Measuring the Contributions of Nurses to High-Value Health Care

Special Report

Field of Work: Measuring the contributions of nurses to quality health care

Problem Synopsis: Nurses are the single largest group of health care providers and in close proximity to the delivery of patient care. Yet, the critical work nurses provide—especially in inpatient settings—is unseen and undervalued. One reason is that the growing evidence base that quantifies how nursing and nursing interventions affect quality of care and patient outcomes has not been well understood or disseminated.

Synopsis of the Work: In 2001, RWJF provided funding to the Washington-based National Quality Forum (NQF) for the identification and endorsement of a set of standards that would adequately quantify nurses’ contributions to higher-value inpatient care—improvements in the quality of care hospitalized patients receive and efficiencies in the way care is delivered.

Key Results/Findings

After a rigorous consensus process, in 2004, the NQF endorsed 15 national voluntary consensus standards for nursing-sensitive care—referred to as the “NQF–15”—that can be used for performance measurement and public reporting of hospital-level performance in three domains:

  • Patient-centered measures, such as patient falls with injuries
  • Nursing-centered measures, such as smoking-cessation counseling
  • System-centered measures, such as the mix of registered nurses to licensed practical nurses and unlicensed assistive personnel

The revised Implementation Guide for the NQF Endorsed Nursing-Sensitive Care Performance Measures, published in the fall of 2009, includes those measures approved for continued endorsement and reflects updates to the guide because of the comprehensive testing.