|
November
7, 2002
For
Immediate Release
|
Contact:
Richard Deutsch
202-331-5790 Ext. 313 |
Federal
Nursing Home Quality Initiative
Success
in Six-State Test Sets Stage
For
Nov. 12 National Launch
Washington,
D.C.— A six-state pilot test of the federal Nursing Home Quality Initiative shows
that significant improvement in care can be achieved when nursing homes and Quality
Improvement Organizations (QIOs) work together to create better treatment systems.
The
federal initiative—scheduled for a national launch in Washington on November 12—began
with a pilot test in Colorado, Florida, Maryland, Ohio, Rhode Island, and Washington
from April to October this year. The initiative combines the publishing of information
on the quality of care in individual nursing homes with a program of technical
assistance provided by the national network of QIOs under contract to the Centers
for Medicare and Medicaid Services (CMS) at the Department of Health and Human
Services. Nursing home participation in the assistance program is voluntary.
"The
Institute of Medicine recently called for Medicare and other federal health care
programs to standardize quality measures and report to the public on the quality
of care delivered by individual providers," notes David Schulke, executive
vice president of the American Health Quality Association, which represents QIOs.
"This initiative exemplifies the reforms recommended by the IOM. It’s the
first big step in that direction. It informs the public and provides assistance
critical for helping nursing homes attack the root causes of quality problems."
Results
of the Six-State Pilot
In
the pilot states, the initiative successfully promoted quality improvement activities
among nursing homes. Over half of the nursing homes (52%) in the six pilot states
requested quality improvement technical assistance from local QIOs.
Over
three-quarters of nursing homes (78%) reported making quality improvement changes
during
the
NHQI pilot and 77% indicated that the NHQI contributed to their decision to undertake
these activities.
"The
ultimate test of the Nursing Home Quality Initiative is whether it results in
better patient care," said Schulke. "Already, some nursing homes working
with QIOs in the pilot states have greatly reduced the number of patients in pain
and the number suffering from facility-acquired pressure ulcers. While not all
results will be so immediately dramatic, we are encouraged that nursing facilities
nationwide will seek to take advantage of expertise offered by QIOs under the
initiative."
For
example, during the pilot:
- Clear
Creek Care Center in Westminster, Colorado, cut by 50% the number of residents
experiencing moderate to severe daily pain.
- Riverview
Healthcare Community in Coventry, Rhode Island, cut the percentage of residents
in pain by more than a third.
- St.
Mary’s Nursing Center in Leonardtown, Maryland, reduced facility-acquired pressure
ulcers in a test group of fifty residents by 69%.
Intensive,
on-site QIO assistance in the pilot states focused mainly on pain management.
Most nursing homes that participated made fundamental improvements, such as development
of better pain assessment tools and monitoring procedures, and the education of
staff at all levels about pain management—including the use of non-pharmacological
pain control.
QIOs
Now To Offer Assistance in Every State
With
the launch of the initiative, QIOs begin working directly with nursing homes throughout
the nation to help them assess the quality of their services and provide information
on best practices. For all nursing homes, QIOs will serve as an information clearinghouse
and disseminate educational materials, with targeted mailings to low-performing
nursing facilities. QIOs will also hold training sessions to teach nursing home
staff effective methods for improving clinical outcomes. In addition, QIOs will
offer on-site assistance to a number of nursing homes in each state, including:
- Teaching
nursing home staff how to measure their performance.
- Holding
workshops to teach administrators, medical directors, and directors of nursing
the importance of actively supporting continuous quality improvement, and empowering
front-line nursing staff.
- Holding
workshops for nurses and aides offering clinical education and training in quality
improvement techniques.
- Step-by-step
guidance in helping facilities revise policies, increase staff commitment to improvement,
monitor patient conditions, and implement more effective plans of care.
QIO
Experience Improving Nursing Home Care
QIO
assistance to nursing homes is based on more than a decade of working with health
care providers to improve systems of care. Since 1999, QIOs have partnered with
nursing homes in more than 35 states to implement projects directed at prevention
of pressure ulcers, fall prevention, pain management, development of quality measures
for rehabilitation services, improved diabetes outcomes, improved anticoagulant
use, reduction in the use of restraints, immunization campaigns, and treatment
for depression. Many of these projects are making a difference:
- Pain
Management. Quality Partners of Rhode Island improved pain assessment polices
and procedures in all 18 nursing homes that participated in a statewide project.
- Diabetes
Management. The Indiana QIO, Health Care Excel, conducted a project with nursing
homes to improve the rate of blood glucose testing to prevent complications of
diabetes. Testing rates in participating facilities improved from 57% to 87% in
2001.
- Prevention
of Pressure Ulcers. In Pennsylvania QIO, KePRO worked with 12 nursing homes
to test interventions designed to reduce incidence of pressure ulcers. The percentage
of residents with appropriate ulcer care plans rose from 57% to 90%.
- Immunizations.
The Virginia Health Quality Center increased immunization
rates for pneumonia from 26% to 52% in 15 participating nursing homes. Health
Services Advisory Group conducted a project in 127 Arizona nursing homes that
increased resident vaccination for pneumonia from 52% to 75%. Seattle-based Qualis
Health improved pneumococcal vaccination rates from 53% to 74% in 26 long-term
care facilities in Alaska; increased flu immunization from 65% to 73% and pneumococcal
vaccination from 43% to 58% in Idaho; and increased pneumococcal vaccinations
from 47% to 61% in 300 Washington state facilities.
- Fall
Prevention Alabama Quality Assurance Foundation reduced resident fall rates
in 13 of 14 facilities. Falls declined at a rate equivalent to 3 fewer falls per
month at a 100-bed facility.
For
More Information, Visit Our Web Site at www.ahqa.org
|
