On-Time Quality Improvement Manual for Long-Term Care Facilities

The On-Time Quality Improvement program is a practical approach to quality improvement (QI) in long-term care, embedding QI strategies and best practices into health information technology. This manual is an introduction to the On-Time QI approach. It provides an overview of the tools and process improvements and describes the implementation process. Target users are stakeholders interested in nursing home QI, nursing home leaders responsible for deciding QI priorities, and nursing home personnel responsible for quality improvement.

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850

Prepared by:
Siobhan Sharkey, M.B.A., and Sandra Hudak, M.S., RN
Health Management Strategies
Susan Horn, Ph.D.
International Severity Information Systems 

Contents

Introduction
   Challenges of Improving Pressure Ulcer Prevention Practices in Nursing Homes
   Purpose of the On-Time QI Manual
   References
On-Time Overview
   On-Time Results to Date
   On-Time Guiding Principles
   On-Time Tools
   On-Time Implementation Process
   Where To Learn More About On-Time
   Resources
Getting Started
   Readiness for On-Time
   Resources Needed
   On-Time Work Plan
On-Time Implementation
   Step 1: Standardize CNA Documentation Data Elements and Redesign Workflow
   Step 2: Monitor CNA Documentation
   Step 3: Implement Process Improvements Using Nutrition and Weight Summary Reports
   Step 4: Implement Process Improvements Using the Pressure Ulcer Trigger Summary Report
   Step 5: Implement Process Improvements Using the Priority Report
   Step 6: Implement Process Improvements Using Red Area Report: Optional
   Step 7: Monitor Impact
On-Time Tools (Word® File, 265 KB).

This document is in the public domain and may be used and reprinted without special permission. Citation of the source is appreciated.

The information in this On-Time Quality Improvement Manual for Long-Term Care Facilities manual is intended to help long-term care facilities adopt and implement the On-Time Quality Improvement program. It is intended as a reference and not as a substitute for professional judgment. The findings and conclusions are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this manual should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services. In addition, AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products may not be stated or implied. None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this manual.