key factors in achieving quality neil kurtz, m.d. president and ceo
TRANSCRIPT
Key Factors in Achieving Quality
Neil Kurtz, M.D.President and CEO
Presentation Overview
•What quality means to our company– How we define it– How we measure it– How we maintain and improve it
•Challenges we face
•Quality initiatives to address the challenges
•Results
What is Quality?
•We define quality as:– “Skilled Compassionate Care”
•We look at quality in three basic ways– Process-based measures: these
represent the actions of providers– Outcome-based measures: these
represent the results of care processes– Best practices: these explain and define
the nuances of best possible care
•Clinical, rehab outcomes
•Quality Indicators
•Survey performance,5-Star results
•Rehospitalizations
•Medication management
•Customer satisfaction, quality of life
•Employee engagement/retention
Measuring Quality
Communicating Quality
•Discussion of quality results and outcomes starts every leadership meeting
•Publications focusing on quality– Quality Highlights
• Internal and external– Partners in Quality
• ED, DNS, physicians– First Monday
• For Medical Directorsand attending physicians
– Safety Caps• Medication safety for nurses
•Daily Clinical Start-Up
•Clinical Scoreboard
•Facility PerformanceAssessment
•“Stop and Watch”
•SBAR nurse/physician communication tool– Situation, Background, Assessment, Response
•Quality Assessment and Assurance process
Quality Management Tools
Challenges
•More medically complex patients
•Shorter-term stays
•Varying approaches at multiple facilities
•Shortage of qualified staff
•Acceptance of change
•Funding
Addressing the Challenges
•Standardize care across multiple facilities– Ensure uniformity in approach
•Enhance measuring and monitoring tools
•Get better at managing transitions of care
•Reduce rehospitalizations
•Adjust staffing mix, scheduling approaches
•Modify and improve training
• Improve physician alignment
Key Initiatives
•Quality Improvement System utilizing Baldrige criteria
•Enhanced technology– Amalga for Daily Clinical Start-Up
• Increased Medical Director involvement
•Building a network of healthcare services
• Improving medication management– Golden Clinical Rx Solutions
• Improving the patient experience
Improved Survey Performance
• Average number of deficiencies 5.95 5.48
• Deficiency-free surveys 17 30
• Surveys resulting in sub-standard2.8% 1.8%
• Surveys resulting in IJ 2.5% 1.4%
• LivingCenters with 3 or less tags 33% 41%
• Overall HDI .97 .92
2009
2010
Industry-Leading 5-Star Quality Results
All Facilitie
s
Natl. Not For Profit
Natl. For
Profit
Perce
nt o
f Fa
cilities
January 2011
5-Star Quality Improvement
3.20
3.25
3.30
3.35
3.40
3.45
3.50
3.55
3.60
3.65
3.70
3.75
Q1-09 Q2-09 Q3-09 Q4-09 Q1-10 Q2-10 Q3-10 Q4-10
Golden LivingAverage 5-Star Quality Rating by
Quarter
5-Star Recognition
NURSING HOMES
52 Golden LivingCenters named to the 2011 U.S. News & World Report
List of America’s Best Nursing Homes
Golden
Living