State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. 7.0 Suggestions from Study States to Others Considering Quality Improvement Programs


We asked providers, state program administrators, and consumer representatives in each of our study states for general guidance advice they would offer other states considering quality improvement programs. We also asked for specific suggestions based on lessons they learned in relation to programs initiated in their states. The following list summarizes general guidance from state administrators to states considering developing a QI initiative:

  • Take time to study other quality improvement models before designing and implementing any new program.

  • Developing an adequate evaluation component is particularly important in the current environment of fiscal constraints, which increasingly requires programs to demonstrate their worth through hard evaluation evidence.

  • Look for creative ways to balance punitive and non-punitive programs.

  • Never underestimate the need to obtain industry and legislative buy-in.

  • Disclose program goals and be upfront with facilities when launching quality improvement programs.

  • Take a multi-faceted approach in improving nursing home quality, since it remains unclear what specific aspects of TA and similar efforts work best.

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