NMMRA Articles

Published In: Southwest Senior, February 2007

New National Quality Campaign Aims to Improve Nursing Homes

This past fall, national leaders from the Centers for Medicare & Medicaid Services (CMS), the American Health Care Association, the American Association of Homes and Services for the Aging, the Alliance for Quality Nursing Home Care, the American Medical Directors Association, the National Citizens' Coalition for Nursing Home Reform, and many others launched the Advancing Excellence in America's Nursing Homes Campaign. This voluntary two-year campaign represents an unprecedented combined effort of broad-based coalitions as well as individuals committed to providing high quality of care and quality of life for America's nursing home residents. In addition, the campaign builds on the success of other quality initiatives as well as the culture change movement and aims to create a culture of person-centered, individualized care, an empowered long-term care workforce and improved clinical outcomes.

The Advancing Excellence in America's Nursing Homes Campaign will assess progress toward achieving the following measurable goals:

1. Reduce high-risk pressure ulcers
2. Reduce the use of daily physical restraints
3. Improve the management and treatment of pain in long-stay residents
4. Improve the management and treatment of pain in post-acute residents
5. Set annual quality improvement targets
6. Measure resident and/or family satisfaction
7. Measure and reduce workforce turnover
8. Adopt consistent assignment of staff

Nursing homes participating in the campaign will work on at least three of the eight goals and can access technical assistance and guidance from quality experts in reaching their targeted goals. The first four goals focus on clinical outcomes while the remaining goals address process-related organizational culture objectives. Of the three goals a provider selects, at least one goal must be a clinical outcome measure and another must be focused on organizational culture change. Consumers participating in the campaign will help to create greater awareness of quality care and the resources available now, and encourage providers to improve the care they deliver. The campaign will report on providers' continuing quality improvement progress overall, and those reports will help to inform consumer choices for future long-term care needs.

The campaign will rely on Local Area Networks for Excellence (LANEs) to disseminate information and encourage participation at the local level.  In New Mexico, the New Mexico Medical Review Association (NMMRA), the New Mexico Health Care Association (NMHCA), New Mexico's Aging and Long-Term Care Services, as well as nursing home providers are working together in the LANE capacity to support the campaign by lending leadership, organizational, technical, communications and other expertise. NMMRA is New Mexico's LANE Convener.

New Mexico's Campaign Launch
New Mexico's LANE launched the Advancing Excellence in America's Nursing Homes Campaign at the New Mexico Health Care Association's (NMHCA's) recent fall conference in Las Cruces. Chris Condeelis, senior director of quality and professional development of the American Health Care Association (AHCA), introduced the campaign to New Mexico's long-term care community, providing a campaign overview of  goals, provider benefits for campaign members, New Mexico benchmarks and national targets and the importance of partnering with quality improvement organizations (QIOs) and state culture change coalitions.

Following Condeelis's presentation, Linda Sechovec, NMHCA's executive director, provided a local context for the campaign and encouraged New Mexico's nursing homes to participate. "The Advancing Excellence campaign sets goals that operationalize and measure the improvements in quality that many nursing homes are already achieving," said Sechovec.  "Voluntarily signing on to work on at least three of the eight campaign goals is an important way for nursing homes in our state to demonstrate that high quality is a top priority." Nursing home leaders at corporate and regional levels as well as Ms. Amber Espinosa-Trujillo, New Mexico's Long-Term Care Program Manager with the New Mexico Department of Health (NMDOH) endorsed participation in the campaign. During the event, NMMRA's nursing home team assisted facilities in signing on to the campaign via the campaign Web site.

New Mexico's Campaign Participants
To date, 32 of New Mexico's 76 nursing homes or 42 percent have joined the campaign and participation is still growing. Campaign members are enthusiastic about the opportunity to be part of a nationwide effort aimed at accelerating quality improvement in America's nursing homes. According to Carlene Whitney, administrator of University Terrace Good Samaritan Village in Las Cruces, "This campaign is important to our facility because it has kept us focused on exceeding resident and staff expectations. We continue to listen to our residents and staff so that we may learn what is important to them."

A successful, ongoing project at University Terrace is the adoption of consistent assignment. Residents and staff alike speak with enthusiasm about this recent program. "We have noticed an increase in the morale of our residents and staff. This program has not only enabled staff to provide enhanced care to residents, it has provided staff with the ability to anticipate resident needs expeditiously and has allowed staff and resident relationships to blossom," said Whitney.

Another of University Terrace's significant accomplishments is the reduction of staff turnover. For example, "We have reduced our staff turnover by nearly one quarter this year. Certified nursing assistant (CNA) turnover, in particular, has been reduced by almost 50 percent," Whitney said. "Our staff genuinely care about the residents and are committed to becoming ever better at what they do."

Donald Wilson, administrator at The Village at Northrise is also thrilled his facility has joined the campaign. "Being a part of this campaign is especially meaningful because The Village at Northrise has been working diligently to provide the best possible care to its residents. Joining this campaign is yet an additional indicator of our commitment to high quality of nursing home care." Furthermore, Wilson noted, "I'm pleased at having access to additional quality improvement data."

Networking and sharing best practices are key components of the Advancing Excellence Campaign. According to Ramona Lenderman, director of nursing at Casa de Oro, "This initiative is productive because it is unifying the long-term care community. This sense of unity allows for the sharing of a wide range of ideas to improve quality of life and quality of care. The campaign has energized our quality improvement efforts."

New Mexico's LANE Activities
New Mexico's LANE is currently developing a campaign kit that includes a template news release for nursing homes to send to local media, a certificate of participation to display in the nursing home's lobby or reception area, a poster to be displayed in the nursing home's staff lounge, common areas or on community bulletin boards, as well as buttons and ribbons for nursing home staff to wear to show their facility is a proud member of the campaign. The LANE is also developing QI training and materials, which are tied to clinical and process campaign goals. "We have seen important improvements in the quality of care in our state's nursing homes since Medicare began publicly reporting on clinical quality nearly four years ago," said Lorri Eberlein, RN, nursing home quality improvement manager at NMMRA and a former director of nursing and nursing home administrator. "But we know we must aim to accelerate improvement, so that every resident is getting the best care possible."

For more information about the Advancing Excellence in America's Nursing Homes Campaign, visit http://www.nhqualitycampaign.org/ or http://www.nmmra.org/providers/nursinghomes.php. You may also obtain additional information about New Mexico's LANE by calling Elayne Villa, nursing home quality improvement coordinator at NMMRA at (505) 998-9758 or via e-mail at evilla@nmmra.org.

Christine Beechhold, MA, is a communications specialist with NMMRA, working on the nursing home and home health teams. She has over 10 years experience in health care communications and media relations.