Quality Improvement: what is it and why is everyone from CMS with QAPI so interested in it? QI activities can be undertaken by interdisciplinary teams (IDT) in the nursing facility to address quality of life issues like: infection rates, immunization rates, fall reduction, pain tratment, or staffing issues. Each nursing home has a wealth of data through the MDS and other sources to address the quality of care for patients they serve. The IDT and care plan process offer a perfect environment for applying QI principles.

Beginning in 2012, the AMDA Foundation will provide three awards to facilities; at least one of the awards is given specifically for improved advanced care planning and/or palliative care programs. These prestigious awards are based on programs medical directors and care teams have implemented and demonstrated to improve the quality of life for their long term care residents.

Each awardee will present their award-winning program at a session during Long Term Care Medicine - 2012, following a formal award presentation at AMDA's annual symposium in San Antonio, Texas in March 2012. Award winners will be spotlighted in future AMDA publications and join our esteemed list of QI Program Award recipients on our website where the LTC community can review their QI program for the benefit of all.

Types of programs might include:

• Patient safety initiatives – reducing falls, medication errors
• Reduction of avoidable ER visits and acute hospitalizations
• Improved consistency of staffing
• Improved comprehensive advanced care planning
• Improved palliative care programs

To look at topics that past QI award winner have looked at click here. All nursing home facilities are eligible for the awards. Facilities may be for profit or not for profit and/or individual facility, regional or national chain. In order for the program to be eligible, the program must be internally generated and funded by the nursing home facility; have demonstrated measurable outcomes and objectives; and have proven sustainability and ability to be replicated in other facilities.

 
Applying Online

We are no longer accepting applications for 2012 as the application period has expired.

All completed applications must be submitted electronically.Please note that you must be logged in to this web site to access the application page. Please go to My Area for registration or log in information. After you have logged in you may then access the online application under Programs/AMDA Foundation-QI and Health Outcome Awards/Online Application. The application deadline is November 21, 2011.

Before you access the online application you'll need to first attend to the following preparation:

Document Uploads

The 2012 AMDA Foundation QI and Health Outcome Awards Online Application requires that you also obtain, complete as necessary and upload the following documents to be included on your application:

• Current copy of state/federal survey results;
• Letter of Support from the medical director for the facility/institution;
• A completed AMDA Foundation/QI and Health Outcome Awards Project Proposal demonstrating measurable objectives and outcomes (see examples below); and
• A completed AMDA Foundation/QI and Health Outcome Awards Detailed Budget.

Documents of the following types are acceptable for uploading: ms-word; pdf; rtf; ms-excel; ms-powerpoint; ms-works; text; and zip. Documents for uploading must not exceed 6,144KB in size (6 megabytes).

Obtaining the Documents to Upload

• The state/federal survey results document may be obtained at the facility where the project was conducted or you may go to www.medicare.gov for survey results.
• The Letter of Support must be from the medical director for the facility/institution where the project was conducted. The letter must affirm that the program was (1) internally generated and funded by the nursing home facility; (2) demonstrated measurable outcomes and objectives; and (3) proven sustainability and ability to be replicated in other facilities. These three points must be addressed in the letter or the application will not be considered.
• The remaining two forms (MS Word format) may be obtained by downloading the documents from the links below. After you have completed the forms, please save the completed forms on your computer so you may attach them with your electronic application.
  • QI and Health Outcome Awards Project Proposal
  • QI and Health Outcome Awards Detailed Budget

Applications to this competitive program are judged on:

• Feasibility: The project can feasibly be completed within most facilities. (Note: Consider total cost and staff time)
• Generalizability: The results of the project are generalizable to other LTC facilities and organizations
• Methods: Adequacy of the description of the project methods
• Outcomes and Objectives: The measurable extent of the project’s impact on resident’s quality of life, supported by quantitative outcomes
• Facility Commitment: The extent of the facility’s commitment to the project. (In-Kind services or facility funding)
• Impact on LTC: The extent to which the successful completion of this project has the potential to improve quality in LTC

Some Examples of Measurable Outcomes

• If a project focused on reducing staff turnover, then document the decline in staff turnover rates over a particular period of time in comparison to state average (turnover rate of CNAs from X% in 2003 to X% in 2009; you facility is X% below state average)
• If a project focused on enhancing hands-on direct care, then document facility’s hours of nursing care per resident compared to standard State requirements (X hours of nursing care per resident per day as compared to standard State requirements of X hours per resident per day)
• If a project focused on reducing emergency room visits and acute hospitalizations, then document the effect of using in-house specialties or services (X service decreased number of X-related hospitalizations from X in 2003 to X in 2008)
• If a project focused on decreasing the number of infections, then document the decrease over a specific period of time (decrease in the number of infections from XX in 2003 to X in 2008)

Additional Resources:

1. Equator Network: (Enhancing QUality and Transparency Of Health Research)
   http://www.equator-network.org/resource-centre/resource-centre/
   See “Guidance for Reporting Quality Improvement Studies” in the Library for Health Research Reporting, especially link to article in QSHC by Davidoff et al.
2. The SQUIRE Guidelines: (Standards for QUality Improvement Reporting Excellence)
   www.squire-statement.org/
   Offers a very helpful framework for formally presenting a QI project.

Please note that you must be logged in to the web site to access the application page.