In Nursing, Accountability Fosters Quality

Michelle Wilson Berger for HealthLeaders Media, July 31, 2012

This article appears in the July 2012 issue of HealthLeaders magazine.

In northeastern Indiana, about 15 miles west of Fort Wayne, sits the 30-bed community hospital Parkview Whitley in Columbia City. Poudre Valley Hospital in Fort Collins, Colo., has 241 beds and more than a dozen patient-care units. And New Jersey's Robert Wood Johnson University Hospital, a 600-bed academic medical center in New Brunswick, has 32 nursing units that vary in size from eight to 47 beds. 

Despite dramatic differences in facility type and community setting, the trio shares one crucial similarity: high-quality nurses. Nursing leadership at each organization takes seriously the notion of holding accountable these caregivers and measuring their success against internal and national standards. The high expectations have paid off, earning them national accolades—Magnet designation from the American Nurses Credentialing Center, American Nurses Association awards, and more—but nurse leaders at all three say the acknowledgment doesn't change the way they practice. Rather, it reinforces the importance of high-quality nursing care—keeping patients satisfied and out of harm's path.

"Patient safety and quality are the most important outcomes that we have here," says Kathy Easter, RN, CCRN, interim director of the Magnet program at Robert Wood Johnson. "Obviously, many of our patients are ill when they're admitted. But we want to make sure they're in a better condition upon discharge than they were on admission."

To make this happen consistently, give nurses a barometer—in the form of metrics and standards—to measure where they stand compared with individuals and units at their hospital and at like institutions. The accountability fosters empowerment, which fosters high-quality care, says Terri Veneziano, MSN, RN, assistant vice president of nursing at Robert Wood Johnson. "We've really driven accountability to the nurses at the bedside. They truly are the ones who have the ability … to impact both positive and negative outcomes for patients."



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