The AHCA Quality Award Application Workshop Wednesday, October 10 3:00pm – 5:00pm

AHCA/NCAL Quality Award

A Brief History 1993: AHCA launches its first Quality Initiative 1996: AHCA/NCAL Quality Award Program initiated – 16 step I applications 1997: Step II awards added 1998: Step III awards added 2004: First Step III Award Recipients

AHCA Quality Award 3 Steps to Baldrige Malcolm Baldrige National Quality Award Program Step I – Organizational Profile  5 Pages Step II – Core Values and Concepts  18 Pages Step III – Health Care Criteria for Performance Excellence  44 Pages

AHCA Quality Award Benefits Draw a true picture of your mission, goals & customer expectations Assess & maximize your facility’s strengths Apply systematic approaches that produce results Receive customized feedback & solutions to improve performance – especially in relation to Quality First Principles

AHCA Quality Award Benefits Increase your performance management Validate & secure links between continuous improvement, quality & customer satisfaction

What award winners say “The application process focused the center’s team by providing the pathway & the foundation to identify successes & communicate performance excellence by quantifiable indicators. In the journey to the Step I level, it brought the team together around performance practices & capabilities, & helped us enchance our business plan incorporating our mission statement & stakeholder’s needs. The Step II level has given us the platform to expand our pursuit of excellence, by sharing our best practice models with others & becoming visible leaders in our community.”Ira M. Schoenberger Senior Adm., Heritage Hall East

What award winners say “Winning the Step I & Step II AHCA/NCAL Quality Award has been a source of great pride & accomplishment for our entire organization. The application process itself provided outstanding opportunities to examine our focus, processes, & presence in our community. Working together, we benefited greatly from the self-examination process & a focused approach to our customer’s needs & expectations. Our commitment to quality & excellence continues as our focus, & we look forward to the Step III application process.” Greg Dowdy Senior VP, Friendship Retirement Community

The Quality Effect Source: Harborside Healthcare – November 2005

The Quality Effect Source: Harborside Healthcare – November 2005

The Quality Effect Source: Harborside Healthcare – November 2005 (ytd)

AHCA Quality Award Eligibility Member of AHCA & NCAL No substandard care or immediate jeopardy on standard or complaint surveys within the last three years Applicants at Step II & Step III levels must have a 3-year weighted average survey deficiency score that is no higher than 3-year weighted average in their State.

Requirements at Step I Respond to 20 criteria grouped in six areas:  Basic Description of the Facility  Stakeholder Requirements  Supplier and Partnering Requirements  Competitive Factors  Other Factors Important to the Facility  Other Measures (including regulatory disqualifier)

How Do We Get There? Who are our customers and stakeholders? What are their needs? How do we identify them? How do we measure them? How do we act on the measurements? What is the value proposition to the organization for meeting their needs?

1 - Basic Description of the Facility a. Environment – Urban, etc. b. Major Health Care Services c. Mission – How communicated d. Employee Base – Education e. Equipment and Technology f. Regulatory Environment

2 - Stakeholder Requirements a. Principal Stakeholders b. Key Resident Requirements Quality of Care Quality of Life How are they differentiated by groups How have you gained this understanding c. Other Stakeholder Requirements List EVERY stakeholder from 2.a.

3 – Supplier and Partnerships a. Types and numbers of suppliers Medical Suppliers, Utilities, Food, Pharmacy, etc b. The most important type of supplier Related to mission c. Limitations Formulary?

4 – Competitive Factors a. Position in local market place Numbers and types of competitors Relative strengths and weaknesses (briefly) b. Principal Success Factors What is your product differentiation?

5 – Other Factors a. Key facility performance measures Measurement of customer needs, organizational goals, turnover? b. Major strategic challenges Product differentiation. Find a Strategic challenge. Census, Contract Labor, Regulatory Compliance are more Tactical challenges c. Org Structure and key links to company. Staff, department heads, administrator, RVP and Regional consultants for each discipline.

6 – Other Measures Continued a. Quality Improvement Choose one quality outcome which you successfully improved through a performance improvement initiative Assess, Plan, Implement, Evaluate – report where you were and what you did Results – Show quantitative improvement. Explain any glitches. E.g. 4 months improvement, then a spike then return to improvement. b. For AL only. Same as a, but not necessarily clinical. c. Specific, personal actions of top leaders

Step 1 Application Getting it Done, Getting it Right

Step I Success There are no trick questions! The Step I Award award judging is based largely on completeness. The applicant who addresses all criteria thoroughly, and specifically according to the criteria, is likely to be successful. Subjectivity is built in to the judging process. Leave no holes!

Project Team Project leader who ensures that the outline and eventual application stays on target, both for timeline and content. Management team and select floor staff provide input. Strong business writer has to bring together the input of the staff. A camel is a horse designed by a committee.

Writing the Application Be thorough, but concise. Pay attention to your space budget for each section. Plan ahead, outline before writing. Write in complete narrative sentences. Say enough, say it well, then stop.

Judging and Awards February 28, 2008 Deadline Spring Summer 2008, two person teams of examiners, often administrators of former winners evaluate applications. Mostly for thoroughness. July – Notices of decisions October 2008 AHCA Convention

Work Plan Start now  Review application materials  What does each criterion require? December – January: Develop a plan of attack  Decide on Quality Improvement project (6.c)  Gather information  Farm out information gathering to department heads  Strong Outline for each section – space budget

Work Plan January – early February  Write the sections  Develop strong draft before 2/28  Solicit guidance as needed, the sooner the better.  Check request Late February  Polish  Study requirements and submittal instructions  Submit

Step I Application Review Judging process Results

Step I – Top 8 Problems 6dOther Measures - results of improvement effort (ALF only)75% 2cStakeholder Req. - other requirements/how known49% 2bStakeholder Req. - resident requirements/how known29% 6cOther Measures - Improvement in one clinical indicator29% 5bOther Factors - major strategic challenges21% 5aOther Factors - key facility performance measures20% 3cSupplier/partnering relationships - limitations/requirements20% 1dBasic Description - employee base20%

If Successful July  Receive notice August  Plan recognition program  Order materials September  Facility implements recognition program  Staff event  Postcards to referrals and families  Letters to medical staff and politicians October  Awards given at Convention

Receiving the Award… Reaping the Benefits Press Releases Family Letters Pins and Plaques Marketing and Advertising (using the logo) Community Events and Recognition Events Laying the groundwork for the next step

Technical Requirements Due via AHCA website, February 28, 2008 Applicant information and eligibility certification entered on-line One Microsoft Word document that includes responses to criteria (5 Page maximum) uploaded into system 1” Margins 12 pt Times Roman Font Original!

Space Budget Five Page Limit Basic Description of the Facility - 1 Page Stakeholder Requirements – 1 Page Supplier and Partnering Relationships ½ Page Competitive Factors ½ Page Other Factors Important to the Facility ½ Page Other Measures 1 Page

Writing the Application Be very thorough in response to the criteria. Address every section of every criterion. E.G. 1.d. Facility’s employee base… “Education Levels” Be sure to address every section, so say something about the education level of the staff, not just their licensure. E.G. 2.c. Mission and how it is communicated. Be sure to say that your mission statement is posted in the lobby. EVEN if you have stated that it is very important to you.

Resources AHCA Quality Award program requirements and application information ( or Baldrige National Quality Program (call to order free copy of Health Care Criteria for Performance Excellence booklet or download from Books available at  Conducting Satisfaction-Based Customer Surveys: A Guidebook for Long Term Care Providers by Vivian Tellis-Nayak, Ph.D.  Continuous Quality Improvement: Using the Regulatory Framework by Barbara Baylis  Developing a Quality Management System: The Foundation for Performance Excellence in Long Term Care by Bernie Dana  Quality Management Integration in Long-Term Care: Guidelines for Excellence by Maryjane Bradley and Nancy Thompson

We look forward to seeing your application!