Quality Improvement There are several key quality improvement activities in which my hospital participates. The first is the use of bedside shift reports. One of the reasons this improves quality is that it means that the nurse coming into a shift receives this report from the previous shift, and learns about the different things that happened. So there is more information that is being transferred between nurses, and that allows them to make better decisions, more accurate decisions and overall decisions that are better for the patient. This enhanced knowledge transfer has proven to be effective in a number of different studies.

Additionally, administrators measure outcomes, and relate those to the actions that people take. What this means is when a procedure has changed, the outcomes are measured and then evaluated against the past performance. If the new technique delivers better results, they keep it and if the new technique is not as effective then it can be removed from the operating procedure. Another quality improvement initiative is training that nurses receive on different things that are important to the job. This training helps with the constant process of improvement. A third thing that is done to help improve quality is that there are occasionally quality meetings among managers. Sometimes others are brought into these meetings. The objective is really just to identify where there are problems with quality, and to brainstorm different ways for how those things can be fixed or improvements implemented.

2. I do participate in some of...

I contribute to the bedside shift reports. I was in favor of this initiative and I have worked to make sure it is implemented smoothly. For me, this is important to make a positive contribution to communication in the hospital, especially in a way that delivers enhanced patient care.
I am able to make some contributions to things like meetings, and I take some of the training as well. But I also feel that I have a role where I have to vow to learn more for myself about quality. I need to take the time to understand what quality is, how it is measured and what sorts of things I can do to improve quality and the overall quality mindset at my hospital. I am not in a position where I can take a leadership role in quality -- there are things like level of authority that matter when actually trying to implement something. But to the extent that I am asked to be knowledgeable and to make a contribution, I make myself available for just that.

3. There are a few different factors that can affect a nurse's involvement in quality improvement. The first is the organizational structure at the hospital. There are different levels of empowerment that exist -- in some institutions nurses are handed more responsibility and therefore are…