The purpose of this session is to share the experience of one federally-designated Quality Improvement Organization (QIO) in using quality indicators to achieve quality improvement using publicly reported data and to review national trends in public reporting and pay for performance.

 The presenter will also suggest that nursing-sensitive quality indicators should be expanded to include not only those interventions where the nurse is the initiator of care (assessment, initial and ongoing treatments) but also to encourage research and study which may broaden our understanding of “nursing-sensitive measures” to include situations where nurses intercept and prevent errors, or prompt consideration of omitted elements of care by other disciplines. She will also describe organizational cultures which promote or inhibit these kinds of nursing interventions.3. Relevance

The quality and safety of health care services being provided in all settings is a point of national discussion. Medicare websites that compare nursing home, hospital and home health agencies’ performance on a number of indicators are readily available to consumers. Dr. Thomas R. Russell, Executive Director of the American College of Surgeons, was recently quoted as saying, “Transparency is unquestionably one of the most commonly stated words today. In health care, the term describes a policy of medical professionals and providers openly sharing with payers and patients facts about their performance and background.”4. Summary of Presentation

The presenter will provide an overview of the quality improvement work, conducted nationally and in Nevada and Utah, which uses transparency as the strategy which results in transformational change. The overview will include information on barriers, successes, and lessons learned from this experience.

The presenter will also suggest that, based on science, the definition of “nursing sensitive quality indicators” should be expanded to include situations where nurses prevent or mitigate the results of errors.

5. Implication for Practice
A scientifically-based approach to quality improvement, coupled with transparency—making the results of our current system’s performance known to providers, customers, payers and stakeholders--can improve our clinical practices and processes, and the recognition of the crucial and unique role nursing plays in positive patient outcomes.