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Advancing Excellence in America's Nursing Homes

Project Overview
Tools & Resources
FAQs
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Project Overview

As America's population ages and the first of the "baby boomers" turn 60 years old, a new coalition concerned about how we care for elderly and disabled citizens is reinvigorating efforts to improve the quality of care and quality of life for those living or recuperating in America's nursing homes.

Health care providers, caregivers, medical and quality improvement experts, government agencies, consumers and others are joining an ongoing Advancing Excellence in America's Nursing Homes campaign that builds on the success of other quality initiatives like Quality First, the Nursing Home Quality Initiative (NHQI) and the culture change movement.

The Advancing Excellence in America’s Nursing Homes campaign website includes a wealth of information for nursing homes, including detailed instructions for signing on to the campaign at www.nhqualitycampaign.org.

Project Goals:

The voluntary campaign, which monitors key indicators of nursing home care quality, promotes excellence in caregiving for nursing home residents and acknowledges the critical role of nursing home staff in providing that care. Advancing Excellence in America's Nursing Homes will assess progress toward achieving the following measurable goals:

Reducing high risk pressure ulcers;
Reducing the use of daily physical restraints;
Improving pain management for longer term nursing home residents;
Improving pain management for short stay, post-acute nursing home residents;
Establishing individual targets for improving quality;
Assessing resident and family satisfaction with the quality of care;
Increasing staff retention; and
Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers.

Nursing homes participating in the campaign will work on at least three of the eight goals mentioned above and can access technical assistance and guidance from quality experts in reaching their targeted goals.

Consumers participating in the campaign will help to create greater awareness of quality care and the resources available now, and encourage providers to improve the care they deliver. The campaign will report on providers' continuing quality improvement progress overall, and those reports will inform consumer choices for future long term care needs.

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Tools and Resources

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.

Steps to Quality Improvement Worksheets - This is a series of quality improvement worksheets for nursing home staff to use when undergoing a quality improvement project. The worksheets cover every aspect of a complete quality improvement process. You may find them most useful if you need to look at your current practice more critically.

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FAQs

What is the Advancing Excellence in America’s Nursing Homes campaign?
How did the Advancing Excellence in America’s Nursing Homes campaign get started?
What is different about this campaign?
How can organizations get involved in this campaign?
What is the aim of the campaign?
Why is this campaign necessary?
Will tools and technical assistance be available to help providers improve their performance and meet their targets? If so, where will providers get those tools?
What are the goals of the campaign, and how will the campaign track nursing homes’ progress in achieving the goals?
How can a nursing home join the campaign?
What types of quality issues should residents and their families care about?
If I am already working with the QIO or have signed onto Quality First, why should I join this campaign? Isn’t this just another quality initiative that I have to work on?

What is the Advancing Excellence in America’s Nursing Homes campaign?
The Advancing Excellence in America’s Nursing Homes campaign represents an unprecedented combined effort of multiple organizations, both public and private, as well as individuals who are committed to continuous quality improvement in caring for frail, elderly, and disabled Americans in nursing homes nationwide.

How did the Advancing Excellence in America’s Nursing Homes campaign get started?
Leaders from long-term care provider organizations and Centers for Medicare & Medicaid Services (CMS) began discussing the idea of a campaign with measurable goals, and proposed it to the Administrator of CMS, Dr. Mark McClellan, in December of 2005. Dr. McClellan encouraged the group to further develop its proposal. With this support, a coalition of providers, caregivers, advocates, and government experts worked together to develop the Advancing Excellence in America’s Nursing Homes campaign based on key quality improvement goals.

What is different about this campaign?
This campaign was created by an unprecedented, broad-based coalition of organizations representing long-term care providers, caregivers, medical and quality improvement experts, government agencies, and consumers. This is the first time all of these groups with a stake in improving nursing home quality have come together in a national effort to coordinate combined resources with nationwide support, assistance, and commitment from national and local organizations. The coalition members are committed to providing Americans with an expectation of high quality care in nursing homes, nothing less.

How can organizations get involved in this campaign?
Organizations may participate in the Advancing Excellence in America’s Nursing Homes campaign in several ways. Many organizations are lending resources to launch this initiative. The true "core" of this campaign will be action at the local level. Both nursing homes and consumers are encouraged to join the campaign, and their commitment is vital to its success. Joining the campaign is free.

What is the aim of the campaign?
Advancing Excellence in America’s Nursing Homes seeks excellence in the quality of life and quality of care for the more than 1.5 million American nursing home residents by enhancing choice, strengthening the workforce, and improving clinical outcomes.

Why is this campaign necessary?
Many nursing homes are already committed to providing quality care and many already do so. Some may not know how to focus their attention on quality improvement around specific care or quality of life concerns. This is an opportunity to help those homes that want to improve to do so and highlight the nursing home community’s commitment to quality of care and quality of life. The campaign will also raise the visibility of quality in nursing home care to increase public confidence.

Will tools and technical assistance be available to help providers improve their performance and meet their targets? If so, where will providers get those tools?
Yes. Several tools already have been developed to assist providers’ ongoing quality improvement efforts, and the campaign Web site will provide access to these tools and more.

Materials from the Quality Improvement Organizations (QIOs) may be accessed at www.medqic.org; moreover, the QIOs offer their expertise to providers primarily through phone calls and group meetings, and formal collaborative improvement projects.
Providers’ groups such as the American Health Care Association (AHCA), the American Association for Homes and Services for the Aging (AAHSA), and the Alliance for Quality Nursing Home Care have designed various tools to complement their Quality First initiative, which seeks to improve quality.
The American Medical Directors Association (AMDA) has produced Clinical Practice Guidelines designed to assist providers to establish "Best Practices" in their nursing homes.
Consumer groups such as the National Citizens’ Coalition for Nursing Home Reform (NCCNHR) offer tools through their Campaign for Quality Care.
The Advancing Excellence in America’s Nursing Homes campaign’s Technical Assistance Workgroup will continue to work to identify and develop additional tools and resources to help providers reach continuous quality improvement goals.

What are the goals of the campaign, and how will the campaign track nursing homes’ progress in achieving the goals?
In the Advancing Excellence in America’s Nursing Homes campaign, providers will voluntarily commit to track their progress on at least three of eight measurable quality goals. Four of the goals focus on clinical outcomes for those receiving care in nursing homes, and the other four goals address process-related organizational culture objectives. A provider must select at least three goals with at least one goal that is a clinical outcome measure and at least one goal that is process-related.

The clinical goals include reducing the use of physical restraints; reducing pressure ulcers among high risk residents; and reducing pain for both short stay and longer-term residents. Data for these important clinical measures are collected via the Minimum Data Set (MDS), which is a tool used by nursing homes to assess residents’ health upon admission to and throughout their stay at a facility. Providers submit MDS data quarterly to CMS. CMS then publicly reports on these quality measures on the Nursing Home Compare tool on www.medicare.gov/nhcompare/home.asp.

The process-oriented goals encourage providers to set individual targets for continuously improving care quality in nursing homes and assessing resident and family satisfaction as well as staff retention and consistent assignment of staff. While the campaign will track these goals, too, the data for these four goals remain confidential and will not be publicly reported unless the provider elects to publish these process objectives. Those nursing homes that voluntarily elect to share their results for the process-related goals with the public will have this data listed on the Web site and can seek QIO assistance in developing trending reports. Providers not wishing to make their results public can monitor overall progress of the campaign, which will track the data in aggregate.

Regular campaign updates showing progress in the aggregate will be posted on the campaign Web site at www.nhqualitycampaign.org. In addition, the campaign will provide a listing of the homes participating in the campaign to allow consumers, providers and organizations (such as state and national associations) to track which homes have enrolled.

How can a nursing home join the campaign?
Homes can visit the campaign Web site at www.nhqualitycampaign.org to sign up for the campaign.

What types of quality issues should residents and their families care about?
There should be a public expectation of quality in nursing homes. Older adults should seek aging services organizations that will provide quality of care and quality of life to meet their particular needs. Older adults and their loved ones should review information about nursing homes, talk with health care and long-term care professionals, ask others who have experience with nursing homes, etc. Consumers should also ask providers about their quality improvement initiatives, including this nursing home quality campaign, Quality First, accreditation, etc. After selecting a nursing home, family and friends should stay involved in the care of their loved one.

If I am already working with the QIO or have signed onto Quality First, why should I join this campaign? Isn’t this just another quality initiative that I have to work on?
The goals of the campaign are closely aligned with the work that the QIOs are doing with nursing homes. Nursing Homes that are working with QIOs are already working on at least five of the campaign goals. However, these nursing homes are not currently acknowledged for their commitment to quality improvement and hard work. Nursing homes who are signed onto QualityFirst have already committed to the principles measured by the campaign. By signing onto the campaign, nursing homes are acknowledging their commitment to these goals and principles and getting public recognition for their dedication. Enrollment in the campaign only takes 1-2 minutes and will not involve any new work or change in current focus for those already committed to Quality First or to working with the QIOs, however, enrollment is not automatic. So please sign up at www.nhqualitycampaign.org

Project Overview |Tools & Resources | FAQs | Contact | Events