QIOs in Action: Reenergizing Statewide Efforts to Reduce the Use of Antipsychotics in Nursing Homes

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The overuse of antipsychotic medications among residents living with dementia remains a concern for nursing homes in the United States. A report from the U.S. Department of Health and Human Services’ (HHS) Office of the Inspector General found that 14 percent of nursing home residents take at least one prescription antipsychotic medication. More recently, a study found that 179,000 nursing home residents are inappropriately administered antipsychotic medications in an average week.

To address this issue, the Centers for Medicare & Medicaid Services (CMS) founded the National Partnership to Improve Dementia Care in Nursing Homes in 2012 to optimize the quality of care and life for residents of America’s nursing homes by improving care for all residents, especially those with dementia. While the initial focus of the Partnership was on reducing the use of antipsychotic medications, the larger mission is to enhance the use of non-pharmacologic approaches and person-centered dementia care practices. To date, the Partnership has helped reduce the prevalence of antipsychotic use among long-stay nursing home residents by 35.4 percent.

However, there are still nursing homes experiencing higher rates of antipsychotic medication use. For these homes — often referred to as late adopters” — the Partnership set a new goal of decreasing use by 15 percent for long-stay residents by the end of 2019.

To help jump-start efforts in New Mexico nursing homes identified as late adopters, HealthInsight—the Quality Innovation Network–Quality Improvement Organization (QIN – QIO) for New Mexico, Nevada, Oregon and Utah — created a series of short, 30-minute webinars in early 2018. These webinars are focused on educating providers and caregivers about the importance of reducing antipsychotic usage, as well as non-pharmacologic approaches to dementia care.

To help facilitate the webinars — known as Half-Hour Hot Topics” — HealthInsight engaged the New Mexico State Dementia Care Coalition, which includes public and private partners such as the New Mexico Health Care Association, the New Mexico Department of Health, AARP and other area dementia experts and organizations. These community partners provided expertise and resources on best practices to curb antipsychotic medication use during the online trainings.

Results

Since the webinars began, HealthInsight has seen an overwhelmingly positive reaction to the trainings, which have helped cultivate a growing commitment among nursing home staff to reduce antipsychotic usage. Nursing homes have expressed appreciation for the short, focused trainings that are easy to fit into busy schedules. Moving forward, HealthInsight and its partners plan to engage both the late adopter and more advanced homes to foster peer sharing through online trainings.

Recordings of past Half-Hour Hot Topic webinars are available on HealthInsight’s website.