MDS Alert
SPECIAL NEW YEAR SUPPLEMENT - Prepare For The New QMs Now
Here are the inside secrets to succeed.
What's the best strategy to prepare for the new publicly reported quality measures slated to go into effect early in 2004? Study up and make the right plans - care plans, that is.
Facilities should be taking a look at their internal systems for how they are assessing, monitoring and care planning the issues addressed by the QMs, advises Ruta Kadonoff, a senior health policy analyst for the American Association of Homes & Services for the Aging. "In addition, pay attention to how you're implementing and evaluating care plans" in those areas, she advises.
"Given the complexity of the new covariates, nursing facilities that want to prepare for the QMs should just provide the right kind of care, implementing continuous quality improvement ... and let the quality measures fall where they may," advises Rena Shephard, MHA, RN, FACDONA, chair of the American Association of Nurse Assessment Coordinators and president of RRS Healthcare Consulting in San Diego.
Check With Your QIO
Also look for information on the new QMs from your state quality improvement organizations (QIOs). "The QIOs are revising the user's manual and will have that available at the time the QMs are ready to be implemented," says geriatrician David Gifford, MD, MPH, chief medical officer for the Rhode Island QIO. "We're developing another crosswalk in the manual that will compare the existing QMs to the new ones and the new QMs to the quality indicators used in the survey process," he adds.
Evaluate UTI Diagnosis and Coding Criteria
Make sure your facility isn't over-coding UTI on the MDS (for details, see the next MDS Alert). The UTI measure can be improved not only by preventing UTIs, but also by more accurately diagnosing UTIs in nursing facilities that are over-diagnosing the condition, Gifford advises.
"Over diagnosis and treatment of UTI result in overuse of antibiotics which promotes higher rates of antibiotic resistance, and that is a growing problem in nursing homes and other settings," Gifford says.
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