In Rhode Island, the New England QIN-QIO Nursing Home Team convened staff from local nursing facilities who were struggling to reduce antipsychotic medication use among their resident population. During this meeting, held in January 2017, the QIN-QIO team incorporated input and participation in collaboration with the New England QIN-QIO Quality Improvement Initiative Lead, to offer technical support to attendees in an effort to help the challenged facilities to reduce their antipsychotic rate.
The Eye and Lasik Center in Greenfield, Massachusetts reached out to the Massachusetts Quality Payment Program (QPP) Team for assistance with successfully reporting to MIPS for a full year. As part of this effort, the MA QPP Team helped the group to identify appropriate improvement activities based on existing clinical practice improvements, including: workflow redesign, patient experience and engagement.
The New England QIN-QIO teamed up with Pratt Homes, a subsidized senior housing complex in Nashua, NH to provide a six week Diabetes Self-Management Education (DSME) course to residents. Ten residents completed the program, and were provided tools to deal with daily challenges that come with diabetes. In addition, members reported benefitting from the peer-to-peer support the class provided. Due to its success, the New England QIN-QIO plans to offer future DSME classes at Pratt Homes.
In partnership with the New Hampshire Department of Health and Human Services, the New England QIN-QIO works to implement Million Hearts strategies, including smoking cessation, one of the “ABCS of Heart Health.” Together, they are working closely with home health agencies across New Hampshire, including Cornerstone VNA, to manage smoking assessment data for the population via the HHQI Cardiovascular Data registry and deliver evidence-based smoking cessation resources to clinicians and patients.
Through a program developed by the University Of Rhode Island College Of Pharmacy, students traveled with a Visiting Nurse Agency to patients’ homes, to provide medication reconciliation and education. The New England QIN-QIO partnered with URI by creating a data collection tool for their findings. Data showed these visits prevented 186 physician visits and 46 hospital admissions. It is hoped that the collection of this data will lead to more utilization of pharmacists in the homecare setting.
A nursing home in western Massachusetts implemented a new hydration program to monitor and prevent dehydration among their residents, specifically those with chronic kidney disease. The program incorporated hydration alert protocols which were performed at least once per shift. Since the initial roll out, the facility has been 100% compliant with performing hydration alert protocols, thereby delivering improved care to their residents.
Staff at the Maine Veterans’ Home (MVH) began using the PAM tool to identify patients at greater risk for readmission due to lack of medication adherence and reconciliation. Patients scoring a low activation level receive additional consultation and follow-up from pharmacy staff after discharge. Since implementing processes using this tool and subsequent interventions, MVH has reduced their readmission rate by 23%.
The Southwestern Vermont Medical Center worked with the New England QIN-QIO to perform a hand hygiene assessment on the hospital staff using the mobile app, iScrub. The hospital staff found the observational hand hygiene data from an outside observer as a great addition to their reporting. The data helped to reinforce the need for the continued emphasis on hand hygiene, including efforts to raise awareness as a critical patient safety issue.
Residents of the Vermont Veteran’s Home helped to implement in a hand hygiene program, led by the home’s Infection Preventionist, to keep their home free from the flu and norovirus. As a result of this program and the resident participation, the facility achieved zero flu and norovirus outbreaks and documented a 95% improvement in hand hygiene.