Health Care Quality Indicators (Nursing)

00:00 Welcome back, everyone.

00:02 Measuring performance is central to improving the quality of health care.

00:06 Performance measurements conveys the message of importance.

00:10 That is what is important is measured, while what is not measured is considered less important by many.

00:16 Measures of health care quality that make use of readily available hospital inpatient administrative data are known as quality indicators.

00:24 Quality indicators are standardized evidence-based measures of health care quality that can be used with readily available data to measure and track clinical performance and outcomes.

00:35 The quality indicators developed and maintained by the Agency for Healthcare Research and Quality are one response to the need for multidimensional, accessible quality measures that can be used to gauge performance in health care.

00:50 The QIs are evidence-based and can be used to identify variations in the quality of care provided on both an inpatient and outpatient basis.

01:00 These measures are currently organized into four modules: the prevention of quality indicators, inpatient quality indicators, patient safety indicators, and pediatric quality indicators.

01:16 Prevention quality indicators identify ambulatory care sensitive conditions defined as conditions for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease.

01:32 PQI examples include: diabetes long-term complication admission rate, chronic obstructive pulmonary disease admission rates, hypertension admission rates, congestive heart failure admission rates, low birth weight rate, and dehydration admission rate.

01:52 The PQIs help answer questions such as: Does the admission rate for diabetes complications in my community suggest a problem in the provision of appropriate outpatient care to this population? Also, how does the admission rate for congestive heart failure vary over time and from one region of the country to another? Inpatient quality indicators provide information about the quality of medical care delivered in a hospital and represents the state of the art in measuring the quality of hospital care using inpatient administrative data.

02:23 The IQIs include measures in the areas of inpatient mortality, utilization of procedures for which there are questions of overuse, underuse, or misuse.

02:35 Volume of procedures for which there is evidence that a higher volume is associated with lower mortality.

02:42 There are four different levels of inpatient quality indicators and they are provider-level volume indicators, mortality indicators for inpatient procedures, mortality indicators for impatient conditions, and utilization indicators.

03:00 Patient safety indicators provides information on potentially avoidable safety events that represent opportunities for improvement in the delivery of care.

03:09 More specifically, they focus on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth.

03:17 Patient safety indicators can be used to help hospitals assess the incidence of adverse events and in-hospital complications, identify issues that might need further study.

03:29 Some PSI examples include: a pressure ulcer rate, post-operative sepsis rate, birth trauma rate-injury to neonates, postoperative respiratory failure rate.

03:43 A pediatric quality indicator reflects the quality of care for children younger than 17 years of age and neonates inside hospitals, and identify potentially avoidable hospitalization among children.

03:55 PDIs examples include: pediatric heart surgery mortality, postoperative respiratory failure, postoperative sepsis, asthma admission rates, and gastroenteritis admission rates.

04:10 Current uses for QI include: quality improvement, Public Reporting and Paper Performance, research.

04:19 Quality indicators are an important part of the equation when it comes to providing the best care possible.

04:24 But measuring these indicators is not simply good science, it's an ethical imperative.

04:30 Nursing foundational principles and guidelines state that as a profession, nursing has a responsibility to measure, evaluate, and improve the quality of nursing practice.

04:41 So when thinking of everything that we've discussed today, I'd like for you to consider this question.

04:46 What are the four AHRQ quality indicators? They are prevention quality indicators, inpatient quality indicators, patient safety indicators, and finally, pediatric quality indicators.

05:07 I hope you've enjoyed today's video on Quality Indicators.

05:10 Thanks so much for watching.