More than 1 million Americans live in nursing homes across the nation. Great Plains Quality Innovation Network unites nursing homes in a collaborative structure to share tools, knowledge and experiences for improving resident safety and clinical processes and reducing preventable healthcare conditions.

Riverview Estates is a private, locally owned, not-for-profit skilled nursing facility in Marquette, Kansas. In November 2016, the Riverview Estates team determined they needed to reduce their long-stay pain Quality Measure (QM) score. Twenty-four percent (7 residents) reported moderate to severe pain on a regular basis, compared to the state average of 9.6 percent and the national average of 6.7 percent. The Riverview Estates leadership team acknowledged major adjustments were needed to achieve improvement in their long-stay pain QM score.They consulted Great Plains QIN for assistance.

The team utilized the CASPER report for their QM rates and to determine which residents to focus on for a pain reduction Performance Improvement Project (PIP). The goal was to reduce the long-stay pain measure to less than the state average of 9.6 percent; which meant an improvement in three residents (at minimum). The team began by increasing non-pharmacological interventions to decrease pain prior to pain assessments. For example, they began re-positioning residents to avoid pain pressure points and pain assessments on a weekly basis, instead of a quarterly basis.

All direct care staff were involved, along with residents and family members. Charge nurses were also assigned to assist with pain assessments on a more frequent basis.The skilled nursing facility also scheduled monthly coaching calls with the Great Plains QIN team to review successes and tackle any barriers they were experiencing.

After much hard work and commitment, the Riverside Estates team achieved their goal. Their current long-stay pain score is 3.2 percent (1 resident of 31). An improvement in their pain score was evident after only three months of activity and continues to show a downward trend.

After reviewing MDS data from the CASPER report, resident pain decreased and outcomes improved. More importantly, the overall quality of life of their residents has improved.

“The Riverview Estates leadership team utilized their QAPI processes to proactively identify areas of need and seek out assistance from our staff. The entire staff committed to educating each other and the residents to provide increased attention to residents’ pain needs. This Performance Improvement Project helped increase the quality of life for all residents with chronic pain at their facility,” stated Johnathan Reeves, Quality Improvement Consultant at Great Plains Quality Innovation Network.

For more information about Riverview Estates and their efforts, click here. For more information on how Great Plains QIN is working with nursing homes to reduce preventable healthcare conditions, click here.

Kansas Foundation for Medical Care, Inc. is a member of the Great Plains Quality Innovation Network.