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 monthly 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 links to improvement tools, resources, news, best practices, and success stories. 
Upcoming Webinars
HSAG and the Florida Pioneer Network invite you to attend
an upcoming webinar!
Tuesday, November 13, 2018
11:00 a.m. to 12:15 p.m. ET
Join the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use: A National Program for Antibiotic Stewardship
Attend one of the three remaining informational webinars to learn more about the program.
Tues., October 30 | 12:30 p.m. ET
Thurs., November 1 |10:30 a.m. ET
Wed., November 7 | 3:30 p.m. ET
Provide Exceptional Compassionate Clinical Care That Treats the Whole Person
Focusing on person-centered care is critical when it comes to delivering top-quality clinical care that leads to improved clinical outcomes and quality of life for residents. To ensure your nursing home achieves this, the National Nursing Home Quality Care Collaborative (NNHQCC) Change Package recommends focusing on this four-pronged strategy:
  • Implement consistent assignment.
  • Choose and engage medical leadership wisely.
  • Ensure transitions are done with care.
  • Strive to prevent problems, and treat when necessary.
  • The presence of a Certified Medical Director (CMD) has been shown to improve nursing home quality by as much as 15 percent. At your facility, the medical director should be a CMD, or at a minimum he or see should be a member of your state's AMDA (The Society for Post-Acute and Long-Term Care Medicine, chapter.

For more insight and practical tips about connecting with residents , read pages 25-29 of the National Nursing Home Quality Care Collaborative Change Package.

Contact us with any questions at
Tips and Change Ideas for
Decline in Activities of Daily Living
The decline in Activities of Daily Living (ADLs) is a common issue in long-term care. While not always preventable, facilities can focus on improving underlying impairments in physical abilities, including balance, muscle strength, and the ability to transfer from one position to another.
Make an impact on ADL decline by:
  • Considering physical therapy as appropriate.
  • Incorporating balance training.
  • Increasing intensity and frequency of observation.
  • Making environmental adaptations.
  • Identifying and reducing medications with potential side effects.
For more suggestions, check out these resources:
  1. Vanderbilt University's Mobility Decline Prevention Training Module 
  2. The American Geriatrics Society guidelines for fall reduction programs 
  3. HSAG Quality Measure Tip Sheet: Activities of Daily Living-Long Stay

Next month: Tips and change ideas for high-risk pressure ulcers. 
QAPI Corner
Step 6: Conduct a QAPI Awareness Campaign

Communication is the key to a QAPI awareness campaign--and it starts with communicating with all caregivers involved in the care of residents. The first item on the agenda is to let everyone know about your QAPI plan. QAPI is about systems of care, management practices, and business practices. With a goal of widespread awareness, multiple education exposures are critical to a successful campaign:  
  • Use dialogue, examples, and exercises.
  • Make sure all of your vendors and collaborating agencies are aware of your QAPI approach. 
  • Look for opportunities to involve vendors and collaborating agencies in your process.
  • Ensure that every caregiver in your facility feels safe to raise quality concerns.
Don't leave the residents and their families behind in the awareness campaign! Make sure they know their views are both sought after and valued. Ask them to tell you about their quality concerns--and view those concerns through the residents' eyes. You might even consider including QAPI information in routine communications to families. Family and resident complaints are often underused, and yet they are valuable in identifying more general problems. 
For more information about conducting a QAPI awareness campaign, read pages 13 and 14 of QAPI at a Glance. In addition, the tool provided on page 13 provides a template guide for conducting such a campaign.
Next month: Develop a strategy for collecting and using QAPI data
Hand in Hand: A Training Series for Nursing Homes
The updated Hand in Hand: A Training Series for Nursing Homes  is now available on the Centers for Medicare & Medicaid Services’ (CMS’s) Integrated Surveyor Training Website (ISTW). Hand in Hand is available as a self-paced training as well as an instructor-led course and may be accessed using the links below. The self-paced training may take approximately 24 hours to complete.
Self-Paced Online Training
Downloadable Materials for Instructor-Led Training
Training Description
This training focuses on caring for residents with dementia and on preventing abuse. CMS, supported by a team of training developers and subject matter experts, created this training to address the need for nurse aides’ in-service training on these important topics.
The Hand in Hand: A Training Series for Nursing Homes was previously developed as an instructor-led training conducted by nursing home staff members for nurse aides. The Hand in Hand training will now be available as a self-paced, online training and available to download for use as an instructor-led course.
Target Audience
Federal law requires that nurse aides complete in-service training on dementia management and resident abuse prevention. Additionally, facilities must provide dementia management and resident abuse prevention training to all facility staff members, (direct and indirect care and auxiliary functions) contractors, and volunteers.
For help with registration and all other technical issues, please contact the ISTW Helpdesk at .
CDC Antibiotic Stewardship Training Course
Sections three and four have been added to CDC’s no-cost online antibiotic stewardship training course! The entire four-section course is now available on the CDC Train site and offers up to eight hours of continuing education (CE) credit.
The following topics are covered in the course:  
  • Section 1: Antibiotic resistance and the benefits of antibiotic stewardship.
  • Section 2: Antibiotic stewardship in outpatient settings.
  • Section 3 (New): Antibiotic stewardship considerations for the management of common outpatient conditions and dentistry.
  • Section 4 (New): Antibiotic stewardship in emergency departments, hospitals, and nursing homes.
While this course is primarily for clinicians who prescribe antibiotics, the CDC recognizes that everyone plays an important role in improving antibiotic use.
This course is open to physicians, nurse practitioners, physician assistants, certified health education specialists, nurses, pharmacists, and public health practitioners with a master’s degree in public health, and they are eligible to receive up to eight hours of no cost CE credit.
To learn more about this course, as well as other CE opportunities, visit the CDC Antibiotic Use Continuing Education page .
This course fulfills Improvement Activities (IA) Patient Safety, and Practice Assessment (PSPA)_23 and PSPA_24 under the Centers for Medicare & Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS).
Create an account and register for this course directly on CDC Train
HSAG Resource Spotlight
Access to all of the CMS tools for QAPI from one easy-to-use electronic resource library.   Learn more.

Ensure resources are in place for your facility's PIP teams with this helpful one-page checklist. Learn more.

This guide helps walk your team through the action steps of developing your organization's QAPI plan. Learn more.
This material was prepared by Health Services Advisory Group, the Medicare Quality Innovation Network-Quality Improvement Organization for Arizona, California, Florida, Ohio, and the U.S. Virgin Islands, 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.2-10292018-01