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Disclosures • Conflict of interest > The following members of the Planning Committee and Faculty report no conflict of interest: —Mary G. Harper, PhD, RN-BC, Lead Nurse Planner, subject matter expert (SME) —Judith Bowling, MSN, MHA, RN-BC, Nurse Planner, SME —Joan M. Robinson, MSN, RN, SME —Pam Dickerson, PhD, RN-BC, FAAN, speaker
Successful Completion • View Webinar • Sign online attestation statement verifying completion • Complete online evaluation
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Continuing Nursing Education This continuing nursing education activity was approved by the Georgia Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission On Accreditation. Activity ID: 31727 Contact Hours Awarded: 1.0 Expiration Date: Jan. 21, 2017
Outcome Measures: Capturing Evidence of Success Pamela S. Dickerson, PhD, RN-BC, FAAN Director of Continuing Education, Montana Nurses Association 5
Objectives 1. Differentiate department / provider unit quality outcomes from educational activity evaluation. 2. Explore strategies for creating quality outcome measures for nursing professional development departments.
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Purpose • Participants will develop and measure department / provider unit quality outcomes.
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What Are You Measuring?
Self-Assessment I know how to:
Strong = 3
Moderate = 2
Weak = 1
Conduct a meaningful needs assessment Analyze gaps Determine the desired outcome for an educational activity Measure the outcome of an educational activity Tie the outcome of an educational activity to the overall performance measures for my department
Total Score = 9
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Self-Assessment • My knowledge score is in the range of: 1. 5 - 8 2. 9 -12 3. 13 -15
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Self-Assessment I am confident in my ability to:
Strong = 3
Moderate = 2
Weak = 1
Determine the desired outcome of an educational activity Measure achievement of the desired outcome for an educational activity Develop measurable outcomes for my department Analyze aggregate evaluation data in relation to departmental outcomes Provide evidence to justify the importance of my education department
Total Score =
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Self-Assessment • My “performance in practice” score is in the range of: 1. 5 - 8 2. 9 -12 3. 13 - 15
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Why Do Outcomes Matter? • Evidence related to patient safety • Evidence related to quality of care • Evidence related to life-long learning • Accountability > > > >
To To To To
nurses patients employers the public
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Benefits of Outcomes Evaluation for Providers of Nursing Professional Development • Credibility • Sustainability • Provide evidence to support the value of continuing nursing education • (Read: How to keep your job!) 14
What is an Outcome? • Webster: “A final consequence”, “result” • NPD Scope & Standards, 2010: “something that follows, is the result of, or is the consequence of a project, program, or event” • Outcome Measurement: “The process of observing, describing, and quantifying predefined indicators of outcomes of performance.” 15
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What Do We Mean By “Measurable”? • Webster – Able to be measured; of distinguished importance – SIGNIFICANT • Webster – “Measure” = basis of comparison • Quantifiable
EVIDENCE • Observable
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Department / Provider Unit Outcomes Measures • Outcome: “The impact of structure and process on the organization…and the value/benefit to nursing professional development.” (ANCC, 2013). • Scope and Standards: Standard 6: Evaluation “Synthesizes evaluation data, rends, and expectations to guide decision-making about changes and improvement of all components of NPD practice” (ANA/NNSDO, 2010).
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Why Does Your Department / Provider Unit Exist? •
Single- focused organization:
> Why is continuing education important enough to make it your business? > What does “success” for your organization look like? •
Multi-focused organization:
> Why is continuing education part of what your organization does? > How does continuing education benefit the organization?
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Let’s Look at Your Organization • What is its mission? • What are its goals? • Who are its stakeholders? (Who cares about the organization, its success, and its functions?) 19
Now, Look at Your Department / Provider Unit • What are its goals? • Who are its stakeholders? • How do these goals match those of your organization? (If they don’t, it’s time for some serious reassessment.) 20
Stakeholders: People Who Care > > > >
> > > >
Learners Faculty Department/Provider Unit Nurse Educators & Key Personnel Organizational Personnel —Administration —Finance —Risk Management —Others Community representatives Advisory Committee or Board Stockholders or owners, Board of Directors Others 21
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Time To Reflect I am able to see the connection between the educational activities I develop, the expected outcomes for my department, and the strategic goals for my organization. 1. Not at all 2. To some extent 3. Most of the time 4. Consistently 22
Example • Strategic Goal of Organization: • Become certified as a center of excellence for joint replacement surgery by January of 2016. • Education Department Quality Outcome Measure: • 100% of nurses working in the joint replacement program will practice according to evidence-based standards by the beginning of the 4th quarter of 2015.
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Educational Initiatives • Start with the end in mind: • Are all nurses in the program currently using evidence-based practice standards? > If yes, then why is this an outcome measure? Concentrate your energies somewhere else! > If no, why not?
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Developing Activities to Achieve Measurable Outcomes •
Why are nurses not using evidence-based standards in the care of joint replacement patients? > Too new – still “learning the ropes” > Too “old” – used to doing things in a familiar way > No perceived value – don’t want to invest the time in learning something new > Not enough resources – staffing, equipment, money…. > Not familiar with how to access data about current standards > No support from administration and/or colleagues > Organizational culture focuses on “get it done” – task orientation vs. quality
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Where Is The Gap? • Knowledge – they don’t know what • Skill – they don’t know how • Application in practice – they don’t make it work
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Education Department Action Meet with stakeholders Do a “deep dive” into the needs assessment related to the evidence-based standards Determine the current state and desired state for nursing practice related to each standard Construct a series of educational activities to build knowledge, skill, and ability to apply in practice Build in outcomes measures at each level
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Outcome • What is the desired outcome of our educational intervention? • How will we be able to know when “success” has been achieved? (the gap has been filled – or lessened) A B X Y 28
Outcome Statement • Medical-surgical patients will receive pain management in accordance with TJC recommendations regarding opioid use. • Is this a strong activity outcome statement? > Yes > No 29
Outcome Statement • We know the population – medical-surgical patients • We know the standard – TJC recommendation • We don’t know what “success” looks like – how many patients? What assessment data will be collected? Documented? Is success based on the assessment, the intervention, or the documentation – or all of the above?
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A Stronger Statement • From April 1-14, 2016, 90% of patients on the medicalsurgical unit will receive pain management in accordance with TJC recommendations regarding opioid use. • Previous data is 20% - gap to close is between 20 and 90 • Why this outcome? How does it tie to the mission and values of your organization and the goals of your department?
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Activity Evaluation Options • Intent to change practice • Pre-test / Post-test / Follow-up test • Surveys of managers • Nurse educator observations of practice • Chart reviews • Monitoring of incidents, e.g. medication errors • Other
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Department Outcome Measure Options Sample External Sources of Data National Database for Nursing Quality Indicators: Clinical: falls, pressure ulcers, pain assessments, healthcare-acquired infections, etc. Non-clinical: workforce data, practice environment, etc.
AHRQ: Extensive data base related to health care quality initiatives Centers for Disease Control and Prevention Standards of Practice
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Department Outcome Measure Options Sample Internal Sources of Data: Risk management Quality / Performance Improvement Incident reports Recruitment / Retention Data Finance – cost of care, cost of equipment & supplies, etc. Readmission data
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Organizational Goal • Create and sustain a healthy work environment that serves as a premier place of employment in the State of Health. What are some department / provider unit outcome measures that would support this goal? What educational activities would fit? 35
Healthy Work Environment Focus • Department / Provider Unit Outcomes might include: Nurse turnover rates will decrease from 20% in 2014 to 5% or less in 2016. The number of nurses participating in organizational improvement activities will increase by 30% by the end of 2015. All nurses will identify at least one leadership role they have in the organization by the end of 2015.
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Self-Assessment I know how to:
Strong = 3
Moderate = 2
Weak = 1
Conduct a meaningful needs assessment Analyze gaps Determine the desired outcome for an educational activity Measure the outcome of an educational activity Tie the outcome of an educational activity to the overall performance measures for my department
Your Score =
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Self-Assessment • My knowledge score is in the range of: 1. 5 – 8 2. 9 – 12 3. 13 - 15
The Bottom Line • Evaluation of your provider unit helps you identify strengths, contributions, and areas of opportunity. • Providing evidence of accomplishments of your goals and related outcome measures helps you validate your worth to the organization and the nurses you serve. 39
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Questions / Comments
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For Additional Information: Pam Dickerson, PhD, RN-BC, FAAN
[email protected] [email protected]
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References and Resources •
American Nurses Association and National Nursing Staff Development Organization (2010). Nursing Professional Development Scope and Standards of Practice. Silver Spring, MD; author.
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American Nurses Credentialing Center Commission on Accreditation. (2014). The Importance of Evaluating the Impact of Continuing Nursing Education on Outcomes: Professional Nursing Practice and Patient Care. Silver Spring, MD; author.
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American Nurses Credentialing Center. (2013). Primary Accreditation Manual for Providers and Approvers. Version 3.0. Silver Spring, MD; author.
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American Nurses Credentialing Center Commission on Accreditation. (2012). The Value of Accreditation for Continuing Nursing Education: Quality Education Contributing to Quality Outcomes. Silver Spring, MD; author.
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References and Resources •
Cervero, R. & Gaines, J. (2014). Effectiveness of Continuing Medical Education: Updated Synthesis of Systematic Reviews. Chicago: Accreditation Council for Continuing Medical Education.
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Dickerson, P., & Chappell, K (2012). Purpose, objectives, & outcomes: tying the pieces together. Journal of Continuing Education in Nursing, 43(9), 389-390.
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Institute of Medicine. (2010). Redesigning Continuing Education in the Health Professions. Washington DC; National Academies Press.
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Moore, D.; Green, J.; & Gallis, H. (2009). Achieving the desired results and improved outcomes: integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions 29 (1), 1-15.
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