More than 70 nursing home executives attended the two-day Requirements of Participation workshop this week featuring top experts in quality from the American Health Care Association (AHCA), the national industry group for skilled nursing facilities.
The event at the Doubletree by Hilton Hotel Alana – Waikiki Beach focused on the changing requirements by the Centers for Medicare and Medicaid Services. Dr. David Gifford and Lyn Bentley from AHCA conducted the two-day program.
The workshop included interactive exercises on leadership and communication, and covered topics such as discharge planning, changes to the care planning process, new policies and procedures, new requirements on quality assurance and quality improvements, staffing stability strategies, and improving a nursing home’s Five Star rating.
Members of the public shared personal stories of contracting sepsis, and health care professionals shared information on improving sepsis treatment during the Healthcare Association of Hawaii’s Sepsis Awareness Day event at the Queen’s Conference Center.
The event drew nearly 80 people, including former state Senator Fred Rohlfing, whose wife passed away from sepsis, and state Senator Josh Green, a physician on the Big Island.
Sepsis is a complication caused by the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death. It is difficult to predict, diagnose, and treat, according to the Centers for Disease Control.
Event speakers and community members presented sepsis issues, at both a professional and personal level:
Melinda Ashton, MD, VP of Patient Safety & Quality, Hawaii Pacific Health, moderated the event and the question and answer session at the end of the program. Scott Gallacher, MD, MC, FCCP, Medical Director, MICU, The Queen’s Medical Center; and Melissa Viray, MD, Deputy Director at the Hawaii Department of Health, were among the presenters.
Ways to prevent sepsis include being vaccinated against infectious diseases and taking proper care of cuts and injuries. People should also know their own bodies and recognize when something is wrong and seek care promptly.
There is no single sign or symptom of sepsis. It is, rather, a combination of symptoms. Since sepsis is the result of an infection, symptoms can include infection signs such as diarrhea, vomiting, and sore throat, as well as shivering, extreme pain, pale or discolored skin, and shortness of breath.
Quality of care and patient safety is #1 priority for healthcare facilities. In addition, quality improvement and outcomes will continue to be a focus of federal and state legislators and regulatory agencies.
HAH members determined that quality is such an important focus that HAH started a program to spearhead local collaborative efforts and leverage the resources and best practices of statewide and federal initiatives.
In 2009, HAH established the Patient Safety & Quality Committee. In 2010, HAH hired a dedicated Quality Director. The program has continued to expand with grant funding, robust collaboration among members across the continuum of care, and the passage of legislation in 2011 (Act 176) to protect the confidentiality of quality discussions.
In HAH’s 2011-2014 Strategic Plan, Quality is one of the five key strategies for member success.
HAH is committed to recognizing and sharing the advancements that have been made in the patient safety arena, while acknowledging the challenges that remain—and committing to work on them, every day.
In another quality measure, Hawaii has again taken the #1 spot for quality performance in a health care setting. In a study released by CMS, Hawaii has reduced its rate of antipsychotic medication for dementia residents from 19% last year to 11% this year.
Hawaii skilled nursing facilities joined a nationwide CMA Partnership to Improve Dementia Care in Nursing Homes, which included training staff and emphasizing non-medical interventions for behavioral health issues faced by long term care residents.
Keith Ridley, Chief of the Hawaii Department of Health’s Office of Health Care Assurance and head of the Dementia Care Improvement task force, called the results “remarkable”. “Hawaii was already one of the leaders across the country when it comes to low utilization of antipsychotic medications,” he told HAH’s long term care leadership group. “I congratulate you for further reducing a rate already well below the national average [~24%].”
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Providers can be proud of this accomplishment, and for Hawaii’s consistently high ranking in Long Term Care quality metrics.