Quality Insights’ goal is to provide support and meaningful webinar content to nursing homes. To meet this goal and to identify innovative ways to provide weekly COVID-19 infection control and vaccination/booster education to nursing homes, the Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO) created a three-part webinar series intended to help nursing homes use their Quality Assurance and Performance Improvement (QAPI) plan to improve resident COVID-19 booster rates. All three sessions were among the QIN-QIO’s highest attended webinars.  

Quality Insights came to this decision after comparing its previous webinar topics with attendance. The QIN-QIO found its most highly attended webinars focused on policies or guidance from CMS and the Centers for Disease Control and Prevention (CDC). The findings also aligned with a comment from a previous webinar attendee who expressed interest in better understanding QAPI, a program CMS requires all nursing homes to have in place. At the time the comment was made, QAPI was also among Quality Insights’ internally proposed topics for webinars, reinforcing the idea for the series.

Leveraging Existing Videos to Provide Value to Nursing Homes

Each of the three webinars in the series featured a five- to seven-minute video highlighting processes that apply to the QAPI approach – Brainstorming, Root-Cause Analysis (RCA) and the Plan-Do-Study-Act (PDSA) cycle – and how to use the processes to identify possible causes of low resident COVID-19 booster rates. The first two videos were created by Quality Insights months before the webinar series to provide easily digestible content to frontline nursing home staff. Prior to being featured in the series, each video had approximately 40 views on YouTube. Since then, views have doubled or more; and the videos have been shared nearly 20 times.

During each session, a Quality Insights Quality Improvement Specialist introduced the Brainstorming, RCA or PDSA process, played the video, engaged attendees in a discussion about what they learned and ended with a question-and-answer session. During the RCA session, for example, the video showed a fictional nursing home using the “5 Whys” technique to get to the root cause of their low COVID-19 resident booster rate. The “whys” included residents being vaccine hesitant, issues securing booster doses and not entering National Healthcare Safety Network data accurately. To further reinforce this technique, the QIN-QIO role-played using a different scenario. A Quality Insights communications team member played a family member who was angry his loved one’s dentures kept getting lost, and the Quality Improvement Specialist played a nursing home staff member demonstrating how to use the “5 Whys” to get to the root cause of the issue.

Meaningful Content and Follow-Up from the QIO Drives Continued Attendance

Following each webinar, Quality Insights shared links to the webinar recording and YouTube video in its weekly Last-Minute Lowdown email blast. The links to the recording and video were also included in the following week’s email blast promoting the next session in the series.

Improved Engagement with Nursing Homes

Comparing attendance of this webinar series with the average attendance at webinars in the two months prior to the series, participation increased by 89 percent for the first session, 48 percent for the second session and 42 percent for the third session. The QIN-QIO also noticed increased engagement between nursing homes and their Quality Improvement Specialists following the sessions, such as asking questions or requesting more information about the QAPI process. Several nursing homes also indicated they planned to share the individual videos with staff to educate them about the QAPI process.

Keys to Success

The success of Quality Insights’ QAPI series can be replicated by taking the following steps:

The Quality Insights team is considering developing additional series for its weekly webinars on topics such as emerging infectious diseases, vaccinations, updated regulatory guidance and other nursing home quality measures.

This material was prepared by The Bizzell Group (Bizzell), the Data Validation and Administrative (DVA) contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. 12SOW/Bizzell/DVA-1116-07/18/2023