Measuring nurses' impact on health care quality: progress, challenges, and future directions

Area of Science:

• Healthcare Quality Improvement
• Nursing Research
• Health Services Research

Background:

• Quality measurement is crucial for enhancing healthcare delivery and financing.
• The Interdisciplinary Nursing Quality Research Initiative funded research to address measurement gaps in nursing's contribution to quality care.

Purpose of the Study:

• To synthesize research from four interdisciplinary teams funded by the initiative.
• To identify challenges and future directions for improving quality measurement in nursing care.

Main Methods:

• Each funded team reported on their measurement gap, methods, results, and next steps.
• Authors discussed overarching challenges and proposed future research directions.

Main Results:

• Projects developed patient experience measures, modeled structure-process-outcome relationships, and measured care across the continuum.
• Research examined nursing care's impact on outcomes and measured interdisciplinary care delivery.
• Initiative projects focused on positive care aspects and addressed cross-cutting quality issues.

Conclusions:

• Challenges include measuring diverse perspectives, care "dose," and the complete care process.
• There is a need for simple, feasible, affordable quality measures integrated into electronic health records.
• Advancements in health information systems offer opportunities for innovative quality measurement.