Key Factors in
Achieving Quality
Neil Kurtz, M.D.
President and CEO
Presentation Overview
• What quality means to our company
– How we define it
– How we measure it
– How we maintain and improve it
• Challenges we face
• Quality initiatives to address the
challenges
• Results
What is Quality?
• We define quality as:
– “Skilled Compassionate Care”
• We look at quality in three basic ways
– Process-based measures: these represent the
actions of providers
– Outcome-based measures: these represent
the results of care processes
– Best practices: these explain and define the
nuances of best possible care
Measuring Quality
• Clinical, rehab outcomes
• Quality Indicators
• Survey performance,
5-Star results
• Rehospitalizations
• Medication management
• Customer satisfaction, quality of life
• Employee engagement/retention
Communicating Quality
• Discussion of quality results and outcomes
starts every leadership meeting
• Publications focusing on quality
– Quality Highlights
• Internal and external
– Partners in Quality
• ED, DNS, physicians
– First Monday
• For Medical Directors
and attending physicians
– Safety Caps
• Medication safety for nurses
Quality Management Tools
• Daily Clinical Start-Up
• Clinical Scoreboard
• Facility Performance
Assessment
• “Stop and Watch”
• SBAR nurse/physician communication tool
– Situation, Background, Assessment, Response
• Quality Assessment and Assurance process
Challenges
• More medically complex
patients
• Shorter-term stays
• Varying approaches at
multiple facilities
• Shortage of qualified staff
• Acceptance of change
• Funding
Addressing the Challenges
• Standardize care across multiple facilities
– Ensure uniformity in approach
• Enhance measuring and monitoring tools
• Get better at managing transitions of care
• Reduce rehospitalizations
• Adjust staffing mix, scheduling approaches
• Modify and improve training
• Improve physician alignment
Key Initiatives
• Quality Improvement System utilizing
Baldrige criteria
• Enhanced technology
– Amalga for Daily Clinical Start-Up
• Increased Medical Director involvement
• Building a network of healthcare services
• Improving medication management
– Golden Clinical Rx Solutions
• Improving the patient experience
Improved Survey Performance
• Average number of deficiencies
• Deficiency-free surveys
• Surveys resulting in sub-standard
• Surveys resulting in IJ
• LivingCenters with 3 or less tags
• Overall HDI
2009
2010
5.95
5.48
17
30
2.8%
1.8%
2.5%
1.4%
33%
41%
.97
.92
Industry-Leading 5-Star Quality Results
January 2011
Percent of Facilities
All
Facilities
Natl. Not
For Profit
Natl. For
Profit
5-Star Quality Improvement
3.75
3.70
3.65
3.60
3.55
3.50
3.45
3.40
3.35
3.30
Golden Living
Average 5-Star Quality Rating by Quarter
3.25
3.20
Q1-09 Q2-09 Q3-09 Q4-09 Q1-10 Q2-10 Q3-10 Q4-10
5-Star Recognition
52 Golden LivingCenters named to the
2011 U.S. News & World Report List of
America’s Best Nursing Homes
NURSING HOMES
Golden
Living