NDNQI+ Quality Measure Indicators+ Throughput Metrics+ Automated Dashboard= Innovation to Improve Mutual Quality Goals

Purpose:
The demands placed on nurse's time can lead to key pieces of quality iniatives being missed or undocumented. This project's goal was to take the various quality indicators and unite them in a realtime dashboard, that unit leaders could use as a tool to support staff nurses in daily patient care.

Significance:
Pay for Performance, CMS, The Joint Commission and other regulatory agencies use quality indicators as a means of ascertaining complilance with certain key quality practices. The current recession has placed an increased emphasis on maximizing the quality of care and reimbursement.

Strategy and Implementation:
The CNO and Director of Clinical Transformation lead a multidisciplinary group to create a plan that would empower unit leaders and staff nurses to deliver consistent safe care. A tool was required that reflected hospital and individual patient needs. A morning huddle directed at Length of Stay (LOS) had been successful so it was decided to build on this platform and bring together all the key documentation components of several important quality initiatives. The indiators chosen focused on LOS, pressure ulcer prevention/ documentation, alerts for indwelling catheter use and Flu and Pneumonia vaccine compliance. An innovative computer program was designed to pull the necessary data from the Electronic Health Record (EHR) instead of multiple existing reports. The program automated the population of an Excel Dashboard for daily review. Other worksheets in this document revealed patient detail so that any missed care or documentation could be completed before the patient left the unit.

Evaluation:
Using the dashboard the unit leaders were sucessful in identifying processes that needed improvement to ensure excellent safe patient care. Leadership and staff nurses were held accountable for the care delivered. Sucess was measured by favorable changes in most indicators measured.

Implications for Practice:
A unified dashboard of NDNQI and other quality indicators provides nurses the necessary tool to be accountable for changes in care processes. Increased compliance with mutual quality goals improves patient healing and provides a more inclusive view of all that is necessary for safe patietnt care.