I agree that when working day-to-day at the bedside, it is difficult to see the value of quality improvement initiatives that are happening "over there in the board room". I think that the biggest mistake many health care systems make is not to involve front-line staff in these activities. This includes CNAs, RNs, pharmacists, medical residents, and all other staff who have daily interaction with the patients. This is the essence of what Magnet movement should be about- to get bedside nurses more involved how the hospital is run.
As infection control nurse, I am now responsible for maintaining databases of infection control data, generating reports, attending numerous QI meetings throughout the month, and attempting to direct new QI initiatives when the data shows that they are warranted. All of this paperwork is a tremendous administrative burden for my department. However, the Joint Commission and other regulatory groups demands this level of documentation when they do site visits. If we do not document our activities, there is no way to assure the regulators and patients that we are complying with their expectations. In addition, without constant surveillance, it is possible that problems will pop up and remain undetected, leading to a very negative consequence. It is important to be proactive to prevent these things from happening rather than reacting after something terrible has occurred and it's too late to do anything about it.