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150 unit 2 | Working Within the Organization CikguOnline
Also having a multifaceted mission, the physical plant, number of patient beds per nurse,
renowned Robert Wood Johnson Foundation credentialing of service providers, and other
(RWJF) serves multiple missions and seeks to standards for each department. This system of
improve health and health care for all Americans. evaluation has given way to a more process- and
RWJF’s success comes from leveraging partner- outcome-focused model: CQI. Today, the JC
ships and its endowment to “building evidence and accredits more than 19,000 health-care organiza-
producing, synthesizing and distributing knowl- tions. Evaluation of nursing services is an impor-
edge, new ideas and expertise” (RWJF, 2008) in tant part of the accreditation. JC–accredited
eight program areas. RWJF is responsible for agencies are measured against national standards
sucessfully funded projects and research that set by health-care professionals. Hospitals,
improve quality and safety for all Americans. health-care networks, long-term care facilities,
The Leapfrog Group is a nonprofit organiza- ambulatory care centers, home health agencies,
tion interested in improving safety, quality, and behavioral health-care facilities, and clinical
affordability of health care through incentives and laboratories are among the organizations seeking
rewards to those who use and pay for health care JC accreditation. Although accreditation by the
(Leapfrog Group, 2007). With a focus on reducing JC is voluntary, Medicare and Medicaid reim-
preventable medical mistakes, the Leapfrog Group bursement cannot be sought by organizations not
touted their benefits to improve safety and quality accredited by JCAHO.
to consumers and business owners with three leaps:
(a) improve transparency by reporting hospital Integrating Initiatives and
survey results addressing quality and safety indica- Evidenced-Based
tors; (b) incentivize better quality and safety Practices Into Patient Care
performance; and (c) collaborate with other orga- As you familiarize yourself with each of these
nizations to improve quality and safety. To date, organizations and their respective initiatives, con-
there is limited evidence that the Leapfrog Group sider how they will affect the management of
has effectively improved quality or safety. patient care. Your responsibility as a professional
Limitations to success may be in part because too RN is to acknowledge their presence, understand
few hospitals have participated in the surveys and and value their importance, and participate in your
too few consumers have used the available infor- facility-adopted initiatives and evidence-based
mation to make health decisions; however, there is practices.Additionally,as a leader and manager,you
an indication that, with time, participation could will be expected to drive changes based upon
improve with adjustments in strategy by the endeavors of many of these organizations, agencies,
Leapfrog Group (Galvin, Delbanco, Milstein, & and initiatives ensuring that quality and safety con-
Belden, 2005). tinue to improve.

Quality Organizations Health-Care System Reform
Each of the quality organizations strives to improve Eighty-two percent of Americans believe the U.S.
system-wide quality for Americans through a vari- health-care system is in need of either fundamental
ety of programs and methods. change or complete rebuilding (How, Shih, Lau,
The National Committee for Quality Assurance & Shoen, 2008). Americans want leadership to
(NCQA) was established in 1990 to accredit health address quality, cost, coverage, and access. The
plans and certify organizations. Its success in sup- debate rests on how best to achieve necessary
porting quality and safety resides in its Health reform.
Effectiveness Data and Information Set (HEDIS). The IOM report proposed five core compe-
Over 90% of U.S. health plans use HEDIS to tencies (Box 10-10) in which all health-care
measure performance. HEDIS allows for con- professionals will need to be effective as providers
sumers and employers to evaluate health plans and leaders in the 21st-century health-care
using data from HEDIS as a report card of the system.
plan’s success. By integrating these competencies into
JC was established in 1951 with a focus on 21st-century health profession education, you can
structural measures of quality, assessment of the begin to support health-care reform while managing