Summary

The Institute for Clinical Outcomes Research, in partnership with the Institute for the Future of Aging Services, the American Association of Homes and Services for the Aging, and the American Health Quality Association, has been awarded funding from the Agency for Healthcare Research and Quality to implement best practices through automated standardized data collection forms (TELEforms) and/or information technology (IT) tools within nursing homes.  The tools will encompass evidence-based care protocols and resident assessment in an automated process – enabling optimal care planning in real-time.  

This project builds upon research findings from the National Pressure Ulcer Long-Term Care Study.  Although the focus for improvement is in prevention of pressure ulcers, many of the best practices associated with preventing pressure ulcers are also associated with fewer UTIs, hospitalizations, and deaths, less weight loss, and less decline in ADL function.

Working with nursing homes and state Quality Improvement Organizations (QIOs), this project will design, implement, and evaluate use of automated standardized documentation forms and subsequently an IT tool to:

• Improve resident assessment and treatment in areas such as medications, pressure relief, incontinence, and nutrition;
• Streamline daily documentation;
• Alert or prompt for specific interventions based on resident needs;
• Summarize clinical information in a variety of formats previously requiring a chart pull and abstraction, such as for MDS requirements; and
• Provide information technology at point of care for RNs and CNAs to accelerate the adoption of research findings/best practices that have been shown to improve quality of care. 

This project will make better use of staff time and improving resident outcomes by:

• Focusing staff time on specific interventions associated with improved outcomes;
• Incorporating protocols developed through extensive research on pressure ulcer prevention (comprehensive database of 2,500 residents);
• Ensuring protocol adherence by providing automated standardized tools for documenting and reporting information related to prevention of pressure ulcers;
• Eliminating extra paper documentation and redundant data entry, thereby reducing errors attributed to copying data from one form to another;
• Improving accuracy and completeness of documentation by CNAs;
• Reducing need for extra training efforts since protocols are integrated into everyday workflow and practice;
• Facilitating clinical process redesign;
• Minimizing labor-intensive manual data abstraction process for MDS and quality indicators.