OFMQ has consulted with Long Term Care (LTC) facilities in Oklahoma since 2002 and is a trusted resource providing industry leading experts trained in helping to improve the quality of care of residents. Through a Quality Assurance/Process Improvement (QAPI) approach, we help our clients identify opportunities for improvement in order to achieve positive outcomes. We provide direct, onsite technical assistance and deliver educational workshops and trainings as well as tools and resources for health care professionals. We are currently working on the following projects:
Oklahoma State Department of Health Grant:
This project works with up to 60 Nursing Homes to address four clinical quality topics: long-stay self-reported pain, falls with major injury, pressure ulcers and Urinary Tract Infections. The project begins with a baseline assessment for residents who trigger for these quality measures, and these become the focus of initial PDSA improvement cycles. During this assessment we look at the current workflow for the home as it relates to their need for improvement in the identified quality measures to determine gaps in practices or processes, staff education needs, and necessary workflow and/or documentation modification. Interventions include onsite visits to provide staff education regarding basic QI principles including documentation and tracking. Interventions also include providing onsite support and reinforcement training for nursing home MDS staff regarding pulling their CASPER data and how to analyze and interpret the results. OFMQ staff help the home to form a Quality Improvement (QI) Team to include nursing home leadership, direct care staff and a representative from the Resident Council. At each interactive meeting with the QI Team we mentor the team in the review of data, their interventions and progress toward stated improvement goals. These multi-disciplinary QI Teams drive improvement efforts within their homes related to appropriate pain management and falls reduction. Regional educational offerings reinforce QI Team efforts and provide opportunities for networking and peer-to-peer sharing and spread of evidence-based tools and resources.
This project is in partnership with the Oklahoma University College of Pharmacy and works with up to 12 Nursing Homes (NHs) over a three year period, half which have adopted Electronic Health Record (EHR) technology, and the other half which have not. After an initial baseline assessment as to processes related to medication safety practices, recommendations are made in areas identified for improvement. A medication review follows which consists of a resident or family interview to obtain a clean medication history, and medication reconciliation is performed through chart reviews. Medication therapy management is provided through interventional education and consultation. Progress is assessed quarterly throughout the project to determine opportunities for improvement. Interventional education is provided to include the improved use of an EHR in medication safety management, physiologic changes that occur with aging, and instructions in the process of screening all medications for contraindications in the elderly using best-practices screening tools such as the American Geriatrics Society Beers Criteria 2012 or the STOPP START toolkit (STOPP = Screening Tool in Older Persons for Potentially Inappropriate Prescriptions, START = Screening Tool to Alert Doctors to Right Treatments). Interventions also include the creation, education and implementation of a Medication Safety Toolkit.