Quality improvement in the ESRD program: implications for nephrology nurses

Pressure to adopt and adapt the concepts and principles associated with total quality management to health care organizations is increasing as globally the health care industry struggles with demands for accountability from both purchasers and receivers of health care services. Quality organizations committed to assessing quality in health care are designing new and distinct measuring and reporting mechanisms that use some of the principles of total quality management while striving to preserve the uniqueness of the health care profession. Providers of renal replacement therapies will soon become engaged in newer quality initiatives that will strive to measure the delivery of routine care. These initiatives will require new knowledge, skills, and the use of a new "quality language." Nephrology nurses in all positions must become more informed about the changes that are taking place, participate in the learning curve, and become active players in judging organizational quality performance.