would be involved in implementing the innovation and outcome measure-
ments. Utilizing an interdisciplinary approach including nursing, education,
ancillary support services, and quality improvement allows for incorporation
of different viewpoints and knowledge. It may also result in recommenda-
tion of new outcomes that were not previously considered. The creation of
interdisciplinary relationships in the formulation and approval of policies
and protocols is required to achieve American Nurses Credentialing Center
(ANCC) Magnet Recognition (ANCC, 2017).
Advanced practice nurses (APNs) are integral members of interdisciplin-
ary teams. The APN has expert clinical knowledge about rapidly occurring
changes in the healthcare environment. APNs are familiar with institutional
data and are able to assist with comparison to national benchmarks. APNs
can assist with selecting realistic outcomes. An outcome that is realistic has a
base definition that is true to life (Minnick, 2009). For example, selecting an
outcome such as “improved quality of life in heart failure patients” is vague
and has a multitude of meanings dependent upon the individual and the
severity of the associated disease condition. People with slight limitation of
physical activities might have a different perception of quality of life than do
individuals who are unable to carry out physical activities without discom-
fort or symptoms at rest. Therefore, the vaguely written outcome cannot be
realistically evaluated. APNs can assist to narrow the focus, thus making an
outcome more measurable.
Staff nurses may be involved at several different levels during outcome selec-
tion and subsequent measurements. Nurses are familiar with the continuous
quality improvement (CQI) process through participation with internal quality
improvement measures. Staff nurses are often members of the interdisciplinary
team involved in protocol development. They frequently provide insightful
suggestions about approaches that can be used in the clinical setting to obtain
outcome measurements. Staff nurses can identify patients who meet criteria for
inclusion in the protocol. They can also collect data such as reviewing charts
for compliance in documentation.Organizational Priorities
A second consideration is selecting outcomes that address
organizational priorities (Burston, Chaboyer, & Gillespie,
2013). Sometimes outcomes can be linked to the mission
of the healthcare organization. For example, a faith-based
hospital may focus attention on ensuring that all patients
receive a spiritual assessment. Organizations may also use
outcomes to evaluate specific areas that need improvement.
CQI activities are an evaluation of existing practices thatKEY TERM
continuous quality
improvement:
A participatory
process involving
indicators that
measure qualityFYI
Choosing outcomes that appropriately fit an
innovation is vital. Outcomes should be con-
sidered for their significance and scope and
should be measured using specific quantita-
tive criteria, called indicators. The four major
factors to consider are patient populations,
organizational priorities, mandated reporting,
and team selection.476 CHAPTER 18 Evaluating Outcomes of Innovations