1. 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.

2. Campaign Overview How We Got Started Our Members Continuing Our Work

3. 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)

4. Circle of Success

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

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

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

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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

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

17. PlanDoStudyAct 17

18. Explore the Goal

19. www.nhqualitycampaign.org

20. 20 Why Choose Mobility?

21. PlanDoStudyAct

22. Where am I?

23. PlanDoStudyAct

24. Study Examine Processes Probing Questions

25. PlanDoStudyAct 25

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

27. 27 Engage

28. The Tracking Tools 28 AE_YourGoalTrackingTool.xls

29. 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

30. 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?

31. 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

32. 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

33. Staff Stability

34. Consistent Assignment

35. Person Centered Care

36. Hospitalizations

37. Infections

38. Medications

39. Mobility

40. Pressure Ulcers

41. Pain

42. 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

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

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