Quality Insights of Pennsylvania (now a part of Quality Insights Quality Innovation Network*), the QIO for the state, worked with nursing homes across Pennsylvania to help reduce the use of physical restraints. One example is Pennswood Nursing Home, a 53-bed facility in Bucks County, Pennsylvania, which reduced its restraint use from 6.6 percent to zero over a 12 month period from August 2011 to July 2012.
A dedicated project coordinator at Quality Insights worked with the director of nursing at Pennswood Nursing Home on a plan to educate staff about physical restraints and improve processes to prevent restraint use. The QIO provided a physical restraint checklist and the nursing home established a multidisciplinary Physical Restraint Team to educate staff about the negative effects of restraints. Nursing home staff also participated in Quality Insights webinars focused on the legal aspects of physical restraints using real-life scenarios.
Soon after, staff began to identify issues related to coding restraints on the assessment form as well as doctors’ and therapists’ concerns over resident falls.
“Our restraint reduction program took off after we started it with Quality Insights,” said Lois Pasco, Pennswood’s nursing home administrator, who was the director of nursing during the project with Quality Insights. “The driving force for our care team was an appreciation of resident independence and reducing falls due to restraints.”
Nursing home management also began to examine staff stability. In doing this, hiring practices were implemented to better keep and retain staff.
“When residents have the same caregiver, they get to know each other better, which improves quality of care,” said Pasco.
As of summer 2013, Pennswood continued to remain restraint-free.
*As of August 1, 2014, Pennsylvania has two Quality Improvement Organizations. Quality Insights of Pennsylvania now provides quality improvement technical assistance as a part of Quality Insights Quality Innovation Network. Beneficiary and family centered care quality improvement services are now provided by Livanta.