Nursing home Advancing Excellence campaign results in decrease in pressure ulcers, physical restraints, pain rates, coalition says

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Mary Jane Koren, MD
Mary Jane Koren, MD
Advancing Excellence, a voluntary, nationwide campaign formed to improve care in nursing homes has done just that, organizers say. There has been a drop in the number of pressure ulcers and the use of physical restraints, and improved pain management for both long-term and short-term stays, according to newly released data.

"I'm extremely gratified because it's showing the campaign worked," said Mary Jane Koren, M.D., M.P.H., who is chair of the Advancing Excellence coalition and notably is not a long-term care provider. "Nothing like this has been tried before.

The campaign, which now includes 7,400 facilities, released its results last week on its two-year anniversary. The coalition estimates that in the course of the campaign, there were 1.8 million fewer days where a resident was at high risk for developing a pressure sore or was suffering from one. Also during this time, there were an estimated 8.5 million fewer days where a nursing home resident used a physical restraint, Koren said.

Advancing Excellence members had an 11.4% rate of pressure ulcer prevalence among residents, well below the 12.1% rate of non-participants, according to the report. Physical restraints prevalence was 4.3% among coalition members but 4.5% among non-participants.

When it came to residents with chronic care pain, the rate was 3.9% for Advancing Excellence members and 4.2% for non-members; post-acute care pain rates were 20.4% and 21.1%, respectively.

Advancing Excellence members are asked to choose three of eight care areas to concentrate on improving. They are supported by local agencies with free resources. (For more info, visit www.nhqualitycampaign.org.)

"The campaign is alive and well and we want people to join," Koren said, adding that from now on, all members' choices will carry performance targets. "We know that nursing homes participating have not had negative or unintended consequences. People were afraid there might be legal ramifications or people pointing fingers at them (about incident rates). It hasn't happened."