating NDNQI data in quality improvement efforts

Overview: The National Database of Nursing Quality Indicators (NDNQI) promotes a systematic process to evaluating the structure, process, and outcomes of nursing care.  Participation in the NDNQI provides valuable information that an institution can use to assess quality performance as well as compare performance to national benchmarks. Yet, assuring awareness of institutional performance on the NDNQI to key stakeholders within the institution and developing strategies to improve performance can prove challenging. 

Purpose: This session will present an overview of a successful dissemination framework for NDNQI information that simultaneously drives quality improvement at a Midwestern Magnet designated facility. 

Overview: A shared governance model provides the central organizing structure for the comprehensive Quality Improvement structure in nursing. Unit-based committees report to a department level committee that feeds into a division-wide Nursing Quality Improvement Committee (NQIC). The NQIC, as an important element of the shared governance organization, brings together nursing operational leaders and the nursing staff representatives from committees that address quality of care issues. Chaired by the Chief Nursing Officer, the NQIC directs a divisional quality improvement program, which promotes excellence in nursing practice. NDNQI data are reviewed on an ongoing basis at the NQIC, disseminated to the department and unit based committees and strategies are then developed to address performance on selected NDNQI parameters.

Two-way communication between all the levels of committees ensures that changes in practice and measures to improve performance on NDNQI parameters are both evidence based and reflect realistic nursing practice. Representatives from the NQIC sit on the hospital-wide performance improvement committee, linking nursing with the medical center quality structure. NDNQI data is shared with nurses throughout the Division of Nursing through this structure. Unit committees develop action plans based on their unit's benchmarked data. Each unit identifies quality issues they wish to address using the FOCUS-PDCA methodology.  The grid shows the dissemination of NDNQI data and other sources of data that are used to identify quality improvement activities.

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 This session will review the process of NDNQI data dissemination and discuss how performance improvement initiatives are developed to target NDNQI parameters.  Successful initiatives and resulting outcomes will be highlighted.  The value of a structured process to review and respond to NDNQI data will also be addressed. 

Implications for Practice : A shared governance model with established communication and feedback from staff nurses, unit based advisory committees, department advisory committees and formal linkages to the hospital performance improvement committee has proven to be a successful model for disseminating and responding to NDNQI data.  The model, formulated around a central organizing structure for the comprehensive quality improvement structure, has enabled nurses to take ownership of NDNQI data and to actively focus on improving the structure, process and outcomes of nursing care.