NH Recruitment, Engagement, and Peer to Peer

QIN-QIO Program Breakout:
Nursing Home Recruitment, Engagement, and
Peer-to-Peer Coaching
Carmen T. Winston MHSA, BSN, BA
The CMS Healthcare Quality Conference
Baltimore, MD | December 2 – 4, 2014
Follow us on Twitter:
@QIOProgram
Tweet with our conference hashtag:
#QualityNet14
Questions we are running on
• How can I supplement the recruitment methods that I
am using with proven strategies employed by other
QIN-QIOs?
• What can be done to maintain engagement or reengage participating nursing homes?
• How can peer coaches be used to strengthen my QINQIO nursing home collaborative?
• What methods to engage hospital leadership in quality
mentorship programs may be helpful in designing peer
coaching efforts for nursing homes?
• What ideas have I heard that will strengthen my
personal action plan
2
Sharing Minute
• Share with someone next to you:
Your single most effective strategy for recruiting
nursing homes so far…
3
Health Services Advisory Group (HSAG)
Nursing Home Recruitment and
Engagement Strategies
Joe Bestic, NHA, BA, Nursing Home Task Director
December 3, 2014
Phone: 602.801.6930
Email: [email protected]
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@QIOProgram
Tweet with our conference hashtag:
#QualityNet14
4
Presentation Goals
Review HSAG 11th Statement of Work
(11SOW) Nursing Home Quality Care
Collaborative (NHQCC) recruitment efforts.
Discuss successful strategies for 11SOW
one- and five-star nursing home recruitment.
Learn new ways to engage nursing homes in
a collaborative.
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Successful Recruitment Tasks/Strategies
for the NHQCC
The Dating Game!
• Use of data criteria for “courtship.”
• Pilot recruitment materials with “suitors.”
-Stakeholder meetings and presentations (trade
associations, state survey agency [SSA],
Medicaid program, State Long-Term Care
Ombudsman, and nursing home corporations).
• Collaborative cover letter with stakeholder support.
• SSA letter of agreement.
6
HSAG Nursing Home Recruitment Stats
Total NH Recruitment
250
One-Star NH Recruitment
35
226
202
31
30
200
25
150
20
122
109
100
84
65
15
11
10
61
8
10
5
50
4
5
12
3
0
0
0
Arizona
California
Current NHs
Florida
Ohio
November Goal
California
Current One-Star NHs
Data as of 11/10/14
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Arizona
Florida
Ohio
November Goal
Ideas for One-Star and Difficult to
Recruit Nursing Homes
• First, discuss with facility administrator benefits of joining
the NHQCC (technical assistance, peer-support, QIN-QIO
support, etc.).
• Second, if unsuccessful, discuss the Decision-Not-ToParticipate process with the facility administrator.
• Third, if needed, reach out to the nursing home corporation
executive staff and/or ownership.
• In addition to the above, use the trade associations, State
Long-Term Care Ombudsman, the SSA, the state Medicaid
program, as well as the CMS COR and GTL as recruitment
leverage.
8
Five-Star Nursing Home Recruitment Ideas
• Discuss with administrators their role as coaches and
mentors (peer-coach process).
• Emphasize “all-teach, all-learn.”
• Explain that key stakeholders will be in attendance at
collaborative events, including accountable care
organizations, hospitals, the SSA, trade associations,
etc.
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Sharing Minute
• Share with someone next to you:
One effective strategy to keep participating
nursing homes engaged in working with your QINQIO
10
Director of Nursing (DON) Advisory Group:
Collaboration and Peer Coaching
Jo A. Taylor, RN, MPH
Phone: 828.551.9852
Email: [email protected]
Follow us on Twitter:
@QIOProgram
Tweet with our conference hashtag:
#QualityNet14
11
DON Advisory Group during 10th SOW
WHO?
HOW?
• 10-12 DON’s with long
standing success and
enthusiasm
• Relationships from prior LAN
events
• Stakeholder
recommendations
• Nursing home corporation
recommendations
• National Association Directors
of Nursing Administration
(NADONA) leadership
recommendations
– NADONA membership and
national leadership
• Staff in nursing home
corporations
• QIO nursing home staff
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DON Advisory Group during 10th SOW
WHAT?
• 1 hour teleconference
• QIO lead
• Every other month, more
frequently in beginning
• Doodle calendar
• Agenda and minutes
• In person workshop at one
DON’s facility with expert
speaker and NADONA
news
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Activities
• Review and critique content for LAN events
• Suggest expert speakers
• Provide examples to share at LAN events and on
informational Listserv and e-newsletter
• Present at LAN events
– Antipsychotic medication reduction
– End of life care
– PDSA cycles
• Contribute to ACE Best Practices
14
11th SOW
Same
• Personal invitation
• Similar format and frequency
New
• Formalize mentor role
• Utilize as key avenue for identification of staff,
residents, and families for participation as peer
coaches
• Build leadership as peer coaches and mentors
15
Sharing Minute
• Share with someone next to you:
What ideas can I use from this approach to
strengthen plans for using peer-coaches?
16
Learning from the Partnership for Patients
Campaign
Martin J. Hatlie, JD
CEO, Project Patient Care
& Core Team Member for the Partnership for Patients National
Content Developer
Email: [email protected]
Twitter handle: @Mhatlie
Linked In: https://www.linkedin.com/in/martinjhatlie
Follow us on Twitter:
@QIOProgram
Tweet with our conference hashtag:
#QualityNet14
17
Partnership for Patients Campaign:
April 2011 through December 31, 2014
• Partnership for Patients Campaign: April 2011 through
December 31, 2014
• Clear & “Thrilling” Goals:
• 3700+ hospitals engaged & reporting progress
• 27 Hospital Engagement Networks in action recruiting
& supporting hospital participation
– National & State Hospital Associations
– Large Health Systems
– Other nationwide hospital networks, i.e., Premier, VHA, Joint
Commission
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Partnership for Patients Campaign Recruiting:
What worked?
• CMS prioritization
– Big vision, splashy launch
• Thoughtful selection of goals
– Stretch goals, but evidence- based & achievable
• Existing relationships
• WIFM?
– Resources!
– Competitive advantage, Pay for Performance
• Relentless Campaign mode
– Frequent benchmarking
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National Support System for HENs: Hospitals
Engaged, Reporting, Improving, & Generating
Benchmark Results
5,196
3,699
3,524
3,479
3,155
1,953
278
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Partnership for Patients Campaign Recruiting:
What worked?
• Stratified recruitment strategies
–
–
–
–
Improvement leaders
C-Suite and BoD
Physicians
Patients & family members
• Multimodal engagement opportunities
– “Pacing events”
– “All Hospital” events
– Affinity Groups
• Leadership and patient/family engagement metrics
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Partnership for Patients PEPL Metrics
(Promoting Engagement with Patients and Leaders)
Hospital Leadership
On PFP Goals
Governance
• Public Commitment to PFP
Safety, Data Transparency
Hospital Structure For
Patient Family Engagement
• Patient Family Engagement
(PFE) Advocate on The Board
• Board Quality Committee
Reviews Safety Data
Policy and
Protocol
• Regular Quality Review Aligned
with PFP goals
• Active PFE Committee or Advocate
• Staff w Proactive PFE Responsibility
• PFE Advocates Are SAB Trained
Point of
Care
• Staff Have Explicit Role
in Patient Safety
• Pre-Admission Checklist w Patient
• Huddles With Patient, Family
• Post-Discharge Medication
Reconciliation w Patient, Family
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Minnesota HEN Relationship Between
PFE and Outcomes
1.1
PPR ratio
1.0
Comparing Minnesota PPR of Low Performers (0-3 PFE) to High Performers (4-5 PFE)
0.987
0.9
0.798
0.817
0.8
0.7
0.631
0.6
2009
2010
2011 2012-1 2012-2 2012-3 2012-4 2013-1 2013-2 2013-3 2013-4
# PFE met 0-3
# PFE met 4-5
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Net Forward Energy
What We Think…
What We Say…and
What We Spread to Others
Makes All the Difference.
A Continuum of Energy, Thoughts,
Statements
Positive
Negative
 What works
 Good stories
 Opportunities
 What we can do
 What I do have
 Acting
 Taking Responsibility
 Open
-- What doesn’t work
-- Bad stories
-- Problems
-- What we can’t do
-- What I don’t have
-- Analyzing, waiting, wishing
-- Blame
-- Judgmental
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Our Request to You:
Think…
Say…and
Spread Net Forward Energy
It Will Make All the Difference.
Sharing Minute and Action Plan
• Share with someone next to you:
How can this information enhance peer coaching
efforts in our nursing home work?
• Take a few minutes to jot down insights, actions, and
follow up to strengthen your recruitment, engagement,
and peer-coaching
27

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