Florida Nursing Home Quality Care Connection

The Florida Nursing Home Quality Care Connection

Provide Exceptional Compassionate Clinical Care that Treats the Whole Person

Focusing on person-centered care is critical when it comes to delivering top-quality clinical care that leads to improved clinical outcomes and quality of life for residents. To ensure your nursing home achieves this, the National Nursing Home Quality Care Collaborative (NNHQCC) Change Package recommends focusing on this four-pronged strategy:

Implement consistent assignment.
Choose and engage medical leadership wisely.
Ensure transitions are done with care.
Strive to prevent problems, and treat when necessary.

The presence of a Certified Medical Director (CMD) has been shown to improve nursing home quality by as much as 15 percent. At your facility, the medical director should be a CMD, or at a minimum he or see should be a member of your state's AMDA (The Society for Post-Acute and Long-Term Care Medicine, www.amda.com) chapter.

For more insight and practical tips, read pages 25-29 of the NNHQCC Change Package.

Tips and Change Ideas for Decline in Activities of Daily Living

The decline in Activities of Daily Living (ADLs) is a common issue in long-term care. While not always preventable, facilities can focus on improving underlying impairments in physical abilities, including balance, muscle strength, and the ability to transfer from one position to another.

Make an impact on ADL decline by:

Considering physical therapy as appropriate.
Incorporating balance training.
Increasing intensity and frequency of observation.
Making environmental adaptations.
Identifying and reducing medications with potential side effects.

For more suggestions, check out these resources:

Vanderbilt University's Mobility Decline Prevention Training Module
The American Geriatrics Society guidelines for fall reduction programs

Next month: Tips and change ideas for high-risk pressure ulcers

QAPI Corner

Step 6: Conduct a QAPI Awareness Campaign

Communication is the key to a QAPI awareness campaign--and it starts with communicating with all caregivers involved in the care of residents. The first item on the agenda is to let everyone know about your QAPI plan. QAPI is about systems of care, management practices, and business practices. With a goal of widespread awareness, multiple education exposures are critical to a successful campaign:

Use dialogue, examples, and exercises.
Make sure all of your vendors and collaborating agencies are aware of your QAPI approach.
Look for opportunities to involve vendors and collaborating agencies in your process.
Ensure that every caregiver in your facility feels safe to raise quality concerns.

Don't leave the residents and their families behind in the awareness campaign! Make sure they know their views are both sought after and valued. Ask them to tell you about their quality concerns--and view those concerns through the residents' eyes. You might even consider including QAPI information in routine communications to families. Family and resident complaints are often underused, and yet they are valuable in identifying more general problems.

For more information about conducting a QAPI awareness campaign, read pages 13-14 of QAPI at a Glance. In addition, the tool provided on page 13 provides a template guide for conducting such a campaign.

Next month: Develop a strategy for collecting and using QAPI data

HSAG Resource Spotlight

QAPI Resource Library

Access all of the CMS tools for QAPI from one easy-to-use electronic resource library. Learn more.

QAPI Plan Template

Ensure resources are in place for your facility's PIP teams with this helpful one-page checklist. Learn more.

QAPI Companion Guide

This guide helps walk your team through the actions steps of developing your organization's QAPI plan. Learn more.

This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-C.2-10262015-01