Advancing Excellence in Americas Nursing Homes Campaign OUR

Advancing Excellence in America’s Nursing Homes Campaign OUR MISSION OUR VISION Making nursing homes better places to live, work and visit Every nursing home resident in America experiences personcentered quality of life as a result of a stable and empowered workforce, dedicated to improving clinical and organizational outcomes, and engaging in open communication and transparency.

Campaign Overview How We Got Started Our Members Continuing Our Work

Campaign Overview THE CAMPAIGN INCLUDES: • More than 60% (9, 455) of the nation’s nursing homes • 3, 578 consumers • 3, 216 nursing home staff members • 52 state-based Local Area Networks of Excellence (LANEs)

Circle of Success

Nine New Goals PROCESS GOALS • Improving Staff Stability • Increasing Use of Consistent Assignment • Increasing Person-Centered Care • Safely Reducing Hospitalizations Continued …

Nine New Goals CLINICAL GOALS • Using Medications Appropriately • Increasing Resident Mobility • Preventing and Managing Infections Safely • Reducing Pressure Ulcers • Decreasing Symptoms of Pain

Expected Outcomes To Engage and Challenge Nursing Homes To Provide Valuable Data and Quality Improvement

Expected Outcomes To Establish National Standards and Best Practices Becoming a Central Voice for Quality Initiatives

Broader Impact Advancing Excellence and QAPI New CMS Quality Assurance/Performance Improvement requirements emphasize: • Problem identification • Data collection • Root-cause analysis • Performance measurement and tracking

Broader Impact 5 Elements of QAPI Element 1 Design and Scope Element 2 Governance and Leadership Element 3 Feedback, Data Systems and Monitoring Element 4 Performance Improvement Projects Element 5 Systematic Analysis and Systemic Action

Broader Impact Quality Assurance Performance Improvement Reactive Proactive Episode or event-based Aggregate data and patterns Prevent recurrence Optimize process Sometime anecdotal Always measurable Retrospective Concurrent Audit-based monitoring Continuous monitoring Sometimes punitive Positive change

Broader Impact Using Advancing Excellence to support QAPI Advancing Excellence goal “packages” can help nursing homes align with QAPI – Goals include clinical, resident choice and organizational infrastructure topics (QAPI Element 1 and 4) – Advancing Excellence’s Circle of Success – PDSA change framework for systematic performance analysis leading to systemic action (QAPI Element 5) – Data measurement and tracking tools (QAPI Elements 3, 4 and 5)

Broader Impact Using Advancing Excellence to support QAPI Advancing Excellence goal “packages” can help nursing homes align with QAPI – Root-cause analysis tools – called “Probing Questions” (QAPI Element 5) – Measures created from best available evidence (QAPI Element 1) – Vetted resources to guide interventions (QAPI Element 4) – Consumer, staff and leadership fact sheets (QAPI Element 2)

About the Campaign National, Voluntary, Aligned Registered Participant/Active Participant Register, Update Profile Select Goals Submit Data

Quality Improvement Resources for NINE New Goals Hospitalizations Staff Stability Pressure Ulcers Medications Antipsychotics Consistent Assignment Infections C. difficile Mobility Person. Centered Care Pain Management 15

Organizational Goals Hospitalizations Staff Stability Pressure Ulcers Medications Antipsychotics Consistent Assignment Infections C. difficile Mobility Person. Centered Care Pain Management 16

Plan. Do. Study. Act 17

Explore the Goal

www. nhqualitycampaign. org

Why Choose Mobility? 20

Plan. Do. Study. Act

Where am I?

Plan. Do. Study. Act

Study Examine Processes Probing Questions

Plan. Do. Study. Act 25

Improve http: //www. nhqualit ycampaign. org/star_ index. aspx? controls =Mobility. Improve 26

Engage 27

The Tracking Tools AE_Your. Goal. Tracking. Tool. xls 28

QA and PI Quality Assurance Performance Improvement Reactive Proactive Episode or event-based Aggregate data & patterns Prevent recurrence Optimize process Sometime anecdotal Always measurable Retrospective Concurrent Audit-based monitoring Continuous monitoring Sometimes punitive Positive change

QA and PI Quality Assurance Performance Improvement Reactive Proactive Episode or event-based Aggregate data & patterns Prevent recurrence Optimize process Sometime anecdotal Always measurable Retrospective Concurrent Audit-based monitoring Continuous monitoring What went wrong? How can we be excellent?

Tracking Tools Support QA and PI Easy view of individual records allows resident-level view Matrix of individual data allows scanning for patterns Summary information helps identify opportunities to improve at the system level

Data and the Quality Improvement Process How do I know where I am? Where do I want to be? What processes are associated with my outcome? When I change a process, how do I know it had the effect I wanted? How am I doing compared to other nursing homes working on this goal? 32

Staff Stability

Consistent Assignment

Person Centered Care

Hospitalizations

Infections

Medications

Mobility

Pressure Ulcers

Pain

Monthly Data Entry on the AE Website From You • Enter ONLY summary data from your tracking tool – just a few numbers each month. • Estimated time: 10 minutes or less For You • Maintain your status as an Active Participant • Let consumers find you and display your contact information and a link to your website • View your data: Trend graphs display your progress over time • See your progress compared to other Campaign participants within your state and the nation

What’s Next Strengthening the Lanes Increasing Nursing Home Participation Expanding Campaign Outreach

Thank you! Visit Us www. nhqualitycampaign. org Connect Online Contact Us Adrienne Thomas athomas@aeltcc. org (202) 508 -9439