Quality Control

Order Description
Chamberlain College of Nursing NR-531 Nursing Leadership in Healthcare Organization
Quality Control (graded)
SLMC has a continuous commitment to delivering the highest quality care by addressing crucial issues, such as patient safety, technology, and expanding services to meet community needs. As the
nurse administrator, you determine an audit of elder-patient readmissions would be helpful data to be collected. Discuss some of the information you would include on this tool and how you would
proceed with this project.
Introduction
As we begin this week’s lesson, we will focus on quality standards and controls for the nurse administrator.
Quality Management
As the nurse leader within a healthcare organization, the American Nurses Association (ANA) (2010) Nursing: Scope and Standards of Practice, is one resource it is beneficial to become familiar
with; it offers guidance and a foundation for nursing leadership practice.
A standard is a level of excellence predetermined by a set authority and is typically objective, measureable, and achievable (Marquis & Huston, 2015). There are a variety of standards, and the
organization determines which standards will be adopted to support and guide the care provided.
Various tools can assist the nurse leader to manage the quality within a facility. One example of quality monitoring is an audit on a select outcome, process, or structure issue. The outcome audit
is generally conducted to determine the result of a designated nursing intervention and indicates the general quality of care. Some examples include the mortality rate or length of stay for a
particular organization (Marquis & Huston, 2015).
When monitoring a process outcome, typically a task is reviewed to determine if documentation exists to support that it was completed. Checking a patient chart to determine if a patient received
discharge instructions or if the patient’s medications were reconciled at discharge are two examples of a process outcome.
Some structure-outcome elements are determined by accreditation or licensing bodies; for example, there may be set criteria for staffing ratios and staffing mix on a particular area that must be
followed. Documentation of schedules should reflect this outcome element.
To ensure the highest level of care provided, quality controls should be an ongoing process and not simply a reaction to an event. When an unforeseen event occurs, some organizations will conduct a
root-cause analysis (RCA) with all the departments involved to help determine the cause of the event. After the cause of an event is determined, recommendations, and oftentimes policy or other
changes, will be implemented to hopefully prevent a repeat of a similar event. As the nurse leader, participation on this committee is highly recommended to reinforce your support of quality within
the organization.
Quality Control
Various quality-control measures exist in organizations to monitor and measure set quality standards or benchmarks. As the nurse leader, the designated person must be held accountable for a
specific measure and ensure continued monitoring and follow-up occurs to maintain quality standards. According to the Institute of Medicine (IOM) (1994), healthcare quality is the degree that
health services for individuals and populations align with the desired health outcomes. However, oftentimes the definition of healthcare quality may differ between patients and healthcare
providers. It can be a challenge to the nurse leader to help facilitate a common understanding of healthcare quality for all persons involved in a situation.
In an effort to support quality improvement, the Robert Wood Johnson Foundation (RWJF) and the Institute of Health (IHI) fund various initiatives around the country to support quality-improvement
projects (Marquis & Huston, 2015).
Quality control provides employees feedback about the care they provide to their patients. Quality-control information and data is used by other entities for quality monitoring. Once a set standard
or criterion is established and the information to be collected or monitored is determined, education needs to occur so employees are aware of the standard, process, and expectations for their role
in the standard. After a designated amount of time, if employees are not following the set process, corrective action may be taken. These corrective-action steps must be clearly outlined in writing
for personnel.
Quality Patient Care
Various models to promote and improve quality patient care may be utilized within healthcare organizations. Two quality-improvement models include total quality management (TQM) and the Toyota
Production System (TPS) (Marquis & Huston, 2015). The focus of quality improvement is an ongoing attempt to continuously improve quality.
As a nurse leader, it is important to be familiar with various monitoring agencies involved with your organization. In 1984, The Joint Commission—a nonprofit, independent organization that
accredits healthcare organizations and programs in the United States—mandated quality controls must be in place to promote assurance of quality patient care. In addition, the core-measures program
and the National Patient Safety Goals (NPSGs) have been implemented by The Joint Commission to promote improvements in patient care and safety within healthcare settings (Marquis & Huston, 2015).
The Centers for Medicare and Medicaid Services (CMS) also set standards for measuring quality healthcare. Process changes in required reporting, monitoring, and reimbursement information for
various agencies can have an impact on organizations in a variety of ways that may affect the organizational processes, structures, and outcomes.
Some additional influences on healthcare quality and safety include Six Sigma and the Leapfrog Group. The IOM (2001) released a report, To Err is Human: Building a Safer Health Care System in the
21st Century, and stated goals to assist with improving quality and safety in healthcare environments. The plethora of quality-and-safety resources available can be overwhelming. However,
developing a strategic approach with ongoing monitoring, reporting, follow-up, and reevaluation can be helpful, once a process has been implemented, to ensure targets and goals are being met.
Executive Summary
As we discussed last week, the nurse leader may need to communicate with the team for a multitude of reasons. After a visit by an accrediting or other agency, an overview of the lengthy report is
helpful to share information to persons who may not have time to read the whole lengthy report. An executive summary is a written, nonverbal means of communication used to share concise information
related to a specific topic. This summary provides an overview to determine if the reader would like to read the entire document. There are specific elements an executive summary should include;
however, it is essential the summary explains these three points: why the document was written, your recommendations and conclusions, and any financial considerations; only include the most
significant points to support the stated conclusions (Roussel, 2013). Examples of executive summaries are provided in your textbook.
Summary
This week, we explored quality management, specifically related to nursing-administrator controls and quality patient care. Next week, we will reflect on the last 7 weeks of the course and offer
feedback to our peers regarding their executive-summary project.

References
Marquis, B.L. & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and application.(8th ed.). Philadelphia: Lippincott Williams & Wilkins.
• Chapter 23: Quality Control
Roussel, L. (2013). Management and leadership for nurse administrators. (6th ed.). Boston: Jones & Bartlett Learning.
• Chapter 24: Executive Summary in Healthcare
Articles
Roberts, D. & Hurst, K. (2013, February). Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data. Palliative Medicine. 27
(2), 123–130.
Ferenc, J. (2013, April). ‘Good guys’ survey hospitals: Joint Commission views itself as an advocate. Health Facilities Management. 26(4), 11-2.
American Nurses Association. (2010). Nursing: Scope and standards of practice. (2nd ed.). Silver Spring, Maryland.
Institute of Medicine (IOM). (1994), American’s health in transition: Protecting and improving quality. Washington, DC: National Academy Press. Retrieved
from:http://nationalacademies.org/hmd/reports/2010/the-future-of-nursing-leading-change-advancing-health.aspx
Institute of Medicine (2001), Crossing the quality chasm: A new health system for the 21st century. Committee on Quality of Health Care in America. Washington, DC: National Academy Press. Retrieved
from: http://nationalacademies.org/hmd/reports/1999/to-err-is-human-building-a-safer-health-system.aspx
Marquis, B.L. & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
National Academies of Sciences. (2010). The Future of Nursing: Leading Change, Advancing Health. http://www.nationalacademies.org/hmd/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-
Health.aspx
Roussel, L. (2013). Management and leadership for nurse administrators. (6th ed.). Boston: Jones & Bartlett Learning.
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