Identify government and private resources available to assist providers’ quality improvement programs
Chapter 12
Long-Term Care Quality
Learning Objectives
Understand the concept of quality improvement and how it applies to
long-term care
Identify the similarities and differences between quality assurance and continuous quality improvement
Discuss and compare outcomes-based measures and process-based measures
Learning Objectives (continued)
4. Discuss the value of a systemwide approach to management of quality
5. Identify government and private resources available to assist providers’ quality improvement programs
Defining Quality
Means different things to different people
A matter of judgment
Measures “goodness”
Involves both technical care and interpersonal exchanges
Quality of life is increasingly important
Measuring Quality
Most common measurement methods:
1. Process
2. Structure
3. Outcomes
Quality Initiatives
Two categories:
External – Systemwide
Internal – Provider-administered
Systemwide Quality
Improvement Programs
Government initiatives:
Regulation
Public information initiatives
Quality-related research
Regulation of Quality
History of quality regulation:
Quality assurance
Minimum data set (MDS)
OASIS
Quality improvement organizations (QIO)
QAPI
Pay-for-performance
Public Information Initiatives
Nursing Home Compare
Five-Star Quality Rating system
Quality-Related Research
AHRQ
National Library of Medicine
Private Quality Programs
Private initiatives:
Quality First
Organizational programs (AHCA/NCAL, AQNHC, AHQA, NQF)
Advancing Excellence in America’s Nursing Homes
Accreditation
Private foundations
College and university research institutes
Internal (Provider-Administered) Quality Improvement Programs
Quality Assurance (QA)
Continuous Quality Improvement (CQI)
Quality Improvement (QI)
Developing a QI Program
Need top-level support
Must be mission based
Define the organization’s customers
Determine standards
Measure against standards
Evaluate data
Take steps toward improvement
Ongoing measurement and evaluation
Quality Teams
May have several teams
Each team:
- Is multidisciplinary
- Includes those closest to the topic area
- Includes others based on expertise
- Reports to a central committee
Technology
Improved data collection and interpretation using information technology:
Faster
More accurate
Easier to store data
Summary
Long-term care quality is difficult to define and measure. Yet, numerous initiatives by providers, government, and outside agencies show a strong commitment to quality and progress.
