Federal Nursing Home Quality Initiative
Statement by AHQA Executive Vice President David Schulke

The Nursing Home Quality Initiative (NHQI) exemplifies the reforms recommended last week by the Institute of Medicine. The IOM called for federal officials to standardize quality measures and report to the public on the quality of care delivered by individual providers. This initiative is a big step in that direction. It will significantly improve nursing home care.

The initiative will not only inform the public about quality of care in individual nursing homes, as the IOM recommended. It will also provide technical assistance to facilities through a national network of Quality Improvement Organizations (QIOs). Such assistance is critically important because many nursing homes need help identifying and resolving the root causes of quality problems.

The ultimate test of the Nursing Home Quality Initiative is whether it results in better patient care. 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.

Since the pilot began last April, half of all nursing homes in the six pilot states have requested QIO assistance. Many have joined intensive technical assistance programs or attended workshops conducted by QIOs. The vast majority of homes that worked with QIOs in the pilot states have made fundamental improvements in their processes for managing pain.

For the past decade, QIOs have assisted hospitals and physicians across the nation in improving clinical processes that lead to better care. QIOs also have extensive experience helping nursing homes redesign clinical systems with a focus on better pain management, treatment of pressure ulcers, immunizations, and treatment for chronic diseases and conditions.