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.

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