Kentucky Nursing Home Collaborative Action Period 1 Scott Gibson, Quality Improvement Advisor June 9, 2015
QIO Program Restructures New multistate, five-year contract began Aug 1, 2014 Quality Innovation Network (QIN)-Quality Improvement Organizations (QIOs) awarded 14 nationwide-to advance national quality improvement activities atom Alliance QIO Qsource atom Alliance lead member www.atomalliance.org 2
atom Alliance Partners Multistate alliance for powerful change composed of three nonprofit, healthcare quality improvement consulting companies 3
atom Alliance Nursing Home Collaborative We provide Data Reports Customized onsite consultation Quality improvement skills training Evidence-based tools and resources Ongoing educational opportunities Peer mentoring Active nursing home collaborative 4
Nursing Home Aims Ensure every resident gets the highest quality of care Instill quality and performance improvement practices in nursing homes Eliminate healthcare acquired conditions (HACs) Improve patient satisfaction 5
Nursing Home Goals Improve the national nursing home composite quality measure score Improve resident mobility Reduce antipsychotic drug use in dementia residents Improve national nursing home star rating Increase provider participation in the Advancing Excellence Campaign: Active Participant 6
Nursing Home Compare Changes Revised scoring methodology Nationwide focused survey inspections Payroll-based staffing reporting Additional quality measures Ease of use for families Includes alternatives to nursing homes 7
8 Changes in Kentucky
Composite Score Comprised of the 13 long-stay quality measures Calculated as (sum of numerators/sum of denominators) x 100 Since the two vaccination measures are directionally opposite (i.e., higher rate represents better performance), composite numerator for these two measures is (denominator-numerator). Interpreted as lower = better Calculated based on the opportunity model concept Number of missed opportunities in the following graphs represent clinical areas that need most improvement to improve overall composite score 9
Example 1: Missed Opportunities vs. Composite Score 10 While this facility seems to be performing well on most measures, use of antipsychotic medications burdens overall composite score.
Example 2: Missed Opportunities vs. Composite Score 11 This facility has several opportunities for improvement; focusing on incon (incontinence) and ADL (ADL decline) measures may improve the overall composite score.
Trends in Composite Scores KY 12 National Goal: At least 50% of recruited nursing homes achieve a composite score of 6.00 or better.
Kotter s 8 Steps of Change John Kotter 13
High Functioning Teams Drive and Sustain systemic change QAPI Methodology Leadership Driven 14
Ask Yourself These Probing Questions Who is on our QAPI Steering Committee? Is our Medical Director involved in QAPI? How can we provide needed resources for QAPI? Is our climate open, respecting and just (fair)? What does our climate look like? How can QAPI blend with our existing QA efforts? 15
Ask Yourself These Probing Questions (Cont.) How can residents and families be involved in our QAPI efforts? Do we have effective teamwork? How do we know? What does it look like? How does leadership support the development of effective teams? Do we have effective communication in our facility? How do we know? Do team members support one another? 16
Action Period 1: Teamwork Activities June, July and August Assemble a team Establish a leader Assign roles and responsibilities Hold team members accountable Actively share information among team members Submit QAPI Self-Assessment Tool Individual commitment to a group effort that is what makes a team work, a company work, a society work, a civilization work. Vince Lombardi 17
Learn More Kotter s 8 Step Process for Leading Change http://www.kotterinternational.com/the-8-step-process-forleading-change/ TeamSTEPPS http://www.ahrq.gov/professionals/education/curriculum-tools/ teamstepps/longtermcare/ 18
For More Information Visit our LSSCC dedicated webpage http://www.atomalliance.org/lsscc 19
Join Us! Be a part of the powerful change taking place in nursing homes across the nation. Contact: Scott Gibson Quality Improvement Advisor 502-680-2669 scott.gibson@area-g.hcqis.org Join our collaborative! This material was prepared by the atom Alliance, the Quality Innovation Network-Quality Improvement Organization (QIN-QIO), coordinated by Qsource for Tennessee, Kentucky, Indiana, Mississippi and Alabama, under a contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Content presented does not necessarily reflect CMS policy 15.SS.KY.05.004