Nursing Care Center Webinar Series - Best Practices …...Nursing Care Center Webinar Series - Best...

September 4, 2019

Nursing Care Center Webinar Series -

Best Practices in Preventing

Rehospitalization

9:00-10:00 am (PT)

10:00-11:00 am (MT)

11:00 am-noon (CT)

12:00-1:00 pm (ET)

• Audio is by VOIP only – use your computer

speakers or headphones to listen

• There are no dial in lines

• If you hear background music, you have more

than one window open. Close the “test” window

& music will stop.

• If you currently cannot hear audio, click the “play”

icon in the upper left pane to launch audio

• Participants are connected in listen-only mode

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streaming events. Refresh your screen or rejoin

the event if this occurs.

Nursing Care Center Webinar Series - Best Practices in

Preventing Rehospitalization

Webinar Audio – Information & Tips

Nursing Care Center (NCC) Webinar Series

• NCC performance measure dashboards help identify

quality targets and assist organizations identify where

their performance lags and leads

• To help NCCs improve in antipsychotic medication use and

rehospitalizations, a two-webinar series was developed

• Intended audience is NCC leaders, managers and point-of-

care staff

• Opportunity for NCCs to learn best practices and lessons

learned in achieving and sustaining impressive outcomes

from high-performing organizations



Nursing Care Center (NCC) Webinar Series

– Recording and slides available

– Visit webinar landing page

– You will be asked to register to view the recording

If link is not clickable, please cut and paste this url into your browser

https://goto.webcasts.com/starthere.jsp?ei=1254688&tp_key=f0a58fea53


Preventing Rehospitalization /

August 13 NCC Webinar –

Best Practices in Antipsychotic

Medication Use



http://www.jointcommission.org/_new_nursing_care_center_webinar_series_%E2%80%93_registration_open/

At the end of this session, participants should

be able to:

1. Apply concepts learned about evidence-based

best practices regarding rehospitalizations in

nursing care centers.

2. Identify common performance and outcome

challenges in rehospitalizations in nursing care

centers and

3. Prepare to implement at least one new best-

practice to reduce rehospitalizations and improve

outcomes in the learner’s facility.



• To access the slides, see the

Event Resources Pane

• Select the slides for today’s

session

• A new window will open where

you can download and save or

print the PDFs

Slides are available now!



• Ask questions through the

Questions pane

• Visit any links or resources

provided in the slides

• If you experience audio issues,

see slide 2 for tips to resolve

• Recording and slides will be

posted within a few weeks of

this session.

• Please share the recording with

your colleagues



Housekeeping Information



Webinar is approved for 1.0 Continuing Education Credit for:

• Accreditation Council for Continuing Medical Education (ACCME)

• American Nurses Credentialing Center (ANCC)

• American College of Healthcare Executives (ACHE)

• California Board of Registered Nursing

• International Association for Continuing Education and Training (IACET)

(.1 credit)

Continuing Education credits are available for the live webinar

presentation only. Credits will not be available for webinar replays.



To claim credit, you must have:

• 1) Individually registered

• 2) Listened to the entire live webinar*

• 3) Completed a post-program evaluation/attestation**

* Listening with colleagues and did not use your own computer to join? You can

still claim CE credit if you meet these criteria.

** Program evaluation/attestation survey link will be emailed to participants

tomorrow.

PDF certificates will be emailed 2 weeks after the session; all participant CE

certificates are sent at the same time.

For more information on The Joint Commission’s continuing education policies, visit this link

http://www.jcrinc.com/store/learning-events/continuing-education/

http://www.jcrinc.com/store/learning-events/continuing-education/

Disclosure Statement

These staff and speakers have disclosed that neither they nor their

spouses/partners have any financial arrangements or affiliations with corporate

organizations that either provide educational grants to this program or may be

referenced in this activity:

Brigette B. DeMarzo, MPH, CIC, CPHQ, CPPS, Project Director, Quality

Measurement, The Joint Commission

Irwin J. Pomerantz, LNHA, Administrator, Long Island Care Center

Nickanor Baltazar RN, BSN, Director of Nursing, Long Island Care Center

Michelle Shepard, LNHA, Executive Director, Consulate Healthcare of Port

Charlotte



The Power of Data

• Opportunity to take another step forward on the

road to being a quality improvement organization

by partnering with our surveyors and accredited

organizations in the use of data

• Quality Dashboards:

– Guide survey activity and discussion

– Consistent view of valid, actionable data

– Focus conversation on where performance

leads and lags

Program Dashboards

• Nursing Care Centers = 2019 Q1

• Home Health and Hospice = 2019 Q2

• Ambulatory Surgical Centers = 2019 Q3

• Hospitals = 2020 Q1

Dashboard Development

Selected Measures

Stakeholder Review

Measure Criteria

Available Measures

Data Sources

Dashboard Development Selected Measures

Stakeholder Review

Measure Criteria

Available Measures

Data Sources


Stakeholder Review

Measure Criteria

Available Measures

Data Sources

Re-hospitalized after nursing home

admission

Outpatient emergency department visit

Antipsychotic medication for first

time Pressure ulcers are new or worsened

Reported moderate to severe pain

Successfully discharged home

Improved in ability to move independently

Received antipsychotic medication

One or more falls with major injury

Pressure ulcer prevalence

Urinary tract infection prevalence

Catheter inserted and remained indwelling

Ability to move independently

worsened

Need for help with daily activities increased

Patients physically restrained

Report moderate to severe pain

Needed and got a flu shot

Needed and got a vaccine to prevent

pneumonia

One or more falls with major injury Functional abilities

assessed and goals in treatment plan

Rate of potentially preventable readmissions

MSPB



pneumonia

Hospitalizations per 1,000 resident days

Loss of bowels or bladder control

Lose too much weight

Symptoms of depression


Stakeholder Review

Measure Criteria

Available Measures

Data Sources


admission













worsened






pneumonia




MSPB



pneumonia





Are all 30 measures created equal?


Stakeholder Review

Measure Criteria

Available Measures

Data Sources

EvidenceThere is a strong evidence base that the care process leads to improved outcomes.

Performance GapThere is a measurable opportunity to see improvement in outcomes.

Adverse EventsImplementing the measure has little or no chance of inducing unintended, adverse consequences.

AccuracyThe measure captures whether the evidence-based care process has been provided.

ProximityThe measure addresses a process that has few intervening processes before the outcome is realized.

Data QualityRequired elements are complete, available, and accessible.

Risk Adjusted / StratifiedThe influences of factors that differ among groups can be controlled or taken into account.

ActionableMeasure rationale and results are easily understood and can be used by the audiences of the data.

Dashboard DevelopmentStrategic Focus Area

Selected Measures

Stakeholder Review

Measure Criteria

Available Measures

Data Sources

TJC BD Executive Director

TJC Surveyors and Reviewers

CEOs of NCCs CQOs of NCCs

NCC Stakeholders

Invited individuals were subsequently empowered to

invite additional team members from their

organizations


Selected Measures

Stakeholder Review

Measure Criteria

Available Measures

Data Sources


admission













worsened






pneumonia




MSPB



pneumonia






Selected Measures

Stakeholder Review

Measure Criteria

Available Measures

Data Sources


admission


time

Pressure ulcers are new or worsened







Dashboard Features

• National, state, and local comparison rates by

measure

• Hyperlinks to vetted QI resources, specific by topic

• Standardized jumping off point for dialogue on QI

during your triennial survey

• Narrowed list of important QI topics – Permission

to Prioritize

Dashboard LocationClick on the Continuous Compliance tab, and then under the Program Dashboard Reports heading, click on Program Dashboard Reports.

Dashboard Location

Click on the PDF icon under the “View” column.

Targeting Topics

• Among long stay measures, antipsychotic

medication use had the biggest opportunity for

improvement

• Among short stay measures, rehospitalizations

had the biggest opportunity for improvement

Our Quality Journey

― Its all about the data and outcomes

― Data plays a huge role in determining who we are as

industry leaders.

― Data determines who are the best of the best.

― Top Guns in our industry.





―JAMA. 2014 Oct 15; 312(15): 1542–1551.

―doi: 10.1001/jama.2014.13513

―https://customer.jointcommission.org/TJCPages/SQLReports.aspx?report=PrgDashboard&OnTab=3

―https://ltctt.ahcancal.org/secure/dashboard

―https://www.medicare.gov/nursinghomecompare/search.html

―www.CMS.gov

References

https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=25321909

https://dx.doi.org/10.1001/jama.2014.13513

https://customer.jointcommission.org/TJCPages/SQLReports.aspx?report=PrgDashboard&OnTab=3

https://ltctt.ahcancal.org/secure/dashboard

https://www.medicare.gov/nursinghomecompare/search.html

http://www.cms.gov/

• Please ask questions through

the Ask a Question pane

• Click the arrow to expand and

close the pane.

• Include slide reference number

or organization to which question

pertains, when possible



• To access the slides, see

the Event Resources Pane

• Select the slides for today’s

session

• A new window will open

permitting you to download

and save or print the PDF

REMINDER - Slides are available now!





Within two weeks,

the webinar

recording and slide

deck will be

accessible on The

Joint Commission

website via the NCC

webinar landing

page:

https://www.jointcommi

ssion.org/_new_nursin

g_care_center_webinar

_series_%E2%80%93_

registration_open/

https://www.jointcommission.org/piq_expert_to_expert_series/



CE Session Evaluation Survey and Certificate

You will receive an automated email that will direct

you how to access the evaluation survey.

We use your feedback to inform future content and

assess the quality of our session.

The evaluation closes in 2 weeks.

After the evaluation period closes, a printable certificate will be emailed to all participants that complete the survey and meet all CE requirements.

Thank you for attending this session.



Nursing Care Center Webinar Series - Best Practices …...Nursing Care Center Webinar Series - Best...

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