Tuesday, November 10, 2015

Quality Journey to Gold: Best Practices from 2015 Recipient Effingham County Care Center

(LtoR Current Chair Tom Coble, Morgan and Previous Chair Len Russ)
By Norma Jean Morgan, CEO and Administrator of Effingham County Care Center

Effingham Care Center (ECC) began its journey toward Gold Quality performance long before the first AHCA application filed in 2009. In 1992, the organization embraced The Deming Management Method and initiated a systematic process to identify and establish continuous measures for key quality and customer measures. This foundational approach expanded over the years as various healthcare regulatory bodies required increased evidence of clinical accountability. Maintaining this type of oversight of ECC operations, however, provided a limited view of the overall effectiveness of the non-clinical aspects of the business. Accordingly, when the ECC Nursing Home Administration (NHA) learned of the AHCA approach to measuring overall quality of essential processes based on the Baldrige Criteria, the discovery became the motivating factor in developing and filing an application for Bronze Award status in 2009. The application feedback provided very specific and useful opportunities for improvement.

Using the feedback, the organization focused on hard-wiring many of the processes that had guided operations. In addition, the report highlighted the need for increased strategic alignment as well as increased specificity in goal-setting. This led to the formalization of the strategic planning process. In addition, through developing the 2010 Silver Award application and processing the feedback, changes such as expanding decision support services and hiring a full time ECC Quality Nurse were implemented to facilitate the systematic translation of results to the improvement of products and services.
Effingham Care Center Achieve Gold

In 2014, Effingham Care Center submitted its first Gold award application. The depth of additional informational requirements set a challenge that was difficult to meet in the time block set aside to complete the application. While ECC operated at a higher level of compliance with Baldrige Criteria, the application content itself did not sufficiently represent evidence of all activities. As a result, the organization revised its approach to the development of the 2015 Gold application, making three significant changes that contributed to our success:
  1. Invest in an AHCA training course regarding developing the application.
  2. Hire a coach with expertise in the Baldrige criteria to provide critical commentary as well as identify areas where additional evidence/measures are needed to demonstrate a process.
  3. Expand the time block set to complete the application draft.
The 2015 process also involved a much broader cross-section of workforce segments. As a result, preparation for the site visit was simplified and the celebration of success of reaching the Gold level was much more meaningful.

Over the course of involvement in using Baldrige Criteria, ECC has achieved improvements in the majority of measurement categories, with some measures at best possible performance. Examples include:

Category
Examples
% Improvement
Clinical Measures
Residents without Falls
17.3%

Residents Not Using Anti-Psychotic Medications
25.4%

Residents with Behavioral Symptoms Affecting Others
33.1%

Residents with Depressive Symptoms
93.4%

Residents without Unplanned Weight Loss/Gain
9.2%
Operational/ Business Measures
Days in Accounts Receivable
41.7%

Actual Gross Revenue
4.1%
Customer Measures
Resident/Family Overall Satisfaction
3.6%

Resident/Family Recommendation for Care
2.2%

Resident/Family Meaningfulness of Activities
14.1%

Resident/Family CNA Care
8.8%


ECC leadership recognizes that the organization will continue to have challenges to develop and implement new cycles of learning and performance. The Baldrige approach provides both clarity and a roadmap that points the way.
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Want to achieve and excel at quality performance? Be sure to submit your Intent to Apply for a 2016 Quality Award by 8 pm EST on November 19!

Have questions? Contact the Quality Award staff at qualityaward@ahca.org.

*** Upcoming Dates ***
November 19: ITA deadline
December 7: Applications accepted online
January 28: All Application deadlines

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