Vol IV, Mar `05

I. Nurse recruitment

We first identified six participant states--CA, FL, IN, OH, PA, and TX.

Second, we hired state nurse coordinators to lead the project in each state. (Five of these nurses were highlighted in last month's e-Newsletter.)

II. Facility recruitment

After hiring a state nurse coordinator, each state enters the facility recruitment phase:

• We identify target geographic areas near the nurses' hometowns, and then mail letters of introduction to eligible facilities.
• Interested facilities work with the state nurse coordinators to decide whether or not to participate.

III. State roll outs

When a state has several facilities enrolled in the study, it is ready to "roll out" the project via a daylong welcome and training session:

• At the state roll out, facilities are taught about CPGs and CPG implementation and are provided with implementation toolkits to use in the coming months.
• Facilities are also randomized to implement either the pain management or pressure ulcer prevention CPG. Pennsylvania rolled out the project in September; Florida will be next, in April.

IV. Data collection

Facilities leave the state roll out prepared to begin collecting baseline process of care data:

• Using the LTC-QI Partnership's unique data collection Web site, facilities abstract data directly into a secure Web site.
• There, they view data feedback reports showing their own process measure scores vs. the aggregate score for their state.

Once baseline data collection is complete, facilities turn to other activities for several months (see Phase VII). They resume data collection again at months nine and 15.

V. CPG Implementation

With guidance from their state nurse coordinators, who mentor them through the process, facilities begin implementing their assigned CPG (i.e., pain or pressure ulcers) as soon as baseline data collection is done.

VI. Analysis

Once the LTC-QI Partnership concludes next year, we hope to demonstrate that the CPG implementation toolkits improve adherence to the processes of care recommended in AMDA's guidelines:

• We will aggregate process and outcome data across facilities.
• After analysis, we will share the results of our final analyses with you-our National Quality Coalition members.

VII. Dissemination

At the end of the project, our efforts will turn towards sharing results, lessons learned, and any modifications of the CPG implementation tool kits:

• We plan to share this information via publications and presentations.
• In addition to LTC-QI Partnership staff sharing this information, we will encourage you to participate fully in dissemination activities.