D.C. Medicaid Nursing Facility Quality Improvement Collaborative

Sponsored by the District of Columbia Department of Health Care Finance and led by Comagine Health, the initiative’s aim is to improve the quality and safety of resident care by engaging 15 local nursing homes in system-level improvement, such as team building and/or staff stabilization through rapid-cycle improvement initiatives. The initiative provides individualized technical assistance and learning and coaching sessions to nursing homes to assess their readiness to participate in the DHCF’s pay-for-performance program.

Collaborative members work together and individually to test system changes for improving quality, identify gaps in care, check beneficiaries’ satisfaction, encourage innovation, share successful practices and strategies, and build tools for participating in pay-for-performance programs.

The Collaborative is based on the Institute for Healthcare Improvement’s Breakthrough Series model:

1. Prework
2. Learning Sessions
3. Action Periods
4. Outcomes Congress

The Collaborative uses one-year cycles to focus on subjects that include:

• End of life
• Quality Assurance and Performance Improvement
• Minimum Data Set
• Facility system-level topics, such as:
  • Staff retention
  • Team building
  • Staff burnout
• Clinical topics related to quality measures:
  • Bowel or bladder incontinence
  • Pressure injuries
  • The use of antipsychotic medication
  • Falls
• Care transitions
• Readmissions
• Interventions relevant to findings and gaps identified by the consumer assessment of health care providers and systems surveys