Friday, July 13, 2007
This presentation is part of : Models for Sub-Acute Care
Quality Improvement Program in Missouri
Marilyn Rantz, PhD, RN, Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, USA
Learning Objective #1: The learner will able to understand the history of the Quality Improvement Program in Missouri
Learning Objective #2: The learner will be able to understand the value of the Quality Improvement Program in improving patient care quality

There is an increasing need for evidence-based nursing implementation in the long-term care arena.  One effort that is being made in that direction is The Quality Improvement Program for Missouri (QIPMO), which was developed in the 1990's by the Missouri Department of Health and Senior Services (known then as the Division of Aging) and the MU Sinclair School of Nursing.  Faculty who had expertise with the Minimum Data Set (MDS) resident assessment tool worked with DA staff to find ways to use the MDS data submitted by nursing homes to improve patient care quality. QIPMO began as a pilot project in 1999, becoming an official state sponsored program in 2000.  By 2004, QIPMO employed seven expert gerontology nurses who conducted over 1000 site visits per year to skilled, intermediate, and residential care facilities.  Data were collected and tabulated, using statewide analyses of quality indicators and improvements seen in facilities using the services of QIPMO staff.  The results of these analyses have consistently indicated that resident outcomes are improved with expert nurse on-site consultations with facility staff.  For the period 8/1/05-6/30/06, QIPMO nurses made a total of 1,808 contacts with the estimated 1,169 long-term care facilities in Missouri.  For this period, overall statewide improvements were noted in areas such as pain (10% improvement) and pressure ulcer reduction and for residents at high risk (9% improvement and 12% improvement, respectively).  This means 347 residents in facilities throughout the state this year did not develop pressure sores as compared to last year at a savings of nearly $14 million to heal them (estimated cost $40,000 per ulcer).  These studies show that receiving expert support with such issues as care planning and the MDS enable the facilities to identify “best practices” strategies they can use to significantly improve quality of care of their residents.