Importance of quality measures

by | May 28, 2019 | Analysis

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
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Learning Resources
This page contains the Learning Resources for this module. Be sure to scroll down the page to see all of this module’s assigned Learning Resources.
Required Readings
Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

Hain, D., & Fleck, L. M. (2014). Barriers to NP practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2).
Note: Retrieved from the Walden Library databases.

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.

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.
Note: Retrieved from the Walden Library databases. ARTICLE.
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
Note: Retrieved from the Walden Library databases.

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.pdf

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

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.pdf

Discussion: Quality and Cost Measurements
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)
Paper is
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.

Sample Solution

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.


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God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

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