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 Pressure Ulcer (PrU) Prevention Project. A component of CMS’ Patient Safety Theme, this project was designed to bring together hospitals and nursing homes in a collaborative effort to reduce the incidence of PrUs. The project originally included hospitals, but CMS concluded that the goals for this aspect have already been attained. Many hospitals continue to participate, however, on a voluntary basis. This nationally recognized initiative gives local providers the opportunity to demonstrate their commitment to enhancing quality of care and improving resident health.

Project Goal
PrUs are a significant problem for residents in long-term care settings. The goal of the Pressure Ulcer Prevention Project is to reduce/eliminate PrU development. To achieve this goal and sustain improvement, the project promotes a collegial relationship among healthcare providers. PrU prevention and treatment is a shared responsibility across provider settings.

Project Activities
HQSI is working with more than 68 participating nursing homes across New Jersey to identify opportunities for improvement and implement evidence-based best practices. These include consistently utilizing risk assessments, prevention techniques, and treatment. HQSI’s activities to date include:

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• Conducting conference calls/WebExes to review project requirements

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• Introducing a “cluster” group concept where participating providers from across New Jersey meet for knowledge transfer and sharing of best practices

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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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• Providing a Pressure Ulcer Tool Kit

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• Conducting regularly scheduled on-site visits and 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:

“The staff really liked how much easier it made our day- to-day work flow when we initiated the use of the SBAR Skin Care Form.”

“Thank you for the pressure ulcer crossword puzzle. This is a ready-made, in-service education that my staff really enjoyed. A fun way to learn.”

“We found the Pressure Ulcer Tool Kit to be very helpful, as we did not have to reinvent the wheel.”