A state-level program to improve the quality of care and lower avoidable hospitalizations in Missouri nursing homes has worked so well that policymakers are pointing to it as a possible national solution.
The Quality Improvement Program for Missouri, QIPMO, helps identify illnesses earlier, control the spread of infections and boost patient care, according to a recent study published in the Journal of the American Medical Directors Association.
Investigators tracked the number of urinary tract infections, high-risk pressure ulcers, antipsychotic use, emergency room visits and hospitalizations, and other factors before and after technical assistance services provided the program. QIPMO provides on-site clinical consultation by expert nurses; evidence-based practice information; teaches nursing homes how to embed quality improvement methods; and guides their use of Centers for Medicare & Medicaid Services reports to improve care.
“The key takeaway is that every single nursing home that received our QIPMO services saw overall improvement,” said Marilyn Rantz, PhD, a University of Missouri Sinclair School of Nursing professor emerita who has worked in and with the nursing industry for nearly 55 years.
“Whether it’s infection control practices, disinfecting procedures in common spaces, education regarding hand-washing or noticing if something seems off with a resident’s behavior, ensuring these evidence-based best practices are being followed around the clock is key,” she added. “The program has helped improve hundreds — if not thousands — of lives.”
Rantz also said the QIPMO has saved nursing homes and the Medicare program millions of dollars by reducing hospitalizations, and that that has allowed Missouri nursing homes to invest more in staffing.
Workforce improvements were a major focus of the National Academies of Sciences, Engineering and Medicine and its landmark 2022 report, The Quality of Care in Nursing Homes.
Rantz served on the Academies committee that authored the report, which included a recommendation to replicate intensive quality programs like QIPMO in all states.
“Our work at Mizzou and with the Missouri Department of Health and Senior Services has set the standard in terms of raising the bar for nursing home care statewide,” Rantz said. “Now, it is time to get these best practices implemented across the country.”
QIPMO began in 1999 as a partnership between University of Missouri Sinclair School of Nursing and the Missouri Department of Health and Senior Services. All 510 Missouri nursing homes have access to the free services, and all, in fact, used at least some help during the study period of 2020 to 2022.
