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 New National QIO
Effort: Improving Nursing Home Quality of Care
A new federal initiative
spearheaded by Quality Improvement Organizations will help nursing homes improve
care for residents who often suffer from pain, delirium, depression, pressure
ulcers, and loss of everyday functions. In 2002, working under contract to the
U.S. Department of Health and Human Services, QIOs will begin providing nursing
homes with materials and technical support needed to upgrade clinical and organizational
systems.
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 will focus on indicators of quality selected by the National
Quality Forum such as pain, delirium, re-hospitalization, walking, pressure ulcers,
psychotropic drug use, assisted daily living decline, weight loss, infections,
and restraints. QIO teams will help the public understand and use the indicators
in selecting nursing home facilities.
Building on
Experience and Partnerships
QIOs in nearly
every state have worked with nursing homes on specific projects to improve care.
QIOs will draw on this experience, as well as partnerships forged with state agencies,
health plans, professional and industry associations, and consumer advocacy organizations
to broadly improve nursing home quality of care. Current
projects include assistance in the prevention and treatment of pressure
sores, falls prevention, pain management, development of quality measures for
rehabilitation services, improving diabetes outcomes, improving anticoagulant
use, and immunization campaigns.
Sharing Methods
and Best Practices
QIOs will help
nursing home management identify what is necessary to create a quality improvement
culture and empower staff to build quality improvement processes into everyday
work. QIOs will give all nursing homes materials providing guidelines for proper
care, methods for improving care, staff training information, model policies and
protocols, and tools for assessing care. QIOs also will facilitate 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 will offer intensive technical assistance to a significant number of nursing
homes in each state. In facilities that volunteer to participate, QIOs will help
staff identify leadership roles, establish clinical care teams, and learn a process
for continuously improving quality of care. Focusing on specific clinical indicators,
teams will perform clinical assessments, establish new policies and treatment
protocols, provide additional staff training, and assess whether the changes cause
sustainable improvement in care.
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