Five years ago, when Dr. David R. Gifford became Rhode Island’s director of health, his previous employer was little-known outside the world of elder care.
Quality Partners of Rhode Island, where Gifford was chief medical officer, had become an invaluable resource for local nursing homes seeking to implement “culture change,” but in the broader health care industry, it was still little-known.
Today, Quality Partners is everywhere: leading the ICU Collaborative with Rhode Island’s hospitals, gathering and reporting quality data for the state, helping doctors adopt electronic medical records, and of course, still actively involved in long-term care improvements.
CEO H. John Keimig answered questions about the nonprofit organizations’s extensive work.
PBN: I think most people now know your name, but not quite all you do, or what your role is as a Medicare Quality Improvement Organization. Can you give us an overview?
KEIMIG: Quality Partners of Rhode Island is a nonprofit agency with a staff of 50 health care professionals that assists different types of health care providers – including nursing homes, hospitals, home health agencies and physician practices – to improve the quality and safety of the care they deliver to their patients.
We do that in a variety of ways, including individualized consultation and group educational trainings. We also have a contract with the federal government to serve as the Medicare Quality Improvement Organization for Rhode Island and work directly with a number of providers on specific initiatives, such as improving the quality and safety of care transitions and improving care for Medicare patients with chronic kidney disease.
Beyond Cash Donations: How New Forms of Giving Are Transforming Not-for-Profit Accounting
Evolving Funding Landscape for Not-for-Profits Not-for-profit organizations are being asked to do more with less,…
Learn More
PBN: One of the best-known aspects of your work involves nursing home quality improvement. What have you done in this field recently, and do you see signs that you’ve changed local nursing homes in lasting and significant ways?
KEIMIG: The staff at Quality Partners is passionate about our work in long-term care and has a great deal of experience working on both national and local levels. Some of the work I am most proud of is working with nursing homes to implement individualized care practices, moving away from institutional models of care.
Nursing homes have achieved tremendous success around this. Specific examples of this involve homes that have achieved significant noise reduction and homes that have creative dining strategies such as restaurant-style and buffet-style dining, which give residents a choice and what and how they eat.
Other highlights include working with particularly struggling homes to stabilize their leadership, their direct-care staff and provide quality care, and working with homes with higher restraint rates that have now achieved an aggregate rate of less than 1 percent.
We have also worked with long-term care nursing professionals to increase their clinical knowledge and achieve advanced credentials in wound care, creating pressure ulcer prevention and treatment expertise in 24 nursing homes.
[And we do see] tangible signs that Rhode Island nursing homes have improved: continued improvement in publicly reported quality measures and resident satisfaction, improved staff retention rates, and high-performing homes implementing more and greater culture change principles such as building redesign and more resident autonomy.
PBN: You also work a lot with hospitals; we’ve covered the ICU Collaborative. Can you tell us what other hospital quality and safety initiatives you are involved with?
KEIMIG: In addition to serving as the project manager for the ICU Collaborative, Quality Partners is working with selected hospitals across the state on a number of quality and safety improvement projects. These include reducing the infection and transmission rates for MRSA, reducing hospital-acquired pressure ulcers, improving the rate of best practices for the selection and use of antibiotics prior to and during surgery, and reducing the number of preventable hospital re-admissions.
PBN: You have a contract with the state to gather and report data on hospital-acquired infections. Do you think this kind of reporting can improve health care?
KEIMIG: This kind of reporting can create healthy competition among hospitals, encourage hospitals to improve and/or implement evidenced-based practices that reduce or eliminate hospital-acquired infections. It also helps to inform and educate consumers on evaluating facilities based on actual performance outcomes, and educates consumers on their role in preventing hospital-acquired infections.
PBN: How do you expect health care reform to affect Quality Partners?
KEIMIG: It is too early to tell specifically, but the recently enacted health reform legislation contains a number of provisions that are focused on creating a safer, higher-quality, and more reliable health care system. Many of these provisions are directly related to work that Quality Partners is currently performing as an independent agency and as a QIO. These include increased transparency and greater public reporting on health outcomes and hospital performance, reducing avoidable hospital re-admissions, increasing the use of evidence-based care, and advancing the adoption of electronic health records.
To learn more about Quality Partners of Rhode Island, go to www.qualitypartnersri.org.
