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Nurses in the Process of Quality Improvement


The issue of quality is one of the leading concerns in healthcare. Quality improvement should become a continuous intervention to provide better patient outcomes and increased safety. However, quality improvement usually involves many stakeholders and demands funding (Sollecito & Johnson, 2013). Primary care is a rapidly changing sector and is frequently in the focus of improvement interventions. One of the important changes is the introduction of organizational focus in addition to educational one because medical education and continuous training by themselves do not have the potential for change (Sollecito & Johnson, 2013). The current paper discloses the role of nurses in the process of quality improvement, focuses on the significance of the transparency of change, and touches the financial side of the improvement interventions.

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Nurses’ Roles and Responsibilities

In the process of quality improvement of primary care, nurses have specific roles and responsibilities. For example, they are involved in interventions aimed at meeting and maintaining quality outcomes, following the standards of practice, performance measures, and the use of competencies. As for the necessary organizational processes, nurses can be involved in keeping registries of patients with chronic conditions (Sollecito & Johnson, 2013). One of the opportunities to improve this work is the use of IT for healthcare which helps to optimize these registries (Institute of Medicine, 2011). Also, Johnson, Miller, and Horowitz (2008) claim that nurses can contribute to better care for patients through the improvement of the system of care. For example, nurses are trained to be able to use their skills and competencies, follow the existing standards, and contribute to their improvement.

The Importance of Transparency

In every change process, transparency is a leading concern. Every stakeholder should be aware of the course of quality improvement and participate in the change process. It is particularly important for continuous quality improvement because it allows seeing the progress (Sollecito & Johnson, 2013). Usually, the process of quality improvement involves the public healthcare system as a whole, public health organizations, local health agencies, and the state health agency. Moreover, insurance companies and citizens become participants in the change process. Consequently, communication between these stakeholders, mutual control, and publication of results provide the necessary transparency.

The CMS Position on Financial Reimbursement for “Never Events”

“Never events” include medical errors that should not happen. At present, never events in healthcare include 7 categories such as “surgical, product or device, patient protection, care management, environmental, radiologic, and criminal” which comprise 29 events (“Never events,” 2017, para. 1). Health agencies treat these events differently. Centers for Medicare and Medicaid Services (CMS), which is included in the Department of Health and Human Services, is known for its nonpayment policy about these never events (Phillips, 2015). The investigation on the basis of the National Database of Nursing Quality Indicators data proves the reduction of never events rates due to the non-payment policy. Instead of providing financial coverage of medical mistakes, CMS supports prevention strategies that are likely to be more effective.


On the whole, quality improvement should be the concern of every professional involved in the healthcare system. Significant improvement is possible due to the united efforts of different stakeholders. Thus, governmental and public organizations, healthcare facilities, and their staff should collaborate to achieve improved safety and better patient outcomes. It can be done through the introduction of organizational change and continuous improvement together with the constant professional growth of healthcare professionals.


Johnson, J.K., Miller, S.H., & Horowitz, S.D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work. Web.

Institute of Medicine. (2011). Health IT and patient safety: Building safer systems for better care. Web.

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Never events. (2017). Web.

Phillips, D. (2015). Medicare’s nonpayment policy may be working. Medscape. Web.

Sollecito, W. A., & Johnson, J. K. (2013). Continuous quality improvement in health care (4th ed.). Burlington, MA: Jones & Bartlett Learning.

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StudyCorgi. "Nurses in the Process of Quality Improvement." December 29, 2020.


StudyCorgi. 2020. "Nurses in the Process of Quality Improvement." December 29, 2020.


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