Roles, Accountabilities and Culture: Organizational Alignment for Powerful Impact Measurement

Quality outcomes result from implementation of practice changes based on the most reliable evidence, best practices, and professional judgment regarding fit in different settings.  Understanding effectiveness of practice changes requires measurement of impact within the healthcare setting.  Environments that embrace quality initiatives supported by EBP and impact measurement require attention to structures and processes, which facilitate access to current evidence, as well as reliable clinical, financial, human resource, and satisfaction data.  Access alone is inadequate to build robust measurement systems where information is provided regularly to leadership and caregivers charged with using the information to evaluate the effectiveness of their actions.  Organizational cultures where interdisciplinary problem solving, data driven decision making, and continuous improvement are valued by leaders and clinical staff must also be in place.  Accountability for achieving quality outcomes must be hardwired into organizational structures.  Improvement goals must be set and performance data reported on a regular schedule to provide evidence of impact in association with practice changes.  Leadership support of necessary resources and removal of barriers to change will facilitate realization of goals and outcome targets.  Organization leaders have used different frameworks to guide building such environments.  One example of a framework is the fourteen forces of magnetism used by the Magnet Recognition program.  Regardless of the framework used, staff with roles designed to support improvement and measurement of impact, that possess the requisite skills and data analysis tools to measure impact must be in place to support operational staff in understanding the impact of their care.  Examples of roles and accountabilities associated with successful implementation of such environments will be provided.