1. Improving Nursing Home Quality: Accelerating Change through the Advancing Excellence in America’s Nursing Homes Campaign Centers for Medicare & Medicaid Services Satellite Broadcast and Webcast Friday, March 23, :00 PM –3:00 PM EDT

2. Campaign Aim To pursue excellence in the quality
of life and quality of care for the
more than 1.5 million residents of
America’s nursing homes by
enhancing choice, strengthening
workforce and improving clinical
outcomes.

3. National Founding Members
The Alliance for Quality Nursing Home Care
American Association of Homes and Services for the Aging -- AAHSA
American Association of Nurse Assessment Coordinators -- AANAC
American College of Health Care Administrators – ACHCA
American Health Care Association -- AHCA
American Medical Directors Association -- AMDA
Centers for Medicare & Medicaid Services -- CMS
The Commonwealth Fund
The Evangelical Lutheran Good Samaritan Society
National Association of Health Care Assistants -- NAHCA
National Citizens’ Coalition for Nursing Home Reform -- NCCNHR
National Commission for Quality Long-term Care

5. An Unprecedented Coalition
Representing:
11,000 nursing homes nationwide
45,000 health care professionals, including:
3,500 Health Care Administrators
6,000 Directors of Nursing
7,200 Medical Directors
9,000 Gerontological Nurses and Nurse Coordinators
20,000 Certified Nursing Assistants
1,000 Consumer Advocates; Millions of caregivers
1.8 million Service Employees
National Commission for Quality Long-term Care:
Two Governors
Four current Members of Congress
Former Senator Kerrey and Former Speaker Gingrich
Quality experts

6. Campaign Components Meaningful Goals Measures and Data Sources
National and State Infrastructure
Technical Assistance
Evidenced-based Protocols
Guidelines

7. National Quality Initiatives: Common Goals
Goal / Aspect of the campaign
Advancing Excellence in America’s Nursing Homes
Quality First
(AHCA, AAHSA, The Alliance)
Nursing Home Quality Initiative
(CMS)
Culture Change
AMDA-F
LTC Quality Improvement Study
Voluntary participation X
Reduce Pressure Sores
Reduce use of restraints
Reduce pain in long-stay residents
Reduce pain in short stay residents
Set targets for clinical quality improvement
Measure resident / family satisfaction and incorporate into care plan
Measure staff turnover and develop plans to improve staff retention
Adopt “consistent assignment” of CNAs

8. Campaign Goals Clinical Goals:
Reduce prevalence of pressure ulcers among high risk residents
Reduce use of daily physical restraints
Management of pain among long stay residents
Management of pain among post acute residents
Measure definitions available on
Data derived from MDS
Automatically updated quarterly from MDS

9. Campaign Goals Organizational Goals:
Target setting among nation’s nursing homes
Measurement of resident and/or family satisfaction
Reduce workforce turnover
Adoption of consistent assignment

10. Provider Benefits of a National Campaign
Advances Evidenced-based Practice
Improved Strategies to Promote Positive Clinical Outcomes and Regulatory Compliance
Improved Customer Satisfaction
Focus on Staff Retention
Cost Savings
Improved Decision-making Strategies
Supports Risk Management
Supports Pay for Performance Initiatives
Advances Use of Technology
National Support At the Table – Now & in the Future

11. National Benchmarks & Targets
Baseline
3rd Q/2005
Goals
2008
Pressure Ulcer Reduction
13%
10%
Physical Restraints Reduction 7% 5%
Pain/Long Stay Reduction 6% 4%
Pain/Post Acute Reduction
23%
15%
Target Setting (baseline 2006)
34%
90%
Measuring Customer Satisfaction (estimate)
20%
80%
Measuring Staff Turnover (estimate)
Consistent Staffing X
33%

12. Target Setting
Definition: Setting personal quality improvement goals for pressure ulcers, physical restraints, and pain
Use
Easy to use
More than 8,000 nursing homes have already set targets
Pre-established accounts for all providers
Provides ideas about how to set targets
Updated at least annually

14. Measuring Customer Satisfaction
Definition: Is the resident and/or family member satisfied with the quality of care and services received?
Use
Providers can select from a drop down list
Or enter “other”
Use this information for internal improvement
Self-reported at least annually on Web site

17. Measuring & Reducing Nursing Staff Turnover
Definition: Reducing the number of nursing staff (RN, LPN, CNA) who leave the facility annually
Use
Download excel spreadsheet
Document clinical staff terminations & average number clinical staff
Use this information to calculate annual turnover
Enter turnover rate on campaign website
Self-reported at least annually on Web site

19. Adoption of Consistent Assignment
Definition: Having the same caregiver consistently caring for the same person on at least 85% of that caregiver’s shifts
Use
Click yes or no
Date when first initiated
Self-reported at least annually on Web site

20. Advancing Excellence Considerations
Understand the clinical and organizational goals
Measurement
Each process framework
Benchmark how your facility is doing
Evaluate costs and outcomes
Assess which goals you are already working on and ones that you want to work on
Spend time on
Work with your LANE or QIO to learn how the campaign complements what you’re already doing

21. National and State Infrastructure
National Campaign Steering Committee
Local Area Networks for Excellence (LANES)
Quality Improvement Organizations (QIOs)
Clinical Tools
Quality First Online Resources
Clinical Practice Guidelines from American Medical Director’s Association
Agency for Healthcare Research and Quality Guidelines

22. National Campaign Steering Committee
New relationship paradigm that includes consumer advocates, nursing home providers, key sectors of government, quality improvement organizations, nurses, medical experts, and others.
Provide leadership, communication, and motivation for the campaign.
Monitor key indicators of nursing home quality; promoting excellence in care giving for nursing home residents, and acknowledging the critical role nursing home staff has in providing care.

23. Local Area Networks for Excellence (LANEs)
Network of individuals and organizations across the
state (or territory) working together to fulfill needs at
the local level to ensure campaign success.
Roles and Responsibilities:
Raise Awareness
Drive Enrollment
Convene Meetings
Provide Technical Assistance
Communicate Key Campaign Messages
Respond to Critical Issues

24. Monitoring Campaign Progress
Visit Web site at
will be updated regularly with campaign
progress:
Enrollment by state and nationally
List of providers enrolled in campaign
Progress toward campaign goals
(Voluntary) individual progress towards campaign goals

25. How to Become a Participating Provider
Visit
Click on link “For Nursing Homes”
Commit to three to eight goals for quality improvement and register
Begin to work on selected goals using available technical resources
Connect with LANE or QIO
Join thousands of other providers
We encourage you to register by November 30, 2007

26. How to Become a Participating Consumer
Visit
Click on “For Consumers”
Read about opportunities for consumers to support the campaign
Fill out registration form
Begin communicating with others about the campaign

27. Improving Nursing Home Quality: Accelerating Change through the Advancing Excellence in America’s Nursing Homes Campaign