DNP Role Development for Doctoral Advanced Nursing Practice, Second Edition

208 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE

■ PROGRAM EVALUATION

Program evaluation is a central component to the NQS and AHRQ’s QI process. This
component of an organization’s QI plan often focuses on improving the quality, cred-
ibility, and usefulness of the program as well as ascertaining whether the program’s
resources are being used efficiently. These data are therefore useful in guiding resource
allocation as well as in identifying how to improve program outcomes. There is no spe-
cific standard for defining a program; however, the term often includes organizational
activities, services, projects, functions, and policies. The term program evaluation is a
broad term indicating a systematic approach to evaluating a program’s performance in
relationship to achieving its goals, objectives, and desired (and undesired) outcomes
(CDC, 2012). This approach typically employs a variety of data collection methods
based on specific questions about a program’s effectiveness and efficiency. The scope of
the evaluation can include the entire program, a program component, or individual pro-
gram parts with the selection of scope depending on the desired outcome of the evalu-
ation. Program evaluation results are used to assess its effectiveness in meeting defined
goals and desired outcomes. Furthermore, results increasingly are used as evidence of
overall organizational effectiveness.
Performance measurement and reporting is an increasingly important QI com-
ponent and is closely related to program evaluation. Performance measurement is the
systematic, ongoing monitoring and reporting of QIs that have been identified as cen-
tral to the achievement of the organization’s goals. AHRQ’s inpatient quality indicator

TABLE 8.3 AHRQ’s Inpatient Quality Indicators

Volume indicators Indirect, measures of quality based on counts of admissions

during which certain intensive, high- technology, or highly

complex procedures were performed

Mortality indicators for

inpatient procedures

Procedures for which mortality has been shown to vary across

institutions and for which there is evidence that high mortality

may be associated with poorer quality

Mortality indicators for

inpatient conditions

Conditions for which mortality has been shown to vary

substantially across institutions and for which evidence suggests

that high mortality may be associated with deficiencies in the

quality of care

Utilization indicators Procedures whose use varies significantly across hospitals and

for which questions have been raised about overuse, underuse, or

misuse

TABLE 8.4 AHRQ’s Patient Safety Indicators

Provider- level indicators Potentially preventable complications for patients who received

their initial care and the complication of care within the same

hospitalization

Area- level indicators All cases of potentially preventable complications that occur for a

given population (metropolitan area, county, health plan), either

during hospitalization or in a subsequent hospitalization