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Understanding the Risk Manager's Role

Created Sep 08 2014, 8:00 PM by Lippincott Solutions

Tuesday, September 9, 2014

Do you know the importance of nurse quality managers and how they fit into the healthcare continuum?

A big part of keeping patients happy — aka "patient satisfaction" — is making sure the staff provides the highest quality of care. This applies to not just the nursing team, but to each and every department across the facility, from billing to housekeeping.

Quality care not only benefits patients, the hospital and entire healthcare system reap rewards that are both financial and systematic.

Most facilities have a nurse quality/risk manager on staff. You may know him or her as the person responsible for implementing programs that ensure continuous quality, reduce risks, and comply with federal and state regulations. The nurse quality/risk manager also measures results using quantitative metrics that are known as NDNQI (National Database of Nursing Quality Indicators), which track hospitals’ effectiveness in certain areas that can be adversely affected by poor care quality.

Facilities across the country recently celebrated Healthcare Quality Week, sponsored by the National Association for Healthcare Quality (NAHQ), whose members are all quality/risk managers. The week highlighted the influence of healthcare quality professionals in improving healthcare delivery systems and achieving improved patient care outcomes. 

NAHQ is a professional organization that encourages knowledge sharing and represents healthcare quality in all settings and specialty areas. Founded in 1976, NAHQ has more than 6,000 individual members and 8,000 Certified Professionals in Healthcare Quality (CPHQ). The association’s goal is to promote the continuous improvement of quality in healthcare by providing educational and development opportunities for professionals at all management levels and within all healthcare settings. 
 
Besides positive patient outcomes, why is quality care so important? With Affordable Care Act legislation, hospitals are now getting financial incentives for demonstrating high levels of quality patient care, and conversely are being penalized for low-quality care.
 
Here's an example of a real-world problem, and how the nurse quality/risk manager might handle it. A nurse quality/risk manager discovers data that is showing an alarming trend of increased pressure ulcers in a particular unit or area of the hospital, and reports this to the chief nursing officer (CNO). Recognizing the need to address the issue, the CNO instructs the Director of Education to provide more education on pressure ulcer prevention. The education director then coordinates staff training either by developing his or her own course or using an educational resource to customize accordingly. Staff nurses learn more about pressure ulcer prevention techniques, and hopefully incidents decrease.

What are some examples of best nursing practices your facility has implemented that reduce risk and improve quality?

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