1. M ISSOURI Q UALITY I NITIATIVE FOR N URSING H OMES PRESENTED BY C OLLEEN G ALAMBOS P H D C ARE T RANSITIONS L EAD M ARILYN R ANTZ PHD P RINCIPAL I NVESTIGATOR

2. MOQI M ODEL

3. MOQI T EAM

4. T HEORETICAL M ODEL : C OMPLEXITY S CIENCE Relationships Communication Cognitive diversity Relationships Communication Cognitive diversity

5. K EY V ARIABLES  Relationships - Personal relationships are essential in organizations for positive outcomes. Intact relationships lead to better information exchanges needed for decision-making.  Communication - Communication is a social act of collaboration. Being able to say what you mean without fear of retribution is communication openness.  Cognitive Diversity - Using organizational connections and relationships to exchange information in decision making. Influences decision outcomes and resident outcomes.

6. MOQI I NTERVENTION

7. P RELIMINARY F INDINGS Resident enrollment Hospitalizations Monthly management

8. P RELIMINARY ECCP A GGREGATE M ETRICS FOR T OTAL I NITIATIVE U PDATED A PRIL 2014 C ALENDAR Q UARTER 1-D EMOGRAPHICS

14. H EALTH I NFORMATION T ECHNOLOGY C ARE M AIL P RELIMINARY W ORKFLOW A NALYSIS T ECHNOLOGY U SE

15. C ARE M AIL U SE Messages Sent Messages Received

16. C ARE T RANSITIONS A DVANCE D IRECTIVES Improved Communication in Transitions Support Quality Improvement Processes Between SNF’s and Hospitals Education about Advance Directives and Advance Care Planning Provide Opportunities for Enactment of Advance Directives Improve psychosocial support and care in facilities

19. APRN I NTERVENTION IN S KILLED N URSING F ACILITIES

20. P RELIMINARY ECCP A GGREGATE M ETRICS FOR T OTAL I NITIATIVE U PDATED A PRIL 2014 C ALENDAR Q UARTER 1- O UTCOMES

21. D ISCLAIMER Please note that the data contained in this presentation are preliminary findings only. The Nursing Facility Initiative has an independent contractor that will be performing the official evaluation.

22. QUESTIONS ??