Overview and Summary: Healthcare and Quality: Perspectives from Nursing

Abstract

Healthcare quality has been front and in many newspaper, news television, and news magazine features. In healthcare professional literature, It is a rare journal that does not cite an Institute of Medicine (IOM) report from the Quality Chasm Series such as, To Err is Human or Crossing the Quality Chasm (IOM, 1999: IOM. 2001: IOM, 2003: IOM, 2010J. As you might expect, the authors in this issue cite these multiple times. This is as It should be. In all other areas of commerce, consumers demand the highest quality they can afford In all of their products and services. In most other areas of commerce, quality Is relatively easy to discern. The consumer can pick the product up, hold it to the light, and see Its flaws or Imperfections. For services, the consumer can ask her neighbor or search the Internet about whether the service was any good. The unusual part of healthcare is that the products and services are often so unique to the consumer that comparison seems impossible. The culture has evolved in such a way that It almost seems rude to ask.Quality Is a concept. It expresses people's perceptions of what makes something seem better or worse In some way that can only be measured by proxy, comparison, or using some abstract metric. Authors In this OJIN topic give their unique perspectives on quality, Its measurement, and outcomes of quality research and application work starting with a broad overview of quality perspectives, followed by specific applications In research and clinical care, and ending with an overview of the National Quality Strategy that helps readers answer questions they may have about where nurses can fit in discussions about quality at various levels.Before nurses can truly engage In quality policy and quality research, they must first learn about quality in context of their nursing roles. Dolansky and Moore explain the value of teaching and using systems thinking In quality. Their article, Quality and Safety Education for Nurses IOSEN): The Key is Systems Thinking, presents the QSEN educational Initiative and Its growth since Its inception. QSEN gives a framework for applying the systems approach to healthcare quality. Using this systems approach, nurses can multiply their personal efforts and accelerate healthcare quality and safety Improvements. The authors provide an overview of the QSEN competencies and educational programs that make this acceleration possible with examples of applications of the framework.The next article, The Influence of Quality Improvement Efforts on Patient Outcomes And Nursing Work: A Perspective from Chief Nursing Officers at Three Large Health Systems, highlights this systems approach In practice by discussing quality projects in action. Authors, Weston and Roberts, contextualize three quality and performance Improvement initiative vignettes with contributions from Chief Nursing Officers at the Department of Veterans Affairs, Kaiser Permanente, and Ascension Health. Each of the three systems has recently made significant Investments Into quality programs. The article describes how each system's forward-thinking projects approached quality Improvement from different, but equally valuable perspectives.An Academic Practice Partnership: Helping New Registered Nurses to Advance Quality and Patient Safety takes the QSEN framework one step further. Flores, Hickenlooper, and Saxton provide an example of an academicpractice partnership that engaged undergraduate nursing students Into the organizational level of quality Improvement. Students worked with preceptors, faculty, and other organization staff at a large medical center to collect, analyze, and disseminate quality-related findings. The establishment of an academic-practice partnership allowed the organization to Improve quality, while also giving students a much needed background In quality Improvement.In Building Linkages between Nursing Care and Improved Patient Outcomes: The Role of Health Information Technology. …