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2016 HealthInsight Nursing Home Quality Award

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Please complete all four pages of this application to be considered for the 2016 HealthInsight Nursing Home Quality Award. If completing on-line, the tab key may be used to navigate to the next field. You must complete the entire form at one time, as your application cannot be saved until completed. Please write the agency's name as the agency would like it to appear on the award in the event that the agency is a recipient.

Note: Please do not send protected health information (PHI) with your report. Please de-identify your reports of any patient identifiers.

Facility Information

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Last Name, First Name

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Please select and complete the requirements of either Method #1 or Method # 2 from the drop box below:

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Method #1 – Potentially Avoidable Hospitalizations:
Please answer all of the following questions in detail:

Method #2 - Unnecessary Antipsychotic Medication Reduction
Please answer all of the following questions below in detail:

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How did your building identify the need for improvement with potentially avoidable hospitalizations?

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How did your staff organize themselves around the effort? Was a team formed? Who were the members? What role did leadership play in the project?

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What were the interventions? What did you do and how did you do it? What is different today as a result of this project that was not occurring before it began?

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How was performance measured? How did your facility know that the interventions were appropriate? How did your facility know if the interventions were working or not working?

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What were the results? What percentage of improvement did you experience? What was your return to acute (RTA) rate before the initiative (baseline) and what were your results after the initiative (remeasurement)?

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Did you partner with any local hospitals or other community health care providers? If so, please share your experience.

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How does your building provide a supportive environment that promotes comfort and recognizes individual needs and preferences?

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How does your facility assess the staffing ratios and the quality of staff training in relationship to meeting the needs of the residents as determined by resident assessments and individualized plans of care (i.e., timely interactions to engage resident in meaningful activity to prevent frustration or anxiety, addressing loneliness, depression, or care preferences)?

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Describe the process for evaluating new or worsening behavioral or psychological symptoms of dementia (BPSD) by the interdisciplinary team, including the physician, in order to identify and address treatable medical, physical, emotional, psychiatric, psychological, functional, social, and environmental factors that may be contributing to behaviors.

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Describe the consistent process used to reduce behavioral expressions of distress in some residents by identifying a resident’s individual needs and understanding behavior as a form of communication.

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Explain how your building determines if a resident may benefit from the use of antipsychotic medications to treat a specific condition and target symptoms as diagnosed and documented in the medical record. What is the process used for gradual dose reductions and behavioral interventions, unless clinically contraindicated, in an effort to discontinue these drugs? Provide data on the number of residents with dementia in your building and the number of those residents prescribed an antipsychotic medication. Include the number of gradual dose reductions attempted and antipsychotic medications discontinued. Data shared must represent a minimum of two full quarters and must occur within the previous twelve months.

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Describe how your building involves residents (to the extent possible) and/or family or resident representatives in the discussion of potential approaches to address behavioral symptoms. How do you ensure these conversations are documented consistently in the medical record?

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Feedback

Feedback is welcome on the application process or suggestions for measures or technologies to incorporate in the future. Please provide your feedback here:

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Nevada: Please complete this application by 5:00 p.m. (PT) Wednesday, August 10, 2016. If you have any questions, please contact Donna Thorson at dthorson@healthinsight.org. Awards will be presented to recipients at the Nevada Health Care Association conference in South Lake Tahoe in August, 2015. We will also publish names of award recipients on our website and disseminate press releases for their use to promote the award.

Utah: Please complete this application by 5:00 p.m. (MT) Wednesday, August 31, 2016. If you have any questions, please contact Michelle Carlson at mcarlson@healthinsight.org. Awards will be presented to recipients at the Utah HealthCare Association Fall Convention in September, 2015. We will also publish names of award recipients on our website and disseminate press releases for their use to promote the award.

HealthInsight will cover the cost of the plaque for the recipient buildings. If additional plaques are requested, the requestor must incur those costs.

If my practice is selected as a recipient of the 2016 HealthInsight Quality Award:

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I authorize HealthInsight to release my organization’s name for publication via press releases, articles, and website announcements.

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I authorize HealthInsight to photograph our staff representatives with the award and display the photograph(s) in QualityInsight and on healthinsight.org.

After you click ‘submit’ your form will be checked for errors and you will be returned to the pages that have information that needs to be fixed. After you fix these errors, please continue through to the end of the form to resubmit