Nursing homes' quality campaign shows promise

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Nursing homes can pat themselves on the back this week. At least, nearly 7,400 can.

That is the number of facilities participating in the Advancing Excellence Campaign, an initiative supported by both major long-term care associations, to improve skilled nursing care across the United States.

A report released by the campaign on its two-year anniversary showed improvements in four critical areas: incidence of pressure ulcers, use of restraints, chronic care pain, and post-acute care pain. Reports for the campaign's organizational goals (goals five through eight, which are harder to quantify) are under development.

A few highlights from the recently released findings: Pressure ulcer prevalence among residents of Advancing Excellence members is 11.4%. That compares with a 12.1% rate among residents of non-participants who are at a high risk of developing them. The current national average is 11.7%.

Physical restraints prevalence is 4.3% among coalition members but 4.5% among non-participants. The national average is 4.1%.

Regarding chronic care pain, the rate is 3.9% for Advancing Excellence members and 4.2% for non-members. Nationally, it averages 4.1%. Post-acute care pain rates are 20.4% for campaign participants—the same as the national average. They are 21.1% for non-campaign members.

Not bad. Of course, objectively speaking, compared with the national averages, improvement does not seem to be overwhelming in these four areas. But the results are encouraging nonetheless and have positively affected thousands of individuals.

It's easy for outsiders to think that a nursing home can just magically eliminate the existence of pressure ulcers. Those working in the field know that's just not realistic. But if the goal is higher quality care, then nursing homes are heading the right way.

And the public is watching. One writer for U.S. News & World Report this week blogged about the relationship between cost and quality of care at nursing homes in the U.S. He referred to the Advancing Excellence results, as well as the recent Genworth study about costs of care around the country for his story. His conclusion? A higher-cost nursing home does not necessarily equate to better quality. See his entry here.

Regarding the issue of funding, you cannot look at the Advancing Excellence results without considering the shortage of resources that most nursing homes are operating under. Medicaid reimbursement is woefully inadequate, as we all know. And this recession is not helping any.

Knowing this, nursing homes as a whole should be doubly proud that they not only are working toward offering better care, but, as the results now show, are actually doing it.
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McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan, Senior Editor Elizabeth Newman and Staff Writer Emily Mongan.

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