South Carolina Initiative to Improve Dementia Care And Eliminate Off-Label Antipsychotics in SC Nursing Homes

In 2016 LeadingAge SC received funding for a 3-year CMS CMP Grant. The purpose of the Grant was for LeadingAge South Carolina, in collaboration with B&F Consulting and the SC Coalition for Dementia Care, to improve the delivery of care for residents with dementia; reduce the use of off-able antipsychotic medications; improve consistent staff assignment; staff turnover; and staff retention in a minimum of 75 nursing homes.

LeadingAge South Carolina also partnered with Brown University School of Public Health, Center for Long-Term Care Quality Innovation to evaluate the project results and outcomes.

Year 1 of the Grant was a Pilot where six nursing homes were selected to participate in learning sessions over a year: two nursing homes each from Charleston, Columbia and Greenville. The Pilot Homes received extensive onsite assistance through half-day learning sessions on quality improvement, with a goal of improving staff stability and quality outcomes, behavioral health, sleep and much more. The Pilot Homes also received Hand -In -Hand training for all staff conducted by Dr. Charla Long.

Year 2 of the Grant was set up as a Learning Collaborative also offered in the 3 aforementioned locations. The statewide Learning Collaborative provided 9 different learning sessions over the year to expand on the tools, tips and training materials developed during the Pilot and to disseminate best practices and lessons learned SC nursing homes. The Learning Collaborative also featured the Hand-in-Hand training as a “Train the Trainer for participating nursing home staff educators.

The Grant provided information on many topics such as:

  • Participating nursing homes learned three root cause analysis tools: Brainstorming, Process Mapping, Tracking and Trending
  • Staff Stability
  • Functioning behavior management programs

Pilot Homes and Learning Collaborative participant nursing homes measured:

  • The monthly rate of antipsychotic medication use by long -stay and short stay residents using publicly reported CMS data on antipsychotic use and the MDS Casper Resident Level Quality Measure Report.
  • The monthly rate of antianxiety and hypnotic medication use by long -stay residents using publicly reported CMS data and the MDS CASPER Resident Level Quality Measure Report;
  • The monthly incidence of Behavioral Symptoms through the MDS incidence of EO 200 (e.g. behavior, presence, frequency) and EO 800 (e.g. rejection of care, presence frequency); and,
  • Monthly staff turnover using payroll records.

Pilot Homes and Learning Collaborative participants also completed a QAPI Pre and Post assessment as well as a Brown University's Center for Long Term Care Quality & Innovation baseline line survey, pre and post, for evaluation purposes.

 

Year 1 - Pilot Home Video Link

Pilot Home Video Link: https://www.dropbox.com/s/jvcirhhzzb7yghc/SC%20Initiative%20to%20Improve%20Dementia%20Care.mp4?dl=0

 

GRANT QUICK TIPS

 

FROM AP REDUCTION TO INDIVIDUALIZED DEMENTIA CARE

STAFF STABILITY: A MULTI-PRONGED APPROACH

SYSTEMS FOR COMMUNICATION AND TEAMWORK

MAXIMIZING HAND IN HAND TRAINING

PROTECTING UNINTERRUPTED SLEEP

STAY INTERVIEWS

TAKING OFF ALARMS AND SUPPORTING SAFE MOBILITY

TURNOVER BY LENGTH OF SERVICE

UNDERSTANDING BEHAVIOR AS COMMUNICATION

WATCH LIST HUDDLES