A Transparency and Accountability Framework for High-Value Inpatient Nursing Care

The Reward for Performance Reporting Model and the Reward for Performance Improvement Model extend transparency and accountability to the nursing profession.

Transparency and accountability are strategic concepts that can be used to hold health care providers responsible for their performance. Transparency and accountability policies incorporate financial rewards for strong performance. Within the broader health care system, a transparency and accountability infrastructure—consisting of trade and professional organizations—devises performance measures and establishes the basis for performance-based payment programs.

There are approximately 2.9 million registered nurses (RNs) and nearly 1 million active licensed practical nurses (LPNs) currently working in the U.S. health care system. Nurses work in every health care setting and have frequent contact with patients. Presently the health care system’s transparency and accountability infrastructure, known as the “quality enterprise,” excludes the nursing profession.

This article establishes a transparency and accountability framework for the nursing profession. The authors discuss: the costs of developing performance measures; previous national efforts to establish those measures; the limited public reporting of nursing care quality; the reliability of patient-level versus administrative data; and value-based purchasing.

Key Findings:

  • Six national health care priorities, established in 2008 by the National Priorities Partnership, are a starting point for nursing specific priorities and goals.
  • New designs of performance measures for nursing care can either be unique measures that are nursing specific or adapted measures of related health care outcomes.

Transparency and accountability create higher-value health care by improving care and reducing costs. This article introduces a transparency and accountability framework for the nursing profession that will create higher-value inpatient nursing care.