How Transparency and Accountability Policy Directions Could Reflect the Contributions of Hospital Nurses

Mounting health care costs, misaligned reimbursement systems and suboptimal quality have prompted employers, health care purchasers and health policy-makers to call for the creation of performance measures and transparency in reporting provider performance. More recently, experts have started to use those performance measures as the basis for incentive programs such as "pay-for-performance" initiatives that reward high-performing health care providers.

The purpose of this project, according to Project Director Ellen Kurtzman, RN, MPH, FAAN, at George Washington University Medical Center, "was to better understand how transparency and accountability policy directions could reflect the contributions of hospital nurses in more direct and meaningful ways."

Kurtzman and her research team wrote nine articles published in peer-reviewed journals as well as three reports. In "The Contribution of Nursing to High-Value Inpatient Care," in Policy, Politics, & Nursing Practice, they concluded that there are significant gaps in the evidence base regarding the relationship between nursing and value.

Key Results

Researchers proposed a framework for a system to measure, report and reward nursing's contributions to quality, safety and value. This framework includes 22 recommendations in the areas of priority setting, performance measurement, public reporting, data quality and availability, and rewards and incentives.

An article published in Nursing Economics, "A Transparency and Accountability Framework for High Value Inpatient Nursing Care," describes the framework.