Basic, Intermediate, & Advanced Quality Improvement Resources

The areas below are categorized (some overlapping) into basic, intermediate, and advanced, for ease of locating the desired quality improvement resources.

Basic Quality Information Level

VA Patient Safety Website is an excellent resource for those seeking to understand the variety of tools used for performance improvement.NCPS
Level of quality improvement information: Basic.

Agency for Healthcare Research and Policy (AHRQ): Patient Safety Network introduces patient safety initiatives. It is an excellent resource for those who are in the process of understanding and/or conducting research related to any of the current inpatient safety initiatives. Links are also available to research, tools, quality measurement, and other quality related information.
Level of quality improvement information: Basic.

The Joint Commission (TJC) Public Reporting for the Joint Commission provides reports for all TJC Accredited Health Care Organizations, and those participating in TJC Certification Programs. Public access to this site allows viewers to see performance measurement information on ANY Health Care Organizations participating in the TJC programs.
Level of quality improvement information: Basic.

Hospital Compare Consumer provides public information on specific care measured in hospitals registered for Medicare/Medicaid reimbursement. Information provided includes clinical process and outcome measures on AMI, Pneumonia, Heart Failure, Surgical Care, Patient Satisfaction, and volume/payment data such as Pay for Performance programs.
Level of quality improvement information: Basic.

Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), along with the Hospital Quality Alliance (HQA). This site is an excellent starting place to learn how CMS measures hospital quality. This section provides links to the Hospital Compare Website, hospital historical data (through Access databases), and Hospital Care Quality Information from the Consumer Perspective (HCAHPS) information.
Level of quality improvement information: Basic.

National Information Center on Health Services Research and Health Care Technology provides access to databases to enable a quick search for the evidence on a particular topic such as central line associated bloodstream infections.

It is the information center of the National Library of Medicine (NLM) that works with the Agency for Healthcare Quality and Research to make the results of health service research, including national practice guidelines and technology assessments, readily available to healthcare professionals. This is a single website that lists resources from multiple NLM program areas.

There are direct links to several public databases including PubMed, MedLine, MedLine Plus, MeSH, and all NLM databases.
Level of quality improvement information: Basic to Advanced.

Consumer Assessment of HealthCare Providers and Systems - This site provides surveys and quality performance improvement tools to advance patient centered care.
Level of quality improvement information: Basic.


Basic & Intermediate Quality Information Levels

Cause Mapping - Root Cause Analysis: Medicare Hospital-Acquired Conditions Website describes cause mapping and root cause analysis processes to help in understanding ways to identify and plan to prevent root causes of patient incidents. It contains excellent free tools. Additional resources are available for purchase.
Level of quality improvement information: Basic & Intermediate.

"NDNQI": National Database of Nursing Quality Indicators encourages membership in order to gain full access, however, the site offers great deal of free information, support and quality performance tools. Specifically, it is an excellent resource for pressure ulcer prevention and falls prevention.
Level of quality improvement information: Basic & Intermediate.


Basic, Intermediate, & Advanced Quality Information Levels

The Joint Commission provides information about quality safety tools on core and non-core measures, standards, and National Patient Safety Goals. Links include information on Performance Measures, Standards, Accountability Measures, two Specifications Manuals on data collection and quality reporting, and links to a Wiki Healthcare question and answer resource.

Examples of Quality measure tools included are: Sentinel Event Data and Root Cause Analysis. There is also access to a Topic Library Resource. Available information for the public on Health Care Organization Accreditation, Disease Specific Certification, Other Certification programs, The Joint Commission Resources, a network of free information for quality programs, and information on The Joint Commission International are also available.
Level of quality improvement information: Basic, Intermediate, & Advanced.

Institute for Healthcare Improvement focuses on improving safety by assisting organizations to test innovative ideas, share, and adopt best practices. The site includes a Knowledge Center of resources on the IHI Model for Improvement, performance improvement tools, change ideas, measures, case studies, presentation and publications, including audios and videos.

There are IHI educational programs offered, both learning and training opportunities. There are User Communities for group user communication forum. The site may be explored by interest to access information on specific areas for quality/performance improvement such falls prevention, catheter associated UTI, etc.

There are multiple real-life improvement stories from healthcare organizations around the nation that medical-surgical nurses can relate to. Searches can be narrowed to the medical-surgical care setting which highlights topics centered on Transforming Care at the Bedside. In addition, the IHI website supports organizations as they conduct performance/quality improvement initiatives, including tracking online and publishing success stories. Free registration is required in order for users to gain full access to the resources.
Level of quality improvement information: Basic, Intermediate, & Advanced.

Department of Human and health Services, Office of Healthcare Quality (OHQ) is a national website established by the Assistant Secretary for Health to lead and coordinate initiatives which improve the national quality of healthcare and public health. One key area is the Healthcare Associated Infections Prevention Initiative. There is a link to the Action Plan to Prevent HAIs - the roadmap for acute care hospitals to reduce and prevent infections. Med-surg nurses will have access to the national guidelines to assess the performance of their hospitals with regards to the prevention of HAIs, as well as adopt the recommendations for improvement. There is also a link to the Partnership for Patients which seeks to improve the quality, safety, and affordability of all Americans.
Level of quality improvement information: Basic, Intermediate, & Advanced.

Institute of Medicine - The Institute of Medicine site offers a wealth of information related to health care quality. Of particular interest is the section entitled: Quality & Patient Safety. This section provides a brief description of a current quality related health topic. A topic of interest may be clicked on to obtain an article with more details and a free PDF report about. Examples of topics relevant to medical/surgical nurses include: Adverse Effects of Vaccines, Medical Devices, and Health Information Technology and Patient Safety.

The free site information is very informative. Additional information and reports found on this site are the Future of Nursing, Crossing the Quality Chasm: A New Health Care System for the 21st Century. A Reports section contains all of the IOM reports since 1998 listed in reverse chronological order.
Level of quality improvement information: Basic, Intermediate, & Advanced.

AHRQ Innovations Exchange - The focus of the site is innovations and tools to improve quality and reduce health care disparities. Visitors to this site may search broad topics or may narrow a search by topics. Broad topic examples are disease or clinical category, patient care process, setting of care, quality tool topics. Under patient care process there are a number of articles/brief reports such as: Alerts, Standing Orders, Care Pathways Boost Quality Care for Pneumonia, Heart Attack, and Heart Failure.
Level of quality improvement information: Basic, Intermediate, & Advanced.

Intermediate Quality Information Level

Quality Safety Education for Nurses - This site offers many creative suggestions for quality education strategies for RNs as well as nursing students. Useful when conducting performance improvement projects in which education is needed regarding patient safety strategies, patient centered care, teamwork and collaboration, evidence based practice, quality improvement, and informatics.
Level of quality improvement information: Intermediate.

National Quality Forum - This inter-professional site provides excellent information about quality issues and quality measures under development and maintenance of current measures ready for review/modification based on new literature.
Level of quality improvement information: Intermediate.

Quality Progress Magazine is a good site on which to locate educational journal information related to healthcare and other fields about quality departments, networking, news, and events. The searcher can access archived magazine articles without a password. Examples of quality tools featured are: Affinity Tools, Pareto Charts, Check Sheets, Diagrams, Idea Creation tools, and Brainstorming tools. Education links for books and training on healthcare quality are also provided.
Level of quality improvement information: Intermediate.


Intermediate & Advanced Quality Information Levels

The American Health Care Association has a section dedicated to quality projects in long term care. Selected topics relevant to medical/surgical nurses include: scholarly citations from the Gazette, press releases and publications from their own journal with links to other journals, information on policy making, supplies, products and services for business members (such as pharmacy companies) of the AHCA and their products, and pdf documents of their presentations.

The Book Store tab has multiple media items on staffing and retentions, nursing schools, quality service literature, management and leadership books, and media. There are other tables with quality symposiums, quality reports, and leadership improvement course information.
Level of quality improvement information: Intermediate & Advanced.

American Healthcare through Quality Information provides health information, electronic medical records, and specific information relating to the network of an electronic health record. Information specific to quality and health informatics ICD 10, coding, abstraction, data collection to decisions regarding translation from ICD 9 to ICD 10. Access to an interesting educational media of a Virtual lab with HIS and HIM software and corresponding lessons is available for view.
Level of quality improvement information: Intermediate & Advanced.

Healthcare Failure Mode Effect Analysis is subcategory of the VA education for performance improvement. This site provides a power point education presentation about Healthcare Failure Mode Effect and Analysis (HFMEA), both defining HFMEA and providing an example of how HRMEA works.
Level of quality improvement information: Intermediate & Advanced.

Advanced Quality Information Level

Center for Medicare and Medicaid Service includes a wealth of information, on topics such as patient safety, quality measures, healthcare reform, reimbursement, and education. Research statistics on national data collected and stored in the CMS warehouse gives organizational level comparisons. Regulations/Guidance/Policy/and Legislations and Administration, healthcare reform, outreach and education on specificCenter for Medicare and Medicaid Service topics at organizational levels are also available. Browsing available by specific disease category, research, specific site tools, and resources for federal regulation provides a helpful way to locate information needed.
Level of quality improvement information: Advanced.

American Association of Healthcare Administration Management includes legislative links, revenue cycles, and other information pertaining to healthcare administration, in hospital and other health care environments. The site includes quality improvement articles (published its own journal), information about quality improvement conferences, job opportunities, continuing education units (CEU’s) for professional development on topics related to Admissions/Registration, Billing, Credit/ Collections, and Accounts Receivable Management. Other sections address Patient Communication/Registration, Billing, and Credit/Collections.
Level of quality improvement information: Advanced.

Healthcare Information and Management Systems Society (HIMSS) is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare.
Level of quality improvement information: Advanced.

LEAN Six Sigma - Provides free performance improvement tools (i.e. LEAN, 5S Tool Box, and other commonly used performance improvement methodologies) along with education about the use of these tools. Also contains links for purchase of additional performance improvement education.
Level of quality improvement information: Advanced.

Agency for Healthcare Research and Policy - The Agency for Healthcare Research and Quality (AHRQ) has developed a number of health care decision making and research tools. These tools are available at no charge. The Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. This is the same data used by CMS to measure quality. Links are provided to Patient Safety Indicator information ("preventable harm" in acute care) and Inpatient Quality Indicator information ("preventable deaths" in acute care). Access to free software is also available to help measure the indicators.
Level of quality improvement information: Advanced.

Quality Net is the link for all current CMS related information, like "value-based purchasing" and core measures: inpatient, outpatient, and physician offices measures. The site is supported by the Quality Improvement Organizations (QIO), from all Medicare districts throughout the U.S. There are also multiple links to inside the CMS website for specific information. (Please Note: the site is challenging to navigate).
Level of quality improvement information: Advanced.