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Indiana Healthcare Leadership Conference: Improving Nutrition

Indiana Healthcare Leadership Conference: Improving Nutrition. Review of Quality of Care Initiatives. Nursing Home Quality Status: 2007. High number of immediate jeopardy violations (5 th highest) High number of deficiencies per standard survey (7.6 compared with national average of 6.9)

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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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