Who owns the quality measure and patient outcome scores in your hospital? Most hospitals have quality, safety, and infection prevention professionals devoted solely to these statistics and ways to improve them.
All their efforts are meaningless unless nurses and other clinical staff are engaged in the process. Too often, they are not. Most staff nurses don't know what value-based purchasing is or why they should care about it. All they know is that when Administration or "Quality" has a new scheme it will take nurses more time to do their jobs.
Nurses may fully support the changes because they will benefit patients, but they don't own them and they don't own those scores.
As the people who actually touch patients, all members of the nursing staff need to feel directly responsible for patient safety. Quality improvement becomes one more meaningless directive from "above" unless nurses feel engaged in the process, involved in the plans, and accountable for the results.
"Culture eats strategy for lunch," says Mary J. Voutt-Goos, MSN, RN, CCRN, director, Patient Safety Initiatives and Clinical Care Design at Henry Ford Health System in Detroit. "If frontline staff aren't in agreement and actively engaged in the process, it won't happen. Top-down approaches to culture change are typically unsuccessful."
This is one reason why scores can start creeping downward after a successful quality improvement effort has come and gone. If nurses aren't engaged in the process, they have less inclination to remain on a directed path.