DISCUSSION WEEK #3

Week 3: Ongoing Performance Evaluation

The quality of health care provided by NPs is under constant scrutiny. Many physicians are hesitant of NPs ability to provide quality and cost-effective care. It is critical for NPs to see themselves as full partners in health care. NPs are challenged to improve the quality and measurement of health care delivery and patient health outcomes. NPs must be recognized for the care that they provide. Thus NPs must constantly ask the question, how do we ensure measurement of the care that we provide?

Ongoing monitoring and continuous improvement is vital for all practicing NPs to ensure patients receive safe, competent, and quality health care (Hamric, Hanson, Tracy & Grady, 2014). It is imperative for advanced practice nurses to have strategies to measure, report, and reward excellence in health delivery. Advanced practice nurses are well situated to provide quality, cost effective, and patient-centered care (IOM, 2015). This week, as you examine quality measures, consider how standards of care are developed and implemented.

Learning Objectives

By the end of this week, students will:

Analyze importance of quality measures

Evaluate the use of incentive payment for care

Analyze external motivators for incentive payment for care

Apply comprehensive knowledge of nurse practitioner practice

Learning Resources

Required Readings

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Chapter 15, “Measuring Nurse Practitioner Performance” (pp. 463-468)

This chapter will cover standards of care, and measures of nurse practitioner performance

Hain, D., & Fleck, L. M. (2014). Barriers to NP practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). doi:10.3912/OJIN.Vol19No02Man02

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Evidence-Based Practice. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (237-262). St. Louis, MO: Elsevier Saunders.

This chapter will cover a historical perspective of evidence and current best evidence, steps of the evidence based process, tips for achieving meaningful changes in practice based on current best evidence.

Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An incentive plan for advanced practice registered nurses: Impact on provider and organizational outcomes. Nursing Economics, 33(3), 125-131.

Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., . . . Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal for Nurse Practitioners, 9(8), 492-500. doi:10.1016/j.nurpra.2013.07.004

Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). Nurse Practitioner Core Competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012

Wilkinson, K. (2015). Legal Nuts and Bolts for PNPs in Today s Healthcare Environment [PowerPoint slides]. Retrieved from http://docplayer.net/5760521-Legal-nuts-and-bolts-for-pnps-in-today-s-healthcare-environment-karen-wilkinson-mn-arnp-lnc-wilkinson-legal-nurse-consulting.html

Required Media

Institute of Medicine. (2015, December 7). Assessing Progress on the Implementation of the Recommendations of The Future of Nursing [Video file]. Retrieved from https://www.youtube.com/watch?v=sMOjACA2ats

Note: The approximate length of this media piece is 1 hour.

Optional Resources

This is an optional resource that students should be familiar with as advanced practice nurses.

Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010). Retrieved from

https://democrats.senate.gov/pdfs/reform/patient-protection-affordable-care-act-as-passed

Week 3: Ongoing Performance Evaluation
The quality of health care provided by NPs is under constant scrutiny. Many physicians are hesitant of NPs ability to provide quality and cost-effective care. It is critical for NPs to see themselves as full partners in health care. NPs are challenged to improve the quality and measurement of health care delivery and patient health outcomes. NPs must be recognized for the care that they provide. Thus NPs must constantly ask the question, how do we ensure measurement of the care that we provide?
Ongoing monitoring and continuous improvement is vital for all practicing NPs to ensure patients receive safe, competent, and quality health care (Hamric, Hanson, Tracy & Grady, 2014). It is imperative for advanced practice nurses to have strategies to measure, report, and reward excellence in health delivery. Advanced practice nurses are well situated to provide quality, cost effective, and patient-centered care (IOM, 2015). This week, as you examine quality measures, consider how standards of care are developed and implemented.
Learning Objectives
By the end of this week, students will:
Analyze importance of quality measures
Evaluate the use of incentive payment for care
Analyze external motivators for incentive payment for care
Apply comprehensive knowledge of nurse practitioner practice
Learning Resources
Required Readings
Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.
Chapter 15, “Measuring Nurse Practitioner Performance” (pp. 463-468)
This chapter will cover standards of care, and measures of nurse practitioner performance
Hain, D., & Fleck, L. M. (2014). Barriers to NP practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). doi:10.3912/OJIN.Vol19No02Man02
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2014). Evidence-Based Practice. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (237-262). St. Louis, MO: Elsevier Saunders.
This chapter will cover a historical perspective of evidence and current best evidence, steps of the evidence based process, tips for achieving meaningful changes in practice based on current best evidence.
Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An incentive plan for advanced practice registered nurses: Impact on provider and organizational outcomes. Nursing Economics, 33(3), 125-131.
Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., . . . Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal for Nurse Practitioners, 9(8), 492-500. doi:10.1016/j.nurpra.2013.07.004
Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). Nurse Practitioner Core Competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012
Wilkinson, K. (2015). Legal Nuts and Bolts for PNPs in Today s Healthcare Environment [PowerPoint slides]. Retrieved from http://docplayer.net/5760521-Legal-nuts-and-bolts-for-pnps-in-today-s-healthcare-environment-karen-wilkinson-mn-arnp-lnc-wilkinson-legal-nurse-consulting.html
Required Media
Institute of Medicine. (2015, December 7). Assessing Progress on the Implementation of the Recommendations of The Future of Nursing [Video file]. Retrieved from https://www.youtube.com/watch?v=sMOjACA2ats

Note: The approximate length of this media piece is 1 hour.
Optional Resources
This is an optional resource that students should be familiar with as advanced practice nurses.

Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 et seq. (2010). Retrieved from https://democrats.senate.gov/pdfs/reform/patient-protection-affordable-care-act-as-passed

As nurse practitioners continue to expand their role in delivering health care, it is imperative for NPs to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization. This week it is important to explore the connection of quality care and performance measures. Some questions to consider as we discuss this topic are:

Why are quality measures important?

What is the difference between quality measures and performance indicators?

What performance measures are used for NP productivity?

Why are incentive plans used in clinical organizations?

To prepare:

Read the article, An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes, by Catherine A. Rhodes, Mavis Bechtle, and Molly McNett (2015)

Explore quality measures and identify at least one clinical performance measure, such as the Agency for Healthcare Research and Quality (AHRQ)

Post an explanation of the importance of quality measures using the clinical performance measure you identified as an example. Then, identify the performance measures used for NP productivity in Rhodes, Bechtle, and McNett (2015) article. Finally, share your opinion on incentive payment for care, including external motivators and at least one business model.