Background
As part of the Centers for Medicare & Medicaid Services’ (CMS’) Ninth Scope of Work (9th SOW), which began nationwide on August 1, 2008, Healthcare Quality Strategies, Inc., (HQSI) has implemented a Physical Restraint (PR) Reduction Project. A component of CMS’ Patient Safety Theme, the project is designed to reduce or eliminate the use of PRs for nursing home residents. This nationally recognized initiative gives local providers the opportunity to demonstrate their commitment to enhancing quality of care and improving resident health.

Project Goal
New Jersey nursing homes have made great strides in reducing the use of PRs for residents. However, there are still instances where staff and family members believe the use of restraints is necessary. The project has placed special emphasis on educating staff, family, and residents regarding the appropriate use of PRs. The goal of HQSI’s Physical Restraint Reduction Project is to reduce the inappropriate use of PRs, while providing a safe environment for all residents and staff.

Project Activities
HQSI is working with 20 participating nursing homes across New Jersey to identify opportunities for improved quality of care, implement evidence-based best practices for reducing PR usage, and utilize restraint alternatives. HQSI’s activities to date include:

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• Conducting conference calls/WebExes to review project requirements

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• Providing a Physical Restraints Tool Kit and a Falls Management Tool Kit, as falls are commonly linked to PR usage

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• Sponsoring workshops that give project participants an opportunity to share and discuss strategies, tools, barriers, successes, and lessons learned in meeting the goals of the initiative

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• Conducting regularly scheduled on-site visits or conference calls with participating providers to review quality measure benchmarking data, gain information about quality improvement activities, provide resources and web links, and assess progress toward achieving goals

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• Facilitating the dissemination of a Patient Safety Culture Survey and providing analysis of survey results to assist in an improvement plan

New Jersey nursing homes participating in HQSI’s project offered the following comments:

“Thank you. You have really helped make our job a lot easier using the Physical Restraint Tracking Form.”

“The Falls Management Tool Kit helped us a lot; we have used much of the information included in this tool kit to help us prevent falls in our facility.”