Determining the return on investment for evidence-based practice: an essential skill for all clinicians.
What do catheter?associated urinary tract infections, central line?associated blood stream infections, falls with injury, hospital?acquired pressure ulcers, surgical site infections, and ventilator?associated pneumonia have in common? Also, how about the commonalities among patient satisfaction regarding communication with nurses, urinary catheter removal on post?operative day 1 or 2, and mortality rates 30 days following an acute myocardial infarction? They all are quality indicators that are attached to financial outcomes. In the United States, these indicators are either (a) hospital?acquired conditions (HACs) declared by the Centers for Medicare and Medicaid Services (CMS) as preventable unless present upon admission to the hospital (Centers for Medicare & Medicaid Services [CMS], 2014); or (b) included in the scoring for the value?based purchasing program (VBP) that CMS began in 2013, whereby incentive payments will be distributed across all hospitals performing in the top 50% on selected quality indicators. These incentive payments are based on how closely hospitals follow best clinical practices and how well they enhance patients experiences of care (CMS, 2012). Such significant changes call for healthcare and nursing leaders to clearly understand how to obtain quality outcomes and how to articulate the business case and expected return on investment (ROI) committed to promoting quality care.