State Nursing Home Quality Improvement Programs: Site Visit and Synthesis Report. Aspects of Quality Improvement Programs that were Noted to Work Well

05/15/2003

With regard to the Quality Monitor Program, virtually all of the Quality Monitors with whom we spoke were enthusiastic about the program and the opportunity to make a difference. Several noted that the program provided an opportunity to do the type of teaching they felt was needed. Mid-level program managers noted that program leadership had been exceptionally good and consumer advocates agreed with this assessment. Most of the providers and their representatives also expressed confidence in the current DHS leadership team, reported that opportunities for communication were good, and commented that the Quality Monitors with whom they had had contact were courteous and professional. But consumer representatives and providers we interviewed had difficulty pointing out any other particular aspect of the Quality Monitor Program as excellent at this stage. Since the program is still being rolled out, many were in a "wait and see mode."

According to DHS, those providers who had taken the time to report their comments electronically to program managers as of August 2002 offered a generally positive picture of the Quality Monitor Program:

  • Among 68 providers expressing an opinion, 70 percent agreed or agreed strongly that the visit had helped them to focus on specific system issues.

  • Among 60 providers expressing an opinion, 70 percent agreed or agreed strongly that the visit had helped them formulate quality improvement strategies.

  • Among 70 providers expressing an opinion, 83 percent agreed or agreed strongly that the visit had yielded helpful resources.

Those we spoke with who had positive comments about QMWeb noted the ease with it can be navigated, the usefulness of the content, and the cost/effectiveness of that approach to helping keep practitioners informed. The QMWeb was unfamiliar to many, however, and some who had tried it found using it to be somewhat daunting.

With respect to the Quality Reporting System (QRS), consumer representatives and providers generally agreed about its strong points as well as some of the limitations (discussed below). The system was given high marks for being "consumer friendly" and easy to navigate. While those with whom we held discussions raised various levels of concern about the accuracy of the data and the validity of the rating system, virtually all said that in general, the rating system fairly accurately identified outliers (both excellent and poorer performers). Consumer representatives noted that they did suggest that potential consumers use the system as just one factor in making a decision about a nursing facility and stressed the importance of personal inspections and other sources of information. Providers noted that some facilities who scored well in the QRS were using the fact as a marketing tool.

Two of the newer educational programs, the Geriatric Symposium and Joint Training, were widely acclaimed by those providers who had had experience with them.

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