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Improving N ursing Home Quality: Accelerating Change through the Advancing Excellence in America’s Nursing Homes Campaign Centers for Medicare & Medicaid Services Satellite Broadcast and Webcast Friday, March 23, 2007 1:00 PM –3:00 PM EDT. Campaign Aim. To pursue excellence in the quality

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Campaign Aim

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Campaign aim

Improving Nursing Home Quality:Accelerating Change through the Advancing Excellence in America’s Nursing Homes CampaignCenters for Medicare & Medicaid ServicesSatellite Broadcast and WebcastFriday, March 23, 20071:00 PM –3:00 PM EDT

Campaign aim

Campaign Aim

To pursue excellence in the quality

of life and quality of care for the

more than 1.5 million residents of

America’s nursing homes by

enhancing choice, strengthening

workforce and improving clinical


National founding members

National Founding Members

  • The Alliance for Quality Nursing Home Care

  • American Association of Homes and Services for the Aging -- AAHSA

  • American Association of Nurse Assessment Coordinators -- AANAC

  • American College of Health Care Administrators – ACHCA

  • American Health Care Association -- AHCA

  • American Medical Directors Association -- AMDA

  • Centers for Medicare & Medicaid Services -- CMS

  • The Commonwealth Fund

  • The Evangelical Lutheran Good Samaritan Society

  • National Association of Health Care Assistants -- NAHCA

  • National Citizens’ Coalition for Nursing Home Reform -- NCCNHR

  • National Commission for Quality Long-term Care

An unprecedented coalition

An Unprecedented Coalition


  • 11,000 nursing homes nationwide

  • 45,000 health care professionals, including:

    • 3,500 Health Care Administrators

    • 6,000 Directors of Nursing

    • 7,200 Medical Directors

    • 9,000 Gerontological Nurses and Nurse Coordinators

    • 20,000 Certified Nursing Assistants

  • 1,000 Consumer Advocates; Millions of caregivers

  • 1.8 million Service Employees

  • National Commission for Quality Long-term Care:

    • Two Governors

    • Four current Members of Congress

    • Former Senator Kerrey and Former Speaker Gingrich

    • Quality experts

Campaign components

Campaign Components

  • Meaningful Goals

  • Measures and Data Sources

  • National and State Infrastructure

  • Technical Assistance

    • Evidenced-based Protocols

    • Guidelines

National quality initiatives common goals

National Quality Initiatives: Common Goals

Campaign goals

Campaign Goals

Clinical Goals:

  • Reduce prevalence of pressure ulcers among high risk residents

  • Reduce use of daily physical restraints

  • Management of pain among long stay residents

  • Management of pain among post acute residents

    • Measure definitions available on

    • Data derived from MDS

    • Automatically updated quarterly from MDS

Campaign goals1

Campaign Goals

Organizational Goals:

  • Target setting among nation’s nursing homes

  • Measurement of resident and/or family satisfaction

  • Reduce workforce turnover

  • Adoption of consistent assignment

Provider benefits of a national campaign

Provider Benefits of a National Campaign

  • Advances Evidenced-based Practice

  • Improved Strategies to Promote Positive Clinical Outcomes and Regulatory Compliance

  • Improved Customer Satisfaction

  • Focus on Staff Retention

  • Cost Savings

  • Improved Decision-making Strategies

  • Supports Risk Management

  • Supports Pay for Performance Initiatives

  • Advances Use of Technology

  • National Support At the Table – Now & in the Future

National benchmarks targets

National Benchmarks & Targets

Target setting

Target Setting

  • Definition: Setting personal quality improvement goals for pressure ulcers, physical restraints, and pain

  • Use

    • Easy to use

    • More than 8,000 nursing homes have already set targets

    • Pre-established accounts for all providers

    • Provides ideas about how to set targets

  • Updated at least annually

Measuring customer satisfaction

Measuring Customer Satisfaction

  • Definition: Is the resident and/or family member satisfied with the quality of care and services received?

  • Use

    • Providers can select from a drop down list

      • Or enter “other”

    • Use this information for internal improvement

  • Self-reported at least annually on Web site

Measuring reducing nursing staff turnover

Measuring & Reducing Nursing Staff Turnover

  • Definition: Reducing the number of nursing staff (RN, LPN, CNA) who leave the facility annually

  • Use

    • Download excel spreadsheet

    • Document clinical staff terminations & average number clinical staff

    • Use this information to calculate annual turnover

    • Enter turnover rate on campaign website

  • Self-reported at least annually on Web site

Adoption of consistent assignment

Adoption of Consistent Assignment

  • Definition: Having the same caregiver consistently caring for the same person on at least 85% of that caregiver’s shifts

  • Use

    • Click yes or no

    • Date when first initiated

  • Self-reported at least annually on Web site

Advancing excellence considerations

Advancing Excellence Considerations

  • Understand the clinical and organizational goals

    • Measurement

    • Each process framework

  • Benchmark how your facility is doing

  • Evaluate costs and outcomes

  • Assess which goals you are already working on and ones that you want to work on

  • Spend time on

  • Work with your LANE or QIO to learn how the campaign complements what you’re already doing

National and state infrastructure

National and State Infrastructure

  • National Campaign Steering Committee

  • Local Area Networks for Excellence (LANES)

  • Quality Improvement Organizations (QIOs)

  • Clinical Tools



    • Quality First Online Resources

    • Clinical Practice Guidelines from American Medical Director’s Association

    • Agency for Healthcare Research and Quality Guidelines

National campaign steering committee

National Campaign Steering Committee

  • New relationship paradigm that includes consumer advocates, nursing home providers, key sectors of government, quality improvement organizations, nurses, medical experts, and others.

  • Provide leadership, communication, and motivation for the campaign.

  • Monitor key indicators of nursing home quality; promoting excellence in care giving for nursing home residents, and acknowledging the critical role nursing home staff has in providing care.

Local area networks for excellence lanes

Local Area Networks for Excellence (LANEs)

Network of individuals and organizations across the

state (or territory) working together to fulfill needs at

the local level to ensure campaign success.

Roles and Responsibilities:

  • Raise Awareness

  • Drive Enrollment

  • Convene Meetings

  • Provide Technical Assistance

  • Communicate Key Campaign Messages

  • Respond to Critical Issues

Monitoring campaign progress

Monitoring Campaign Progress

Visit Web site at,

will be updated regularly with campaign


  • Enrollment by state and nationally

  • List of providers enrolled in campaign

  • Progress toward campaign goals

  • (Voluntary) individual progress towards campaign goals

How to become a participating provider

How to Become a Participating Provider


  • Click on link “For Nursing Homes”

  • Commit to three to eight goals for quality improvement and register

  • Begin to work on selected goals using available technical resources

  • Connect with LANE or QIO

  • Join thousands of other providers

  • We encourage you to register by November 30, 2007

How to become a participating consumer

How to Become a Participating Consumer


  • Click on “For Consumers”

  • Read about opportunities for consumers to support the campaign

  • Fill out registration form

  • Begin communicating with others about the campaign

Campaign aim

Improving Nursing Home Quality:Accelerating Change through the Advancing Excellence in America’s Nursing Homes

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