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As a nurse educator, I take pride in the fact that the work my team does has a direct impact on patients’ lives. A couple of years ago, my team’s productivity was being measured by the number of calls they made per day rather than the effect of their work. My team does so much more than just make calls, and they wanted to be measured in terms of the quality they delivered to the patients, physicians and healthcare teams they supported. But, as many people know, quality measures can be difficult to define and track, and companies looking for a clear line between productivity and bottom-line results can be skeptical of these kinds of results.

But after eight months of conversations with my team about why quality measures made so much more sense we decided to figure it out. Through many discussions over several weeks, we came to a clear conclusion: the real benefit of nurse educator programs is that they change behavior -- and that is a metric worth measuring.

Educating to a point of action

To demonstrate this qualitative measure we challenged the nurse team to approach every task they complete by thinking about how it can drive positive changes among healthcare staff and the patients they serve. The role of a nurse educator is to transfer skills and knowledge to nurses and other healthcare professionals they support so that they can in turn effect changes in the patient’s behavior. That usually involves making sure the patient adheres to their treatment regimen, and reports any concerns that might prevent them from continuing to follow their treatment plan.

In September of 2014, we implemented this new quality measure in our first program, supporting healthcare teams prescribing an oral oncology medication. One of the side effects of this medication are painful mouth sores, which emerge in the first 10-15 days of treatment. When healthcare providers aren’t familiar with this side effect, they may prescribe the medicine and schedule the next follow up visit for a month later. As a result patients may suffer for weeks with these sores, or quit taking the medication because of the pain and discomfort.

Our goal was to ensure healthcare workers were educated about the occurrence and timing of mouth sores in patients using this drug, and to help them establish strategies to talk to patients about the possible side effect and to define a clear action plan if the sores occurred. That might include conducting follow-up phone-call or nurse visits in the first two weeks of treatment, or letting patients know they should come in to meet with a nurse at the first sign of mouth sores, at which point they could be prescribed a specific mouth wash or other treatment to reduce discomfort. 

A key component of our success would be our ability to communicate and educate healthcare workers, and to encourage them to translate that knowledge to patients so they would continue to use the medication. In theory this would lead to improved sales, though the client was initially skeptical. We knew it would be difficult to measure the impact of this change in focus, and to tie behavior change to business results, but soon they were convinced.

Within four months, we started to see significant behavior change in the teams we worked with. The clinics were talking to patients proactively about side effects, and sharing the knowledge we provided. Several institutions also implemented assessment materials that the client’s brand team developed, because they felt it added real value for the patients and the healthcare team. It is unusual for clinics to incorporate such materials into their offering, so this was viewed as an added benefits for the client and the healthcare teams we supported.

But most importantly, all of this education and support delivered exactly the goal we sought: adherence to the medication increased as did the rate of prescription, which directly impacted sales results. The program was such a success, that two other oncology divisions have adopted similar quality focused initiatives, because they see the value it brings to patients and the bottom line.

This project proved to us and to our clients, that tracking the quality of a service and its impact on patient behavior is possible, and that when you focus on quality rather than quantity, you can deliver real results. We gave our nurse educators a purpose that they could believe in, and in turn they drove positive outcomes for everyone involved.

As we celebrate International Nurses Day on May 12, it is important to recognize that nurse educators do more than share information. We improve the lives of patients while benefitting the clients we serve. It’s a business model where everyone wins, and that is definitely worth celebrating.

Topics in this blog post: Healthcare, Patient Outcomes, Patient-centered