Advocating for Quality Healthcare Outcomes reflection

Lesson 1

Advocating for Quality Healthcare Outcomes

Introduction

Healthcare reform and rising medical costs have significantly impacted the intricacies of
providing patient care. Decisions on nursing and medical services are made based on
outcome data and the best available evidence at the point of service. Many factors can
impact patient outcomes and the perception of patients on the care they receive. The
DNP-prepared nurse leader is in a pivotal position to identify indicators that reflect a
need for improvement in processes or procedures and turn to the evidence to pinpoint a
solution. The establishment of quality indicators and accurate interpretation of outcome
data is crucial to ensure high-quality services and improve the patient experience.
Healthcare Quality and Performance

Activities to measure
performance and outcomes are entrenched in all aspects of healthcare. As a DNP-
prepared nurse leader, examining outcomes through a lens of continuous quality
improvement is crucial to optimizing resources, both human and material, and improving
the quality of care provided by the organization. In healthcare, a process of continual
quality improvement assists an organization in identifying the key interventions or
changes that can have the greatest impact on processes, behaviors, patient outcomes,
and accreditation standards. As goals are achieved and outcomes sustained, new goals
should be established that raise the stakes and expectations of a higher benchmark.
Within organizations that incorporate a philosophy of total quality management (TQM),
all staff are engaged and dedicated to a mindset of continuous quality improvement
within their unit, department, or the larger health system.

Measuring Healthcare Outcomes

As a nurse leader, you may be deeply involved in evaluating outcomes at the micro,
meso, and macrosystem level. Many stakeholders are interested in the outcomes of
healthcare organizations. It is important to be able to identify not only trends in data but
what the trends represent. Although patient surveys may be informally done within a
specific unit or department, the only survey results that are considered valid are those
that use a reliable survey instrument or process, such as the Press Ganey Survey.
Outcomes data may come from many different sources, including the following:

Data Sources Image Description

 Patient satisfaction surveys
 Staff and physician surveys
 Report cards from accrediting agencies
 Benchmarking against other organizations
 Functional efficiencies within departments
 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
scores
 Inter-organization performance improvement systems

Each of these measurement tools can provide critical information about the interworking
of the organization and guide the nurse leader back to a cycle of continuous quality
improvement.

Lesson 2

Practice Readiness as a DNP-Prepared Nurse Leader

Transforming Healthcare

Throughout the last eight
weeks, you have explored the role of the nurse leader through a framework of the
American Organization of Nursing Leadership (AONL, 2015) competencies. AONL
serves as a national professional organization for nurse leaders, providing education
and certification to support nurses who are presently in a management or leadership
role, or who aspire to transition into a leadership position in the future. Appraising and
applying the evidence-based AONL competencies to daily practice can provide an
underpinning for the knowledge and skill development needed to navigate and advance
the profession of nursing, as well as the personal and professional growth of the nurse
leader. Nurses who possess the knowledge, skills, and abilities to lead others are an
invaluable resource to the organizations where they practice. Nurse leaders are in the
foreground of healthcare services, planning, organizing, delivering, coordinating, and
providing care to increasingly diverse populations.
As a DNP-prepared nurse leader, you will be a guiding force in ethical decision-
making. During the last eight weeks, you have investigated the characteristics of moral
leadership and the accountability of the nurse leader in supporting and complying with
ethical standards of practice. The nurse leader faces many challenges in their daily
work and is often called upon to make quick decisions, which at times impact individuals
within the organization and/or populations within the community. The decision-making
process is often formed from previous experiences, personal values, and standards of
ethical behavior intrinsic to the DNP-prepared nurse leader.

You have also appraised the role of the nurse leader in promoting and leading quality
improvement through the application of evidence-based practice. With today’s
increasingly complex healthcare environments, the DNP-prepared nurse leader has a
vital role in transforming healthcare through the translation of evidence to the practice
setting. As the consummate consumer of published research, the DNP-prepared
nurse emerges with the knowledge, skills, and abilities to identify gaps in practice
and identify evidence to address the eight National Practice Problems and the Global
Burden of Disease facing all communities.
Through an understanding of the value of diversity and inclusion, you have learned how
you can impact the workplace culture and attitudes as a nurse leader. As a DNP-
prepared nurse leader, your role as an inclusive leader, who values and promotes team
and organizational diversity, will be to create a workplace environment in which all staff
and patients are respected for their individualism. The atmosphere you foster will
enhance the organization’s value for a diverse workforce in terms of ethnicity, age,
gender, and sex.

The nurse leader is an
advocate for both patients and nursing staff during all circumstances, but especially
during times of disaster or crisis. Utilizing your knowledge, past experiences, skills, and
cultural and emotional intelligence, you can provide guidance and direction on a vast
number of issues. When a crisis occurs, the nurse leader must make complex decisions
amid uncertainty and disruption, based on established personal and professional values
and principles. It is during these times of chaos, that the nurse leader may have to set
aside what has worked well in the past and move to “here and now” leadership, to make
sense of the unpredicted events.
As a nurse leader, you will be accountable for the performance of your team as well as
the leadership strategies you model. Through this course, you have learned strategies
to lead a multigenerational nursing workforce. There is much work to be done in leading future generations of nurses. This work will require a keen understanding of the ethical,
moral, and legal responsibilities of the nurse leader.