TY - JOUR
T1 - Longitudinal Evaluation of a Statewide Quality Improvement Program for Nursing Homes
AU - Rantz, Marilyn
AU - Martin, Nicky
AU - Zaniletti, Isabella
AU - Mueller, Jessica
AU - Galambos, Colleen
AU - Vogelsmeier, Amy
AU - Popejoy, Lori L.
AU - Thompson, Roy A.
AU - Crecelius, Charles
N1 - Publisher Copyright:
© 2024 AMDA – The Society for Post-Acute and Long-Term Care Medicine
PY - 2024/5
Y1 - 2024/5
N2 - Objectives: The National Academies of Sciences, Engineering, and Medicine (NASEM) Nursing Home Quality report recommends that states “develop and operate state-based…technical assistance programs…to help nursing homes…improve care and…operations.” The Quality Improvement Program for Missouri (QIPMO) is one such program. This longitudinal evaluation examined and compared differences in quality measures (QMs) and nursing home (NH) characteristics based on intensity of QIPMO services used. Design: A descriptive study compared key QMs of clinical care, facility-level characteristics, and differing QIPMO service intensity use. QIPMO services include on-site clinical consultation by expert nurses; evidence-based practice information; teaching NHs use of quality improvement (QI) methods; and guiding their use of Centers for Medicare and Medicaid Services (CMS)-prepared QM comparative feedback reports to improve care. Setting and Participants: All Missouri NHs (n = 510) have access to QIPMO services at no charge. All used some level of service during the study, 2020–2022. Methods: QM data were drawn from CMS's publicly available website (Refresh April 2023) and NH characteristics data from other public websites. Service intensity was calculated using data from facility contacts (on-site visits, phone calls, texts, emails, webinars). NHs were divided into quartiles based on service intensity. Results: All groups had different beginning QM scores and improved ending scores. Group 2, moderate resource intensity use, started with “worse” overall score and improved to best performing by the end. Group 4, most resource intensity use, improved least but required highest service intensity. Conclusions and Implications: This longitudinal evaluation of QIPMO, a statewide QI technical assistance and support program, provides evidence of programmatic stimulation of statewide NH quality improvements. It provides insight into intensity of services needed to help facilities improve. Other states should consider QIPMO success and develop their own programs, as recommended by the NASEM report so their NHs can embrace QI and “initiate fundamental change” for better care for our nation's older adults.
AB - Objectives: The National Academies of Sciences, Engineering, and Medicine (NASEM) Nursing Home Quality report recommends that states “develop and operate state-based…technical assistance programs…to help nursing homes…improve care and…operations.” The Quality Improvement Program for Missouri (QIPMO) is one such program. This longitudinal evaluation examined and compared differences in quality measures (QMs) and nursing home (NH) characteristics based on intensity of QIPMO services used. Design: A descriptive study compared key QMs of clinical care, facility-level characteristics, and differing QIPMO service intensity use. QIPMO services include on-site clinical consultation by expert nurses; evidence-based practice information; teaching NHs use of quality improvement (QI) methods; and guiding their use of Centers for Medicare and Medicaid Services (CMS)-prepared QM comparative feedback reports to improve care. Setting and Participants: All Missouri NHs (n = 510) have access to QIPMO services at no charge. All used some level of service during the study, 2020–2022. Methods: QM data were drawn from CMS's publicly available website (Refresh April 2023) and NH characteristics data from other public websites. Service intensity was calculated using data from facility contacts (on-site visits, phone calls, texts, emails, webinars). NHs were divided into quartiles based on service intensity. Results: All groups had different beginning QM scores and improved ending scores. Group 2, moderate resource intensity use, started with “worse” overall score and improved to best performing by the end. Group 4, most resource intensity use, improved least but required highest service intensity. Conclusions and Implications: This longitudinal evaluation of QIPMO, a statewide QI technical assistance and support program, provides evidence of programmatic stimulation of statewide NH quality improvements. It provides insight into intensity of services needed to help facilities improve. Other states should consider QIPMO success and develop their own programs, as recommended by the NASEM report so their NHs can embrace QI and “initiate fundamental change” for better care for our nation's older adults.
KW - Nursing homes
KW - care quality
KW - longitudinal evaluation
KW - quality measures
KW - state technical assistance for nursing homes
UR - http://www.scopus.com/inward/record.url?scp=85186378755&partnerID=8YFLogxK
U2 - 10.1016/j.jamda.2023.12.010
DO - 10.1016/j.jamda.2023.12.010
M3 - Article
C2 - 38309303
AN - SCOPUS:85186378755
SN - 1525-8610
VL - 25
SP - 904-911.e1
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 5
ER -