Nursing & Midwifery Quality Care-Metrics (QCM)-The Journey

• Published in: International journal of integrated care 2017-10, Vol.17 (5), p.441
• Main Author: Kavanagh, Paula
• Format: Article
• Language: English
• Subjects: Intellectual disabilities; Mental health; Midwifery; Nurses; Nursing; Public health
• ISSN: 1568-4156; 1568-4156
• DOI: 10.5334/ijic.3761

Introduction: Care delivery should be safe, patient-centred, compassionate, effective and efficient. Nurses and midwives deliver clinical care around the clock yet measuring this care and its effectiveness has been seen as a deficit. Quality Care-Metrics (QCM) are “a measure of the nursing and midwifery clinical care processes, in healthcare settings in Ireland, aligned to evidenced based standards and agreed through consensus” (1). Measuring the degree to which nurses and midwives adhere to fundamental care processes assures the quality of care delivered to patient and clients.The HSE Office of Nursing and Midwifery Services Director (ONMSD) introduced the care quality measurement in 2015. Currently, more than 80% of acute hospitals, incorporating Midwifery and Children’s Services undertake QCM collection. There is a growing penetration of QCM also in Community Services, public health, mental health, intellectual disability and older person’s settings.Practice Change- The ONMSD provide a national standardised tool to measure nursing and midwifery care processes. This involves developing national standardised Metrics measuring the fundamentals of care and the provision of an electronic data collection and reporting system to facilitate easy data entry and reporting for staff on the ground.Many services collected local audits which lacked consistency between what was measured. QCM is bringing about that change and assisting staff to become more familiar with standards measured each month.Aim and Theory of Change Objectives include to:provide a national standardised approach to care quality and measurement collate and report on all results in a standardised formatprovide real time data to nurses, midwives and their managers on delivery of safe, quality careMeasuring the quality of care is deemed critical by the Health Information and Quality Authority who stated:“Unless we actually measure the quality and safety of care, we cannot determine if improvements are being made” (2).The National Clinical Effectiveness Committee (3) defines a standard as a definable measure against which existing structures, processes or outcomes can be compared. Donebedian (4) highlights structure, process and outcomes as three essential components of measuring good quality care. QCM focuses on ensuring the process measures adhere to standards.Targeted Population and Stakeholders: The project initiated in Donegal and grew expansively into a national initiative. QCM is now integrate