Consider the quality measures that are currently analyzed at your practice location. If you do not have a current practice location, select a local healthcare facility or provider
- Describe one clinical client-focused quality measure currently analyzed in your practice location.
- What data is collected and from where is the data taken?
- Who is responsible for data collection analysis and reporting?
- How is the data critically evaluated to accurately reflect the desired care outcomes? Who makes the decisions to apply the data to practice change?
- What are advanced practice nurses’ key challenges when evaluating quality measures in healthcare settings?
Clinical Client-Focused Quality Measure: Medication Reconciliation at Discharge
1. Quality Measure Description
At my selected healthcare facility, a critical client-focused quality measure analyzed is medication reconciliation at discharge. This measure ensures that patients’ medication lists are accurate and complete to prevent medication errors during the transition from inpatient to outpatient care. The goal is to enhance patient safety and reduce readmission rates caused by adverse drug events.
2. Data Collection
- What data is collected?
Data includes discrepancies in prescribed medications at admission versus discharge, the number of reconciliations completed, and whether patients received medication education. - Data sources:
Information is extracted from electronic health records (EHR), pharmacy records, and patient surveys.
3. Responsibilities for Data Collection, Analysis, and Reporting
- Data collection:
The nursing staff, pharmacists, and discharge planners are responsible for documenting medication reconciliation in the EHR. - Data analysis:
The quality improvement (QI) team reviews the collected data using analytics software to identify trends and compliance rates. - Reporting:
Results are shared with clinical teams, department heads, and organizational leaders through monthly QI meetings and reports.
4. Critical Evaluation of Data
- Evaluation process:
The QI team compares data against national benchmarks (e.g., Joint Commission standards) and organizational goals. They use statistical methods to evaluate discrepancies and monitor for improvement over time. - Decision-making:
The healthcare leadership team, including advanced practice nurses (APNs) in leadership roles, assesses the findings. They decide on necessary practice changes, such as additional staff training, updating EHR templates, or policy adjustments.
5. Key Challenges for Advanced Practice Nurses (APNs)
- Data Accessibility:
APNs may face challenges accessing comprehensive data from fragmented systems or during transitions of care. - Interpreting Complex Data:
Translating large datasets into actionable insights requires expertise in informatics and statistics, which may not always be available. - Time Constraints:
APNs often balance clinical duties with administrative tasks, limiting the time available to focus on quality measure evaluation. - Interdisciplinary Collaboration:
Ensuring that all team members contribute to and understand the importance of quality measures can be challenging, especially in larger or understaffed facilities. - Resource Limitations:
Limited access to funding and advanced analytics tools can hinder effective evaluation and implementation of quality improvement initiatives.
Conclusion
While evaluating quality measures like medication reconciliation, APNs play a pivotal role in leading practice changes, ensuring patient safety, and improving outcomes. Overcoming the challenges requires interdisciplinary collaboration, advanced informatics training, and organizational support.