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Learning Objective 1: Describe how nursing leadership can mobilize interdisciplinary professionals to build community capacity and facilitate system-wide change through quality improvement practices that address healthcare disparities.
Learning Objective 2: Define the rights of persons with intellectual / developmental disabilities to self-determination and informed consent in healthcare decision-making, demonstrating quality improvement as a justice enterprise.
Facilitated by nurses, representatives from service providers, acute care facilities, outpatient clinics, and directors and staff from group residential homes met to discuss responsibilities, obligations, and goals. Current processes were reviewed for obtaining family /next-of-kin information and for identifying legitimate decision making authority in accordance with legal statutes and codes. Revisions were made to existing documents and procedures with the goal of ensuring - to the best of our collective abilities - that this special population be afforded the opportunity to have their preferences for medical treatment respected, whether communicated directly by the individual or on their behalf by a legitimate surrogate or proxy.
Using research methodologies meeting institutional policies and compliance standards defined by the Health Information Portability and Accountability Act [HIPAA] a records review was conducted to evaluate intervention effectiveness. Results demonstrated the value of interdisciplinary collaboration for more effective and safer care, and for meeting the justice considerations inherent in the definition of quality to treat similarly situated patients the same [Donebedian, 1980].