Do Nurses Play a Big Enough Role in Process Improvement?

We recently came across an interesting report from a 2009 issue of Health Affairs titled “The Role of Nurses in Improving Hospital Quality and Efficiency: Real-World Results.” In it, authors Jack Needleman and Susan Hassmiller discuss how “lessons from Magnet program hospitals and hospitals implementing front-line staff-driven performance improvement programs such as Transforming Care at the Bedside illustrate how nurses and staff, supported by leadership, can be actively involved in improving both the quality and the efficiency of hospital care.”

Needleman and Hassmiller assert that hospitals should “take full advantage of nurses’ knowledge and commitment to their patients and institutions—to increase the safety and reliability, patient-centeredness, and efficiency of care.”

To do this, the report says, will “require action both within institutions and by those who measure their quality and pay for their services.”

In addition, the report describes the need to look “upstream from the hospital.” Nursing education “will have to change to prepare new graduates to work in environments where they have responsibility for process improvement.”

One model they describe is that of Clinical Nurse Leaders, “which produces nursing school graduates who can implement outcomes-based practice and quality improvement strategies and create and manage unit-level systems for delivering care.”

Of course this makes great sense. Shouldn’t those on the frontlines of care have a voice in process improvement? And shouldn’t that leadership-level training be introduced early?

No one is more familiar with the challenges that impede improvements in the quality and efficiency of care than nurses. But seeing this report six years after it was written begs the question: To what degree is this happening?

We work with nurses every day, as we introduce the IVEA, and we’re continually impressed by their knowledge and dedication. They’re champions at making do with what they have, but they also know what’s needed to make things better.

We see some evidence that nurses are more involved in process improvement, but we look forward to seeing even more hospitals look to these experts in their own midst for solutions to some of healthcare’s toughest challenges.

Where do you think we are on this issue? Do nurses play a big enough role in quality and efficiency improvement? Do you see nursing students learning the leadership skills they’ll need to initiate and manage change? We welcome your comments.

To learn more about how the IVEA patient mobility solution is improving care and making life better for nurses and patients around the country, please visit and watch our short video.


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