Outcomes Demonstration

(Posted on 6/5/09) Our thanks to Professional Issues Committee Chair, Andrea Kline, MS, RN, CPNP-AC/PC, FCCM for providing the answer to this question.

Question:  I work in an inpatient setting with a Pediatric Surgery Team and cannot bill for most of my services since the charges are often bundled into one fee for the patient. How can I document outcomes associated with my practice since I am limited in demonstrating financial outcomes?

Answer:  Documenting outcomes of practice have become critical in order to demonstrate the high quality and cost effective care that NPs provide. There are several ways that your contributions can be tracked and demonstrated. Development and implementation of quality improvement initiatives such as clinical pathway development, evidence-based practice protocols, best-practice initiatives and engagement in clinical research can be used to demonstrate NP outcomes. Specific examples of quality indicator outcomes measures can include ventilator associated pneumonia rates, catheter related blood stream infection rates, health care costs, patient and family satisfaction, length of stay, readmission rates and blood glucose controls. Factors to be considered when documenting outcomes associated with NP practice include identifying which components of the NP role affect specific outcomes, the feasibility in measuring that outcome(s), and whether or not that outcome can be associated specifically with the impact of the NP. No one set of indicators can be monitored by all NPs; these should be tailored to the NPs specific practice area.

Kleinpell, R, & Gawlinski, A. (2005). Assessing outcomes in advanced practice nursing practice. The use of quality indicators and evidence based practice. AACN Clinical Issues, 16(1), 43-57.