Mechanisms for Organizational Behavior Change to Address the Needs of People Living with Alzheimer's Disease and Related Dementias Proceedings of a Workshop (2022) / Chapter Skim
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3 Defining Quality
3 Defining Quality
Pages 19-32
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From page 19... ...
and session moderator, noted in her introduction that identifying optimal approaches to facilitate systemic change to improve the quality of care for people with Alzheimer's disease and related dementia (ADRD) will require collaboration among all organizations engaged in research efforts.
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From page 20... ...
. The committee envisioned nursing home quality as follows: "Residents of nursing homes should receive care in a safe environment that honors their values and preferences, addresses goals of care, promotes equity, and assesses the benefits and risks of care and treatment" (NASEM, 2022)
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in all nursing homes. Recommendations consider pathways to provide financial incentives for electronic health record (EHR)
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DEFINING QUALITY Dr. Eric Schneider is a health disparities researcher who now leads digital quality transformation at the National Committee for Quality Assurance (NCQA)
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FIGURE 3-1 National Academies consensus study conceptual model of quality of care in nursing homes. SOURCE: Presented by Eric Schneider, May 23, 2022, at Mechanisms for Organizational Behavior Change to Address the Needs of People Living with Alzheimer's Disease and Related Dementias: A Workshop.
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SOURCE: Presented by Eric Schneider, May 23, 2022, at Mechanisms for Organizational Behavior Change to Address the Needs of People Living with Alzheimer's Disease and Related Dementias: A Workshop. Reprinted from Primary Care: Clinics in Office Practice, Vol.
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QUALITY IN ADVANCED ADRD CARE TRANSITIONS Lisa Gwyther, Duke School of Medicine and founder of the Duke Aging Center's Dementia Family Support Program, discussed her experience navigating acute care transitions as a family caregiver with expertise in quality care for people with ADRD. Gwyther's husband, Bob, a retired clinician and professor of family medicine, has advanced Lewy body dementia.
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The attending physician in the ED suggested that Gwyther consider completing a medical order for scope of treatment (MOST) form for end-of-life planning.6 When Bob returned to the skilled nursing facility, the speech therapist there observed Gwyther feeding Bob and posted notes for staff about how to help him eat and drink safely.
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Ferrell explained that the nursing home consensus study report emphasized that quality care initiatives should begin by identifying the people who would be affected by those initiatives and considering how those initiatives would affect those people's quality of life. She added that efforts to develop a model to improve quality of care for people with ADRD should ensure that quality care is not limited to those patients with the greatest resources.
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Ferrell added that culturally responsive care requires practitioner training, and a strong recommendation of the report was to hold nursing homes accountable for this training. Schneider noted that NCQA is launching a redesigned health equity accreditation program.
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She explained that the high staff turnover rates in nursing homes affects quality of care and health equity because staff are less familiar with each resident and that person's values and preferences. Staff compensation affects the ability to attract and retain qualified nursing home staff.
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Ferrell added that including social workers as part of the care team for patients with ADRD is helpful because they have skills and training to directly interact with patients and ensure that their identity and needs are preserved across the care continuum. She emphasized that high-quality care provided by qualified people in a safe environment is possible for people with ADRD, and family members should have that expectation.
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From page 31... ...
In that small town, if there is a significant staff shortage at the local hospital, the National Guard provides patient care. She added that while it can be unnerving to see the National Guard at the health care facility, they provide excellent care.
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