Published 21 September 2016 At the federal level, the U.S. Department of Health and Human Services (HHS) convenes federal advisory committees (FACAs) to inform, advise, and guide decisions about regulation, implementation, and enforcement of legislation (U.S. Government Services Administration [GSA], 2012). Helping people to stay independent, maximise well-being and improving health outcomes. The initial document, Towards a Nursing Strategy for Canada: A Consultation Paper for Stakeholders, was developed by the Working Group on Nursing Resources and Unregulated Health Care Workers (WGNR), a sub-committee of the Advisory Committee on Health Human Resources, in March, 2000. JBI Database System Rev Implement Rep. 2015. The body of his work has been captured in numerous publications, as well as presentations at research and professional conferences nationally and internationally. strategy. For many years, she was the Chief Nursing Informatics Officer for Siemens Healthcare Solutions. Regulate: We promote and uphold high standards, maintain the register of professionals eligible to practise, and step in to investigate on the rare occasions when care goes wrong. The use of health IT for quality measurement and improvement aligns closely with a position statement published by the ANA (2009). Berwick, D. M., Nolan, T. W., & Whittington, J. As committees form, or as vacancies on existing committees occur, HHS publishes requests for participation in FACAs in the Federal Register. The development of the strategic plan has its roots firmly in the Nursing Summit which took place in 2011 and the Nursing Compact that was drawn … The article concludes with a call to action to encourage nurses to take a larger role in driving the National Quality Strategy. In nursing informatics positions, nurses may move from individual contributions to becoming team leaders on EHR or other health IT implementation projects. Retrieved from, National Quality Forum. Nurse Leader, 11(2), 50-51. doi:10.1016/j.mnl.2012.10.001, Stone, P. W., Glied, S. A., McNair, P. D., Matthes, N., Cohen, B., Landers, T. F., & Larson, E. L. (2010). Committee membership by nurses helps to ensure that the proposed standards represent nursing practice. For instance, ANA supported the nominations of Norma M. Lang, PhD, RN, FAAN, FRCN, LL to the Health Information Technology Policy Committee Quality Measures Workgroup and Patricia Flatley Brennan, RN, PhD, FAAN, FACMI to the Food and Drug Administration Safety Innovation Act Workgroup. Through strong leadership and active participation, nurses will be able to complete the hard work necessary to create changes to drive the quality agenda and transform healthcare. eMeasures allow for the explicit representation of quality measures through use of data standards. As more nurses participate in leadership roles such as these to impact quality, more of the nursing perspective will become a part of quality initiatives. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. It is integral to the NHS’ definition of quality in healthcare, alongside effectiveness and patient experience. Read More In April 2011, the Department of Health called together nurses at a national nursing summit with the aim of reconstructing and revitalizing the nursing … Enrolling patients in portal accounts, such as Medicare’s Blue Button (Ricciardi, Mostashari, Murphy, Daniel, & Siminerio, 2013), and teaching patients how to use them are important steps toward strengthening patient access to their health information and engagement in their own healthcare. There is no doubt that minority nurses experience slights which are related to race from unconscious bias which permeates our culture. White, J., McColm, D., Kmetik, K., & Fischer, H. (2010, June 23). 3, Manuscript 5. You are pointing out a very important and interesting effect of our “blindedness” to racial injustices toward our minority nurse colleagues. Quality measure data is extracted from EHRs and generates a report that must also follow a standard format so clinicians can compare outcome data across the nation (Fu et al, 2012). OJIN: The Online Journal of Issues in NursingVol. Implement Sci. This statement supports use of standards-based health IT, specifically electronic health records (EHRs), whereby data are accurately and efficiently collected, analyzed, and reported to generate knowledge that leads to improved outcomes through all segments of the healthcare system (Androwich, 2013). There is much work to do once an EHR is installed before an organization has attested to and achieved MU.  |  Nurses are an essential part of healthcare delivery, but often their voices are lacking in the development and implementation of the learning health system. The ICN Leadership For Change™ Programme--20 years of growing influence. MU of EHRs provides three main benefits: 1) to improve completeness and accuracy of health information; 2) to improve accessibility and sharing of information; and 3) to facilitate patient engagement by encouraging clients to access their own health information electronically and securely over the Internet; share that information with their families; and more actively participate in their own care (ONC, 2012). Read the full Nursing Strategy here. Nurses hold seats on both ONC FACAs, as well in the FACAs’ working groups. This introductory information about quality and MU is intended to provide context for readers to be conversant on this important and fast-moving topic. Please enable it to take advantage of the complete set of features! nursing and midwifery workforce will play a major role in achieving the National Health Strategy’s ambitious aims. Journal of Biomedical Informatics, 45(4), 772-781. doi: 10.1016/j.jbi.2012.06.002, Kaplan, L. (2013). Dementia nursing: vision and strategy Sets out the role and responsibilities for nurses providing care and support for people with dementia. Professor Jamie Waterall Deputy Chief Nurse, Health IT standards committee: Recommendations to the national coordinator for health IT. Created by groups of experts and stakeholders, these planning documents establish strategic priorities for tackling the nation’s most pressing health problems. Ferguson SL, Al Rifai F, Maay'a M, Nguyen LB, Qureshi K, Tse AM, Casken J, Parsons T, Shannon M, Napa MD, Samson-Langidrik M, Jeadrik G. Int Nurs Rev. The purpose of incentives is to focus clinicians’ attention on improving care (Stone et al., 2010; Werner, Kolstad, Stuart, & Polsky, 2011). The triple aim: Care, health, and cost. Strategies to mitigate turnover include reducing weekly and incremental overtime and eliminating mandatory overtime. Through development and adoption of data standards, the EHR can be used for electronic quality reporting. A national action plan to support consumer engagement via e-health. Encore Health Resources. Because continuous quality and process improvement are essential elements of MU of EHRs, eligible professionals, healthcare facilities, and critical access hospitals must attest to meeting MU criteria to earn federal incentives. ANA position statement – approved 12/11/09. Get the latest research from NIH: If nurses do not engage in discussions about quality in healthcare, their ideas and opinions will not be heard. Watching for this information can help members become aware of the chance to pursue committee membership and the process for endorsing their attendance with organizational letters of support. of Nursing to achieve its goals of professional growth & development, cost effective use of resources, challenges of workforce shortages, achievement of excellence in patient care and Magnet redesignation. The nursing profession has played a key role in the quality measurement enterprise by helping to set priorities and goals for using EHRs to measure and publicly report quality performance. Even the most respected and knowledgeable experts cannot come to consensus on exactly what quality means. National Health Policies, Strategies and Plans play an essential role in defining a country's vision, policy directions and strategies for ensuring the health of its population. Nurses have provided input into the QDM since its inception. In response to the dire need for systemic reform, National Nurses United will be hosting a Summer Strategy Call for thousands of activists across the country. Guiding nurses and patients toward engagement. To help stakeholders track opportunities, many professional associations, such as ANA and the Association of periOperative Registered Nurses (AORN) monitor these announcements and post information about them on their websites. Providing patients an electronic copy of their record or making them aware of a patient portal gives them the ability to view and download healthcare encounter data available from Medicare, the Department of Veterans Affairs, or other payers. As we move towards 2030, nursing will: be a personalised, rights-based service embedded within a caring and compassionate professional relationship with individuals and communities focus not only on people's immediate perceived problems, but also take into account their wider physical, psychological, social, family and community life to make a real and lasting difference to their health and wellbeing Get the latest public health information from CDC: NLM There are two important FACAs setting the direction for the adoption of data standards for ONC. The HITECH Act establishes criteria for MU, or the set of standards used to incentivize eligible professionals, facilities, and critical access hospitals to use electronic health records (EHRs) in a meaningful way (P.L. 1). The NPP provides input to HHS on the development of a national strategy as well as priorities for healthcare performance measurement and improvement. Current UAPU data collection requires that nurses on a given unit report the midnight census (number of patients admitted to that unit as of midnight). Citation: Kennedy, R., Murphy, J. Roberts, D., (September 30, 2013) "An Overview of the National Quality Strategy: Where Do Nurses Fit?" Many more are needed. Hospital results. Since 2000, we have successfully recruited U.S. experienced RNs (averaging 14 years) as your employees, who fit your culture, and do so in an average time-to-fill of 32 days. For an example, see the link to the VA Maryland Healthcare System, Baltimore (, n.d.) to the Centers for Medicare and Medcaid Services for the Veterans Affairs Maryland Healthcare System, Baltimore, which reports available data and comparisons. Conclusions: The MAP focuses on alignment around the best measures of quality for use in public reporting and performance-based payment programs, such as Pay-for-Performance (NQF, 2011). 2015 Dec 18;13:97. doi: 10.1186/s12960-015-0096-1. Issued by the Department of Health, the strategy aims to address the seven major problem areas identified during recent national consultations. Organizations and individuals need to identify and articulate how achieving meaningful use fits with their unique strategic plan related to those specific outcomes. 23 Sepember 2013. Nursing: Scope and standards of practice: Silver Spring, MD: Health Affairs, 32(2), 376-384. doi: 10.1377/hlthaff.2012.1216, Schumann, M. J. She is a fellow in the American Academy of Nursing and received the HIMSS 2009 Nursing Informatics Award as well as the top 25 women in healthcare award for 2009. (2010). The future of quality measurement for improvement and accountability. For example, the term “medications” was not explicitly represented across measures, to indicate whether the measure required medications ordered, dispensed, or administered (NQF, 2013). The national nursing strategies prioritized multisectoral collaboration, professional competencies, and standardized educational systems, with some countries underscoring the need to align policies with efforts to promote nursing leadership, and others, focusing on expanding the scope of practice to improve health care delivery. This article will outline the quality conversation and some of its participants; reveal some of the perceived gaps in the conversation into which nursing could contribute valuable insights; and hopefully prompt nurses to volunteer to participate in committees, comment on regulations, or otherwise engage in the discussion. Quality improvement solutions from ANA. ET The development of shared governance programs that give nurses a voice in scheduling, workflows, and hospital policies can also help. Many of these activities are open and transparent processes, so participation as an observer seeking knowledge and awareness of current initiatives is also easy to accomplish.  |  This work includes creating an environment in which use of the EHR becomes essential to support an ongoing, programmatic approach to improve patient care safety and quality and drive the changes to decrease cost. (2013). Returning 2021. Retrieved from:, NDNQI. Nursing Science Quarterly, 26(1), 37-41. doi: 10.1177/0894318412466746, American Nurses Association. Retrieved from: The strategy has been reaffirmed by the health ministers a number of times since 1992. The annual NSI National Health Care Retention and RN Staffing Report published by NSI Nursing Solutions Inc. shares some startling statistics about the current nursing turnover rate: The 2019 hospital turnover rate was 15.9%, a decrease of 1.3% from the year prior. Strategic Plan for Nursing Education, Training and Practice 2012/13 – 2016/17 4 Acknowledgement by the Director-General of Health The Department of Health is deeply grateful to all participants of the country’s first national Nursing Summit in April 2011 whose contributions provided the … Professional issues panels. The American Recovery and Reinvestment Act (ARRA) of 2009 (PL 111-5) mandated the EHR Incentive Program (U.S. Government Printing Office, 2009). Integrate efficient and effective hospital services across healthcare providers. Meaningful use of health IT is best considered as a platform for continuous quality and process improvement, as opposed to simply implementing technologies as an end unto themselves. Email: In addition, hospitals and other healthcare employers often have committees to address quality improvement, automated documentation, and patient engagement. It is not their role. (2013). 001/World Health Organization/International.  |  One way for this process to occur is with quality through development of effective transition of care documents (ANA, 2010a). He has been a nurse with 25 years of experience in such diverse areas as chronic pulmonary care, hospice, mental health, informatics, health care quality, and the learning healthcare system. The purpose of MU incentives is to increase the speed of EHR adoption and healthcare improvement. Improving healthcare quality. CMS changes in reimbursement for HAIs: Setting a research agenda. In addition to being an informatics domain expert, she holds many leadership roles through her work with the American Medical Informatics Association (AMIA) and Technology Informatics Guiding Educational Reform Board (TIGER). Health IT can be implemented and employed in such a way as to support the National Quality Strategy and help achieve the 3-part aim of better care, better health, and lower cost (Berwick et al., 2008). American Nurses Association. The Department of HHS spearheaded the development of eMeasures, which are quality measures represented in a standardized electronic format, allowing a consistent, replicable comparison of quality (Knecht, Boberg, Kiley, & Giles, 2012; White, McColm, Kmetik, & Fischer, 2010). (n.d.). Nursing's social policy statement: The essence of the profession. It is also an essential component for meeting the criteria for MU (Blumenthal & Tavenner, 2010; Buntin, Jain, & Blumenthal, 2010). These discussions occur at multiple levels through councils, committees, workgroups, task forces, and expert panels. Even nurses who choose not to participate can remain aware of activities at the organizational, state, and national levels. Retrieved from, Building an electronic data infrastructure is a fundamental backbone for successful quality measurement and improvement. ANA is currently developing eMeasures of nursing quality for NDNQI using the QDM and HQMF. In the case of health IT, nurses can lead as role models who use their own electronic personal health records. Input from nurses has helped HHS to promote and support the transition from traditional paper-based quality measure formats to the electronic quality measures (eMeasures) format that can be processed by EHRs to generate quality measure reports (ONC, 2012). Use of the QDM for documenting quality measures and care will provide a mechanism for reporting of clinicians’ influences on outcomes and subsequent improvement in care at a national level (NQF, 2011; NQF Testimony, 2012). Key words: quality, National Quality Strategy, meaningful use, quality legislation, Quality Measurement Data Standards. Leadership makes a difference. These examples illustrate just some of the ways that nurses can impact healthcare quality by involvement in health IT initiatives. The agency or contractor seeking participation will detail recommended backgrounds and time commitments in the request (GSA, 2012). (2010a). Major challenges facing the nursing profession, identified by the Summit, are ... strategy will ensure that our country has nurses of high calibre who can contribute to (2012). Federal Advisory Committees Improving health and health care quality can occur only if all sectors, individuals, family members, payers, providers, employers, and communities, make it their mission. readmissions, complications, and deaths) for public reporting and comparison. Available at, National Quality Forum. Methods: Rather, it is one tool in the arsenal of health reform. 23, 2010. Many policy-related decisions these groups make affect nurses and nursing care. Journal of Research in Nursing, 18(4), 288-304. doi: 10.1177/1744987112440568. Nurses have an essential role to engage patients in their own care; patients and their families trust nurses (ANA, 2010b; Schumann, 2013). JAMA: The Journal of the American Medical Association, 301(2), 215-217. doi: 10.1136/qshc.2006.022046. Quality reports supported by these programs vary from those used for internal quality improvement and those used for public reporting. Article published September 30, 2013, Substance Use Disorders and Related Concerns, The 200th Birthday of Florence Nightingale, Addressing Social Determinants of Health: Progress and Opportunities, Translational Research: From Knowledge to Practice, U.S. Government Services Administration [GSA], 2012, Fu, Rosenthal, Pevnick, & Eisenberg, 2012, Ricciardi, Mostashari, Murphy, Daniel, & Siminerio, 2013,,,,,,,, (2013). 18, No. The QDM also describes information so EHRs and other health IT systems consistently interpret and locate data required for measurement.
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