Leadership Competencies in Nursing and Healthcare: Applying Measurement and Performance Improvement Tools

This article discusses the application of measurement and performance improvement tools in nursing and healthcare leadership competencies. It covers the Healthcare Effectiveness Data and Information Set (HEDIS) and comprehensive diabetes care, as well as strategies for adaptive leadership, culture, governance, analytics, evidence-based practices, adoption, and financial alignment. The article also explores quality management of improved programs, including patient-centric care plans and effective services based on scientific knowledge. References are provided for further reading.

1
Assignment
On
Leadership Competencies in Nursing and
Healthcare

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Applying Measurement Tools
Scenario 1
The Healthcare Effectiveness Data and Information Set (HEDIS) is a key tool in assessing the
availability of quality care to the patients.
Comprehensive Diabetes Care is important as high blood glucose if not addressed in an
appropriate manner can lead to various other diseases related to heart, kidney, eyes, nervous
system and premature death is a strong possibility (National diabetes statistics report,2017). To
give comprehensive care and deciding patient centric care program, we documented the medical
records which comprises mainly of following:
Results of ophthalmoscopic exam conducted by eye care professional with date of procedure
which reveals if there are any abnormalities in retina etc.
Nephropathy screening and urine test results for detection of diabetic nephropathy, renal
diseases, renal deficiencies and dysfunction, protein/creatinine ratio with a note of any
prescriptions if received by the patients earlier (Murphy D et al., 2016).
HbA1c Testing results of patients along with date and control value. This assessment is for
patients of age group 18-75 with diabetes (Type 1 and Type 2) (Mayer et al., 2012).
 HbA1c Control (<8%)
 HbA1c Control (<7%) (For some selected patients based on other medical conditions).
 HbA1c Poor Control (>9%)
Records of Blood pressure of the patients measured at regular intervals, taking the recent BP
level to see if it is compliant with the standards.
Based on the patient’s progress and response to the treatment, revision in diagnosis is done and
documented for further use.
Documentation of each patient includes reason for the encounter and relevant history, physical
examination findings and prior diagnostics reports. Based on medical charts, we have designed
care plan for the patients.

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Applying Performance Improvement Tools
Scenario 2
Strategies and interventions tried in our unit were partially effective in creating a sustainable
change in the unit. The leadership is confident that the trend of improvement will continue in
future and therefore decided to celebrate the outcomes to create a positive environment for all of
us.
To improve healthcare quality and provide affordable services to the patients in our nursing
home, essentials such as adaptive leadership, culture, governance, analytics, evidence and
consensus-based practices, adoption and financial alignment were taken in consideration.
Adaptive leadership – Staff may have the ability to make continuous improvements, but
individual efforts require the support of leadership and adaptive learning culture to make changes
as per the changing technology.
Analytics are important to keep a track of improvement outcomes. In the lifecycle of
improvement process where our nursing unit stands and what has been done should be measured
to ensure we are moving in right direction.
Evidence and Consensus based practices should be made the foundation of the initiatives to
improve further, automated ways are required to measure the outcomes and make changes in the
strategies accordingly.
Adoption of new strategies by nursing unit is important and for this purpose we need to train our
staff to make them understand why we are doing this and what are their responsibilities to ensure
the required outcome is achieved.
Financial alignment of all the departments in the nursing unit is necessary to ensure minimal
wastage, no clinical variations and smooth operational efficiency.
Implementation of the improved programs required efforts and lack of guidance to certain extent
made the success rate a little lower than expected. With better implementation strategies, we can
predict a better result in future.
Quality management of improved programs included:
Patient-centric care plan – Plan to take care of patient completely depends on individual
preferences, needs and values.
Effective services based on scientific knowledge are being provided in our nursing unit to the
patients who are in need and not to those who could not be benefitted by it. We can say underuse
and misuse both are being refrained.

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By keeping an account of the progress of the patient because of the treatment and care plan, we
are ensuring any possible harm or side effect could be avoided (Tschannen et al., 2008).
We need to streamline our departments in a better way to further improve the timeliness of
attending the patients and reducing the wait time of processes.
Incentives are given to the staff so that they can feel motivated in providing high quality
services.
We can improve further by providing medicine consultation online or through telephonic
conversation once the person is discharged.
System cannot reap the benefits of tools like flow diagrams, run charts, Gantt charts, scatter plots
without skilled resources, training people and designing a framework for establishing the
practices.
The end goal of our nursing unit is to improve patient health and experiences and we believe in
making efforts to transform the industry into one dedicated to quality.

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References
Centers for Disease Control and Prevention (CDC). 2017. “National diabetes statistics report:
estimates of diabetes and its burden in the United States, 2017.” Atlanta, GA: U.S.
Department of Health and Human Services. Retrieved from
https://www.cdc.gov/diabetes/data/statistics-report/index.html
Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J….Wagenknecht L. Incidence trends of type
1 and type 2 diabetes among youths, 2002–2012. N Engl J Med. 2017; 376:1419–1429.
Murphy D, McCulloch CE, Lin F, Banerjee T, Bragg-Gresham, Eberhardt MS...Hsu CY. Trends
in prevalence of chronic kidney disease in the United States. Ann Intern Med. 2016;
165:473–481.
Tschannen D, Keenan G, Yakel E, Mandeville M. HANDS: A Nursing-Oriented Standard for
Documenting and Communicating the Interdisciplinary Plan of Care in the EHR to
Improve Safety, 2008.