Content contained in this newsletter may have been previously published in prior issues of the QCC newsletter.  
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The Florida Nursing Home
Quality Care Connection
This QCC Newsletter is your monthly National Nursing Home Quality Care Collaborative (NNHQCC) in Florida member update that provides information on the latest activities. It is a quick reference for information on links to improvement tools, resources, news, best practices, and success stories. 
Share Your Successes!
The National Nursing Home Quality Care Collaborative (NNHQCC) Change Package  (v2.2) is a menu of strategies, change concepts, and specific actionable tactics that any nursing home can begin testing for purposes of improving residents' quality of life and care. As you test action items from the change package, consider documenting your success stories and sharing them with your staff members, as well as with the FL-NNHQCC, to help spread improvement and best practices across the state.  

Developing a success story is useful for a number of reasons:
  • It provides a historical record of efforts taken to produce positive results.
  • It celebrates achievements.
  • It pinpoints messages to communicate to stakeholders.
  • It can help others emulate your success and establish your nursing home as a leader.

To help, a success story template is included as attachment 1 in the NNHQCC Change Package  (v2.2).
In addition to the NNHQCC Change Package v2.2., the Centers for Medicare & Medicaid Services (CMS) has just released an important new resource: All Cause Harm Prevention in Nursing Homes Change Package.
 
This package is a compendium of successful practices of high performing nursing homes, illustrating how they prevent harm while honoring each resident's rights and preferences.
Contact us with any questions at FL-NNHQCC@hsag.com
Ideas for Urinary Tract Infections
Urinary tract infections (UTIs) can be uncomfortable, painful and can lead to serious complications. The UTI quality measure (QM) reports the percentage of long-stay residents with a target assessment that indicates a UTI within the last 30 days. The denominator of this quality measure includes all long-stay residents with a selected target assessment, except residents whose:

  1. Target assessment is an admission assessment (A0310A = [01]) or a Prospective Payment System (PPS) 5-day or readmissions assessment (A0310B = [01, 06]).
  2. UTI value is missing (I2300 = [-]).

Learn more about the calculation of this QM on page 32 of the Minimum Data Set (MDS) 3.0 Quality Measures User's Manual (v11.0 04-01-2017).

Performance Improvement Project (PIP) teams should assess UTI risk factors for each resident at numerous points of care, including pre-admission, admission, changes in continence status or condition, and with MDS assessments. Interventions may include:

  • Proper catheter management
  • Proper UTI testing
  • Toileting programs
  • Educating staff about resident signs and symptoms to report

Additionally, PIP teams must ensure their goals and strategies to prevent UTIs is clearly communicated and involves all staff members, residents, and families.
  

Next month: Tips and Change Ideas for Catheters
QAPI Corner
STEP 8: Identify Your Gaps and Opportunities

Quality Assurance & Performance Improvement (QAPI) is a data-driven, proactive approach to improving the quality of life, care, and services in nursing homes. Nursing homes are in the best position to assess, evaluate, and improve the care they deliver because they have first-hand knowledge of their own organizational systems, culture, and history
  
Reviewing various sources of information can help determine if gaps or patterns exist in your systems of care that could result in quality of care issues. The following are some data resources to review:

  • MDS 3.0 CASPER QM Package Reports
  • Nursing Home Compare 
  • State survey results and plans of correction
  • Resident care plans noting progress toward goals
  • Resident complaint logs that show trends
  • Satisfaction reports based on resident and family feedback

These data lead to the next step of developing PIPs to deal with high-risk, high-volume, problem-prone areas. Also, don't forget to take time to notice the things that are going well, and recognize your staff members for their achievements.
  
For more information on this topic, read page 16 of QAPI at a Glance .
 
Next month: Prioritize Quality Opportunities and Charter PIPs
Quality Assurance and Performance Improvement Resources
HSAG Resource Spotlight
This material was prepared by Health Services Advisory Group, the Medicare Quality Innovation Network-Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, 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.2-12202018-01