OMQ

PROJECT PURPOSE

The Oklahoma Foundation for Medical Quality will recruit up to 150 nursing homes (NHs) to participate in a Long-Term Care (LTC) Quality Improvement project over 4.5 years by identifying facilities with performance improvement needs in key quality measures, in addition to those who have expressed an interest in adopting Culture Change practices. The goal of this project is to improve resident well-being and quality of care outcomes. To accomplish these goals, OFMQ will assess quality measure performance on areas often associated with the need for Culture Change such as unintended weight loss, behaviors affecting others, depression, and the inappropriate use of antipsychotic medications, and provide education and technical assistance to drive improvement among participating facilities. These measures will be used to create baseline profiles of enrolled NHs and monitor progress over time. Formal training events will be conducted in small group settings for all participants, supplemented by individualized coaching sessions which will be facilitated during onsite technical assistance visits in addition to weekly virtual meetings. OFMQ will use data-driven methodology to assist participants in identifying opportunities for improvement and implement best practices related to the adoption of Culture Change practices to improve health outcomes among residents.

EVIDENCE

Residents in many Oklahoma LTC facilities receive care that is institutional in nature rather than person-centered. Focusing on basic physical needs without Individual preferences being honored. Care delivered in this manner can lead to increased depression, unintended weight loss, behaviors affecting others, and even the use of unnecessary high-risk medications. Oklahoma is ranked poorly on many of these measures compared to other states, providing ample opportunity for improvement. NHs adopting Culture Change transform to a resident-directed holistic model of care, which can lead to improvements not only in quality outcomes, but also in overall well-being, staff retention, and family satisfaction.

POPULATION DESCRIPTION

This project will impact 150 LTC facilities by improving quality of care and quality of life for Nursing Home residents. Overall improvement in well-being and health care outcomes for residents will be achieved through the adoption of CC practices in LTC communities and staff training on resident-directed care practices. Studies show adopting principles of CC will improve staff retention, increase quality of care creating higher levels of well-being among our most vulnerable elderly population greatly impacted and isolated during the pandemic. In some NHs, the first response to residents displaying challenging behaviors is to prescribe medications, usually antipsychotics. Oklahoma NHs, on average, prescribe significantly more antipsychotic medications than other states. The overuse of such medications has been associated with decreased physical mobility, quality of life, and increased confusion, hospitalizations, falls with injury, and, in some cases, death. While OFMQ has facilitated significant improvements for NHs participating in the LIM, TLC and GWEP projects, many Oklahoma NHs are still in need of a CC focused program. This project will provide focused CC training in LTC communities emphasizing person-centered care creating sustainable improvements impacting the quality of care and overall well-being for our treasured Oklahoma NH residents.

PERFORMANCE MEASURING

As trainings are conducted, OFMQ will monitor resident quality of care outcomes on related clinical quality measures, improved knowledge and skills of direct care staff, and improvements to residents? quality of life. Outcomes will be measured through the results of satisfaction surveys and a decrease in the number of complaints related to selected care processes. Quality measure performance data will be collected, aggregated, and put into a graphical comparison for monitoring trends across participating homes as well as used to prioritize training topics for direct care staff.

ONGOING INVESTMENT AMOUNT

$

ONGOING INVESTMENT DESCRIPTION

None

ONGOING INVESTMENT REQUIRED

Able to continue operation without additional funding from the State of Oklahoma