Foundation Announces Pilot States for LTC Quality Improvement Partnership
The AMDA Foundation has named California, Florida, Indiana, Ohio, Pennsylvania, and Texas as the states to pilot AMDA's We Care: Implementing Clinical Practice Guidelines (CPG) tool kit. The pilot, involving 50 nursing homes across the six states, is part of the Foundation's nationwide Long Term Care Quality Improvement Partnership, a 4-year, $1.3 million project funded by the Agency for Healthcare Research and Quality (AHRQ).
The federally-funded Partnership, a collaboration among AMDA
members, state Quality Improvement Organizations (QIOs) and national
and state-based long term care professional and provider groups, is
designed to evaluate the impact of AMDA's pain and pressure ulcer CPGs
on process of care and clinical outcomes including the Centers for
Medicare and Medicaid Services (CMS) quality measures for nursing
homes. The pilot-test will help determine model approaches to CPG
implementation based on facility size, location, staffing and case mix.
Over the past several months, the project's Leadership Team, in
consultation with national partners, has been involved in a careful
process to identify the six pilot states that will participate in
evaluating the outcome of CPG implementation. The Leadership Team
examined a variety of factors in every state, including the resources
of the local AMDA chapter, the state QIO, Research Network member
representation and local LTC stakeholder organizations (e.g., AHCA,
NADONA, AAHSA). After the initial evaluation, the Leadership Team
identified 16 potential pilot states, reduced to nine, based on input
from the Long Term Care Quality Coalition (the advisory board
representing the national organizations of more than 20 LTC
stakeholders groups). Lorraine Tarnove, the AMDA Executive Director,
spoke individually with State Chapter presidents and influential
members within each of the nine states.
In choosing the six pilot states, the Leadership Team was cognizant
of the need to ensure geographic diversity and facility demographics
that will represent a cross-section of long term care within the United
States. In addition, Missouri has been asked to serve as a back-up
state in the event that one of the six pilot states is unable to meet
their recruitment objectives.
AMDA state chapters that are not part of the pilot still have an
important role to play and should take advantage of the many training
opportunities that this Partnership grant provides. Details will be
provided as the project proceeds.
How AMDA State Chapters can help:
- Send chapter members to CPG implementation training
workshops and train-the-trainer sessions that will be held at AMDA
national meetings in 2004 and 2005.
- Introduce the We Care: Implementing Clinical Practice Guidelines
tool kit at state chapter meetings and other venues where long term
care stakeholders will be present. (Key components of the kits will be
made available electronically throughout the nation as the project
progresses. The CPGs for Pain and Pressure Ulcers will also be made
available electronically once completed. Additional hard-copies of the
CPGs and kits may be ordered online at www.amda.com/info/cpg.);
- Provide CPG implementation training workshops at your state meeting;
- Encourage use of the tool kit in facilities throughout your state;
- Work with your state QIO to incorporate the use of the tool kit for successful CPG implementation; and
- Include information on the project, the tool kit, and how to successfully implement AMDA CPGs in your chapter newsletter.
What the AMDA Foundation will be providing to all State Chapters as the project proceeds:
- Educational materials on CPG Implementation for facilities;
- Pain and pressure ulcer CPGs for facilities statewide;
- AMDA's We Care Implementing Clinical Practice Guidelines tool kits for participants who attend training workshops;
- Train-the-trainer programs (e.g., slide kit and speaker guide) which can be downloaded from the Partnership web site;
- A bulletin board/listserv to discuss CPG implementation issues.
Preliminary findings from a Foundation-funded study in Maryland,
which laid the groundwork for the Partnership project, indicate that
CPG implementation improves outcomes, but requires support and guidance
as well as user-friendly, easily comprehended implementation tools to
successfully translate guidelines into practice. Among the kit's
contents are materials that measure facility readiness, determine a
CPG's relevance to a particular patient population, evaluate staff
knowledge and skills relevant to implementation, and track clinical and
process outcomes. Pilot-state implementation of the tool kits will
begin in January 2004.
To learn more about the AMDA Foundation and its Long Term Care Quality Improvement Partnership, visit www.amda.com/foundation. For additional information on AMDA's CPGs and the We Care: Implementing Clinical Practice Guidelines tool kit, go to www.amda.com/info/cpg.
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