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Chapter 5 – Evidence-Based Practice Questions
This activity contains 3 questions.
Evidence for Effective Leadership and Management
Citation: Clarke, S. P., Raphael, C., & Disch, J. (2008). Challenges and directions for
nursing in the pay-for-performance movement. Policy, Politics, & Nursing Practice, 9(2),
127–134. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697611/?tool=pubmed
Overview: This article examines a current change in healthcare that focuses on the issue
of pay-for-performance (P4P). This issue requires more input from nurse leaders as it will
continue to expand, influencing nursing, healthcare budgets, and continuous quality
improvement.
Application: This is a current issue in healthcare finances that has been important to non-
nursing providers, but it should also have relevance to nurses. With the expansion of pay-
for-performance, multiple providers and healthcare organizations may experience its
impact. This is a health policy and reimbursement issue but also includes performance
and thus impacts quality care. Performance includes an evaluation of outcomes.
1.
What does pay-for-performance mean? How would it apply to nurses?
2.
Why might it be important for nurses to pay more attention to P4P—benefits and risks for
nursing?
3.
What are the four ways that healthcare providers can prepare for P4P as suggested by this
article? How do these strategies relate to nursing leadership and management?
Finkelman, Leadership and Management for Nurses: Core Competencies for Quality Care, 3e
Chapter 5 – ANSWER KEY Evidence-Based Practice Questions
1.
Answers will vary. Pay-for-performance (P4P) initiatives attempt to drive quality of care
by aligning desired care processes and outcomes with reimbursement. P4P schemes have
2.
Answers will vary. If nursing factors are linked with the process and/or outcome
indicators involved in P4P—as common sense and early evidence suggest they might
be—then, given nurses’ close contact with patients in acute care and central role in
3.
Answers will vary. The article explores that when preparing for P4P it is essential to learn
from home healthcare, invest in information technology, remembering patients, and
