Nurse Leader and Abbott Northwestern Hospital Essay

Performance outcomes primarily reflect the effect of hospital services on patient experience areas, clinical processes, and financial viability. The measures indicate the organizations progress made in patient safety and quality care. They also enable a hospital to determine the changes needed to improve employee engagement and performance finances or customer satisfaction. The management uses outcome measures to identify priority areas for improvement and related drivers to achieve desired performance levels. This paper aims to develop a performance data scorecard and explore ways of improving outcomes that are below national benchmarks as a nurse leader.

Patient Population
The population served are post-op spine and joint (knee and shoulder) surgical patients on the Orthopedic and Spine floor unit at Abbott NorthWestern Hospital (ANWH), Minneapolis, Minnesota. ANWH is a 668-bed teaching hospital founded in 1882 and currently serving over 200,000 post-op patients in Twin Cities and nearby areas (Allina Health, 2020). It is a part of the Allina Health healthcare system and provides varied specialty services, including mental health and addiction treatment, Minneapolis Heart Institute, Orthopedic Institute, and Surgical Services. ANWHs mission is to serve communities through high-quality care, prevention, and restorative health. The population addressed includes patients with post-surgical needs at the unit. The aim is to provide safe, quality care that reflects empathy, respect, and dignity.

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Outcome Measures
Indicator Outcome measure Drivers
Performance Decrease 30-day readmissions to the Orthopedic and Spine Unit Reduced complications that necessitate readmission
Better transition to primary healthcare
High quality of care
Improved outcomes HICAHPS scores
Quality Provide care based on unique post-op patient/family needs Enhanced patient/family participation in care
Timely and appropriate follow-up after an inpatient stay
Decreased length of stay
Patient safety Reduce pressure injuries and fall rates through evidence-based practice (EBP) Enhanced nurse awareness and responsiveness to pressure injuries and falls
Ability to identify high-risk patients
Reduced length of stay
Employee engagement Increasing the number of RNs with Medical-Surgical Nursing and Orthopedic Nurse Certification Enhances employee engagement and retention through career advancement opportunities
Encourages EBP nursing interventions
Necessary Processes
Effective initiatives to reduce readmissions after a knee or shoulder surgery will be help drive the units performance outcome. As a nurse leader, the first necessary processes for achieving this goal is a root-cause analysis to identify risk factors for readmitting patients at the facility based on hospital data. Subsequent collaboration with facility management will ensure a stronger policy to address those predisposing variables, including medical comorbidities (diabetes and obesity), patient age, type of procedure, pain, and infection. These issues account for a majority of post-surgical readmissions and must be minimized.

The necessary process is creating new protocols for and infection control. Again, partnership with specialists orthopedic surgeons and neurosurgeons can help implement measures to minimize the risk. Physician buy-in for the initiatives will be gained by revealing the cost data related to post-op readmissions. Subsequently, readmission rates will be captured to track performance improvements due to the change. Readmissions are losses under the , and therefore, root-cause analysis and new protocols addressing risk factors are necessary processes for the performance goal. Finally, the results will be revealed to hospital management and third-party payers to enhance support for the initiatives.

The goal for this indicator is to decrease surgical-site infection rates, improving the inpatient experience. The nurse leader will include baseline screening as a pre-op routine or intervention to identify patients with a history of , such as . Positive cases will be referred to specialized preoperative treatment before surgery. Additionally, the pre-op admitting nurse will be required to care for the patient throughout the inpatient stay. Minimizing the number of contacts through this isolated treatment fashion can dramatically reduce infection. Hand hygiene protocols and stricter policies at the post-op unit will be necessary for achieving the quality goal. Patient/family education on wound care, including dressing and measures to prevent infection of the surgical site and post-operative pain, will also be implemented. The goal is to foster the patients experience and self-care capacity upon discharge.

Patient Safety
The goal is to reduce the risk of (PIs) and fall rates. The nurse leader will take several interventions to achieve this outcome. Safety protocols for positioning patients or the flip process will be adopted to reduce friction or skin injury during turning. A minimum of two nurses will be involved in patient transfer and changing position in bed to avoid PIs. Additionally, prescribed exercises for post-op patients, including walking, will involve an assistive device or a physical therapist to reduce the fall risk. Based on assessed needs, a rehabilitation nurse will make arrangements for follow-up upon discharge from the unit.

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