Pressure ulcers can be dangerous and painful for nursing home residents and can sometimes lead to serious medical complications and even death. A group of 19 nursing homes in Idaho and Washington made significant improvements in the quality of care for their residents by working together in a two-state Learning and Action Network (LAN) focused on pressure ulcer prevention and hosted by Qualis Health, the QIO for both states. A LAN brings together communities to problem-solve, learn from one another, and create solutions to improve how care is delivered.
The objective of the Qualis Health nursing home LAN, which began in August 2011, was to help nursing homes decrease the percent of long-stay, high-risk residents with pressure ulcers at least 20 percent by September 2012 and sustain that reduction through December 2012. For the LAN to succeed in its efforts, it was critical to garner buy-in and support from the leadership of involved nursing homes and to educate staff that could then mentor and share learnings with other staff. It also was important to ensure consistent staff assignment to residents, and the presence of proper support surfaces, such as mattresses, chairs, and cushions, in the facilities.
With guidance from Qualis Health, the LAN prepared aim statements, developed action worksheets, and learned to use Run Charts to track improvements. One of the most significant activities was the sharing of success stories via webinars. Fifteen nursing homes shared their plans and interventions over the year, providing valuable concepts and a forum for discussion.
The aggregate pressure ulcer rate among nursing homes in the two-state network at the beginning of 2011 was 12.4 percent. The network finished with an aggregate rate of 7.5 percent through October 2012, representing a relative improvement of 39 percent.