Creating a Good Fit for Quality of Care

Today’s post is written by Dr. Tim Porter-O’Grady, a member of the board of advisors for the Workforce Institute at Kronos.  A long time nursing champion and educator, he writes here about the importance of collaboration between health care providers and  vendors in the drive to optimize the design and application of workforce management solutions in healthcare settings.

Regulators are now writing the legal language and policy for implementation of the Patient Protection and Affordable Care Act. It is now critical for hospitals and health professionals to begin seriously thinking about the implications for staff, staffing, and quality patient care. Make no mistake; the act requires serious and unrelenting focus on issues of cost, quality, and patient safety. Indeed, increasingly the availability of payment for health services is tied to matters of care standards, practices, quality, and safety.

Nurses, at the forefront of patient care services, will have a critical role to play in setting, advancing, and reinforcing clinical standards that evidence a high-level of patient care quality and safety. The time has come for practicing nurses to realize that they are quickly becoming the centerpiece of the coordination, integration, and facilitation of processes and activities that translate mandates for quality and safety into clinical practice is. Because the nurse provides for coordinating and integrating role in patient care delivery settings, it is logical that the nurse become the linchpin in linking resources, persons, and processes to the demand for high-level patient care.

They need to advance a clear shift between the skills of the provider, the demands of clinical practice, and the requisites of quality outcomes now becomes a requisite in the appropriate distribution and use of nurses and other providers. Managers must now look more carefully at their clinical quality control mechanisms including those related to clinical preparation for practice, specific skill sets, the fit between provider and patient, and the expectations for particular patient outcomes. More detailed attention must be paid to the kind of systems and information resources which best support the alignment of practitioners, practice, and patient needs in the most efficient and effective manner.

Practicing nurses and other providers must now become more intimately involved in selecting and configuring information and workload systems tools that best reflect clinical realities and the decisions which respond to them. This emerging information infrastructure now must be intricately interwoven into practice assessment, judgment, decision-making, and clinical evaluation. These tools must increasingly be seamless and portable, embedded into the practice capacity in a way which assures they are seamless and relevant to the day-to-day practice experiences and activities of nurses. Integration and interaction with other data sources will also be essential to aggregate the varieties of information necessary to assure evidence-driven, best practice-based approaches to meeting patient’s needs. Furthermore, since the evidentiary dynamic requires a continuous production of real-time information related to appropriateness of clinical activities, these information tools must display just-in-time data that has utility in the moment and produces information relevant to the nurse in the midst and moment of her or his practice.

Clearly, these issues now call for a much stronger partnership between vendors and nurses in the design stage of information tools and products. This partnership is critical to providing the language and configuration of technology tools necessary to support this growing evidence-based, just-in-time practice relationship between information tools and practitioner. Moreover, time is of the essence. As federal standards and protocols begin to provide a stronger frame for resource distribution based on quality outcomes, providers must have relevant tools necessary to respond to an accelerating demand for quality. Let the partnership begin!!

3 thoughts on “Creating a Good Fit for Quality of Care

  1. I applaud Dr Porter-O’Grady’s call for partnership between nurses and technology vendors! It has never been more important to work together to advance our practice and work towards ever improving patient outcomes. Technology can and should play a significant role.
    However, as a vendor I often see technology used to simply automate current practices – and unfortunately, these are often “bad” practices. Technology applied to “bad” practices simply speeds up the “bad” practice. We get more of the same and faster!
    The real challenge is to partner to incorporate process evaluation in the technology implementation today, and together, nurse and vendors must partner to look to the future and how the technology can evolve and growth with our practice and our patients needs!
    As Tim said, Let the partnership begin!

  2. Further to Dr. Porter-O’Grady recommendation of a partnership between vendors and nurses is a partnership with caretakers and family members. Having gone through a mind boggling 6 months of elder care issue as a care taker I have found our role in facilitating care of our loved ones excluded in the process. We have information that can be invaluable to patient outcomes. Not once was I asked for input or information from hospital or nursing home staff though I made myself very available. I provided information which turned out to be important. As an HR professional, I saw extraordinary gaps in communication all around. If partnerships are to be developed that facilitate patient care and safety, actively include families or care givers. Include HR professionals who can advocate partnerships.

    1. I agree. My mother died on November 24th after years of chronic health issues that spanned medical specialties. I had to aggressively insert myself into the medical discussions in order to ensure that she was being evaluated and treated as a whole human being vs. the particular physiological silo relevant to any given specialist.

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