Pay for Performance and Nursing Care

Is nursing getting recognition because of pay for performance?  Some suggest that is the case.  For example, consider the issue associated with Central-line Associated Bloodstream Infection (CLABI).  While it is a "mixed bag" regarding the reason patients with central lines get infections, nursing is an important part of the equation because we manage the lines after insertion.

I read this morning about the Maryland Healthcare Commission posting the CLABI rates, compared with the national average for all of the hospitals in the state (http://mhcc.maryland.gov/consumerinfo/hospitalguide/hospital_guide/reports/find_a_hospital/clabsi_all_hospital_table.asp?icu_id=AdPed).  I was saddened to see that a hospital where I worked for 13 years 5th from the bottom of the list with a CLABI rate twice the national average.  What was even worse, is that the smaller hospital 50 miles up the road in Easton had a rate that was almost 5 times the national average. 

Reflecting on the problem makes me remember taking a healthcare finance course at the University of Maryland when I was shocked to see the differences in outcomes from a financial perspective.  In that particular case it was looking at hospital length of care days and co-morbitity associated with hysterectomy.  I was shocked to see that a hospital on the southern Eastern Shore of Maryland had LOS that was double of where I worked and a higher morbility rate.  That was when "I got it."

It saddens to see healthcare stimulated to make improvements only because of pay for performance.  That said, on the other hand, before benchmarking data, hospitals really did not have the information to assist in making care improvements. Yes, nursing is getting recognition for performance.  A comparison of hospitals is something that nurses should consider when applying for jobs.  A good place to start is to examine the Department of Health and Human Services Hospital Compare web site at http://www.hospitalcompare.hhs.gov/