Professionals

Nursing Home Quality Initiative

Project Overview

Imagine a health care system where every person receives the right care every time, and where staff and providers have the tools and resources to deliver that care. Qualidigm and the Centers for Medicare & Medicaid Services (CMS) are dedicated to realizing this vision.

Qualidigm, Connecticut's Quality Improvement Organization (QIO) is working to assist nursing home administrators and staff on how to use a variety of techniques and strategies to provide the best quality care and ensure a high quality of life for every resident. As your QIO, we are committed to helping nursing homes deliver care that is consistently safe, effective, efficient, timely, person-centered and equitable.


Qualidigm is working with Connecticut nursing homes on the following key strategies identified by CMS as part of the Nursing Home Quality Initiative:

  • Measure and Report Performance - Identify opportunities for improvement and track progress. Provide publicly reported quality data to consumers to promote informed choice.
  • Redesign Care Processes - Design effective, streamlined processes to deliver individualized care that is safe and efficient.
  • Transform Organizational Culture - Create a resident-centered organizational structure, workforce and environment. Empower leaders and staff to create change through open communication and teamwork.


Project Goals:

Statewide Goals Include:

Qualidigm will assist all nursing homes in setting targets for the conditions listed below using the Setting Targets-Achieving Results (STAR) interactive website. Additionally, Qualidigm will set statewide targets for these conditions based on CMS goals.


Participating Nursing Home Goals - Qualidigm works intensively with 36 Connecticut nursing homes to:

  • Improve the clinical quality provided to their nursing home residents in the areas of physical restraints, pressure ulcers among high-risk residents, identify and improve the management of depression, and management of chronic pain.
  • Collect and monitor resident and staff experience of care/satisfaction.
  • Reduce employee turnover for Certified Nursing Assistants/Aides (CNAs)

Qualidigm's Approach:

Our staff works with nursing homes to improve quality of care by:

Partnership Building

  • Working with nursing home providers, federal and state agencies and consumer advocates to create partnerships that expand our knowledge and resources to promote quality improvement.
  • Sponsoring and participating in the Culture Change Coalition, a voluntary, grassroots effort to drive positive changes in long term care.
    • Participants include representatives from state agencies, nursing home providers and consumer advocates who are dedicated to improving the quality of life for all residents and staff by transforming how care is delivered and experienced by nursing home residents.
  • Collaborating with Connecticut Department of Public Health and nursing homes to ensure that culture change initiatives are in compliance with regulations.

Performance Feedback

  • Training nursing homes on access to the STAR website to select appropriate targets, view quality measure scores and track their progress over time.
  • Helping consumers to understand and use the information provided by the Nursing Home Compare website to assess nursing home facilities. Assist nursing homes in improving quality of care related to these measures.

Quality Improvement Training and Support

  • Convening nursing home providers to share their experience with quality improvement interventions regarding clinical measures and culture change.
  • Conducting onsite visits and provide individualized quality improvement support to participating nursing homes.

Marketing and Communications

  • Recognizing outstanding quality improvement efforts through the Qualidigm Quality Awards program.
  • Providing press releases to nursing homes promoting their involvement in quality improvement efforts with Qualidigm.

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What's New

Connecticut Department of Public Health's Partnering for Quality Conference

Connecticut Department of Public Health sponsored their first ever co-training conference for both surveyors and facility direct care staff and it was a great success. The conference, entitled Partnering for Quality, was co-sponsored by Qualidigm, CANPFA, and CAHCF and featured nationally recognized speakers on pressure ulcers, pain treatment, restraint reduction, and dementia care. Click here to download conference materials.

WebEx Training

Download the WebEx Player to view a WebEx recorded session.

Pressure Ulcer Teleconference Materials - January 31, 2007

Restraints Webex Learning Session Materials

Pain WebEx Learning Session Materials

Pressure Ulcer WebEx Learning Session Materials

Depression WebEx Learning Session Materials

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Tools & Resources

Effective Management of Urinary Incontinence in Long-Term Care Facilities

MedQIC is a website where health care professionals can find and share quality improvement resources and browse through recommended interventions developed by colleagues and experts in their field. MedQIC offers tools, articles and links to resources about how to transform organizational culture, adopt health information technology, redesign care processes, and measure and report performance. The following are some examples:

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FAQs

How do I get involved in the NHQI project?
What does culture change in nursing homes mean?
What culture change models are available?
What is the nursing home STAR website?
How can I get time-trended reports on my Quality Measures performance?
How often is Nursing Home Compare updated?
Who do I contact to change/update my state survey results on Nursing Home Compare?
What is Connecticut’s Culture Change Coalition?
How can I get involved in Connecticut’s Culture Change Coalition?
How does HIPAA effect NHs working with Qualidigm?
I just received a MOA from Qualidigm. What does that mean and what do I have to do?
Where do I find MDS coding clarifications? 

 

 

 

How do I get involved in the NHQI project?
At the start of each new NHQI project round (currently in round 2), Qualidigm sends out applications to every nursing home (usually addressed to the Administrator and/or Director of Nursing). Any nursing home interested in participating in the project does so voluntarily by applying and agreeing to work with Qualidigm to achieve CMS goals during the three-year commitment of the project round. Project round 3 begins in the Fall 2008.

 

 

What does culture change in nursing homes mean?
Culture Change is the change from the institutionalized model of care to a model of care resembling a home – a place that nurtures the spirit as well as the body. The person-centered model of care emphasized in culture change puts as much weight on social and psychological needs of residents as it does on medical needs. Culture Change initiatives in long term care focus on transformational practices and procedures in workplace practice, care practice and the physical environment.

 

 

What culture change models are available?
There are a few different culture change models available to guide you. The current available models are: Eden Alternative, Pioneer Network, Planetree Model, Wellspring Model, and the HATCh Model.

 

 

What is the nursing home STAR website?
The Setting Targets—Achieving Results (STAR) site is a website that helps nursing homes incorporate the publicly reported quality measure data into their own internal quality improvement efforts. The site focuses on depression, pain, pressure ulcers and physical restraints.

After login to the STAR site using a secure login process, nursing homes will see their quality measure trend reports and be able to set quality improvement goals for up to one year (i.e. four quarters) while also comparing their quality measure scores to state and national averages. The site presents nursing homes with several target-setting methods (e.g., a 10 percent reduction) and guides each nursing home through the process of identifying appropriate goals. If the home is successful in achieving the targets early or want to change the targets, staff can submit new targets as frequently as once a quarter.

To use the STAR site, nursing homes will need computers with internet connections. Any internet connection will work, including a modem line; however, a faster connection (such as DSL) will allow the nursing home to view graphs and information more easily.

 

 

How can I get time-trended reports on my quality measures performance?
All nursing homes are able to obtain time-trended reports on their quality measures performance through the STAR site. Upon login to the STAR site, a nursing home can view trend reports for four quality measures and then set goals for up to one year (i.e., four quarters). The time-trended reports are now available each quarter.

 

 

How often is Nursing Home Compare updated?
Nursing Home Compare is updated every quarter.

 

 

Who do I contact to change/update my state survey results on Nursing Home Compare?
To change or request updated state survey information on Nursing Home Compare, you must contact the State of Connecticut, Department of Public Health.

 

 

What is Connecticut’s Culture Change Coalition?
Connecticut’s Culture Change Coalition is a voluntary, grass-roots effort to drive positive changes in long term care from institutional models of care to person-centered environments. The coalition promotes the development of person-centered environments where individuals live, work and grow in nurturing, respectful communities that honor personal choice and diverse lifestyles. The coalition accomplishes this by supporting culture change through:

  • Education and research.
  • Sharing lessons learned.
  • Acting as a liaison between stakeholders.
  • Developing collaborative relationships.
  • Identifying funding sources.

 

 

How can I get involved in Connecticut’s Culture Change Coalition?
The coalition is comprised of both providers and consumers. If you are interested in getting involved, please send your contact information to culturechange@qualidigm.org. You must have a valid email address to receive meeting notifications and information.

 

 

How does HIPAA affect NHs working with Qualidigm?
According to HIPAA regulations, when Qualidigm works with a nursing home under its contract with Medicare, it is considered to be an "oversight" agency. Qualidigm's "oversight" activities are authorized by law. See, e.g. 42 USC § 1320c-5(a)(3); 42 CFR §§ 480.111, 480.112, 480.113. Accordingly, HIPAA permits nursing homes to disclose protected health information to Qualidigm.

 

 

I just received a Memorandum of Agreement (MOA) from Qualidigm. What does that mean and what do I have to do?
In order to participate in the Medicare program, federal law [Section 1866 (a)(1)(F)(ii) of the SS Act] requires Skilled Nursing Facilities (SNFs) to have an MOA with a Quality Improvement Organization (QIO). The MOA outlines the QIO's and SNF's responsibilities in this relationship. If you receive an MOA from Qualidigm, review the document and follow the instructions in the letter that accompanies it.

 

 

Where do I find MDS coding clarifications?
Questions from RAI Panel and Answers from CMS – Fall 2006 - This Q&A document contains MDS coding clarifications directly from CMS. These questions were asked by NHs through their State RAI Coordinators.

 

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Our Partners

The Centers for Medicare & Medicaid Services (CMS)
Connecticut Association of Health Care Facilities
Connecticut Association of Not-for-Profit Providers For the Aging
Connecticut Department of Public Health, State Survey & Certification Agency
Connecticut Chapter of the American Geriatrics Society
Connecticut State Medical Directors Association
Connecticut State Medical Society, Section of Geriatrics
Long Term Care Ombudsman Program, Connecticut Department of Social Services

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Nursing Home Quality Initiative Project Team:

Quality Improvement Consultant
Michelle Pandolfi, MSW
860.632.3735
mpandolfi@ctqio.sdps.org

Administrative Assistant
Doreen Ostapchuk
860.613.3699
dostapchuk@ctqio.sdps.org

Analysis
Shih-Yieh Ho, MPH, PhD

Clinical Advisor
Ann Spenard, MSN, RN

Management
Anne Elwell, RN, BS, MPH, CPHQ

Marketing and Communications
Maxine Goldsmith, RN, MBA


Research and Evaluation
Judith Barr, ScD

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Events

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Qualidigm, 100 Roscommon Drive, Middletown CT 06457
phone: 860.632.2008 | fax: 860.632.5865 | e-mail: info@qualidigm.org