Rachel Nissanholtz-Gannot
Ariel University, Israel
Title: How do primary care physicians perceive the role of nurses in quality measurement and improvement? The Israeli story
Biography
Biography: Rachel Nissanholtz-Gannot
Abstract
Abstract
Nurses have become key partners to the medical profession in promoting and monitoring the quality of community-based health services. Israel has had a highly effective national quality monitoring program for community-based health services since 2004. The objective of this study is to analyze Israeli primary care physicians' (PCP's) perceptions of nurses’ roles in that program and their contributions to the monitoring and improvement of healthcare quality. A representative sample of 1000 PCPs in Israel was surveyed using a 73-item questionnaire. Altogether, responses were received from 605 of the 884 physicians (69%) who met the study criteria, for a response rate of 69%. Descriptive analyses were performed. Most respondents (74%) agreed that nurses shared responsibility for improving the quality measures and that nurses contributed to practice quality. Physician characteristics typically had a minor impact on their perceptions as to whether the nurses contributed to quality improvement. Physicians who felt that measurement improved care quality and those supporting program continuations were likelier to perceive nurses to share responsibility. However, in open ended-questions about the changes they had made in their practice as a result of the program, they made minimal reference to nurses’ importance and contributions in improvement of quality indicators. There was a disparity between the closed-ended and open-ended questions regarding the way physicians depicted the roles of nurses in quality monitoring and improvement. This disparity suggests that the nurses’ growing involvement in quality have not yet been fully internalized or appreciated by the physicians.