Advancing Excellence in America’s Nursing Homes Campaign Making nursing homes better places to live, work and visit OUR MISSION OUR VISION Every nursing home resident in America experiences person- centered 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

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

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

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

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

Broader Impact Quality AssurancePerformance Improvement ReactiveProactive Episode or event-basedAggregate data and patterns Prevent recurrenceOptimize process Sometime anecdotalAlways measurable RetrospectiveConcurrent Audit-based monitoringContinuous monitoring Sometimes punitivePositive change

Broader Impact 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) Using Advancing Excellence to support QAPI

Broader Impact 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) Using Advancing Excellence to support QAPI

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

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

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

PlanDoStudyAct 17

Explore the Goal

20 Why Choose Mobility?

PlanDoStudyAct

Where am I?

PlanDoStudyAct

Study Examine Processes Probing Questions

PlanDoStudyAct 25

26 Improve ycampaign.org/star_ index.aspx?controls= MobilityImprove

27 Engage

The Tracking Tools 28 AE_YourGoalTrackingTool.xls

QA and PI Quality AssurancePerformance Improvement ReactiveProactive Episode or event-basedAggregate data & patterns Prevent recurrenceOptimize process Sometime anecdotalAlways measurable RetrospectiveConcurrent Audit-based monitoringContinuous monitoring Sometimes punitivePositive change

QA and PI Quality AssurancePerformance Improvement ReactiveProactive Episode or event-basedAggregate data & patterns Prevent recurrenceOptimize process Sometime anecdotalAlways measurable RetrospectiveConcurrent Audit-based monitoringContinuous monitoring What went wrong?How can we be excellent?

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 Tracking Tools Support QA and PI

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

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 Monthly Data Entry on the AE Website From You For You Enter ONLY summary data from your tracking tool – just a few numbers each month. Estimated time: 10 minutes or less

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

Thank you! Visit Us Connect Online Contact Us Adrienne Thomas (202)