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). Nursing: Scope and standards of practice: Silver Spring, MD: Nursesbooks.org. NQF: Quality positioning system. Exploring conceptual and theoretical frameworks for nurse practitioner education: a scoping review protocol. Darryl W. Roberts, PhD, MS, RN. (2011b). The effect of pay-for-performance in hospitals: Lessons for quality improvement. JAMA: The Journal of the American Medical Association, 309(21), 2215-2216. doi: 10.1001/jama.2013.4929, Federal register. An integrative review. © 2013 OJIN: The Online Journal of Issues in Nursing Werner, R. M., Kolstad, J. T., Stuart, E. A., & Polsky, D. (2011). Many more are needed. Created by groups of experts and stakeholders, these planning documents establish strategic priorities for tackling the nation’s most pressing health problems. Launching HITECH. For an example, see the link to the VA Maryland Healthcare System, Baltimore (Medicare.gov, n.d.) to the Centers for Medicare and Medcaid Services for the Veterans Affairs Maryland Healthcare System, Baltimore, which reports available data and comparisons. The development of National Health Policies, Strategies and Plans is a complex and dynamic process. Non-government entities, such as NQF and The Joint Commission, convene committees and panels to improve processes and gain stakeholder input. Health IT strategist Leonard Kish stated, “Patient engagement is the blockbuster drug of the century” (Chase, 2012, para. Retrieved from https://ehrincentives.cms.gov/hitech/login.action, Chase, D. (2012). Available at www.nursingquality.org, National Quality Forum. Journal of Biomedical Informatics, 45(4), 772-781. doi: 10.1016/j.jbi.2012.06.002, Kaplan, L. (2013). Dr. Kennedy, RN, MBA, FAAN, is President and CEO of eCare Informatics, and also Associate Professor and Associate Dean of Strategic Initiatives at Thomas Jefferson University School of Nursing in Philadelphia, PA. (2013). ...nurse leaders sitting on FACAs and measurement development teams are working to think about how to leverage MU to drive a patient-centered, quality and safety agenda that includes nursing input. USA.gov. Support: To ensure we regulate as progressively as possible, we proactively support our professions. Nurses could consider involvement in the work of their specialty organizations or state nurses associations on quality initiatives, quality committees, task forces, or on the American Nurses Association Professional Issues Panels (ANA, 2013). The definition of healthcare quality, i… Darryl W. Roberts, PhD, MS, RN American Nurses Association. Nurses can raise a hand to say “yes, I’ll participate” and get involved in these activities. Jamaica shows efforts among the Caribbean countries to promote collaborative practices in research. The National Council of State Boards of Nursing (NCSBN) is a not-for-profit organization whose purpose is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. 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 In this role, she coordinates federal efforts to assist healthcare providers and organizations to adopt health information technology to improve care and promote consumers’ greater understanding and use of health information technology. To illustrate how an eMeasure differs from a traditional, paper-based quality measure, consider how NDNQI currently captures the number of unit-acquired pressure ulcers (UAPU) per 1,000 patient days, as a measure of unit quality today, versus how it might collect UAPU using an eMeasure in the future. HMC’s commitment to helping drive the evolution of nursing and midwifery in Qatar is underpinned by the continuation of the Nursing and Midwifery Strategy. (2013). As evaluation scientist, nurse informatician, clinical researcher, policy advisor, and university educator, Dr. Roberts gives a unique perspective to health care and nursing. Nurses have an essential role to engage patients in their own care; patients and their families trust nurses (ANA, 2010b; Schumann, 2013). 23 Sepember 2013. Read the full Nursing Strategy here. HQMF is an HL7 draft standard electronic format used to represent quality measures consistently. The authors describe ways that nurses can engage in the national quality agenda. 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). This allows users to  translate seemingly independent pieces of data into meaningful conclusions that, if applied and implemented correctly, can improve the health of individuals and populations; lower costs; and help tailor healthcare to individual patient needs. 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, www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Electronic-Health-Record.html, www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Professional-Issues-Panels, www.aannet.org/ep-informatics--technology, https://ehrincentives.cms.gov/hitech/login.action, www.forbes.com/sites/davechase/2012/09/09/patient-engagement-is-the-blockbuster-drug-of-the-century/, http://encorehealthresources.com/wp-content/uploads/2013/05/A-World-Evolving-Toward-Value-Final.pdf, www.medicare.gov/hospitalcompare/results.html#loc=21201&lat=39.2963369&lng=-76.6210539&name=VA%20MARYLAND%20HEALTHCARE%20SYSTEM%20-%20BALTIMORE, www.qualityforum.org/WorkArea/linkit.aspx? Organizations and individuals need to identify and articulate how achieving meaningful use fits with their unique strategic plan related to those specific outcomes. the National Nursing Summit with the aim to reconstruct and revitalise the Nursing Profession for a Long and Health Life for All South Africans. 1). 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. 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). 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. Wilson R, Godfrey CM, Sears K, Medves J, Ross-White A, Lambert N. JBI Database System Rev Implement Rep. 2015 Oct;13(10):146-55. doi: 10.11124/jbisrir-2015-2150. One way for this process to occur is with quality through development of effective transition of care documents (ANA, 2010a). Through development and adoption of data standards, the EHR can be used for electronic quality reporting. Retrieved from www.aannet.org/ep-informatics--technology, Buntin, M. B., Jain, S. H., & Blumenthal, D. (2010). Nursing human resources for health is progressing. Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review. Changes in documentation and care brought on by eMeasures will affect nurses as well as other clinicians. When data necessary for quality measurement are captured as a byproduct of care delivery, and when those data are easily shared between health IT systems, care can be better coordinated, and is safer, more efficient, and of higher quality. (2013). Epub 2015 Sep 25. strategy. Retrieved from www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf. Prior to this, she was Vice President-Electronic Health Record Applications at Aurora Health Care in Wisconsin, where she led the EHR program and was involved with health informatics for over 25 years. Edwards N, Kaseje D, Kahwa E, Klopper HC, Mill J, Webber J, Roelofs S, Harrowing J. There are several gaps in the quality conversation to which nurses could contribute valuable insights. Nursing has become an information-based profession that provides healthcare. Retrieved from: www.gsa.gov/portal/content/244333?r44b=no. All of them affect how patients receive or engage in healthcare. Judy Murphy is Deputy National Coordinator for Programs & Policy at the Office of the National Coordinator for Health IT, Department of Health and Human Services in Washington D.C. 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 Methods: (2011a). CMS changes in reimbursement for HAIs: Setting a research agenda. Historically, quality measures have been paper-based and lacked consistency, which hindered the ability to compare performance results across healthcare settings. Rather, it is one tool in the arsenal of health reform.  |  Finding out where and when a FACA or other committee will form and what purpose it will serve can be a challenge. EP informatics & technology. These examples illustrate just some of the ways that nurses can impact healthcare quality by involvement in health IT initiatives. Nurses teach patients and families and can influence their perceptions of how to engage in their own care. Hum Resour Health. The other is the Health IT Standards Committee, chartered to make recommendations on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information (ONC, 2012).  |  On this day the Department of Health published the National Strategic Plan for Nurse Education, Training and Practice 2012/13 - 2016/17 on its website. Issued by the Department of Health, the strategy aims to address the seven major problem areas identified during recent national consultations. It is also an essential component for meeting the criteria for MU (Blumenthal & Tavenner, 2010; Buntin, Jain, & Blumenthal, 2010). The overview provided above discussed several examples of nurses working to make a difference in the national quality agenda. He earned graduate degrees in Nursing Informatics and Policy Sciences from the University of Maryland School of Nursing and the University of Maryland Baltimore County (UMBC), respectively. LinkIdentifier=id&ItemID=70017, www.qualityforum.org/Setting_Priorities/Improving_Healthcare_Quality.aspx, www.healthit.gov/sites/default/files/nqf_mumeasuredevelopmenttestimony_060712.pdf, www.healthit.gov/policy-researchers-implementers/health-it-standards-committee-recommendations-national-coordinator-h, www.gpo.gov/fdsys/pkg/PLAW-111publ5/content-detail.html, www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf, www.gsa.gov/portal/content/244333?r44b=no, Building Linkages between Nursing Care and Improved Patient Outcomes: The Role of Health Information Technology, Quality and Safety Education for Nurses (QSEN): The Key is Systems Thinking, An Academic Practice Partnership: Helping New Registered Nurses to Advance Quality and Patient Safety, The Influence of Quality Improvement Efforts on Patient Outcomes And Nursing Work: A Perspective from Chief Nursing Officers at Three Large Health Systems. Deliver the right care in the appropriate setting, underpinned by referral guidelines, care pathways and evidence-based practice. 18, No. Additionally, because of its scope, size, and frequency, finding important notices in the Federal Register is not always easy. Even nurses who choose not to participate can remain aware of activities at the organizational, state, and national levels. This requires an electronic data infrastructure (Ricciardi et al, 2013). They are also keenly interested in safeguarding patients across transitions in care from the hospital to their own homes, to home health, or to skilled nursing facilities. A national action plan to support consumer engagement via e-health. Health Affairs, 32(2), 376-384. doi: 10.1377/hlthaff.2012.1216, Schumann, M. J. For instance, participants in the ANA National Database of Nursing Quality Indicators® (NDNQI®, 2013) could use reports on such measures as hospital acquired pressure ulcers and unassisted falls to improve quality outcomes at the unit level. There are other ways that nurses can participate in quality work within their own organizations, such as getting involved in shared governance or professional practice activities (e.g., standards of practice, quality assurance, or performance improvement committees). Using an eMeasure, UAPU data capture would occur as a byproduct of care using documentation already entered into individual patient EHRs from the nurses’ assessments at admission and throughout the patients’ stays. White, J., McColm, D., Kmetik, K., & Fischer, H. (2010, June 23). Quality reports supported by these programs vary from those used for internal quality improvement and those used for public reporting. 18, No. (2010a). 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. Hospital results. The American Recovery and Reinvestment Act (ARRA) of 2009 (PL 111-5) mandated the EHR Incentive Program (U.S. Government Printing Office, 2009). This Strategy delivers a clear roadmap for HMC to build on the strong 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 body of his work has been captured in numerous publications, as well as presentations at research and professional conferences nationally and internationally. This allows us to strike the right balance between investigating rare cases of poor practice and promoting excellent practice. Judy Murphy, RN, FACMI, FAAN eMeasures allow for the explicit representation of quality measures through use of data standards. Blumenthal, D. (2010). 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). It is integral to the NHS’ definition of quality in healthcare, alongside effectiveness and patient experience. New England Journal of Medicine, 362(5), 382-385. doi: 10.1056/NEJMp0912825, Blumenthal, D., & Tavenner, M. (2010). (2012). 2015 Dec 18;13:97. doi: 10.1186/s12960-015-0096-1. Retrieved from www.qualityforum.org/WorkArea/linkit.aspx? Published 21 September 2016 Retrieved from https://www.federalregister.gov/, Fu, P. C., Rosenthal, D., Pevnick, J. M., & Eisenberg, F. (2012). Nurses can take on leadership roles to influence healthcare delivery, improving quality, safety, and efficiency, and bring evidence for decision-making to the point of care to empower patients as partners. Journal of Research in Nursing, 18(4), 288-304. doi: 10.1177/1744987112440568. Committee membership by nurses helps to ensure that the proposed standards represent nursing practice. Federal Advisory Committees Building an electronic data infrastructure is a fundamental backbone for successful quality measurement and improvement. (2013). The purpose of incentives is to focus clinicians’ attention on improving care (Stone et al., 2010; Werner, Kolstad, Stuart, & Polsky, 2011). 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. The impact of emerging standards adoption on automated quality reporting. Influe… 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. Retrieved from http://encorehealthresources.com/wp-content/uploads/2013/05/A-World-Evolving-Toward-Value-Final.pdf, Medicare.gov. 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. The article concludes with a call to action to encourage nurses to take a larger role in driving the National Quality Strategy. AHRQ National Resource Center for Health Information Technology, Administration for Health Research and Quality. Nurses with higher levels of education and skillsets can take even greater roles in nurse informatics or leadership. (2009). Through development and adoption of data standards, the EHR can be used for electronic quality reporting. The QDM also describes information so EHRs and other health IT systems consistently interpret and locate data required for measurement. (2012). The Medicaid electronic health record incentive program. Typically, FACA participation is open to the general public. Quality improvement solutions from ANA. This article discusses the National Quality Strategy by offering a description and history of the quality conversation, including federal advisory committees and quality measurement data standards. This is not a piece of work to be directed by government or by government chief nurses. Inclusion criteria limited documents to those published in 2008-2013 that discussed or assessed situational issues and/or progress surrounding the nursing workforce. 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. The Nursing Strategic Plan allows the Dept. (2009). Members of the Department of HHS are working specifically to move the quality enterprise forward by supporting measurement, reporting, and improvement of healthcare with health IT (Conway et al., 2013). Whatever chair they occupy, nurses must be confident that they can influence health policies and practices at the local, regional, state, and national level. 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 … Strategies to mitigate turnover include reducing weekly and incremental overtime and eliminating mandatory overtime. Decision makers value their input. Medical Care, 48(5), 433. doi: 10.1097/MLR.0b013e3181d5fb3f, U.S. Government Printing Office. The ICN Leadership For Change™ Programme--20 years of growing influence. Berwick, D. M., Nolan, T. W., & Whittington, J. Technology gives nurses access to information at the point of care for decision-making. The “meaningful use” regulation for electronic health records. FACA 101. eMeasures allow for the explicit representation of quality measures through use of data standards. Encore Health Resources. Health Affairs, 27(3), 759-769. According to the National League for Nursing (NLN), between 1995 and 1999, the number of programs of most types has increased in the United States. 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. Retrieved from: www.medicare.gov/hospitalcompare/results.html#loc=21201&lat=39.2963369&lng=-76.6210539&name=VA%20MARYLAND%20HEALTHCARE%20SYSTEM%20-%20BALTIMORE, NDNQI. (2010). Levels of measurement, as well as questions of whom, how, and when to measure are topics of continual deliberation. While the Federal Register is publicly available, few people review it with enough regularity to track FACA calls. Helping people to stay independent, maximise well-being and improving health outcomes. HHS An individual wanting to participate may submit his/her information independently; however, professional organizations like the American Nurses Association (ANA) often submit letters of support for nominees with particularly appropriate backgrounds or experiences. Email: darryl.roberts@ana.org. 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