Accountability for Clinical Outcomes Essay Paper

Throughout your education, patient safety and improving the quality of patient care have been examined. Through numerous readings and media pieces, you have heard about Never Events. These are serious and costly medical errors that are preventable, such as wrong-side surgery, medication errors, and hospital-acquired infections. Each of these types of medical errors is preventable. The consequences of such errors are now financial as well as legal and emotional. The Centers for Medicare & Medicaid Services no longer reimburse for medical errors classified as Never Events. Accountability for Clinical Outcomes Essay Paper

As a nurse, how can you help to prevent these types of medical errors? What is your accountability for clinical outcomes? There are standards and core measures in place that guide nursing practice. In addition, the National Database of Nursing Quality Indicators (NDNQI) examines those components of clinical care that are specific to nursing. The NDNQI quantifies, or assesses, these nurse-sensitive components and provides specific feedback on how well nursing practice is being executed in those areas related to patient care.

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This week, you will consider a series of articles that focus on strategies for ensuring safety and quality care for patients. You will also explore how successful, efficient teamwork between nurses, nursing leaders, physicians, and other medical personnel can help prevent many of the Never Events from occurring and decrease the likelihood of such events in the future.

Learning Objectives
Students will:
Analyze the core measures and standards for nursing practice that promote patient safety and quality of care outcomes
Analyze the impact of the nurse’s role in clinical outcomes for organizations
Analyze nurse-specific challenges for influencing change in quality improvement
Analyze the role of the nurse in supporting the organization’s strategic agenda in improving clinical outcomes

Photo Credit: PhotoAlto/Odilon Dimier / PhotoAlto Agency RF Collections / Getty Images. Accountability for Clinical Outcomes Essay Paper

Learning Resources
Prior Knowledge

It is not uncommon for students to be required to complete group projects or to work as part of a team. While obtaining your RN credentials, or at some time in your work career, you have more than likely at some point been part of a unit or a collaborative team. Reflect on that experience of working with others to achieve a common goal. How did the actions of your team members impact your success as a team? Consider how this same philosophy applies within an organization. How might the actions of the individuals influence the success of the organization?

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Amin, A. N., Hofmann, H., Owen, M. M., Tran, H., Tucker, S., & Kaplan, S. H. (2014). Reduce readmissions with service-based care management. Professional Case Management, 19(6), 255–262. doi: 10.1097/NCM.0000000000000051

Note: You will access this article from the Walden Library databases. Accountability for Clinical Outcomes Essay Paper

Forster, A. J., Dervin, G., Martin, C., & Papp, S. (2012). Improving patient safety through the systematic evaluation of patient outcomes. Canadian Journal of Surgery, 55(6), 419–425. doi: 10.1503/cjs.007811

Note: You will access this article from the Walden Library databases.

Johansen, M. L. (2014). Conflicting priorities: Emergency nurses perceived disconnect between patient satisfaction and the delivery of quality patient care. Journal of Emergency Nursing, 40(1), 13–19. doi: 10.1016/j.jen.2012.04.013

Note: You will access this article from the Walden Library databases.

McDowell, D. S., & McComb, S. A. (2014). Safety checklist briefings: A systematic review of the literature. AORN, 99(1), 125–137. doi: 10.1016/j.orn.2013.11.015

Note: You will access this article from the Walden Library databases.

Payne, D. (2014). Elderly care: Reflecting on that ultimate ‘never event.’ British Journal of Nursing, 23(13), 702. doi: 10.12968/bjon.2014.23.13.702

Note: You will access this article from the Walden Library databases.

Thornlow, D. K., & Merwin, E. (2009). Managing to improve quality: The relationship between accreditation standards, safety practices, and patient outcomes. Health Care Management Review, 34(3), 262–272. doi: 10.1097/HMR.0b013e3181a16bce

Note: You will access this article from the Walden Library databases.

American Hospital Association. (2016). Retrieved from http://www.aha.org/

Explore the American Hospital Association’s website. Focus on the information on improving patient safety and quality of care.

American Organization of Nurse Executives. (2016). Retrieved from http://www.aone.org. Accountability for Clinical Outcomes Essay Paper

“Since 1967, the American Organization of Nurse Executives (AONE) has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care nationwide. AONE is a subsidiary of the American Hospital Association” (AONE, 2016).

Centers for Medicare & Medicaid Services. (n.d.). Quality of care center. Retrieved August 11, 2016, from http://www.cms.gov/Center/Special-Topic/Quality-of-Care-Center.html?redirect=/center/quality.asp

Most health care organizations receive some amount of reimbursement from the Centers for Medicare & Medicaid Services (CMS). Reimbursement continues to be jeopardized and reduced by pay for performance standards. Health care organizations are being held to higher standards by CMS. Explore the standards set to improve patient safety and the quality of care. Consider how they affect acute care providers and nursing practice. Accountability for Clinical Outcomes Essay Paper

The National Academies of Sciences, Engineering, and Medicine. (2016). Health and Medicine Division. Retrieved from http://www.nationalacademies.org/hmd/

The Health and Medicine Division (HMD) promotes policies and best practices in an effort to improve patient safety and delivery of quality care. Review a few of the publications available at this site.

The Joint Commission. (2016). National Quality Forum (NQF) endorsed nursing-sensitive care performance measures. Retrieved from http://www.jointcommission.org/national_quality_forum_nqf_endorsed_nursing-sensitive_care_performance_measures/

The Joint Commission (TJC) also accredits health care organizations. Through funding provided by the Robert Wood Johnson Foundation, the Joint Commission developed the Implementation Guide for the National Quality Forum (NQF) Endorsed Nursing-Sensitive Care Performance Measures. Review this guide as you consider how core measures and national guidelines improve nursing practice.

Required Media

Laureate Education. (Producer). (2009b). Topics in clinical nursing: Accountability for clinical outcomes and promoting safety and quality [Video file]. Baltimore, MD: Author. Accountability for Clinical Outcomes Essay Paper

Note: The approximate length of this media piece is 15 minutes.

Discussion: Promoting Safety and Quality

In the article “Managing to Improve Quality: The Relationship Between Accreditation Standards, Safety Practices, and Patient Outcomes,” the authors discuss the growing trend by medical insurance companies to eliminate reimbursement for Never Events. As these types of mistakes should be easily preventable, hospitals have developed protocols to lessen or extinguish the occurrence of these events. In addition, The Joint Commission (TJC) and the Centers for Medicare & Medicaid Services (CMS) have developed core measures to guide health care providers’ efforts in improving patient safety and the quality of care delivered.

Health care organizations have developed strategic agendas to help meet these standards and reduce the incidence of Never Events. Nurses significantly influence the overall quality of health care provided and play a pivotal role in improving patient outcomes.

For this Discussion, you will consider the standards that are in place for nurses and how they can be used to improve quality of care.

To prepare for this Discussion:

Review the information at the Joint Commission and Centers for Medicare & Medicaid Services websites on the core measures and standards presented in this week’s Learning Resources.
Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.
Conduct an Internet search for either a Never Event or a core measure, and select one to address in your post. Accountability for Clinical Outcomes Essay Paper

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By Day 3

Respond to the following:

How has the emphasis on quality of care, patient safety, and clinical care outcomes been impacted by specific standards emanating from TJC and/or CMS? Cite your selected core measure or Never Event in your response.
What is the impact of the nurse’s role in clinical outcomes for the organization?
Discuss nurse-specific challenges in influencing change in quality improvement.
How does this influence the ability of the organization to achieve its strategic agenda?

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 250–350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Read two or more of your colleagues’ postings from the Discussion question (support with evidence if indicated). Accountability for Clinical Outcomes Essay Paper

In health care, accountability has become a significant concern. Inside a medical facility, accountability has been a part of people’s every move. Even in financial matters, accountability is also observed. It is also beneficial even on little things such as computing the costs for doctor’s time, medicine, hospital bills, pens and papers, salary of nurses, phone lines and electricity, and even to the toilet paper in the hospital restrooms. Through accountability, an organization will have a risk of overuse, mishandling, and underuse of resources. Hence, it is important for management and legal purposes. It also improves the value of patient care by increasing the use of reliable and approved medicine. In terms of performance, health care workers’ accountability reduces risk of medical malpractice applied to patients. Accountability encourages the employees to look forward to further learning and practice in their field (Brinkerhoff, 2003, p.1). If employees and organizations are aware of their accountability, they are more attentive to their work ethics that protects the organization where they belong as well as the patients.

Measuring accountability helps improving patient outcomes. Reaching the purpose of improving health outcomes needs the hospitals to make progress evaluated by accountability measures. At present times, it shows that such progress occurs at a faster pace. Employee accountability in healthcare has three areas as a basis for measurement. These are performance appraisal, competency management, and learning management (Healthcare Source, 2009, n.p.). When measuring an employee’s accountability through performance appraisal, it notes on the strengths, weaknesses, remarks and earlier performance of an employee. Competency management also measures employees’ accountability as it reviews flexibility and dynamic skills. Lastly, learning management delivers instructional content and evaluates healthcare workers according to their progress. All of these metrics of employee accountability aim to offer quality healthcare to patients. Accountability for Clinical Outcomes Essay Paper

Ethics, Financial Integrity and Organizational Culture

Accountability and ethics go hand in hand to meet the organization’s mission and vision. However, practicing accountability and ethics by the very people who lead an organization is helpful. Healthcare executives must show the how accountability can positively affect their leadership and management. As these leaders acknowledge their accountability, it reflects into the organization’s culture and soon becomes an ethical practice.

Checks and balances are very useful in every organization. It helps form a truthful organization and creates reliance. It helps avoid fraudulent acts and inaccuracy in computations. Financial integrity is also one of the aims of using checks and balances. If an organization keeps financial integrity, investors and costumers are confident to associate with this organization (Lessing, 2009, pp.1-7). Hence, an organization must keep it to reach success and the checks and balances are common tools that can help.

In an organization, accountability matters. It influences the organization’s working culture by nurturing each employee’s ethical approach to work and helps build a successful organization. If accountability is not present in an organization, its performance is inefficient and idle. When employees as well as leaders practice accountability, their actions form a habit and routine which eventually becomes a culture within an organization (Freund, 2010, pp.32-36). Hence, accountability forms for a long time to form it into an organizational culture. An organization whose culture includes accountability is more likely to reach successful than those who don’t. Accountability for Clinical Outcomes Essay Paper

Maintaining Positive Working Culture

In an organization, complex problems are usually prone to blaming gaming. Sometimes, the employees’ perception is that, whoever is closest to where a problem arises is the one to blame. This has been a common problem for some organizations. However, to meet success, an organization should keep up a positive working culture. Positive work cultures form for a long time and need continuous attention. There are many ways to avoid the blame game in an organization (Physician Coaching Institute, 2006, n.p.). First of all, each member of an organization including the executives must have awareness of the company’s mission and vision. In times of problems, a leader must not get involved in finger-pointing the culprit. He should set an example among his employees. If an employee is the cause of a problem, constructive comments would help to lessen the risk of facing the same problem again but the flaws on the system have to be eliminated as well. There will be a replacement of the policies that usually hinder the progress of employees with effective and easy ones. Lastly, employees should give their opinion to one another in form of writing or in forum so that they are aware of the things that they are accountable to. Delegation Process

According to National Council of State Boards of Nursing (2012), there are four steps in delegation process of health organizations (pp.1-3).The first step is the assessment and planning, second is communication, third is supervision, and lastly is evaluation and feedback. The assessment stage evaluates the employees who are competent enough to handle a task. Task assignment takes place on this stage. On the communication stage, there will be an exchange of relevant questions between a leader and members. The supervision stage is monitoring the performance of each organization members. Lastly, the evaluation stage will verify if a task is accurately performed and the result is the leader’s feedback. All of these steps play a significant part in the process of delegation. An effective delegation process affects the employees as well as the organization. When there is proper delegation, motivated employees are willing to work harder and contribute their skills which will benefit the organization. A delegation process would also cut the risk of conflict between employees as they are properly assigned of their tasks. Through this process, it is easier to know if a goal is met or not. Accountability for Clinical Outcomes Essay Paper

As for my personal experience, I have applied similar steps mentioned above when I met a difficulty in a group project where I was an assigned leader. The duties assigned to each member were not properly distributed at the start. What I did was, I began with assessing the skills of my members and planned the tasks they are given. Then, I communicated the results of the first step to the rest of the group members. I supervised their progress all throughout the time of group work. Lastly, I evaluated their outputs and provided feedback for revisions. These steps helped me solve the problem with regards to distribution of tasks.

References

Brinkerhoff, Derick. (January 2003). Accountability and Health Systems: Overview, Framework, and Strategies. Bethesda, MD: The Partners for Health Reformplus Project, Abt Associates Inc.

Freund,L. (2010).Creating a Culture of Accountability. Retrieved from Healthcare Executive website: http://www.nonprofithealthcare.org/resources/CreatingACultureOfAccountability.pdf>

Healthcare Source (2009).Healthcare Source: Quality Talent, Quality Care. RetrievedFebruary4, 2014, from http://www.healthcaresource.com/img/documents/hcs106_performance_mgr_overview_0309.pdf>

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Lessing,J. (2009). The Checks and Balances of Good Corporate Governance.Corporate Governance eJournal,2(16), 2-7. Retrieved from http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1015&context=cg>

National Council of State Boards of Nursing (2012).The Four Steps of the Delegation Process. Retrieved from TransitiontoPractice.org website: https://transitiontopractice.org/files/module1/Communication%20-%20Delegation%20Process.pdf> Accountability for Clinical Outcomes Essay Paper