Reducing Healthcare-Acquired Conditions in Nursing Homes

A commitment to making care safer

Improving Quality of Care in Nursing Homes

There are 1.4 million Americans living in the nation’s 15,600 nursing homes. We must be able to depend on nursing homes to provide reliable, compassionate, high-quality care. The Centers for Medicare & Medicaid Services (CMS) has created a strategy for guiding local, state and national efforts to improve nursing home quality of care. As part of that strategy,

Great Plains QIN is uniting nursing homes in a collaborative structure to share tools, knowledge and experiences for improving resident safety and clinical processes and reducing preventable healthcare conditions. Participants are learning from the best practices of nursing homes that have consistently earned a “5-star” rating in Nursing Home Compare, receive free education, resources and participate in rapid-cycle improvement projects. Our efforts align with the CMS National Nursing Home Quality Care Collaborative to:

  • Assist nursing homes to attain a score of six or better on the National Nursing Home Composite Quality Measure
  • Improve the rate of mobility among long-stay nursing home residents
  • Improve the targeted rate of reduction in the use of unnecessary antipsychotic medication in dementia residents
  • Decrease HAIs, other Healthcare–Acquired Conditions (HACs) and potentially avoidable hospitalizations
Through the five-year Nursing Home Collaborative, we are offering:
  • Customized onsite consultation
  • Quality improvement skills training
  • Evidence-based tools and resources
  • Ongoing educational opportunities
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Great Plains Quality Care Collaborative (QCC) Milestone Achievements & Progress

The Great Plains QCC Milestones are a simple way for you to improve your resident care while you test the use of quality improvement techniques essential to the QAPI process. For specific information on actions needed to achieve each Great Plains QCC Milestone level please refer to the Great Plains Quality Care Collaborative Milestones document.

Training Events

Jul 10 @ 2:30 pm – 3:30 pm
https://youtu.be/R5renGn8fIU Presentation handout Sleep Program Guidelines handout   Overview and Purpose: Two long-term care teams will present approaches to a quality sleep culture. Leadership from Avamere Health and Rehabilitation, Eugene, OR, used lessons from the[...]
Jun 19 @ 3:00 pm – 4:00 pm
This event has been canceled; we apologize for any inconvenience. Overview and Purpose: This webinar will outline and discuss the importance of a team effort in creating an effective infection prevention program and how it[...]
Jun 18 @ 1:00 pm – 2:00 pm
Download presentation handout Hospital antimicrobial stewardship programs can reduce inappropriate antimicrobial use, length of stay, Clostridium difficile infection, rates of resistant infections and cost. Electronic health records (EHRs) have the potential to enhance antimicrobial stewardship[...]
May 23 @ 1:00 pm – 5:00 pm Four Locations in North Dakota (Held Simultaneously)
    This year’s Quality Health Associates of North Dakota Annual Quality Forum—The Power of Progress—is an intentional celebration of successes from across the continuum of care throughout North Dakota represented by professionals who are[...]
Apr 17 @ 11:00 am – 12:00 pm
  Presentation Handout Overview and Purpose: Unrecognized and untreated foot ulcers in patients with diabetes can result in a lower extremity amputation (LEA), which may lead to high mortality, increased medical costs and reduced quality[...]
Apr 16 @ 1:00 pm – 2:30 pm
Presentation/Slides Handout Webinar Q&A’s Overview and Purpose: With the implementation of Patient-Driven Payment Model (PDPM) slated for October 1, 2019, diagnosis coding will become even more important. Skilled nursing facility and hospital diagnoses will be[...]
Mar 22 @ 1:00 pm – 2:30 pm
Presentation Handout/Slides Overview and Purpose: The recently finalized Patient Driven Payment Model (PDPM) along with the Quality Reporting Program and Value-Based Purchasing Program will have significant impact on long-term care ratings for 2019 and beyond.[...]
Jan 29 @ 12:00 pm – 1:00 pm
  Presentation Handout Empowering nurses to participate in antimicrobial stewardship programs is the missing link in strengthening antimicrobial stewardship and improving patient care.  It has been found that nurses are generally not comfortable with microbiology[...]
Nov 14 @ 1:00 pm – 2:00 pm
Overview and Purpose: From storms to droughts, wildfires to floods or accidents to epidemics, disasters occur nearly every day in the United States, and the frequency is increasing. How many people are hurt or even[...]
Nov 6 @ 12:15 pm – 12:45 pm WebEx
https://greatplainsqin.org/wp-content/uploads/2015/02/Great-Plains-Teach-Back-Webex-11-6.mp3 Presentation handout Teach-back Quick Start Guide – AHRQ Overview and Purpose: The WebEx will provide practical and specific strategies to incorporate teach-back in the workflow at your clinic, measure effectiveness of teach-back implementation, and[...]
Oct 25 @ 1:00 pm – 2:00 pm
Presentation handout Overview and Purpose: This webinar will provide a brief explanation of antibiograms and will delve into their value in acute care, long-term care and outpatient settings. Using antibiograms to support improved antibiotic use[...]
Oct 23 @ 12:00 pm – 1:00 pm WebEx
https://greatplainsqin.org/wp-content/uploads/2015/02/Great-Plains-QIN-Teach-Back-Recording10-23.mp3 Teach-Back Presentation Additional Presentation Resources American Heart Association – The Salty Six The 10 Elements of Competence for Using Teach-Back Effectivey AHRQ Teach Back Implementation Start Guide FDA Sodium Food Label Overview and Purpose: The purpose of[...]
Sep 19 @ 1:30 pm – 2:00 pm
Presentation handout Overview and Purpose: This 30-minute presentation will describe the development of the Nevada Sepsis Coalition Toolkit for skilled nursing facilities and provide an overview of the individual tools in the toolkit. The Sepsis[...]
Aug 30 @ 12:00 pm – 1:00 pm
  Presentation Slide Handout   Annually thousands of Americans are hospitalized and even die due to vaccine-preventable diseases.  Healthcare workers care for people at high risk for influenza-related complications so it is especially important for[...]
Aug 16 @ 1:00 pm – 2:00 pm
  Presentation Slide Handout   By attending this event, participants will gain additional knowledge about the IMPACT Act and realize how it will help Long-Term Care (LTC) and Skilled Nursing Facilities (SNF) improve quality of[...]
Aug 15 @ 1:00 pm – 2:00 pm
  Presentation slide handout Overview and Purpose: Join Peg Gilbert as she reviews the list of top ten common areas for infection prevention improvement and the evidence-based best practices for addressing them.  Participants will be[...]
Aug 14 @ 2:00 pm – 3:00 pm
Presentation slide handout During this Great 8 WebEx, staff members from three separate nursing homes in Wisconsin, Iowa and Oregon will share their best practices for pain management and prevention of readmissions. Pre-registration is not[...]
Jul 24 @ 3:30 pm – 4:30 pm
Presentation handout Overview and Purpose: Speakers will share insights and knowledge on trauma-informed care in nursing homes. Along with providing information and resources, approaches to care for individuals with a history of trauma will be explained.[...]
Jul 24 @ 12:15 pm – 1:00 pm
  Presentation/Slides Handout Join us as we welcome Johnathan Reeves from the Great Plains QIN, for a cross setting webinar focused on using your quality improvement program to fully utilize antibiotic stewardship efforts.   Target[...]
Jul 19 @ 2:00 pm – 3:30 pm
Presentation Handout Advance Care Planning Resources This webinar will feature a review of the Institute for Healthcare Improvement’s (IHI) framework for improving end-of-life care which includes five “bite-sized” practical principles. Stories from several organizations and[...]
Jun 14 @ 2:00 pm – 3:00 pm
Presentation/Slides Handout Access the WebEx Recording Overview and Purpose: Join us as we welcome Dr. Sarah Kabbani from the Centers for Disease Control and Prevention (CDC) for this timely webinar focused on antibiotic stewardship programs[...]
May 31 @ 1:00 pm – 2:00 pm
Presentation/Slide Handout Resident interview questions for continence shared by Kendra Roloff: Are you having problems with your bladder Do you ever lose urine when you don’t want to Do you ever leak urine when you[...]
May 31 @ 10:00 am – 11:00 am
  Presentation/Slides Handout Learn the recommended techniques for taking blood pressure (BP) Evaluation of blood pressure is essential in assessing cardiovascular health. As a standard part of many physicians’ office workflows, measuring blood pressure may[...]
May 10 @ 3:30 pm – 4:30 pm
Presentation/Slides Handout Participation Instructions: Pre-registration is not required. Please join 15 minutes prior to start. https://qualitynet.webex.com Locate the event, click “Join” Enter your name and email Enter the password: QAPI(If a dialogue box appears, click run. Set-up[...]
Apr 26 @ 2:00 pm – 3:00 pm
Presentation/Slide Handouts Recordings and Presentations Provided by Telligen Overview and Purpose: Please join us for this national webinar on the Immunization Champions, Advocates & Mentors Program (ICAMP) presented by The Gerontological Society of America (GSA).[...]
Apr 11 @ 11:00 am – 12:00 pm
Presentation/Slide Handout Early Recognition and Management of Sepis for Post-acute Settings (MPRO) Sepsis is one of the top diagnoses involved with readmissions throughout the Great Plains and Lake Superior Quality Innovation Networks. This webinar is[...]
Mar 28 @ 12:00 pm – 1:00 pm WebEx
Access the recording and presentation for this WebEx here. Every day, more than 90 Americans die after overdosing on opioids. The misuse of and addiction to opioids is an ongoing and rapidly evolving public health[...]
Mar 8 @ 3:30 pm – 5:00 pm WebEx
Access the WebEx recording This webinar will review the definition, prevalence, incidence and risk factors for delirium. We will discuss the diagnosis, treatment and strategies to prevent delirium. Participants will have the opportunity to explore[...]
Feb 14 @ 11:00 am – 12:00 pm
  Presentation Handout Every two minutes someone dies from sepsis in the United States. Eighty percent of sepsis begins outside the hospital. The elderly, as well as patients with chronic conditions, are at significant risk[...]
Feb 7 @ 2:00 pm – 3:00 pm
Presentation handout Presentation Overview Join this exciting webinar, where nursing home leaders share strategies to boost staff empowerment, increase ownership and accountability, engage staff in quality improvement and promote retention of quality staff. Discover how[...]
Jan 30 @ 12:15 pm – 1:00 pm WebEx Virtual Training
    Presentation Handout WebEx Q&A by Dr. Ashraf   Join staff from Great Plains Quality Innovation Network as we host our Community Antibiotic Stewardship Hot Topic: Urinary Tract Infections in Post-Acute Patients and Long-Term[...]
Jan 24 @ 3:00 pm – 4:00 pm WebEx
  Download WebEx Recording Download PDF of slide handouts Sepsis Matters   Sepsis Matters!! Early Recognition and Management for Nursing Home and Home Health Providers.  This event will provide knowledge on why early recognition and management of[...]
Dec 7 @ 1:00 pm – 2:00 pm
  Aromatherapy Presentation Handout Behavior Monitoring Log Chat Question Responses   Aromatherapy is the therapeutic use of essential oils extracted from plants. In healthcare settings, safety, staff education and intelligent use of essential oils are[...]
Dec 6 @ 12:00 pm – 1:00 pm
Access the presentation recording Access the presentation slides/handout Overview: Join us for this exciting webinar that will provide an overview of Patient and Family Engagement (PFE) strategies for engaging patients and families as part of[...]
Nov 30 @ 2:00 pm – 3:00 pm
  The Data Is In Presentation Handouts During this WebEx, National Healthcare Safety Network-Clostridium Difficile Initiative project participants will learn how to extract reports from the submitted data. Peg Gilbert will share steps to ensure data[...]
Nov 9 @ 10:00 am – 11:30 am
This webinar will focus on wound assessments. Presentation handout Target Audience: Providers, nurses, practice managers and clinical staff are invited to join this event. Objectives: Upon completion of the WebEx, participants will be able to:[...]
Oct 31 @ 12:15 pm – 1:00 pm
Presentation Handout November 13-19, 2017 is Antibiotic Awareness Week. This observance is a key component of Centers for Disease Control and Prevention (CDC) efforts to improve antibiotic stewardship in communities, healthcare facilities and on the[...]
Oct 19 @ 3:00 pm – 4:00 pm
Up to 70 percent of nursing home residents receive an antibiotic during a year and up to 75 percent of antibiotics are prescribed incorrectly.¹ The Centers for Medicare & Medicaid Services (CMS) has finalized a[...]
Oct 5 @ 2:00 pm – 3:00 pm
QAPI Presentation Handout QAPI Plan Template Worksheet QAPI Written Plan How-to Guide Quality Assurance/Performance Improvement (QAPI) is a proactive, data-driven, systems-based approach that prepares nursing homes to provide care with better outcomes—improved quality of life,[...]
Sep 19 @ 11:30 am – 12:30 pm
Presentation Handout   Sepsis is a complication caused by the body’s overwhelming and life-threatening response to infection. It can lead to tissue damage, organ failure, and death. Sepsis is difficult to diagnose. It happens quickly[...]
Aug 29 @ 2:30 pm – 3:30 pm
Presentation Materials: Access the presentation handout. Join us for this exciting webinar, where nursing home colleagues will learn from their peers about innovative ways to improve residents’ quality of life and reduce the use of[...]
Jun 8 @ 2:00 pm – 3:30 pm WebEx
WebEx: Sleep Hygiene/Falls – Part II Thursday, June 8, 2017 2:00 – 3:30 p.m. CT 1:00 – 2:30 p.m. MT Presentation Handout Restorative Sleep Vitality Program Checklist Empira’s Reference List for Restorative Sleep Vitality A[...]
May 25 @ 2:00 pm – 3:00 pm
Presentation materials Overview and Purpose: Communication is the lifeline of a well-functioning team. The TeamSTEPPS® Long Term Care Communication Module provides strategies and tools to improve the effectiveness of communication and promote sharing of information.[...]
Apr 27 @ 3:00 pm – 4:00 pm
Presentation Handout Overview and Purpose: This session explores competencies necessary for staff to create an optimum dining experience and addresses the advantages of learning new skills to improve communication between all stakeholders. It challenges participants[...]
Apr 13 @ 10:00 am – 11:30 am
Presentation Handout Promoting Urinary Continence in LTC 9 Myths of Incontinence in Older Adults Bowel & Bladder Log CNA Continence Quiz Continence Quiz Potential for Bowel & Bladder Training Tool Transient UI Protocol and Assessment[...]
Mar 21 @ 1:00 pm – 2:30 pm
Presentation Handout WebEx Recording Overview and Purpose: Joyce Black, PhD, RN, will provide an update on the National Pressure Ulcer Advisory Panel’s (NPUAP) changes in terminology and in the staging system. In addition, Dr. Black[...]
Feb 2 @ 1:00 pm – 2:00 pm WebEx
Access the Presentation Handout National mobility and alarms expert Sue Ann Guildermann is the speaker for this presentation on reducing falls in nursing homes. Participants will be able to discuss strategies and interventions to prevent[...]
Dec 6 @ 12:30 pm – 2:00 pm
  Description: During this call, learn about the reform of requirements for long-term care facilities, highlighting the Behavioral Health Services & Pharmacy Services sections. A Tennessee nursing home will also discuss innovative approaches that they[...]
Nov 17 @ 10:00 am – 11:00 am
Start WebEx Playback Download Presentation Handouts The Great Plains Quality Innovation Network invites you to attend this webinar. Join guest presenter, Johnathan Reeves, as he guides us through practical application of using data to meet[...]
Sep 22 @ 3:00 pm – 4:00 pm WebEx
MDS Part III: Understanding Quality Measures and Avoiding Common Pitfalls Start WebEx Playback Handouts MDS Series Part 3 Quality Measures Quality Measures Scoring Chart Presenters: Lisa Hohlbein, RN, RAC-MT, CDP,CADDCT AANAC Curriculum Development Judi Kulus,[...]
Sep 15 @ 12:30 pm – 2:00 pm
  Presentation Handout and Recording   Overview and Purpose: This call focused on effective care transitions between long-term and acute care settings, highlighting transitions that involve residents with dementia. This is critical for residents with[...]
Sep 8 @ 3:00 pm – 4:00 pm
Start WebEx Playback WebEx Objectives: As a result of this training, participants will be able to: •    Describe the population distribution according to age •    Explain why the older person’s pain is difficult to diagnose[...]
Aug 25 @ 3:00 pm – 4:00 pm WebEx
  Start WebEx Playback MDS Part II: Sections C, D, F and J: Capturing Resident Voice through Resident Interviews Presenter: Judi Kulus, MSN, MAT, RN, NHA, RAC-MT, DNS-CT, QCP Vice President of AANAC Curriculum Development[...]
Aug 18 @ 10:00 am – 11:00 am
Start WebEx Playback Vaccinations in North Dakota Nursing Homes Handout The North Dakota Immunization Information System (NDIIS) is a confidential, population-based, computerized information system that attempts to collect vaccination data for all North Dakotans. Registered[...]
Aug 9 @ 11:00 am – 12:00 pm WebEx
Start WebEx Playback Presentation Handout Great Plains Quality Innovation Network (QIN) C. difficile Reporting and Reduction Initiative Members will be required to enroll their facility into the National Healthcare Safety Network (NHSN) as well as[...]
Jul 21 @ 3:00 pm – 4:00 pm WebEx
Start WebEx Playback Slide handouts PDF Great 8 MDS Webinar Series 1 Handout MDS Sections AA and GG Handout Section GG Key Coding Tool MDS Part I: Section GG: What You Need to Know about[...]
Jul 15 @ 10:00 am – 11:00 am
Start WebEx Playback Please Note: The audio for this recording cuts out at 16:29 and resumes at 18:29. C. difficile Reporting and Reduction Presentation Handout Clostridium difficile (C. difficile) is a germ that causes major[...]
Jun 15 @ 3:00 pm – 4:00 pm
Start WebEx Playback   Objectives: Upon conclusion of this webex, participants will be able to: Discuss how specific leadership practices generate positive staff, resident and organizational outcomes Identify concrete strategies and systems for recruiting and[...]
Apr 13 @ 1:00 pm – 2:00 pm WebEx
Presentation Download: Prevention of Resident-to-Resident Negative Interactions Overview: The presenter discussed identification, triggers and strategies to manage this type of negative interaction.  Target Audience: This presentation is directed to the long-term care setting. Physicians, nurses,[...]
Feb 24 @ 10:00 am – 11:00 am WebEx
  Start WebEx Playback   Vaccination Quality Measures Handouts Recommended Adult Immunization Schedule -2016 LTCF Annual Influenza Checklist Vaccination Quality Measure Checklist Vaccination Log Vaccination Quality Measure Checklist – Fillable Form Overview Some quality measures[...]
Jan 15 @ 10:00 am – 11:00 am
The Great Plains Quality Innovation Network/Quality Health Associates of North Dakota invites you to attend the webinar “North Dakota Nursing Home Quality Care Collaborative: Where Are We Now?” Start WebEx Playback   Webinar Description Join[...]
Jan 14 @ 2:00 pm – 3:00 pm
Download Presentation Purpose: CMS and long-term care providers have never considered sleep as an integral part of the plan of care and services provided for the resident. This Restorative Sleep Vitality Program (RSVP) is a[...]
Dec 1 @ 2:00 pm – 3:00 pm
All too often patients do not receive the care they wish for as they approach their last days or in medical emergencies. Having conversations about these situations is difficult, but it is critical that these[...]
Nov 19 @ 2:00 pm – 3:00 pm
  Start WebEx Playback   Webinar Objectives This webinar will be a discussion on strategies to engage community-based programs to support advance care planning. Learn about the Institute for Healthcare Improvement’s (IHI) The Conversation Project[...]
Oct 8 @ 1:30 pm – 2:30 pm
Start WebEx Playback Objectives Describe how the use of coaching techniques can enhance communication and strengthen relationships in the workplace Discuss strategies for using coaching tools Target Audience This presentation is directed to all healthcare settings[...]
Sep 10 @ 2:00 pm – 3:15 pm
Start WebEx Playback Presentation Handouts Dr. Lisa O’Hara’s PowerPoint Presentation Comprehensive Therapy Specialists Behavioral Health Evaluation Overview CMS has issued a new challenge to reduce antipsychotic utilization in nursing homes by 25 percent by the[...]
Aug 13 @ 2:30 pm – 3:30 pm
Start WebEx Playback   Presentation Handout Purpose: Treating dementia does not warrant a “one size fits all” method. There are many types of dementia resulting in a myriad of behaviors. Dr. Fisher will explore non-pharmacological[...]
Jul 16 @ 12:30 pm – 1:30 pm
Start WebEx Playback Presentation Handout AD8 Dementia Screening Interview Behavior Log This program explores key elements in addressing the needs of individuals with dementia who are experiencing behavioral and affective challenges across the care continuum.[...]
Jul 9 @ 2:00 pm – 3:00 pm
  Start WebEx Playback Promoting Mobility Access Ms. Lundgren’s Promoting Mobility Presentation We invite you to attend this webinar to learn more about the impact immobility/mobility has on the overall health of the elderly. This[...]
Jun 30 @ 3:00 pm – 4:00 pm
To access the presentation slides/handouts, click here. Start WebEx Playback Overview: This presentation is directed to healthcare professionals in the long-term care setting. You are invited to attend to learn more about Nursing Home Quality[...]
Jun 24 @ 2:00 pm – 3:00 pm
South Dakota Nursing Home Quality Care Collaborative – What’s Your Composite Score Number? Start WebEx Playback Quality Milestones Program Introduction and Step Checklists South Dakota Milestones Success Story Template Milestones PDSA Cycle Template SD NHQCC[...]
Apr 29 @ 2:00 pm – 3:15 pm
Start WebEx Playback   PIP Guide 11SOW Presentation Slides CMS QAPI Goal Setting Overview This webinar will serve as the kickoff event and Learning Session 1 of the South Dakota Nursing Home Quality Care Collaborative.  This[...]
Mar 19 @ 1:30 pm – 2:30 pm
Start WebEx Playback Overview and Purpose: QAPI is the merger of two approaches to quality—Quality Assurance and Performance Improvement.  When these efforts are blended together, the result can be significant improvements to important outcomes: residents can experience[...]
Mar 12 @ 11:00 am – 12:00 pm
  GPQCC QAPI 101 Presentation Slides WebEx Overview The Great Plains Quality Care Collaborative will utilize Quality Assurance Performance Improvement (QAPI) as a data-driven, pro-active approach to provide a solid foundation for quality improvement efforts.[...]
Dementia & Antipsychotic Medication Reduction

External Resources

Other Quality Measure Topics

Nursing Home Composite Score Calculator Video


External Resources
All Cause Harm Prevention in Nursing Homes Change Package
National Nursing Home Quality Improvement Campaign
NNHQI Consistent Assignment
NNHQI Hospitalizations Goals
NNHQI Infection Goals
NNHQI Pain Goals
NNHQI Person-Centered Care Goals
NNHQI Staffing Stability Goal
CDC Influenza Toolkit for LTC Providers
CMS National NH Collaborative Change Package
CMS Nursing Home Compare Five Star Rating System User Guide
CMS Quality Indicator Study (QIS) Survey Form
Pioneer Network
Pressure Ulcers Pressure Ulcer Training Modules - NDNQI
Understanding Depression in Later Life - Myths and Realities - NDSU Extension

QAPI

External Resources

CMS QAPI Process Tool Framework
QAPI At a Glance Toolkit
QAPI Five WHYs Tool for Root Cause Analysis
QAPI Goal Setting Worksheet
QAPI Guidance for Performing RCA with PIPs
QAPI Guide for Developing a QAPI Plan
QAPI Self Assessment Tool 
QIO Program Nurshing Home Facility Assessment Tool
Stratis Root Cause Analysis Toolkit

Meet the Experts

Johnathan Reeves

Johnathan Reeves, BA, CPHQ

Quality Improvement Consultant
Kansas
785-273-2552 x367
Email Johnathan

Krystal Hays

Krystal Hays, DNP, RN, CDP, CADDCT, RAC-CT

Quality Improvement Advisor
Nebraska
402-476-1399 x522
Email Krystal

Michelle Lauckner

Michelle Lauckner, RN, BA, RAC-CT, IP-BC

Quality Improvement Specialist

North Dakota

701-989-6229

Email Michelle

Lori Hintz

Lori Hintz, RN

Program Manager
South Dakota
605-354-3187
Email Lori

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Learning and Action Network

We invite you to join the Great Plains Learning and Action Network (LAN). All LAN partners will be invited to attend educational sessions on a variety of topics, have opportunities to learn from peers throughout the state and region and have access to an abundance of resources and tools. The LAN is a great opportunity to get connected and demonstrate your commitment to quality improvement.