DQ: Identify two quality metrics used in your clinical workplace

NUR 621 Topic 3 Discussion

DQ: Identify two quality metrics used in your clinical workplace

There are several quality measures used in healthcare. The measures used to assess and compare the quality of health care organizations are classified as either a structure, process, or outcome measure. “Structural measures give consumers a sense of a health care provider’s capacity, systems, and processes to provide high-quality care. Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition. These measures typically reflect generally accepted recommendations for clinical practice. Outcome measures reflect the impact of the health care service or intervention on the health status of patients.” (Agency for Healthcare Quality and Research, 2021)

One quality metrics used in the VA is Mission Act Quality Standards comparison data. This allows consumers to examine VA and regional community provider performance on key clinical quality and experience metrics. This metric aids patients in understanding the quality of care available in their geographic region. The metrics included indicators of inpatient, outpatient, and patient experience performance that align with three central tenants of VA care. “Effective care is based on scientific knowledge of what is likely to provide benefit to veterans, Safe Care that avoids harm from the care that is intended to help veterans, and veteran -centered care that anticipates and responds to Veterans and their caregivers.” (United States Department of Veterans Affairs, 2021). The quality metrics are measured by surveys and evaluation of weekly incident reports. The information is shared with nurses via the monthly townhall meetings, electronic mail, and weekly news letters.

Another quality metric used at the VA is catheter associated urinary tract infection rates. The number of patients who contract UTI’s during their inpatient stay that have indwelling catheters is measured daily. The system keeps track of everyone in the facility that has a catheter and charts are audited daily to see if CHG baths were performed. Cultures and labs are consistently drawn to evaluate the range of WBC’s and possible signs of infection. The results are shared with staff on a monthly basis via e-mail and in monthly town hall meetings.

Overall, I think that having quality metrics is a benefit to the VA system. Quality metrics helps to keep us aware of areas of improvement as well as areas that are doing well. It is important to consistently perform evaluations to maintain a high level of quality service.

I am employed in day surgery and we are currently tracking operating room (OR) efficiency by monitoring surgical start times and as well as surgical site infections (SSIs). The OR is responsible for generating revenue for healthcare organizations around the world but is also one of the most expensive areas to manage according to Gómez-Ríos et al. (2019). Therefore, it is imperative that strategies are implemented to increase efficiency and utilization.

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At our facility OR start times and other pertinent data are documented in the VISTA electronic health record. The perioperative nurse

DQ Identify two quality metrics used in your clinical workplace
DQ Identify two quality metrics used in your clinical workplace

manager is responsible for gathering, analyzing, and reporting this information monthly. Unfortunately, dissemination of this information is not always consistent. However, I believe everyone should be fully informed because it is critical in improving on-going processes and patient care.

SSIs are responsible for 20% of all hospital-acquired infections (Ban et al., 2017). Surgical site infections are tracked by the VA Surgical Quality Improvement Program (VASQIP) which is part of the VA National Surgery Office (NSO). This department is responsible for reviewing and reporting data on all patients who undergo surgery within the VA healthcare system including its significance and implications for patient care as well as the quality of the care provided. However, this information is reported to leadership, but not to nursing staff unless requested. This is a significant patient safety issue that requires a multidisciplinary approach and therefore, data should be routinely reported and readily accessible to nursing staff.




Ban, K. A., Minei, J. P., Laronga, C., Harbrecht, B. G., Jensen, E. H., Fry, D. E., Itani, K. M., Dellinger, E. P., Ko, C. Y., & Duane, T. M. (2017). American College of surgeons and surgical infection society: Surgical site infection guidelines, 2016 update. Journal of the American College of Surgeons, 224(1), 59-74.

Gómez-Ríos, M., Abad-Gurumeta, A., Casans-Francés, R., & Calvo-Vecino, J. (2019). Keys to optimize the operating room efficiency. Revista Española de Anestesiología y Reanimación (English Edition), 66(2), 104-112.

The two-quality metrics used in my workplace are the length of stay and readmission rates. Length of stay measures the amount of time a patient spends in the hospital from the time of admission to time of discharge. The length of stay metric is often traced over weeks and months and in annual quarters. The data collected is important because it provides sufficient evidence on the hospital’s level of care efficiency. Care efficiency contributes significantly to how long a patient stays in the hospital. High care efficiency leads to short hospital stays, while inadequate care efficiency extends the length of patient stay. When patients stay in the hospital for too long, they are at risk for hospital-acquired infections (Baek et al., 2018). The length of stay metric results are shared with the nursing staff. The purpose of sharing the results is to encourage nurses to improve care efficiency to enable short hospital stays.

Readmission rates show the number of patients admitted into the same facility or a different facility within thirty days of being discharged for the same condition. It also tracks a patient’s readmission due to a complication related to the original condition of care. The readmission rate metric measures the quality of care given to patients (Fische et al., 2014). When the number of readmitted patients is high, it indicates that the health professionals are delivering low-quality care to patients, ignoring complications or relevant patient information. Conversely, a small number of readmission cases shows the hospital provides high quality of care.

The results of the readmission rate metric are not shared with the nurses. However, I think that these results should be shared because nurses can help reduce the rate of readmission. Nurses can improve on the quality of care they provide to patients. Moreover, they can carry out patient education on proper scheduling of medication and common illnesses that lead to readmission (Nelson & Rosenthal, 2015). They can also enhance communication with patients to determine whether they need further care to prevent readmission.