The Access Cost and Quality of Quality Environments Essay

Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures. The Access Cost and Quality of Quality Environments Essay


Due: Monday, 11:59 pm PT
Length: 1500 words, double-spaced, excluding title and reference pages (required)
Format: APA 6th Edition
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The Access, Cost, and Quality of Quality Environments, and Recent Quality Initiatives


Quality healthcare necessitates access, suitable and acceptable treatment plans, effective patient follow-up, qualified and adequate number of healthcare workers, and adherence to the quality indicators. The healthcare cost should also be cost-effective and affordable. APNs play a key role in ensuring the quality of healthcare and lowering the cost of health (Woo et al., 2017). According to Whittington et al., (2015), healthcare professionals including APNs should aim to enhance the quality of care, the overall population health, and lower the healthcare cost. This paper will provide a discussion about the access, cost, and quality of quality environments and role development. Additionally, the paper will discuss how the ineffective quality measures may affect the role of APNs.

Access, Cost, and Quality of Quality Environments and Quality Initiatives

Access, quality, and cost are the keystones of healthcare provision. The quality of healthcare refers to the level to which healthcare services for people increase and improve the probability of desired health outcomes and match the up-to-date professional knowledge (Whittington et al., 2015). The cost of healthcare refers to the person paying for the healthcare services, to the healthcare provider to provide healthcare services and for the society. The final outcome is the total quality which involves an environment for quality and constant measurement and improvement activities. To ensure the provision of holistic care, quality care services should integrate all these factors.

The nursing work environment is a key factor that impacts the quality of care. Nurses in a supportive and good practice environment are empowered and motivated to practice professionally, be more productive, have a low level of burnout, low turnover rate, and report an increased level of job satisfaction and improved nursing quality (Anåker et al., 2017). Improving the work environment for nurses may prevent a high turnover rate for the nursing staff which is associated with improved quality of care. As Dewanto & Wardhani (2018) provide, a high turnover rate of nurses leads to loss of experienced and competent nursing staff and this may adversely affect the quality of care. This is because when the practice environment is favorable, it ensures high-quality care. Moreover, maintaining a safe and quality environment indicates a level of vigilance and compassion for the welfare of patients. Therefore, the care environment significantly affects the quality of provided care and also ensures patient safety.


Quality improvement in healthcare involves an organized and systematic approach by a healthcare organization through monitoring, assessing, and improving the standards of quality healthcare (Anåker et al., 2017). The organizational activities aimed to improve the quality of care are cyclic and require constant improvement to facilitate the attainment of higher and improved levels of performance. Continuous upgrading and improvement of healthcare activities can move a healthcare organization from the inefficient traditional ideas and approaches to using tools and technologies to facilitate efficient performance and thus produce better and high-quality outcomes. Quality improvement has a direct relationship to the care delivery, patient satisfaction, efficiency of healthcare, and outcome. Successful quality initiatives normally integrate principles of quality improvement to attain an improved performance level and ensure a successful healthcare system (Saver et al., 2015).  The Access Cost and Quality of Quality Environments Essay

Quality Measures and Evaluation and Role Development

Quality measures are used to analyze or measure procedures, outcomes, patient perceptions, as well as organizational systems and structures that impact the capacity of healthcare organizations to deliver good quality care and are related to high-quality goals in healthcare (Saver et al., 2015). The quality measures are essential tools utilized to assess the efficacy of healthcare processes. Quality measures are evaluated against their capacity to provide better and improved quality healthcare services to patients.

Quality measures in health care address patient outcomes, patient safety, and healthcare costs. Through the quality measures, healthcare organizations can monitor care outcomes, evaluate performance, and also adhere to the certification and accreditation requirements.

The quality measures seek to evaluate the quality of care (Jones, 2016). Therefore, the evaluation of the quality of care should take into consideration the care outcomes and patients’ experiences about the quality of care. For example, quality measures such as mortality rate, rate of hospital-acquired infections, fall rate, and medical errors are used to indicate the quality of care. An evaluation that shows a reduced mortality rate, reduced rate of falls, reduced rate of hospital-acquired infections, as well as reduced medical errors indicate the improved quality of care, and vice versa (Jones, 2016). Similarly, patient satisfaction metrics that measure patient experiences are also used to indicate the quality of care. The measurement of the clinical and perceived quality of care by patients in every care continuum can generate a better view of how patients interact with the health systems.

Quality measures and other initiatives that aim to enhance the quality of care mostly focus on outcomes measurement. APNs normally assume an increasing role during the delivery of care to the admitted patients, evaluation of the effect of provided care on patient outcomes, and patient safety, and therefore quality measures are a critical element of performance evaluation. APNs have a key responsibility to ensure the existence of quality measures within the healthcare field. Additionally, the quality measures and evaluation of care ensure that standards of care are adhered to (Kampstra et al., 2018). The scope of APNs requires APNs to adhere to the standards of care and this includes ensuring the provision of quality care by measuring and evaluating the quality of healthcare services. This facilitates the provision of optimal healthcare and decreases the unessential healthcare costs. APNs have been proved to play a key role in ensuring wellness and preventative healthcare determined by consumer demand. Evidence shows that ANPs are cost-effective healthcare providers of high-quality care. Moreover, APNs have been shown to play a key low in reducing healthcare costs and improving access the healthcare (Woo et al., 2017).

How APN role may Change without Effective Quality Measures

APNs have a key role in facilitating the delivery o, high-quality care, evidence-based care, and timely care to optimize care. APNs manage the care of critically and acutely sick patients, implement measures to prevent patient deterioration, and improve care continuity for patients in the healthcare system (Parker & Hill, 2017). APNs make positive effects on the quality of care by improving system outcomes and patient outcomes. APNs design and promote compliance to best-practice guidelines in healthcare organizations; improve patient satisfaction; reduce the duration of patient hospitalization; prevent harm and injury; reduce the mortality rate. This, therefore, shows the significance of APNs in implementing quality measures and ensuring the provision of quality care.

Ineffective quality measures interfere with the ability of APNs to undertake quality improvement initiatives that involve maintaining quality services, undertaking research, implementing evidence-based practice, and developing clinical protocols and guidelines. Additionally, without quality measures, APNs will not be able to effectively implement care standards, improve clinical patient care, or monitor care standards and care outcomes (Salmond & Echevarria, 2017).  The role of APNs may revolve around assessing patients, providing diagnosis, and managing patient problems, including the utilization and prescription of treatment interventions if there are no effective quality measures. Therefore, ineffective quality measures may also interfere with the ability of APNs to save healthcare costs through facilitating reduced length of hospital stay, reduced readmissions, reduced complications, among other care outcomes.  The Access Cost and Quality of Quality Environments Essay


Access, quality, and cost are the keystones of healthcare provision. Access to healthcare ensures that patients get the required care and treatment while the quality of care ensures better patient outcomes and patient safety. Moreover, cost-effective care ensures that patients afford and access quality care and cuts unnecessary spending for healthcare organizations. APNs are significantly involved in improving access, quality, and the cost of healthcare. Healthcare organizations use quality measures to analyze, quantify, or measure procedures, outcomes, patient perceptions, as well as organizational systems and structures that impact the capacity of healthcare organizations to provide high-quality care. Therefore, with effective quality measures, APNs may not be able to adequately play their role that includes ensuring the provision of quality care through evaluation of the quality of care.


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Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC nursing, 17(Suppl 2), 52.

Jones, T. (2016). Outcome measurement in nursing: Imperatives, ideals, history, and challenges. OJIN: The Online Journal of Issues in Nursing, 21(2), 1-15.

Kampstra, N. A., Zipfel, N., van der Nat, P. B., Westert, G. P., van der Wees, P. J., & Groenewoud, A. S. (2018). Health outcomes measurement and organizational readiness support quality improvement: a systematic review. BMC health services research, 18(1), 1005.

Parker, J. M., & Hill, M. N. (2017). A review of advanced practice nursing in the united states, Canada, Australia, and Hong Kong special administrative region (SAR), China. International journal of nursing sciences, 4(2), 196-204.

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Saver, B. G., Martin, S. A., Adler, R. N., Candib, L. M., Deligiannidis, K. E., Golding, J., Mullin, D. J., Roberts, M., & Topolski, S. (2015). Care that Matters: Quality Measurement and Health Care. PLoS medicine, 12(11), e1001902.

Whittington, J. W., Nolan, K., Lewis, N., & Torres, T. (2015). Pursuing the Triple Aim: The First 7 Years. The Milbank Quarterly, 93(2), 263–300.

Woo, B., Lee, J., & Tam, W. (2017). The impact of the advanced practice nursing role on the quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health, 15(1), 63.

The Access Cost and Quality of Quality Environments Essay

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