Content contained in this newsletter may have been previously published in prior issues of the QCC newsletter.  
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The Florida Nursing Home
Quality Care Connection
This QCC Newsletter is your quarterly National Nursing Home Quality Care Collaborative (NNHQCC) in Florida member update that provides information on the latest activities. It is a quick reference for information on upcoming learning events, links to improvement tools, resources, news, best practices, and success stories. 
Recruit and Retain Quality Staff Members
No two days are the same in a nursing home. To meet daily challenges, a quality-driven nursing home identifies and develops great talent. This can be done by setting high expectations and fostering an affirming culture. Nursing homes also must recruit and hire qualified staff members who fit their mission, values, and culture. Staff longevity can then be cultivated through:
  • A supportive work environment that encourages strong relationships across disciplines
  • The exchange of information about resident care
  • Diverse perspectives in problem solving 
Ultimately, every member of the team will feel that his or her primary purpose is to provide quality care to residents. For more insight and practical tips about building a solid team, read pages 10-13 of the Change Package.  
 
Contact us with any questions at 
Avoidance of Unnecessary Antipsychotic Medications in Nursing Home Residents
Living with Dementia
The National Partnership to Improve Dementia Care in Nursing Homes is committed to improving the quality of care for individuals with dementia living in nursing homes. The Partnership has a mission to deliver healthcare that is person-centered, comprehensive, and interdisciplinary with a specific focus on protecting residents from being prescribed antipsychotic medications unless there is a valid, clinical indication and a systematic process to evaluate each individual’s need.
 
Since the launch of The Partnership, significant reductions in the prevalence of antipsychotic medication use in long-stay nursing home residents have been documented. The Partnership continues to work with state coalitions and nursing homes to reduce that rate even further. Recently, CMS announced a new national goal, involving a 15 percent reduction of antipsychotic medication use by the end of 2019 for long-stay residents in those homes with currently limited reduction rates. This goal builds on the progress made to date and expresses the Partnership’s commitment to continue this important effort.
 
While the initial focus was on reducing the use of antipsychotic medications, the Partnership’s larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices. Additional information about the National Partnership can be found by visiting https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/National-Partnership-to-Improve-Dementia-Care-in-Nursing-Homes.html
 
To address these goal, nursing home staff members may implement the Change Package’s 5 Point Bundle titled “Avoidance of Unnecessary Antipsychotic Medications in Nursing Home Residents Living with Dementia”  ( https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/QAPI/Downloads/NNHQCC-Package.pdf , Attachment 2, P. 1):
 
  1. Design and create a calming environment.
  2. Create meaningful relationships.
  3. Provide meaningful activities.
  4. Identify and treat physical and mental conditions.
  5. Define a consistent approach to minimize the use of antipsychotic medications.
 
QAPI Corner
Step 2: Develop a Deliberate Approach to Teamwork

Teamwork can vary greatly between organizations, and in many cases people work together without being defined as a formal team. No matter the structure, a good team will have a clear sense of purpose, defined roles, and a commitment to actively engage each member.

Teamwork is essential for Quality Assessment & Performance Improvement (QAPI) success. For example, Performance Improvement Project (PIP) teams often are formed for long-term work on an issue and to improve quality measures. Below are some basic guidelines for a developing a PIP team: 
  • The PIP team should be composed of interdisciplinary members.
  • Family members and residents may be team members.
  • PIP teams need to plan for sufficient communication.
  • Leadership needs to support PIP teams.
For more information about teamwork,  read pages 10-11 of QAPI At-a-Glance .
  
Next Step: Identifying your organization's guiding principles.

Resource
  • Facility QAPI Plan
  • This document offers a template to assist your facility in creating a QAPI plan that will guide your organization's performance improvement efforts.
Have You Completed Your QAPI Self-Assessment?
Clostridium difficile Infection Prevention Cohort Members
Announcements and Information

  • CDI data for November is due December 10, 2017.
  • Login to NHSN using your SAMS grid card credentials to submit your CDI LabID events (if applicable) and summary data (total resident days for the month, resident admissions, and residents admitted on CDI treatment).
  • Do not forget to check "Report No Events" under the C. difficile row if there were no positive labs collected within your facility for the month.
  • Resolve Alerts: Review the "Alerts tab and complete missing and/or incomplete data.
HSAG Resource Spotlight
This infographic outlines the 5 steps to prevent healthcare-associated infections in nursing homes from the National Nursing Home Quality Care Collaborative (NNHQCC) Change Package.   Learn more .

Effective November 28, 2018, the new long-term care regulations require nursing facilities to conduct, document, and annually review a facility-wide assessment, which includes both their resident population and the resources the facility needs to care for their residents (§483.70(e)). This is an optional template provided for nursing facilities to evaluate its resident population and identify the resources needed to provide the necessary person-centered care and services the residents require . If used, this tool may be modified. Each facility has flexibility to decide the best way to comply with this requirement. Learn more.

The Nursing Home Training Sessions are a set of trainings aimed to provide nursing home leaders with training materials that can be used to enhance understanding of important concepts and practices that promote stewardship and C. difficile prevention, and provide information, tools, and resources to take action to improve practices. Learn more.

This document offers a template to assist your facility in creating a QAPI plan that will guide your organization's performance improvement efforts. Learn more.

Learn more about Antibiotic Resistance and view CDC materials and resources to support the fight against antibiotic-resistance bacteria. You can find materials here that focus on when it is and is not appropriate to prescribe antibiotics and explain why antibiotic resistance is one of the world's most pressing public health problems.
Read more about the guidelines at the AHA news webpage or directly refer to the new guideline as presented in the journal, Hypertension, which offers a downloadable PDF. Share the new blood pressure guidelines flyer prepared by HSAG for
your reference.
This material was prepared by Health Services Advisory Group, the Medicare Quality Improvement Organization for Florida, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. FL-11SOW-C.2-11162017-01