Krystal Hays, RN, MSN, RAC-CT Jane Stotts, RN, BSN Paula Sitzman, RN, BSN Quality Improvement Advisors Nebraska Great Plains Quality Care Collaborative Kick-off
Objectives State the structure, framework, aims and goals of the Collaborative Identify steps to prepare for Collaborative participation Describe tools and resources utilized during the Collaborative 2
The Great Plains Quality Innovation Network: A New Entity The Great Plains QIN was formed with the following four entities serving as subcontractors; each a QIO in previous scopes: Kansas Foundation for Medical Care CIMRO of Nebraska Quality Health Associates of North Dakota South Dakota Foundation for Medical Care 3
11SOW QIN-QIO Map
Make-Up of the Great Plains QIN These four states choose to work together because of: commonalities of Medicare consumers provider characteristics rural and frontier issues similar corporate philosophies and general approaches to the QIO work These common factors are strengths in working cohesively
Great Plains Quality Care Collaborative Aims Support the National Nursing Home Quality Care Collaborative (NNHQCC) objectives to instill quality and performance improvement practices, eliminate healthcare acquired conditions and improve resident satisfaction by: Working with nursing homes to attain a composite score of 6.00 or less Reduce the use of unnecessary antipsychotic medication in dementia residents Reduce avoidable hospital readmissions Improve the rate of mobility 6
Nebraska Great Plains Quality Care Collaborative 7
Recruit: nursing homes, stakeholders and peer coaches Great Plains Quality Care Collaborative Model 18 Months x 2 Sustainability Phase Pre-work: beginning 2-3 months prior to Learning Session 1 Collaborative Learning Session 1 face-to-face session Action Period Learning Session 2 Action Period Learning Session 3 Action Period Collaborative Outcomes Congress Project wrap-up, celebrate successes and sustainability planning session. Email & List Servs, Peer Coaches, Educational Webinars, Technical Assistance 8
Learning Session Objectives Learning Session 1 Get ideas Get methods Get started Learning Session 2 Get more ideas Get better at methods Get a stride Learning Session 3 Continue to learn from one another Celebrate successes Get ready to sustain and spread Test and implement changes. Collect data to measure impact of changes. Test and implement changes, collect data to measure impact of changes. Test and implement changes, collect data to measure impact of changes. Action Period 1 Action Period 2 Action Period 3 9
IHI Model for Improvement PDSA Cycle Image/IHI Model for Improvement 2015 Institute for Healthcare Improvement. All rights reserved 10
Plan, Do, Study, Act (PDSA) Cycle Source: CMS, PDSA Cycle Template 11
Support for Collaborative Members GPQCC Listserv (email for Tip of the Week &/or educational topics) Peer coaches Educational webinars Teleconferences Tools & resources Technical assistance 12
Measuring Success Composite scores Quality measures Self-focus areas Quarterly progress reports 13
Sustainability Period of sustaining the quality improvement Between Collaborative I and II New ways of working and improved outcomes become normal Adapt the change to areas or residents other than the pilot group 14
Pre-Work Zip File 15
Pre-Work Zip File 16
6 Steps to Collaborative Preparation 17
Step 1: Select Team Members Not just leadership At least one direct care team member If you have existing QAPI or PI teams, use that same team! ** Medical Director / Pharmacy etc. will not be added to emails or list servs. 18
Step 2: Education Needs Assessment 1. Teams training needs 2. Areas your NH is doing well in 3. Focus areas for your NH 4. What day of week and time of day is best for monthly webinars & teleconferences 19
Choose Systems-Level Focus Staff stability Consistent/permanent assignment Resident/family engagement Team building Communication Effective leadership Other: 20
Choose Healthcare Acquired Condition Focus Antipsychotic medication reduction Reducing avoidable readmissions Pain management Fall prevention/fall risk assessment Vaccinations (pneumonia/influenza) Infection prevention (UTI, C-Dif, MRSA) Bowel & bladder management Reducing high-risk pressure ulcers Reducing residents with weight loss Reducing residents with symptoms of depression Other: 21
Step 3: Take Your QAPI Pulse Submit most recent QAPI Self- Assessment Review and submit QAPI Self- Assessment tool approximate 1 year later (Mar/April 2016) 22
Step 4: Save the Date QAPI 101 Thursday, March 19, 2015 10:00-11:00 a.m. CST CASPER and Composite Score April 2015 Date, time TBD 23
Step 5: Tell Your Story Why use a storyboard? Educate, communicate QAPI story Condenses the work for presentation Summarize a quality improvement process Organize work, record progress Standardized format to display work Quick to read and understand (staff, residents, families) Promotes the organization s overall QAPI efforts 24
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Step 6: Active Participation Watch your email for Tips of the Week, upcoming educational events, tools and resources Attend monthly webinars (most are recorded) Attend face-to-face Learning Sessions Engage all staff in improvement Learn from others successes, challenges, lessons learned Use QAPI in everything you do Use data to drive and measure improvement 29
Tools and Resources 30
Tools and Resources QAPI at a Glance Step-by-step guide QAPI tools, resources Image Source: http://www.cms.gov/medicare/provider Enrollment and Certification/SurveyCertificationGenInfo/Policy and Memos to States and Regions.html 31
Tools and Resources National Nursing Home Quality Care Collaborative Change Package High-performing nursing homes Successful best practices Action items Update coming soon! Image Source: http://www.cms.gov/medicare/provider-enrollment-and-certification/qapi/downloads/nnhqcc-package.pdf 32
Tools & Resources Image Source: NNHQCC Change Package v 1.2, p. 26 33
Contact Information Krystal Hays, RN, MSN, RAC-CT krystal.hays@hcqis.org Jane Stotts, RN, BSN jane.stotts@hcqis.org Paula Sitzman, RN, BSN paula.sitzman@hcqis.org 1200 Libra Drive, Suite 102 Lincoln, Nebraska 68512 Phone: 402.476.1399 ext. 522 Fax: 402.476.1335 This material was prepared the Great Plains Quality Innovation Network, the Medicare Quality Improvement Organization for Kansas, Nebraska, North Dakota and South Dakota, under contract with the Centers 34 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. 11S0W-GPQIN-NE-C2-16/0215