QIOs Turning the Spotlight Toward Pain Management Carol L. Stanley, MS, CPHQ Senior Project Manager With Contributions from: Carla Thomas, Project Manager and Lee Anne Carroll, Project Coordinator Virginia Health Quality Center, The Medicare Quality Improvement Organization for Virginia

Nursing Home Quality Initiative Centers for Medicare & Medicaid Services (CMS) reports a set of nursing home “quality measures” for every Medicare and/or Medicaid certified nursing home in the country Posted on Nursing Home Compare at www.Medicare.gov/NHcompare.

Quality Measures Selected for Improvement Each state was required by CMS to select three to five of the quality measures for a focused improvement project.

Quality Improvement Organizations’ (QIOs) Selection of Quality Measures Number of QIOs Selecting Pain (Chronic) 51 Pressure Ulcers 43 Pain (PAC) 23 ADLs 17 Restraints 15

Nursing Home QIOSC Quality Improvement Organization Support Contract (QIOSC) is the Rhode Island quality improvement organization - they provide support to all QIOs for the nursing home quality initiative

Virginia’s Experience Post Acute Care and Chronic Pain Quality Measures

How Virginia Decided to Focus on Pain Management The nursing home quality improvement team at the VHQC reviewed the data on Virginia’s nursing home residents It’s a multi-disciplinary team

Reviewed Benefits to Virginia’s Nursing Home Residents - sharing of best practices across the country sharing of effective resources across the country nursing home chains would be able to focus on pain management across state lines

Input and Buy-In from Key Stakeholders Virginia Hospital and Healthcare Association Virginia Health Care Association State Long-Term Care Ombudsman Virginia Association for Non-Profit Homes for the Aging State Survey and Certification Agency

Process for Developing a Pain Management Program (cont.) Develop an interdisciplinary workgroup. Analyze current pain management practices in your care setting. Articulate and implement a standard of practice for pain management. Establish accountability for pain management.

Process for Developing a Pain Management Program (cont.) Provide information about both pharmacologic and non-pharmacologic interventions to clinicians to facilitate order writing, interpretation and implementation of orders. Promise individuals and families a quick response to their reports of pain. Provide education for all staff. Continually evaluate and work to improve the quality of pain management.

Contact Information Carol L. Stanley, MS, CPHQ Senior Project Manager Virginia Health Quality Center 4510 Cox Road, Suite 400 Glen Allen, VA 23060 (804) 289-5320 Cstanley@vaqio.sdps.org