Ask the expert: Engaging staff nurses in quality improvement

Nurse Leader Insider, September 20, 2010

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This week, Cynthia Barnard, MBA, MSJS, CPHQ, discusses ways to get staff nurses interested and involved in quality improvement, and why it’s important. 

Q: I recently designed a quality improvement (QI) program for my facility, but staff nurses complain they are too busy. How can I get staff nurses involved and interested in the process of improvement?

A: It is critical that nurses at the bedside are engaged in QI, carrying out the bundles, protocols, and other processes designed to improve quality and safety. Yet getting direct-care nurses involved in QI is difficult in many hospitals, as bedside nurses complain they are already too busy, they do not have enough staff members to carry out complex QI processes, or they do not feel QI is in the scope of the nursing practice.

To engage direct-care nurses, nurse leaders need to follow four basic rules:

  • Be transparent with your staff at all times. Information and knowledge are crucial to staff engagement, strong performance and efficiency, and in meeting the strategic goals of the healthcare institution. Nurse managers should share information on operating and capital budgets, market share, and labor costs, strategic goals for their institution, and performance on key clinical and business metrics.
  • Make accountability for improvement at the unit and staff nurse levels. Leaders must establish a culture that reinforces that QI is not some other department’s responsibility, but rather is every nurse’s job. Strategies may include surveying unit nurses, creating unit QI councils, or defining accountability for quality outcomes in the yearly performance appraisals of staff members.

Click here to read the rest of the rules.

Editor's note: Do you have a question for our experts? E-mail your queries to Associate Editor Jaclyn Beck at and see your name in print next week! In the meantime, head over to our Web site and view a growing collection of advice from our experts. 

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