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Real-time, meaningful metrics boost nursing quality

A wise person once said, “Save one life you’re a hero, save 100 lives and you’re a nurse.” But how exactly do you measure quality in such a heroic profession?

At Robert Wood Johnson University Hospital (RWJ) (New Brunswick, NJ), achieving quality in nursing is a top priority. The academic medical center employs 1,600 registered nurses to help manage more than 600 inpatient beds.

In 2011 and 2012 the hospital took top honors for outstanding nursing quality in an American Nurses Association recognition program based on its National Database of Nursing Quality Indicators® (NDNQI®). The database collects and evaluates unit-specific nurse-sensitive data from hospitals across the United States.

Methods that earned RWJ honors for quality nursing

At our annual client conference, ACE, we learned more about how RWJ achieved success from Nicole Martinez, RN, director of nursing informatics. She credits the organization’s success to a few key strategies:

Give metrics meaning. RWJ staff equates each number to a person. For example, rather than say the fall rate is 1 per 1000 patients, RWJ notes that one person fell. And that is one person too many.

Visualize metrics in real time. Interdisciplinary clinical teams use real-time data to improve situational awareness, team work and compliance.

Use the Magnet Model. About 30 years ago, the American Academy of Nursing studied hospitals to better understand how to attract and retain nurses who promoted quality patient care. It developed five key components to distinguish “Magnet” organizations. RWJ is one of about 380 facilities holding the credential today.

Identify key data. At times nurses receive a deluge of patient information. Studies show that it can lead to cognitive overload and inaccurate decision making*. Using Knowledge-Based Charting, RWJ nurses follow guidelines to focus on the right pieces of information to help make good decisions.

Collaborate with “Safety Huddles” – Care teams evaluate key information at the unit level and at the bedside. RWJ also offers forums called “M&M: Mistakes and Misjudgments” for nurses to discuss critical events how to prevent them.

Focus on quality helps improve clinical outcomes

All of these efforts helped RWJ achieve some impressive outcomes. For example, nurses helped reduce the number of patient falls by 33% in three years.  In that same time period, 60% fewer patients acquired pressure ulcers (also known as bed sores) during a hospital stay. Great clinical outcomes.

Another key measure shows that job satisfaction for RNs improved 17% in five years. Nurses embrace quality measures. They want to provide the best care possible. Organizations such as RWJ help them do just that.

One more thing we love about RWJ

In the Connected Community of Health, we work with many talented, dedicated individuals. Nicole Martinez has been instrumental in sharing lessons learned at RWJ with other Allscripts nursing informatics teams, and nursing teams (that may not even use Allscripts) at the American Nurses Association (ANA) Quality Conferences. We appreciate their spirit of collaboration and willingness to share these insights to help improve health care.

Read this case study to learn about other successes at Robert Wood Johnson University Hospital.


* Source: Dale, C., Naden,D., von Kugh, G. (2005). Framework for Integrating NANDA, NIC, and NOC Terminology in Electronic Patient Records. Journal of Nursing Scholarship, 37,229-235.

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