Friday, March 22, 2019

Reflections on Nursing Center Quality since 2011

Kiran Sreenivas

I recently rediscovered a 5-minute YouTube video on the aspirations behind launching the 2011 AHCA/NCAL Quality Initiative. Upon hearing the call to reduce readmissions and transition to person-centered care, it is comforting to know the call is being answered based on the latest available data.

Since 2011, the number of people returning to hospitals has declined by 11.6%. As the video points out, reducing readmissions is not just about reducing health care costs. It is what is best for the patient. Studies have shown readmitted patients are four times as likely as non-readmitted patients to die in the 100 days post-hospital discharge.

The reduction in readmissions is not by accident. It reflects the improvement made across 18 quality measures, including a 20% reduction in pressure ulcers and a 61% decrease in urinary tract infections. Eliminating these adverse events means fewer patients needing to go to the hospital to get acute care to address these conditions.

In addition to patients not wanting to go back to the hospital or experience adverse events, they also do not want to experience pain. In 2011, one out of every eight patients reported experiencing pain. Today, we have one out of every 18 patients experiencing pain. This demonstrates efforts made to listen to patients and progress towards person-centered care.

In addition to listening, person-centered care is about helping patients live life according to their individual values. Often time that includes being with friends and family and living at home, which is why it is important that nearly two-thirds of patients admitted to skilled nursing centers return safely to the community. And this rate continues to improve.

The gains made since 2011 do not signify the end of progress. There is still more that can be done. For example, data shows Silver and Gold recipients of AHCA/NCAL National Quality Award Program have better outcomes than others. And while every year we see more centers start and continue the Baldrige journey, currently only 30% of the nations 15,000 plus nursing centers are part of the journey.

I am excited to see the achievements we can highlight in the next eight years.

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