This Change Package, released in 2018, aims to serve as a key resource for anyone interested in improving the quality of life and quality of care for those living in nursing homes. This All Cause Harm Prevention Change Package is focused on the successful practices of high-performing nursing homes. It was developed from a series of site visits to nursing homes across the country and the themes that emerged regarding how they approached prevention of harm while honoring each resident’s rights and preferences and how they carried out their work. The practices in the Change Package reflect how the nursing home leaders and direct care staff at these sites shared and described their efforts to prevent, detect, and mitigate harm.
The Change Package includes strategies to prevent adverse events and abuse and neglect identified by two reports published in 2014 by the Office of Inspector General. It focuses on practices of high-performing nursing homes, and reflects how the staff described their efforts to prevent, detect, and mitigate harm. A nursing home can choose from these strategies to begin improving residents’ quality of life through safer care. Because there is no single, magic bullet to prevent all causes of harm, the Change Package covers a wide range of strategies to promote resident safety. This resource includes suggestions that may be helpful when implementing the Change Package.
This Change Package is intended to support overall nursing home quality and performance improvement and focuses on the systems that impact quality such as: staffing, operations, communication, leadership, compliance, clinical models, promoting resident quality of life, and specific, clinical outcomes It was developed from a series of site visits to nursing homes across the country in 2012 and the themes that emerged regarding how they approached quality and carried out their work. The practices in the change package reflect how the nursing homes leaders and direct care staff at these sites shared and described their efforts. The change package is a menu of strategies, change concepts, and specific actionable items that any nursing home can choose from to begin testing for purposes of improving residents’ quality of life and care.
A crosswalk of two Change Packages to support the National Nursing Home Quality Care Collaborative (NNHQCC)
A new Change Package was released in 2018 that describes foundational QAPI concepts, and includes a “drill down” focus on strategies to prevent specific types of adverse events, abuse, and neglect for nursing home residents. The first NNHQCC Change Package, first released in 2012, provides foundational concepts for Quality Assurance and Performance Improvement (QAPI). Both Change Packages may be helpful for nursing homes in their ongoing work to improve quality of care, quality of life, and safety for residents. This crosswalk provides information on the contents of both Change Packages.
This comprehensive, but not all inclusive, list of resources may be helpful for nursing homes as they work to enhance practices around recruiting and retaining staff. The resources may help nursing homes achieve stable staffing in order to improve resident quality of care and quality of life, and to achieve higher ratings in the staffing component of CMS’s five star quality rating system for nursing homes.
This is a comprehensive, but not all inclusive, list of resources that may be helpful for nursing homes as they work to ensure that residents who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for residents’ experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident (per §483.25(m) requirement that will be implemented beginning November 28, 2019).
These six sessions provide nursing home leaders with a set of training materials that they can use to enhance understanding of important concepts and practices that promote antibiotic stewardship and C. difficile prevention, and communication strategies and tools to promote quality and safety. The content for each session was developed as a set of “bite-sized” sections to keep the information, concise, brief, actionable, and customizable. The Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), developed these sessions with support from the Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality.
This assessment provides nursing home leaders with an optional tool to help them determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. Nursing homes can use this assessment to make decisions about direct care staff needs, as well as their capabilities to provide services to the residents in the facility. This tool can help nursing homes comply with federal regulations to complete a facility assessment. The Quality Innovation Network National Coordinating Center, under contract with the Centers for Medicare & Medicaid Services (CMS), developed the tool.