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Improving 9.5 Million Lives: Pilot Testing Ambulatory Care Nurse-Sensitive Quality Indicators
Leilani Siaki1, Patricia A Patrician, Lori A Loan
1Author Affiliations: Nurse Scientist (Drs Siaki and McCarthy), Madigan Army Medical Center, Tacoma, Washington; Professor and Rachel Z Booth Endowed Chair in Nursing (Dr Patrician) and Associate Professor (Dr Loan), University of Alabama at Birmingham, School of Nursing; Service Chief- Medical Surgical Specialties Captain (Dr Matlock), United States Public Health Service, National Institutes of Health Clinical Center, Bethesda, Maryland; and Associate Vice President (Ms Start), Patient Care Services, Rush University Medical Center. Chicago, Illinois.
Ambulatory care nurse-sensitive quality indicators (ACNSIs) show promise for measuring healthcare quality in military clinics. While generally feasible and valuable, challenges like standardized processes and technological support need addressing.
Area of Science:
- Healthcare Quality Measurement
- Nursing Sensitive Indicators
- Ambulatory Care Metrics
Background:
- Scientifically sound metrics are crucial for healthcare quality and cost optimization.
- Development and measurement of ambulatory care nurse-sensitive indicators (ACNSIs) lag behind inpatient indicators.
- Validated and reliable ACNSIs are needed to support nursing's role in improving healthcare quality.
Purpose of the Study:
- To evaluate the scientific acceptability, feasibility, utility, and value of ACNSIs.
- To assess ACNSIs in military outpatient clinics.
- To identify challenges in implementing ACNSIs.
Main Methods:
- Pilot testing of two staffing and four patient-centered ACNSIs.
- Utilized a mixed-methods design over a six-month period.
- Involved five military outpatient clinics.
Main Results:
- ACNSIs demonstrated generally acceptable reliability and validity.
- Most indicators showed feasibility, utility, and value for performance measurement.
- Challenges included lack of standardized processes, infrastructure, and technological support.
Conclusions:
- ACNSIs show potential as valid performance metrics for ambulatory care.
- Provider- and nurse-level metrics may enhance collaborative practice.
- Addressing implementation challenges is key to maximizing ACNSIs' impact.
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