USA. New national QIO effort: improving nursing home quality of care

Citation

(2002), "USA. New national QIO effort: improving nursing home quality of care", International Journal of Health Care Quality Assurance, Vol. 15 No. 5. https://doi.org/10.1108/ijhcqa.2002.06215eab.015

USA. New national QIO effort: improving nursing home quality of care

USA

New national QIO effort: improving nursing home quality of care

A new federal initiative spearheaded by quality improvement organisations (QIO) will help nursing homes improve care for residents who often suffer from pain, delirium, depression, pressure ulcers, and loss of everyday functions. In 2002, working under contract to the US Department of Health and Human Services (HHS), QIOs will begin providing nursing homes with materials and technical support needed to upgrade clinical and organisational systems.

The QIO initiative complements a move by the Centers for Medicare and Medicaid Services (CMS) at HHS to publicly report on the quality of care at every Medicare and Medicaid participating nursing home. CMS will focus on indicators of quality selected by the National Quality Forum such as pain, delirium, re-hospitalisation, walking, pressure ulcers, psychotropic drug use, assisted daily living decline, weight loss, infections, and restraints. QIO teams will help the public understand and use the indicators in selecting nursing home facilities.

QIOs in nearly every state have worked with nursing homes on specific projects to improve care. QIOs will draw on this experience, as well as partnerships forged with state agencies, health plans, professional and industry associations, and consumer advocacy organisations to broadly improve nursing home quality of care. Current projects include assistance in the prevention and treatment of pressure sores, falls prevention, pain management, development of quality measures for rehabilitation services, improving diabetes outcomes, improving anticoagulant use, and immunisation campaigns.

QIOs will help nursing home management identify what is necessary to create a quality improvement culture and empower staff to build quality improvement processes into everyday work. They will give all nursing homes materials providing guidelines for proper care, methods for improving care, staff training information, model policies and protocols, and tools for assessing care, and will facilitate regional nursing home alliances to help facilities learn from each other and train staff to implement shared lessons and best practices.

In addition, QIOs will offer intensive technical assistance to a significant number of nursing homes in each state. In facilities that volunteer to participate, QIOs will help staff identify leadership roles, establish clinical care teams, and learn a process for continuously improving quality of care. Focusing on specific clinical indicators, teams will perform clinical assessments, establish new policies and treatment protocols, provide additional staff training, and assess whether the changes cause sustainable improvement in care.