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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.