The Pioneer Network in New York has been a driver of the culture change movement to transform nursing homes into resident-centered communities. The Pioneer Network has been awarded a grant from the Picker Institute to move forward in their initiative to promote consumer engagement with person-centered culture change values, as it relates to long term care.
The Pioneer Network approached the Massachusetts Senior Care Foundation, in conjunction with the Massachusetts Culture Change Coalition, as one of three states to participate in the pilot study that will test strategies to optimize consumer involvement in culture change.
Through this grant, leaders in each state have been trained to hold small discussion groups in private homes that focus on culture change. This is a model similar to a book club and has been successfully implemented in other regions. The goal of this project is to increase consumer knowledge about aging and culture change.
How Local Area Networks for Excellence (LANES) Can Strengthen the Ties between Nursing Homes and Advancing Excellence: A Small Pilot
In an earlier study, some relatively simple interventions were identified to facilitate nursing home participation in the Advancing Excellence national quality improvement campaign. Building on that experience, a grant, How Local Area Networks for Excellence (LANES) Can Strengthen the Ties between Nursing Homes and Advancing Excellence: A Small Pilot, was awarded by The Commonwealth Fund to test the implementation of those strategies in six states.
The Massachusetts Senior Care Foundation worked with Local Networks for Excellence (LANE) staff in six states to improve communication from the LANES to participating nursing facilities via more frequent email communications and phone calls. Assistance with data entry was also provided.
The nursing facilities in participating states (10-15 in each state) provided feedback on the new 2009 Advancing Excellence goals. Two to three homes in each state also agreed to pilot new measurement strategies for the consistent assignment of staff and staff turnover goals and provided feedback to project staff. Data will be available shortly. For more information, please contact Helen Magliozzi.
Barriers and Facilitators to a National Quality Improvement Campaign
Advancing Excellence is a coalition-based campaign that monitors key indicators of nursing facility quality, promotes excellence in caregiving for residents, and recognizes the critical role of staff in providing resident-centered care. Facilities that sign up to participate in the campaign enter a minimum of three goals on the campaign website, where nursing home staff can then track their progress and view benchmarks related to those clinical and organizational goals.
In Massachusetts, 67% of the state’s nursing facilities have joined the Advancing Excellence campaign, the ninth highest level of participation in the country. However, the percentage of care facilities that have entered self-reported data on progress toward meeting organizational goals has remained relatively low.
The purpose of the study was to explore the reasons why Massachusetts nursing facilities that committed to participate in the campaign had or had not entered data for their organizational goals. A secondary purpose was to assist Massachusetts nursing facilities with data entry. The study also looked at possible differences in facility characteristics among facilities that had or had not entered data related to their organizational improvement goals.
The majority of facilities indicated that communication problems had prevented them from entering the required data, and 90% said that email reminders would be helpful in increasing reporting. Few facilities reported technical difficulties with data entry or website navigation, and 89% said they would sign up for the Advancing Excellence campaign again.
Preliminary research results were presented to the Advancing Excellence Interchange in Dallas, Texas, in December 2008. A draft manuscript for a peer-reviewed journal has been prepared for submission and is currently under review.
Medication Discrepancies in Hospital to Nursing Facility Transitions
In partnership with the University of Massachusetts Medical School and University of Massachusetts Graduate School of Nursing, the Massachusetts Senior Care Foundation’s second major study examined medication discrepancies among seniors who had recently been admitted to two Massachusetts nursing facilities for sub-acute care. The purpose of the study was to determine how prevalent these discrepancies are and why they occur.
The study found that medication discrepancies occurred in almost three out of four nursing facility admissions. The most common problem was that discharge summaries and patient care referral forms did not match. The study findings underscored the importance of current efforts to improve communication among hospitals and nursing facilities.