Clinical data for use in assessing quality: lessons learned from the Texas Nurses' Association Report Card Project

The purpose of this report is to describe the Texas Nurses' Association Report Card Project. As part of ANA's Safety and Quality Initiative, the project was designed as a feasibility study to determine whether clinically based quality indicator data could be collected in standard ways across acute care agencies in Texas. Clinicians from 12 agencies, under leadership of the professional association (Texas Nurses' Association), participated in this initial effort to reach consensus on clinical indicator definitions and on how to collect clinical data for each indicator. Data were collected for falls and injuries, bacteremias, pressure ulcers, skill mix, nursing hours per patient day, patient satisfaction (with nursing, hospital stay, education, and pain management), and nurse satisfaction. The process used is described, as well as the findings and the lessons learned. The importance of standard definitions and precise and standard primary sources for the data are emphasized for the phase II report card efforts to follow.