Tuesday, April 2, 2013

How Far Have We Come?

Progress on the AHCA Quality Initiative


Over the past year, since Board Chair Neil Pruitt announced the AHCA Quality Initiative in February of 2012, much great work has been done across the country by members committed to achieving the four goals:
  • Safely Reduce Hospital Readmissions: By March 2015, safely reduce the number of hospital readmissions within 30 days during a SNF stay by 15%.
  • Safely Reduce the Off-Label Use of Antipsychotics: By December 2012, safely reduce the off-label use of antipsychotic drugs by 15%.
  • Increase Staff Stability: By March 2015, reduce turnover among nursing staff (RN, LPN/LVN, CNA) by 15%.
  • Increase Customer Satisfaction: By March 2015, increase the number of customers who would recommend the facility to others up to 90%.
So how are we doing? One way we have to assess that is by listening to the stories we hear from you, our members, sharing about the work you are doing and the results you are achieving in your individual facilities and organizations. For just one example, see Cathy McKay’s story about the impressive progress being made in reducing antipsychotic use at Lakewood in Waterville, Maine. Another is by looking at the data we have available.

For each of our goals, our ability to determine progress at a national level varies.

For hospital readmissions, we have analyzed data through the third quarter of 2012, using the OnPoint-30® measure of risk-adjusted rehospitalization data. Comparing to the baseline period of fourth quarter 2011, over half (54%) of AHCA members have seen a decrease in their rates, with 25% of members already achieving the three-year, 15% reduction goal!

With regard to off-label use of antipsychotics, nearly 30% of AHCA members have been able to achieve a 15% reduction from fourth quarter 2011 to third quarter 2012, the latest period for which we have data available. Again, more than half (55%) of members have achieved some reduction in their rates. Data for fourth quarter 2012 will not be available until later in April in order to determine where we stand relative to our 2012 year-end goal.

For our remaining two goals, staff stability and customer satisfaction, we do not yet have the needed data to assess our progress. Staff turnover is measured using our annual staffing survey. The 2011 survey (our baseline period for the Quality Initiative) has just been released, and we are now beginning to collect data for the calendar year 2012, which we will use to report on our first year of progress. (Submit your facility’s staffing data before the April 24th deadline!)

For customer satisfaction, the profession lacks a national data source that would allow us to measure satisfaction across all nursing facilities. The AHCA Customer Experience Committee is hard at work on remedying that situation by developing a core set of customer satisfaction questions. These are currently in testing by researcher Dr. Nicholas Castle at the University of Pittsburgh. Once that research has been completed and a set of approximately 10 questions validated, AHCA will submit them for National Quality Forum (NQF) endorsement later this year and work with survey vendors to incorporate them into the widely-used instruments in our field. We also plan to develop a system for incorporating that data into LTC Trend Tracker to allow members an easy way to track, trend and benchmark their satisfaction data.

We at AHCA are excited and encouraged by the efforts members are making to focus on these areas in your facilities on a day to day basis. Be sure to use the tools and resources available to you through AHCA and your state association to check your own facility’s progress and to implement steps to help you achieve ongoing improvements.

No comments:

Post a Comment