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Indiana Healthcare Leadership Conference: Improving Nutrition

Join us at the Indiana Healthcare Leadership Conference to explore quality improvement efforts in nursing homes, focusing on nutrition initiatives and collaborative projects. Learn from educational programs, surveys, and outcomes to enhance patient care.

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Indiana Healthcare Leadership Conference: Improving Nutrition

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  1. Indiana Healthcare Leadership Conference: Improving Nutrition

  2. Review of Quality of Care Initiatives

  3. Nursing HomeQuality Status: 2007 • High number of immediate jeopardy violations (5th highest) • High number of deficiencies per standard survey (7.6 compared with national average of 6.9) • Above average number of deficiency free surveys (11.7% compared with national rate of 8.3%)

  4. Quality Improvement Efforts: Studies • Medical error reporting system (2005) • Staffing study (2009) • Bladder scanner study (2009)

  5. Quality Improvement Efforts: Education Programs • Alzheimer’s and dementia care training programs (2005) • Leadership Conference (2007) • Consultant program (2004) • Healthcare Quality Resource Center (2009)

  6. Quality Improvement Efforts: Communications • ISDH LTC Newsletter (2008) • Monthly meetings of provider associations and ISDH (2008) • Regular meetings with consumer organizations to discuss quality of care concerns (2005)

  7. Quality Improvement Efforts: Survey Process • Implemented MDS 3.0 (2010) • Implemented CMS Special Focus Facility Program (2008) • CMS and ISDH consistency workgroups (2008) • Review of immediate jeopardy surveys with provider associations (2008)

  8. Quality Improvement Efforts: Collaborative Initiatives • Indiana Pressure Ulcer Initiative (2008 – 2010) • Indiana Healthcare Associated Infection Initiative (2009 – 2011)

  9. Quality Improvement Efforts: Regional Projects • Health Care Excel (QIO) statewide support of CMS GPRA goals (2004) • Health Care Excel pilot of CMS care coordination project in Evansville (2009) • CMS Critical Need Nursing Home Project Pilot in northwest Indiana (2010) coordinated by Health Care Excel

  10. Quality Improvement Efforts: New in 2011 • Community Foundation of St. Joseph County Regional Nursing Home Collaborative (2011) • ISDH Survey Report System (2011) • ISDH Posting of Surveys (2011)

  11. Outcomes to Quality Improvement Efforts

  12. Indiana Pressure Ulcer Initiative • CMS GPRA Initiative – 2005 – 2007 • Indiana Healthcare Leadership Conference on Preventing Pressure Ulcers – October 2008 • Indiana Pressure Ulcer Initiative – August 2008 – November 2010 • Quality Improvement Organization ongoing projects with providers

  13. Indiana Pressure Ulcer Initiative: Outcomes Source: CMS GPRA data from PDQ

  14. Indiana Restraint Reduction Initiative • CMS GPRA Initiative: 2005 –2007 • Indiana Healthcare Leadership Conference on Restraints and Behavior Management: March 2008 • Quality Improvement Organization ongoing projects with providers • Focus by provider associations

  15. Indiana Restraint Reduction Initiative: Outcomes Source: CMS GPRA data from PDQ

  16. Indiana Healthcare Associated Infection Initiative • Overview • Collaborative initiative • Two-year initiative from Sept 2009 – Dec 2011 • 130 participating facilities (80 nursing homes) • Priorities • Catheter associated urinary tract infections (CAUTI) • Clostridium difficile(CDI)

  17. Indiana Nursing Homes: Deficiency Free Surveys • 2006: 33 facilities - 7.0% • 2007: 47 facilities - 9.6% • 2008: 55 facilities - 11.0% • 2009: 56 facilities – 10.7% • 2010: 51 facilities - 10.3% Source: ISDH QAMIS

  18. Outcomes: Average Number of Deficiencies per Standard Survey IndianaNationalRegion V (fewest is 1st) • Fed FY 2007 7.6 6.9 4th • Fed FY 2008 8.0 6.9 5th • Fed FY 2009 7.2 6.8 4th • Fed FY 2010 7.1 6.3 4th Source: CMS data from CASPER 11/8/2010

  19. Outcomes: Percent of LTC with a “J” or Higher on Standard Surveys IndianaNationalRegion V (lowest is 1st) • Fed FY 2007 5.0 2.1 4th • Fed FY 2008 4.6 2.9 5th • Fed FY 2009 1.8 2.7 2nd • Fed FY 2010 2.9 2.5 2nd Source: CMS data from CASPER 11/8/2010

  20. Outcomes: Number of Immediate Jeopardy Findings on all LTC Surveys IndianaRegion V (lowest is 1st) • Fed FY 2007 68 5th • Fed FY 2008 50 5th • Fed FY 2009 35 3rd • Fed FY 2010 33 3rd Source: CMS data from CASPER 11/8/2010

  21. Outcomes: Average Number of Onsite Survey Hours on Standard Surveys IndianaNationalRegion V (lowest is 1st) • Fed FY 2010 83.7 105.6 1st Source: CMS data from CASPER 11/8/2010

  22. Coming Quality Improvement Projects

  23. Coming Initiatives for 2011 Healthcare Associated Infections • Three online learning modules designed for staff and consumers • Consumer brochure • In-service programs

  24. Coming Initiatives for 2011 • Education programs for wound care and infection prevention leading to increased staff certification • Updated aide curriculum • Long Term Care Bed Tracking System

  25. Coming Initiatives for 2011 • Leadership Conference on care coordination and transition • Complete 50% of training for Quality Indicator Survey (QIS) Process • Develop a care coordination and transition initiative for 2012 implementation

  26. Improving Nutrition Conference Checklist • Provide an in-service on information and resources provided at today’s conference • Develop a plan for improving nutrition • Identify and implement 3 activities for improving nutrition

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