Reply to discussion- Nicole

Quality of Care

As the role of advanced nurse practitioners continues to increase in providing care to patients who are hospitalized, the necessity of measuring and monitoring the impact of their care on outcomes of patients and quality of care increases as an aspect of performance evaluation (Quatrara & Dale Shaw, 2017). This paper purposes some of the outcome measures that are currently in use.

• Effectiveness of Care

This metric looks into the NP's compliance with the guidelines of best practice and the achieved outcomes, such as reduced rates of readmission. The best patient outcomes can only be achieved by keeping the best practice guidelines up-to-date, given the increasing technological changes in healthcare. Tracking of compliance of an APN with the given guidelines is very critical. This also goes for monitoring of treatment outcomes and alerting the NPs when a review of the guidelines needs to be done (Quatrara & Dale Shaw, 2017).

• Readmissions

This is a very significant outcome measure following hospitalization, which proves to be very costly. The performance of how the NPs reduce readmissions should be evaluated to enhance the timeliness and accuracy of data for making informed decisions (Quatrara & Dale Shaw, 2017).

• Time to consultation or treatment

This is an outcome measure that determines the time delays in giving and receiving services to the patients. An APN should keep this to a minimum by ensuring that each contact of the patient under her care and the physician is properly managed by an efficient patient flow system for scheduling visits and for providing the clients with notifications with regard to the projected waiting times. Also, emergency situations that demand quick intervention can be identified and acted on within the shortest time possible. An APN can reduce the long waiting times for her patients during follow-up visits. Overcrowding of clinical settings results in increased length of stay, mortality rates, and costs of admission (Hsueh & Dorcy, 2016).

• Patients’ experience

Patient-reported outcome measures (PROMs) fall under this category of outcome measure. They are used to evaluate the perception and experiences of patients of their healthcare from APNs. This can help determine the level of patient satisfaction and feedback with regard to what can be improved and to enable a quicker response to the identified issues. Patient experience can be used as a measure of balance for work improvement (Hsueh & Dorcy, 2016).

• Cost of care

Evidence shows that nurse practitioners have continuously demonstrated to be cost-effective providers of high-quality healthcare for the past 50 years (Woo et al., 2017). They offer an enhanced equivalent level of medical care at a reduced cost as compared to the physicians. Studies show that APNs in a physician practice reduced the costs of patient visits by approximately one-third, especially when seeing the patients independently (Woo et al., 2017). The cost-effectiveness of a nurse practitioner is not reliant on actual price setting and is shown in acute, primary, and long-term care settings. These reduced costs also apply to the management of health for the elderly population.

References

Hsueh, M. T. F., & Dorcy, K. S. (2016). Improving Transitions of Care with an Advanced Practice Nurse: A Pilot Study. Clinical Journal of Oncology Nursing, 20(3).

Quatrara, B., & Dale Shaw, K. (2017). Selecting advanced practice nursing outcomes measures. Outcome assessment in advanced practice nursing. New York, NY: Springer Publishing Company, 45-58.

Woo, B. F. Y., Lee, J. X. Y., & San Tam, W. W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health, 15(1), 63.