Enhancing Quality Improvement in Long-Term Care: Strategies for Success

1. On-Time Quality Improvement for Long-Term Care Siobhan Sharkey, M.B.A., Health Management Strategies Web Conference June 12, 2007

2. Characteristics of Successful Facilities Strong Administrator and Director of Nursing support Willingness to establish a multidisciplinary team to focus on the program Commitment to quality improvement (QI) process and a history of successful QI efforts Dietician participation in team Core group of stable CNAs or lead CNAs Staff development time to support implementation and training

3. Approach: Overview Month 4-12 Month 1-3 Month 12-18 Facility-wide Implementation Review Progress & Assess Impact Workflow Redesign & Pilot Implementation • Establish facility implementation team Implement new CNA documentation Incorporate reports in daily work processes: - Dietary - MDS - Staff development - RNs - CNAs Review progress and refine processes • Redesign CNA documentation Pilot implementation of redesigned forms Month 1 Finalize IT Plan

4. What is Expected of a Participating Provider? Assign project point-person Create a multidisciplinary implementation team including CNAs Replace current CNA documentation forms with facility-specific “On-Time” standardized documentation tools Participate in regular conference calls: facility-specific and multi-facility team meetings Commit to full-facility implementation: CNA documentation forms and workflow redesign Technology solution for data capture and reports Participate in pre- and post-implementation feedback to assess impact

5. Strategies to Address Barriers View program as an accelerator of culture change, QI and health information technology (IT) adoption Partner with staff development and Dietary – Strong team members Dedicate project management resources Provide technical assistance to project leads and promote CNA peer-to-peer training Promote collaborative learning across facilities