“Advancing Excellence” Success Bolsters Recruitment for Second Phase

Advancing Excellence in America’s Nursing Homes, a national campaign to encourage, assist and empower nursing homes to improve the quality of care and life for residents, reported overwhelming success during Phase One of the campaign and increased participation at the start of Phase Two.

The voluntary campaign is run by a coalition of 28 national organizations that include long-term care providers and their associations, consumers, advocates, government agencies and foundations. During the first phase, between September 2006 and September 2009, the campaign earned the participation of more than 47 percent of all nursing homes in America. The initial recruitment period for Phase Two ended on January 31, 2010, and the campaign exceeded its goal of enrolling 5,000 nursing homes – more than 5,860 nursing homes are now enrolled, including 1,132 new participants.

Phase One Goals and Successes

Because participation in the campaign is voluntary, organizers provided a list of improvement goals from which Phase One nursing homes could choose. The goals included:

• Maintaining a stable workforce by minimizing staff turnover
• Assigning consistent caregivers, which is essential to quality of care and quality of life
• Reducing the use of physical restraints
• Preventing and appropriately treating pressure ulcers
• Preventing and minimizing episodes of moderate or severe pain
• Assessing the resident and family experience of care

The success of Phase One was reflected in three areas: attainment of clinical goals, participation by Local Area Networks for Excellence (LANEs) and implementation of quality improvement programs by nursing homes.

Nursing homes participating in Phase One improved at a faster rate than those that did not participate. Facilities that showed the fastest improvement were those that set targets for improvement for certain clinical goals, including: reduction of physical restraints; prevention and appropriate treatment of pressure ulcers; and prevention and minimization of moderate or severe pain.

Participating LANEs, many of which have reactivated for Phase Two, are composed of a broad spectrum of long-term care stakeholders. QIOs lead many LANEs, which typically include representatives from nursing home provider associations, the state long-term care ombudsman office, and the state nursing home survey agency.

“We have created LANEs in just about every state in the country,” said Carol Benner, national director of the Advancing Excellence campaign. “Nursing home stakeholders are typically people who have worked in silos and have not come together. Now they’ve gone through the process of building a coalition and truly learning to work together, so hopefully that will be the legacy of the campaign.”

The third milestone of Phase One involved nursing homes implementing quality improvement programs, in which they routinely identified meaningful areas to improve, studied those areas, and found ways to fix them using tools and educational materials provided by the campaign.

Phase Two and the Future

For Phase Two, strengthening the workforce at nursing homes is a major goal. “Rather than starting with clinical goals, the first step for the nursing home is to stabilize its workforce by decreasing staff turnover and increasing the use of consistent caregiver assignment –meaning the same staff person takes care of the resident every time,” said Benner.

Phase Two goals mirror those of Phase One, with the addition of:

• Opening communication channels to allow residents the opportunity to discuss their goals for care, including their preferences for advanced care planning, and;
• Assessing nursing home staff satisfaction annually.

Campaign officials are already witnessing even greater success in Phase Two. “We exceeded our recruitment goals by nearly 20 percent in Phase Two,” said Mary Jane Koren, M.D., M.P.H. of The Commonwealth Fund, and campaign chair. “Nursing homes in America are more committed than ever to providing the best possible care to their residents and the Advancing Excellence campaign, through our free resources and state-by-state support, is helping them keep that commitment.”

For more information on the Advancing Excellence in America’s Nursing Homes campaign, visit: http://www.nhqualitycampaign.org.