The purpose of this assignment is to achieve the following learning objectives:Correlate a model of healthcare performance and quality in a healthcare organization
Identify the nurse’s role in measuring, monitoring and improving health care quality and safety
Discuss terms and concepts related to health care quality and safety
Each of these objectives will be addressed in this paper.

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A Model of Healthcare Performance and Quality
The chosen organization has a Chief Quality Officer. The quality goals and objectives of the organization are divided into (a) regulatory and (b) internal categories. In terms of regulatory goals, the organization has specific benchmarks that accord with (a) federal law, (b) state and local law, and (c) benchmarks taken from the Joint Commission and other industry bodies. In some categories, the goal is to achieve 100% compliance with listed regulations; however, with voluntary categories such as those promulgated by the Joint Commission, the goals are to (a) achieve parity with peer organizations and (b) obtain year-over-year improvements (unless full compliance has been reached).

The Nurse’s Role
Nurses are responsible for carrying out many of the specific activities that are related to both healthcare performance and quality. The training and evaluation of each nurse is keyed to best practices that are ultimately keyed to both external and internal quality-related goals and objectives. Nurses report vertically in a manner that sends signals of quality compliance up the chain of command and receive horizontal assistance (that is, assistance from personnel in other departments and functions) in a manner that is designed to improve one or more quality improvements. The ultimate point of responsibility and governance for all quality-related initiatives is the Chief Quality Officer, but department heads and other personnel in managerial positions are responsible for carrying out, and reporting on the results of, all relevant quality-related initiatives.

Processes and Philosophies
A common quality improvement approach in the organization is that of management by exception (Force, 2005; Stordeur, Vandenberghe, & D’hoore, 2000). In this approach, the focus is on identifying and improving processes that are not functioning as expected, which can be measured empirically. For example, recently, there were (a) more patient falls than expected based on past data and (b) more medication labelling errors than expected. The quality improvement process sensed these changes by using online software portals to calculate real-time benchmarks and alert the Chief Quality Officer. Once the deviation from the norm was identified, manual follow-up was undertaken to identify the causes of the errors and correct them. In the cases of the two problems identified above, the results were directly related to the improvement of patient outcomes. The philosophy behind this approach is to freeze what works and to identify what isn’t working, fix it, and freeze it. This approach recognizes the fact that management has limited resources and tries to apply these resources efficiently by directing managers to those aspects of quality that are most in need of attention. Nurses play an important role in this process, as they are often the first ones to notice that a particular process is failing in a manner that is likely to have implications for quality. The culture in this organization makes it easy for nurses to report quality issues; there are bonuses for nurses who make reports (typically entered on paper or through the online interface) related to quality issues, and nursing suggestions are acted upon regularly.

    References
  • Force, M. V. (2005). The relationship between effective nurse managers and nursing retention. Journal of Nursing Administration, 35(7-8), 336-341.
  • Stordeur, S., Vandenberghe, C., & D’hoore, W. (2000). Leadership styles across hierarchical levels in nursing departments. Nursing Research, 49(1), 37-43.