The Journal of Continuing Education in Nursing

Administrative Angles 

Achieving Incremental Outcomes to Reach Goals

Caroline Baughman, BS

Abstract

Nursing professional development practitioners often question whether a particular outcome measure is a good one for their activity. Asked by itself, there is no way to answer that question. This article identifies a strategy to develop outcome measures in context with other phases of activity, department, and organizational goals. [J Contin Educ Nurs. 2019;50(5):193–195].

Abstract

Nursing professional development practitioners often question whether a particular outcome measure is a good one for their activity. Asked by itself, there is no way to answer that question. This article identifies a strategy to develop outcome measures in context with other phases of activity, department, and organizational goals. [J Contin Educ Nurs. 2019;50(5):193–195].

Developing an educational activity begins with three fundamental steps—identifying the practice gap that creates the need for the activity, analyzing learning needs assessment data to determine the appropriate level of educational intervention required, and establishing a desired and measurable outcome (American Nurses Credentialing Center, 2015; Harper & Maloney, 2016). Identifying measurable activity outcomes is the foundational step to a successful professional development program.

Determining a practice gap, collecting evidence, selecting an outcome, developing an educational intervention, and deciding on an evaluation method are not isolated educational design components—they are important details that weave together why an activity is important and how it helps address an identified problem or opportunity for improvement. Poorly determined outcomes, or outcomes selected out of context with other pieces of information, can significantly hinder the ability to successfully address issues at the activity, department, or organizational level. Building the framework for an activity by carefully analyzing data and determining how success will be measured forms the foundation for success.

A Real-World Example

An individual realizes that a 50-pound weight loss would be helpful in appearance, self-image, and health promotion. How is this person going to achieve this outcome? Without an incremental and strategic plan, success is not likely. Analyzing the levels of educational intervention needed to achieve this outcome promotes development of a realistic approach to reach the goal. Figure 1 provides an incremental approach with measurable outcomes, resulting in goal attainment. At the broader level, this individual can, over the long term, evaluate the impact of this weight loss in terms of a new wardrobe and reduction in health risk factors.

Incremental goals applied outside of continuing nursing education. ©2019, Caroline Baughman, all rights reserved. Used with permission.

Figure 1.

Incremental goals applied outside of continuing nursing education. ©2019, Caroline Baughman, all rights reserved. Used with permission.

The Professional Development Context

Similarly, this process is helpful in developing learning activities to solve a problem or improve practice in an organization. Activities can be requested based on factors such as sentinel events, policy changes, job description modifications, and the organization's strategic initiatives. With multiple precipitating factors, it is easy to desire the outcome of an activity to fix the problem that led to it. However, it is important to remember that education is one part of the overall solution, and it can address only some components of the educational and organizational needs.

For example, a nursing professional development practitioner is asked to develop an activity because the hospital has an unacceptably high infection rate among postoperative trauma patients. The ultimate goal is to have zero postoperative infections within 6 months. Conducting a gap analysis and learning needs assessment provides the nurse planner with data that postoperative surgical nurses are not familiar with current evidence-based practice guidelines related to caring for trauma patients or how various types of trauma impact operative and postoperative care decisions and are not effectively teaching patients and families how to care for surgical incision sites. Developing one activity about care of postoperative trauma patients is not going to result in achieving the zero infection goal. However, strategically designing a series of activities with incremental and measurable outcomes at knowledge, skill, and practice levels is much more likely to produce the desired result.

At each level of educational intervention, consider which outcome(s) would be best suited for each. Determining the initial desired outcome at the knowledge level of intervention will set the stage for successful implementation of solutions to a problem in practice. Success can be measured at each step of the process, resulting in the ability of the nursing professional development practitioner to provide feedback to stake-holders that progress is being made. Figure 2 (infection rates) shows an incremental approach with measurable outcomes, leading to goal attainment.

Incremental goals applied to continuing nursing education activities. ©2019, Caroline Baughman, all rights reserved. Used with permission.

Figure 2.

Incremental goals applied to continuing nursing education activities. ©2019, Caroline Baughman, all rights reserved. Used with permission.

Utilizing Outcomes

Building a structured, incremental plan with measurable outcome(s) to meet goals—at activity, departmental, or organizational levels—will facilitate efficiency and effectiveness in achieving goals. If one phase of the planned intervention does not meet its desired outcome, planners can clearly determine what needs to be revisited or redesigned for greater effectiveness. Just as in the plan to lose weight, if one successfully develops a healthy exercise plan but then is not skilled in performing the exercises, the likelihood of meeting the long-term goal is significantly reduced. Additionally, when learners meet those incremental benchmarks, they have a deeper understanding of and greater accountability for achieving the long-term goal, which is a more sustainable solution than simply being told to practice differently or suddenly working under a new policy (Pepsnik, 2017). The greater the success among those incremental goals, the more potential impact the education can have on patient outcomes and organizational initiatives.

Facilitating Impact

It is important to gather the evidence of outcome achievement at each level of educational design and implementation in order to foster the greatest impact on nursing practice and, ultimately, community health. Several accrediting bodies describe the use of Moore's seven levels of outcome measure as a guide to designing and evaluating quality continuing education that impacts patient outcomes. Beginning with participation, the levels advance in growing engagement among learners to satisfaction, learning (further categorized into declarative knowledge and procedural knowledge), performance, patient health, and population health (Moore, Green, & Gallis, 2009). The same structure is helpful in determining outcomes and impact at successive levels for continuing nursing education.

Summary

Creating quality continuing nursing education begins in the planning phase with a gap analysis and learning needs assessment, then grows with determination of focused, measurable outcomes. Nursing professional development practitioners should establish desired outcomes based on root causes and evaluate educational effectiveness at successive levels to improve activity quality and ultimately impact organizational initiatives. Determining incremental, measurable outcomes to facilitate change in knowledge, skills, and practice provides evidence of success and validates the importance of the department in supporting the goals of the organization.

References

  • American Nurses Credentialing Center. (2015). ANCC primary accreditation provider application manual. Silver Spring, MD: Author.
  • Harper, M. & Maloney, P. (2016). Nursing professional development: Scope and standards of practice (3rd ed.). Chicago, IL: Association for Nursing Professional Development.
  • Moore, D.E., Green, J.S. & Gallis, H.A. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29, 1–15. doi:10.1002/chp.20001 [CrossRef]
  • Pepsnik, D. (2017). Measuring outcomes at the activity level. In Dickerson, P. (Ed.), Core curriculum for nursing professional development (5th ed., pp. 198–206). Chicago, IL: Association for Nursing Professional Development.
Authors

Ms. Baughman is a Professional Development Associate for Montana Nurses Association, Clancy, Montana, and has earned the Alliance for Continuing Education in the Health Professions Continuing Professional Development Associate Certificate.

The author has disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Caroline Baughman, BS, Professional Development Associate, Montana Nurses Association, 20 Old Montana State Hwy., Clancy, MT 59634; e-mail: caroline@mtnurses.org.

10.3928/00220124-20190416-02

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