Advancing Excellence in Rhode Island’s Nursing Homes
Posted: 10/2/2007
Advancing Excellence in America’s Nursing Homes is a two year, coalition-based campaign focused on improving the quality of care and quality of life for those living or recuperating in America’s nursing homes, including the elderly and disabled. The Advancing Excellence campaign is being undertaken voluntarily by nursing homes, caregivers, medical and quality improvements experts, government agencies, consumers and others. Advancing Excellence participants seek to improve the quality of life and quality of care for the more 1.5 million American nursing homes residents by enhancing choice, strengthening workforce, and improving clinical outcomes. This is done by setting measurable targets that include both clinical goals and "process" goals related to staffing and resident satisfaction.
The quest for quality is nothing new to Rhode Island nursing homes who, by and large, eagerly participate in opportunities to advance the quality of care and quality of life for our residents. I am pleased to report that to date Rhode Island’s nursing homes rank 6th in nation for registration in the Advancing Excellence Campaign and more facilities are signing on every day to join the work.
Goals in Progress
Nursing Homes participating in the Advancing Excellence Campaign choose to work on at least three of eight 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.
In Rhode Island, the majority of our participating facilities have selected reducing high risk pressure ulcers, pain management and resident satisfaction as goals for improvement. All facilities must choose to track at minimum three of the national goals.
The collection and use of clinical data for performance improvement is considered daily life for today’s nursing homes that are systematically scrutinized by regulatory agencies, such as the Center for Medicare & Medicaid Services (CMS). Information supplied by each nursing facility is translated to quality measures and quality indicators for areas of care such as pain, pressure ulcers and falls. Nursing home staff studies then these reports to develop new practices and procedures to improve the quality of care. You are able to view these reports online at www.medicare.gov/nhcompare/home.asp and use them to help evaluate the quality of nursing homes’ care.
The benefit for participants of Advancing Excellence is that the campaign sets specific targets to achieve outcomes by a specific date and provides measurements and benchmarks of our individual progress at both state and national levels. For example, Goal #1 to Reduce Press Ulcers sets forth a national challenge to have 50,000 fewer residents suffering from bed sores by September, 2008. Achieving this goal will require extraordinary teamwork, innovation and commitment on the part of every campaign member.
An Excellent Future in Sight
The Advancing Excellence campaign builds on the success of other national quality initiatives, such as the Nursing Home Quality Initiative (NHQI) and the culture change movement that strives to create a culture of person-centered, individualized care and an empowered workforce in nursing homes. As the state’s largest skilled nursing association, RIHCA is encouraging 100 percent of its members to get on board with the Advancing Excellence Campaign.
"As we watch the advancements being made by nursing homes around the country to transform their nursing homes through the culture change movement, we desire both providers and survey agency staff become aware of these beneficial changes and practices to enhance the quality of life for residents as well as the quality of life for staff," stated Thomas Hamilton, CMS’ director of the Center for Medicaid and State Operations/Survey and Certification Group. Mr. Hamilton’s comments emphasize the need for every stakeholder to understand the importance of this work.
Rhode Island nursing homes that volunteer to join the Advancing Excellence Campaign help advance the transformation of our entire profession by taking leadership roles in our journey for quality. Although Rhode Island facilities have regularly exceeded the national scores for consumer and quality measures, we do not rest on our laurels. Instead, Rhode Island’s nursing homes actively seek every avenue in their pursuit of excellence. Our participation in the Advancing Excellence Campaign is evidence of our commitment to quality and recognizes the critical role our staff in our ability to achieve real progress.
Consumer participation is highly important to the success of the Advancing Excellence Campaign. Consumers can encourage their family member’s nursing home to sign onto the campaign and can ask the administrator if they are participating and which goals they have chosen. Consumers can visit www.nhqualitycampaign.com to register as a participant in the campaign and to find out more information about why it is so important to get involved.
Rick Gamache is administrator of Elmhurst Extended Care in Providence and the chair of the Rhode Island Health Care Association (RIHCA). RIHCA is comprised of the majority of Rhode Island’s skilled nursing facilities that are dedicated to providing accessible, quality health care to the frail and chronically ill.
