Skip to main content

Table 2 Influences on timing and selection of hospital quality improvement activities

From: Chief nursing officers’ perspectives on Medicare’s hospital-acquired conditions non-payment policy: implications for policy design and implementation

Influence

Example

Internal

1. Experience

Surveillance of central line infection rates by unit

2. Resources

a. Material

Lack of bladder scanners, lack of data collection infrastructure for measuring catheter-days

b. Human

Hospital epidemiologist with interest in central line infections

3. Organizational Characteristics

Performance improvement committee of governing board; part of multi-hospital system monitoring performance indicators

External

1. Voluntary/professional

Michigan Keystone, NDNQI*

2. Regulatory

HAC** policy; CMSº core measures, Joint Commission

3. Financial

Non-federal pay for performance (Blue Cross Blue Shield)

  1. *NDNQI = National Dataset of Nursing Quality Indicators.
  2. **HAC = Hospital-acquired Conditions.
  3. ºCMS = Centers for Medicare and Medicaid Services.
Back to article page

Implementation Science

ISSN: 1748-5908