Statewide strategy to improve quality of care in nursing facilities

Purpose: We describe the development of a statewide strategy to improve resident outcomes in nursing facilities, and we present some evaluative data from this strategy. Design and Methods: Key components of the strategy include (a) a partnership between the state agency responsible for the nursing home survey and certification and the school of nursing in an academic health sciences center; and (b) on-site clinical expert technical assistance and support to facilities throughout the state. Results: The partnership has resulted in state agency staff having information from analyses about resident needs and outcomes in the state and facilities having access to the quarterly electronic "Show-Me Quality Indicator Report." On-site clinical expert technical assistance is now used widely across the state, with 569 site visits conducted in 286 different facilities to help them interpret their quality indicator (QI) reports and implement quality improvement programs; statewide improvements in QI scores have been measured in several key QIs. Implications: Other states should consider building partnerships with schools of nursing in an academic health sciences center. Programs using on-site clinical consultation can facilitate improving quality of care in nursing facilities.