Strengthening Community Ties for Improved Pressure Ulcer Care

1
Strengthening Community Ties for Improved
Pressure Ulcer Care

• Joanne Lynn, MD, MS, MA
• David Gifford, MD, MPH

2
Concerning Nursing Home Quality and Other
Providers

• Nursing home quality cant be a lot better than
  quality of care in the community generallysame
  staff, same patients, same community expectations
• Measures of nursing home quality reflect quality
  of care for residents in other settings
• Nursing home issues are often given low priority
  in other settings

3
Nursing Home Leadership Opportunities

• Improve transfers information about patient
  condition, preferences, treatments, family, care
  plans, etc.
• Reduce transfers hospice and consultations
  on-site, reduce contrary incentives (financial
  and human resources)
• Develop regional standards for advance care
  planning, pain management, decision-making, stock
  medications, etc.

4
Why Should Nursing Homes Lead Improvement
Activities?

• We can be so effective as advocates for our
  residents and families
• We see important things differentlyand
  betterthan hospitals and doctors
• We can improve the status and image of long-term
  care in the eyes of the public, regulators, other
  healthcare providers, and funders

5
The Louisiana Story.

• Carole Broussard, RN, C, Louisiana Health Care
  Review, Inc. Cheryl Pucket, MA, LDN, RD,
  Dauterive Hospital
• Adrian Robinns, RN, BSN, New Iberia Manor South

6
Some Ideas from the Louisiana Example

• Convene key playersget to know them, find common
  agendas and pursue them
• Develop regional commitmentPeople here should
  live through to the end of life without pressure
  ulcerscollaborate to understand why they occur
  and to change things to prevent and treat
  effectively
• Take responsibility beyond our walls
• Use the QIOalready serves all providers

7
More Possibilities

• Promote routine use of effective treatment
  strategies and equipment by all providers in
  community (e.g., for pressure ulcers)
• Duplicate the transfer responsibility make
  reliable transfer a responsibility of sending
  team and the receiving team
• Develop shared monitors of success in quality
  regional measures
• Work with hospice, Evercare, and others to expand
  services on-site
• Consult in the hospital on nursing home issues
  like skin care provide expertise

8
More Possibilities (continued)

• Lead disaster preparedness for those with serious
  disabilities
• Others

9
In Closing

• Changing demographics and our own professionalism
• and leadership creates opportunities for new
  roles
• for long term care facilities e.g.,
• Centers of Excellence for the Last Phase of Life
• Excellence requires collaboration with other
  providers!