1. It’s More than a List of Questions: Using the Quality Award Criteria as Your Roadmap to Excellence! Ruta Kadonoff Courtney Bishnoi

4. Exercise: What Will it Take? In groups, choose one improvement priority and discuss: – To improve performance on this goal, what are all the areas that you need to consider and address in your center? – Think broadly – go beyond the obvious – Identify a note taker to record your team’s thoughts – we will come back to this in a later exercise.

5. A System Example

6. Integrated Management System Guided by Organization’s Mission, Vision and Values Workforce Skilled, engaged & empowered Leadership & Strategy Customers/ Stakeholders Residents, families, payors Results Optimum performanc e Operations Effective, consistent, reliable work processes Measurement, Analysis & Knowledge Management Data to drive decisions and dashboard to monitor progress Adapted from Quantum Performance Group

7. Baldrige Core Values Systems perspective Visionary leadership Patient-focused excellence Valuing people Organizational and agility Focus on success Managing for innovation Management by fact Societal responsibility and community health Ethics and transparency Delivering value and results

8. Systems Based Performance Improvement Foundation of the 2015-2018 Quality Initiative Model based on Baldrige and QAPI philosophy Baldrige and QAPI principles are grounded in systematic performance improvement model Not task oriented Organizations who practice this management model will drive success in quality & business outcomes

9. AHCA/NCAL National Quality Award Program Mission: Promote and support the application of continuous quality improvement in AHCA/NCAL member organizations Launched in 1996 Approx. 11,000 applications and 4,700 awards Based on the Baldrige Performance Excellence Program

10. Program Criteria Framework for Performance Excellence Organizational Profile Leadership Strategy Customers Measurement, Analysis and Knowledge Management Workforce Operations Results

11. Three Levels of Distinction Organizations must achieve the award at each level to continue to the next level 1.Bronze – Commitment to Quality 2.Silver – Achievement in Quality 3.Gold – Excellence in Quality

12. Bronze Award Basics Application addresses 21 questions (criteria) - 5 pages Focus on Organization’s context; what makes it unique Many can be addressed in 2-3 sentences No trick questions All applicants receive a feedback report - identifies criteria met and not met (and the reasons why)

13. Customer Requirements Exercise Use the worksheet to complete the following: Principle Customer/Stakeholder Groups Requirements this Group has of your Organization How your Organization Learned of these Requirements 1.Residents 2. 3.

14. Debrief Report out: – Who are your customers/stakeholders? – What are their requirements? – How do you learn from them? How might exploring this question with your team affect actions within your organization?

15. Silver Award Basics Criteria span the 7 Baldrige categories 25 page application Examiners determine each applicant’s level of criteria implementation using established scoring guidelines All applicants receive feedback in each section of the criteria

16. Silver Award Basics Silver award recipients demonstrate effective systems and positive results, indicating they are most likely to keep moving forward on their quality journey, rather than sliding back Not about perfection!

17. Gold Award Basics Responsive to full Baldrige Criteria; builds upon Silver Examiners determine applicant’s level of criteria implementation using established scoring Higher scoring threshold than Silver Potential award recipients are visited onsite by a team of Examiners All applicants receive feedback in each section of the criteria

18. The Importance of Feedback How do you see your organization? vs How do others see you?

19. Number of Recipients 3,405 495 28

20. QAPI

21. QAPI and the Quality Award Program QAPI Element Design and Scope Governance and Leadership Feedback, Data Systems and Monitoring Performance Improvement Projects Systematic Analysis and Systemic Action Baldrige Framework Organizational Profile Category 1 Leadership Category 2 Strategy Category 3 Customer Focus Category 4 Measurement, Analysis & Knowledge Management Category 5 Workforce Focus Category 6 Operations Focus Category 7 Results

22. Using an Integrated System Approach Falls Case Study Issue: Steady increase in falls over the past 6 months. Facility leadership prioritized the issue because it affects requirements of multiple customers and stakeholders, including residents/families, regulators, and payors. Actions: Leadership communicated focus area to staff, set a goal and chartered a team to determine a solution Team used the facility’s Performance Improvement Model, PDSA, to design and implement a set of changes – Used root cause analysis to identify reasons for the increase in falls – Analyzed data, interviewed the workforce, and reviewed operations that might have an effect on falls – Identified noise and chaos at shift change times as key factors and decided to begin there Team determined possible package of solutions and piloted it in the long term care unit Team analyzed and measured the results, finding their solutions were effective Team shared changes with the workforce through a variety of means: team meetings with staff on all shifts; pilot unit staff visiting other units to share successful strategies; reminder messages, etc. Team continued to measure and monitor results until the goal was met Team communicated results to all staff and celebrated the accomplishment Facility continued to track falls monthly and set up an alert if the rate increased above the target rate

23. Exercise: Applying A Systems Approach YOUR PRIORITY AREA Leadership Strategy Customers Measurement, Analysis & Knowledge Management Workforce Operations Results

24. Debrief What new insights resulted from taking this approach to your priority area? What is one thing you learned that you could apply in your center right away?

25. The AHCA/NCAL Quality Award Program Value Proposition Silver and Gold Quality Award recipients demonstrate better results than peers: Five Star Rating Health Outcomes Financial Performance

26. Five Star

27. Off-Label Use of Antipsychotics

28. 30 Day Hospital Readmissions

29. Occupancy Rate

30. In the Words of a Recipient Cheryl Maitland Administrator, Oregon Veterans Home 2014 Gold Quality Award Recipient

31. 2016 Program Cycle Event/DeadlineDate Intent to Apply LaunchMid-September Intent to Apply DeadlineNovember 19, 2015 Application Submission LaunchDecember 7, 2015 Application DeadlineJanuary 28, 2016

32. AHCA Member Resources www.ltctrendtracker.com www.ahcancal.org/qualityaward www.ahcancal.org/qualityinitiative www.ahcancal.org/quality_improvement/QAPI

34. Contact Information Courtney Bishnoi Director, Quality & Quality Award Program cbishnoi@ahca.org (202) 898-2857 Ruta Kadonoff Vice President, Quality & Regulatory Affairs rkadonoff@ahca.org (202) 454-1282