The name of the collaborative tested was the Collaborative Alliance for Nursing Outcomes (CALNOC – formerly known as the California Nursing Outcomes Coalition) [25–29], which shares clinical information regarding the quality of nursing care among California hospitals for the purposes of benchmarking and quality improvement. CALNOC has been in existence since 1996, growing steadily with an increase in membership since 2006 prompted by the increasing demand for comparison data by insurance companies and consumer groups as a condition for receiving contracts [30,31]. CALNOC
measures are included in the Implementation Guide for the National Quality Forum (NQF) Endorsed Nursing-Sensitive Care Performance Measures, which is made available to hospitals nationwide by The Joint Commission [32]. CALNOC member hospitals meet the Centers for Medicare & Medicaid Services’ (CMS) Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) program’s new requirement (July 2010) that hospitals participate in a registry for nursingsensitive quality metrics. CALNOC data have been used to examine the 2004 California mandated nurse staffing ratios, and aggregated trends have been published to help nurses use benchmarks and clinical dashboards for expediting improvement
in patient outcomes