SEATTLE, Dec. 22 /PRNewswire/ -- Nursing homes in Washington State improved the quality of care they provided to residents in the last two years, according to new data released by the Centers for Medicare & Medicaid Services (CMS). Working with Qualis Health in the Nursing Home Quality Initiative, nursing facilities made substantial progress in pain management and reduction in the use of physical restraints between 2002 and 2004.
“Nursing homes have worked hard to improve their quality of care under the national Nursing Home Quality Initiative (NHQI) for the last two years, and the recent data collected by CMS show that their efforts are paying off,” according to Jonathan Sugarman, M.D., MPH, Qualis Health president/CEO. “We commend the nursing homes for their success, while we recognize there is still much work to be done” Dr. Sugarman said.
Qualis Health, a Seattle-based non-profit quality improvement organization with offices in Boise and Anchorage, holds contracts with CMS to improve the quality of health care delivery and health outcomes for Medicare beneficiaries. Here are some highlights of the project:
-- Washington State nursing homes reduced the percentage of residents physically restrained from 9 percent to 4 percent, a relative improvement of 55 percent (nationally, nursing homes improved by 22 percent).
-- Washington State nursing homes reduced the percentage of long-term residents in pain from 14 percent to 9 percent, a relative improvement of 31 percent (nationally, nursing homes improved by 38 percent).
-- Washington State nursing homes overall reduced the percentage of residents in pain following hospitalization from 35 percent to 33 percent, a relative improvement of 6 percent (nationally, nursing homes improved by 13 percent).
-- In the area of pressure ulcers, Washington state nursing homes -- like those nationally -- have yet to see improvements in processes reflected in the quality measures. The percentage of residents with pressure ulcers increased in Washington from 9 to 10 percent, while the national rate increased from 8.5 to 8.7 percent.
“It’s great to see nursing home residents in Washington benefit from these collaborative efforts,” said Patricia Lashway, director of Residential Care Services, Department of Social and Health Services. “We are fortunate to have the help and resources of Qualis Health.”
“Attention to quality is important, and residents almost always benefit when nursing homes actively invest in doing quality improvement work,” said Larita Paulsen, chief of Consumer Services, Residential Care Services, Department of Social and Health Services.
“Through observations made in our partnership with Qualis, it’s clear that the additional education and resources focused on how to do quality improvement work has resulted in several nursing homes with improved outcomes for residents in their care.”
Forty-six Washington State nursing homes volunteered to work intensively with Qualis Health in December 2001 to improve quality measures for pain, pressure ulcers, and use of physical restraints. Volunteer teams identified opportunities for improvement and made systematic changes in areas such as resident assessment, treatment protocols, and staff involvement in quality improvement efforts.
Like all nursing homes in Washington State, the volunteer homes received free educational materials from Qualis Health and the opportunity to attend workshops on clinical topics related to the Quality measures. Many of the volunteer homes achieved improvement results that surpassed even those for Washington state as a whole.
Individual facilities’ achievements
For example, Pinewood Terrace Nursing Center in Colville reduced the percentage of long term residents in pain from 15 percent at the start of the project to zero percent in the latest re-measurement, a relative improvement of 100 percent. At the same time, Pinewood Terrace reduced the percentage of residents in pain after hospitalization from 32 percent to 14 percent, a relative improvement of 56 percent.
“In an environment where time is always a challenge, we found that by focusing our staff’s attention and resources on these specific quality measures it was possible to make major improvements in pain management,” according to Pinewood Terrace Administrator Gail McDowell. “Qualis Health was instrumental in providing us with the tools and training to achieve these changes.”
Horizon House, a downtown Seattle nursing home, reduced the percentage of residents in post-acute pain from 38 percent to 19 percent, a relative improvement of 49 percent. Again, intensive work with staff -- including all employees -- was crucial.
“It’s really a matter of raising awareness of pain with staff and involving all disciplines in the process, not just nursing,” according to Horizon House Director of Nursing Julie Jorgenson. “We involved all staff in the educational process, including janitors and housekeepers.”
Ida Culver Broadview Nursing Care Center in Seattle improved its post-acute pain measure from 41 to 29 percent, a relative improvement of 29 percent. Judy Tracey, director of nursing, said “staff education was key to our success in pain management, along with an involved medical director and supportive hospice teams.” She said being part of the NHQI intensive group helped to focus attention on the issue.
Seattle Keiro reduced the number of long-term residents in pain by 78 percent and the number of residents with pressure ulcers by 27 percent. Administrator Rick Henry said: “Working in partnership with Qualis Health, we were able to achieve significant improvement in the quality measure for residents with pressure ulcers. Through weekly skin team meetings we utilize a systematic approach to monitor skin integrity, evaluate skin concerns and implement appropriate interventions. We are pleased to have made such progress in an area that so greatly affects our residents’ quality of life.”
Deb Murphy, director of Washington Association of Homes and Services for the Aging, which represents nonprofit nursing homes, said: “WAHSA and its members are committed to providing healthy, affordable and ethical aging services and continually strive to achieve excellence in the quality of care and services to seniors in a compassionate environment. When multiple organizations can come together in mutual support for the improvement of care to seniors, much can be accomplished through this trusting and collaborative effort.”
Jonathan Eames, director of the Washington Health Care Association, which represent for-profit nursing homes, said: “Qualis Health has consistently offered top-notch, timely education to WHCA/WCAL members. Nursing facilities across the state have seen their quality of care greatly enhanced due to the efforts of Qualis Health.”
The national Nursing Home Quality Initiative was launched in 2002 by CMS, an agency of the U.S. Department of Health and Human Services, to improve the quality of nursing home care across the nation. The program is part of a national quality initiative focused on improving the quality of care delivered by nursing homes, home health agencies and hospitals.
Seniors, caregivers and others can find valuable information about nursing homes by visiting http://www.medicare.gov/ and clicking on Nursing Home Compare. The site also provides tips for making informed decisions about healthcare. People without Internet access may call 800-MEDICARE, or 800-633-4227, for assistance.
Qualis Health is a private, nonprofit organization that offers programs and services to generate, apply and disseminate knowledge to improve the quality of healthcare delivery and health outcomes. In operation since 1974, the firm has headquarters in Seattle with offices in Boise and Anchorage.
Contact: Todd Langton
206-364-9700, ext. 2460
Qualis Health
CONTACT: Todd Langton, +1-206-364-9700, ext. 2460, for Qualis Health
Web site: http://www.qualishealth.org/
