Improving Nursing Home Quality of Care
Taking
the Lead: Quality
Improvement Organizations (QIOs) are playing a critical role in a federal
initiative to help nursing homes improve care for residents who suffer
from pain, delirium, depression, pressure ulcers, and loss of everyday
functions. Working under contract to the U.S. Department of Health and
Human Services, QIOs are providing nursing homes with materials and technical
support needed to upgrade clinical and organizational systems. Nationwide
rollout of the initiative in November 2002 followed a pilot effort in six
states— Colorado, Florida, Maryland, Ohio,
Rhode Island, and Washington.
Increasing Public Awareness: The
QIO initiative complements a move by the Centers for Medicare and Medicaid
Services ( CMS ) at HHS to publicly report on the quality of care at every
Medicare and Medicaid participating nursing home. CMS is publicizing measures
of quality that include the percentage of residents in each facility with
pain, pressure ulcers, loss of ability in some basic daily tasks, delirium,
depression, and infections—as well as the percentage of residents
in restraints. QIOs are working to help the public understand and use these
quality measures as part of the process of selecting nursing home facilities.
Building on Experience and Partnerships: QIOs in nearly
every state have worked with nursing homes on specific quality of care projects.
QIOs are drawing on this experience, as well as partnerships with state agencies,
health plans, professional groups, industry associations, and consumer advocacy
organizations to broadly improve nursing home quality of care.
Sharing Methods and Best Practices: QIOs are helping nursing
home management identify what is necessary to create a quality improvement
culture and how to empower staff to build quality improvement processes into
everyday work. In every state, QIOs are providing all nursing homes with
up-to-date information and strategies for establishing an organizational
structure that supports quality improvement. The materials focus on guidelines
for proper care, methods for improving care, staff training information,
model policies and protocols, and tools for assessing care. QIOs are also
facilitating regional nursing home alliances to help facilities learn from
each other and train staff to implement shared lessons and best practices.
Offering
Hands-on Assistance: In addition,
QIOs are offering intensive technical assistance to a percentage of nursing
homes in each state. In facilities that volunteer to participate, QIOs are
helping staff identify leadership roles, establish clinical care teams, and
learn a process for continuously improving quality of care. Focusing on specific
clinical indicators, teams are performing clinical assessments, establishing
new policies and treatment protocols, providing additional staff training,
and assessing whether the changes cause sustainable improvement in care.
The
American Health Quality Association is dedicated
to improving the safety and effectiveness of health care. AHQA represents
the national network of Quality Improvement Organizations (QIOs) that work
with hospitals, medical practices, health plans, long-term care facilities,
home health agencies, and employers to encourage the spread of best clinical
practices and improve systems of care delivery. Visit: www.ahqa.org. |
