1. 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

2. 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

4. 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.

5. 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

6. 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

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

8. 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

9. 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

10. 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

11. 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.

12. 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.

13. Contact Information
Carol L. Stanley, MS, CPHQ
Senior Project Manager
Virginia Health Quality Center
4510 Cox Road, Suite 400
Glen Allen, VA
(804)