A few months ago, my family received a personal reminder of the importance of quality in the skilled-nursing care profession. It was delivered as my elderly father was transitioning from a hospital to a nursing home. With the advancement of his dementia and a few other vexing conditions, his health status had declined quickly.
It was obvious to doctors and family members alike that we were acting in his best interests in moving him to a care center where he could receive the support he needed. Yet I will never forget the spooked and bewildered look in his eyes as his stretcher was wheeled out of an ambulance in front of the nursing facility that was to be his new home. And I will never forget how reduced and vulnerable he looked, shivering in a hospital gown in the brisk autumn air, seemingly unable to even ask where we were going. “Dad, it’s OK. This is the right place for you,” I said more than once as we moved down the hall to his bedroom.
Although I had enough objective information to support my assurances of the nursing care center’s high quality, I kept looking for any sign of less-than-stellar care. Fortunately, I found none. And I will never forget how relieved I felt.
If you’ve ever moved a loved one into a care center, you can fully appreciate my initial concern that day. And you might also appreciate my enthusiasm in reporting now on the excellent quality ratings and other beneficial results of nursing homes that have received top honors in recent years in the thriving Baldrige-based quality awards program of the American Health Care Association (AHCA).
Using the Baldrige Health Care Criteria for Performance Excellence as a basis for organizational assessments, the AHCA/National Center for Assisted Living (NCAL) National Quality Award Program draws applicants each year from some 12,280 long-term and post-acute care providers represented by the association. Between its inception in 1996 and 2012, the sector-specific award program received more than 8,000 applications and presented more than 3,000 awards at three levels: Gold, Silver, and Bronze (with 13, 256, and 2,856 awards issued at those levels, respectively). To be considered for the highest level of Gold, applicants must demonstrate “systematic quality performance and organizational effectiveness,” as stated in AHCA’s 2013 Quality Report (PDF file).
The 2013 Quality Report spotlights some impressive aggregated results of Silver- and Gold-level award recipients of the National Quality Award program from 2010 through 2012 (see pages 20 and 21). Consider the following two charts, which plot results data (provided by the Centers for Medicare and Medicaid Services) of AHCA/NCAL top-tier award recipients in comparison to aggregated results of all other industry peers:
As part of AHCA’s Quality Initiative launched in 2012, the association encourages its member organizations across the country to focus on the following four goals: (1) safely reduce hospital readmissions; (2) increase staff stability; (3) increase customer satisfaction; and (4) safely reduce off-label use of antipsychotics. Urvi Shah, quality improvement manager at AHCA, recently affirmed the importance of organizations’ use of the Baldrige Criteria as a framework for quality improvement—in general and in relation to achieving those four goals (for which AHCA has specific target dates and measures, as described in the 2013 report). “We tell our members that following the Baldrige Criteria will help them accomplish not only the four goals, but any goal they have,” said Shah.
The AHCA/NCAL National Quality Award program, like the Malcolm Baldrige National Quality Award program on which it’s based, also emphasizes that the improvements made during an organization’s quest for excellence are much more important than winning the award. “When organizations apply for the [AHCA/NCAL] award,” Shah said, “we say, ‘use your feedback report and see this as a journey of quality improvement.’”
Surely, the customers—and the family members of customers—served by nursing homes agree on this: we want to see every such organization achieving excellence!