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Key Factors in Achieving Quality. Neil Kurtz, M.D. President and CEO. Presentation Overview. What quality means to our company How we define it How we measure it How we maintain and improve it Challenges we face Quality initiatives to address the challenges Results. What is Quality?.
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Key Factors in Achieving Quality Neil Kurtz, M.D. President and CEO
Presentation Overview • What quality means to our company • How we define it • How we measure it • How we maintain and improve it • Challenges we face • Quality initiatives to address the challenges • Results
What is Quality? • We define quality as: • “Skilled Compassionate Care” • We look at quality in three basic ways • Process-based measures: these represent the actions of providers • Outcome-based measures: these represent the results of care processes • Best practices: these explain and define the nuances of best possible care
Measuring Quality • Clinical, rehab outcomes • Quality Indicators • Survey performance,5-Star results • Rehospitalizations • Medication management • Customer satisfaction, quality of life • Employee engagement/retention
Communicating Quality • Discussion of quality results and outcomes starts every leadership meeting • Publications focusing on quality • Quality Highlights • Internal and external • Partners in Quality • ED, DNS, physicians • First Monday • For Medical Directorsand attending physicians • Safety Caps • Medication safety for nurses
Quality Management Tools • Daily Clinical Start-Up • Clinical Scoreboard • Facility PerformanceAssessment • “Stop and Watch” • SBAR nurse/physician communication tool • Situation, Background, Assessment, Response • Quality Assessment and Assurance process
Challenges • More medically complex patients • Shorter-term stays • Varying approaches at multiple facilities • Shortage of qualified staff • Acceptance of change • Funding
Addressing the Challenges • Standardize care across multiple facilities • Ensure uniformity in approach • Enhance measuring and monitoring tools • Get better at managing transitions of care • Reduce rehospitalizations • Adjust staffing mix, scheduling approaches • Modify and improve training • Improve physician alignment
Key Initiatives • Quality Improvement System utilizing Baldrige criteria • Enhanced technology • Amalga for Daily Clinical Start-Up • Increased Medical Director involvement • Building a network of healthcare services • Improving medication management • Golden Clinical Rx Solutions • Improving the patient experience
Improved Survey Performance • Average number of deficiencies 5.95 5.48 • Deficiency-free surveys 17 30 • Surveys resulting in sub-standard 2.8% 1.8% • Surveys resulting in IJ 2.5% 1.4% • LivingCenters with 3 or less tags 33% 41% • Overall HDI .97 .92 2009 2010
Industry-Leading 5-Star Quality Results January 2011 Percent of Facilities All Facilities Natl. Not For Profit Natl. For Profit
5-Star Quality Improvement Golden LivingAverage 5-Star Quality Rating by Quarter
5-Star Recognition 52 Golden LivingCenters named to the 2011 U.S. News & World Report List of America’s Best Nursing Homes NURSING HOMES
Golden Living