Woodmere Rehabilitation & Health Care Center
When assessing their facility's Pressure Ulcer (PU) Quality Measure (QM) rate quarterly trends, Woodmere Rehabilitation and Health Care Center recognized opportunities for improvement in the prevention and treatment of residents at high-risk for developing pressure ulcers.
Working with IPRO's NHQI staff, the facility embarked on its pressure ulcer QI journey. The QI interventions commenced with the development of a standardized process for weekly PU meetings, and re-structuring of the PU team to include the facility's interdisciplinary staff. The next step incorporated assessment of internal protocols and systems of care pertaining to the prevention and treatment of pressure ulcers, and included review of PU statistics and QI interventions. Assessment of the flow of information and communication throughout the organization, and review of documentation sources and charts; along with audit of these processes, were completed with the assistance of IPRO's QI team. PU protocols were enhanced, thus ensuring their adherence to clinical standards. The step-by-step QI process was instrumental in addressing the challenges posed by the unique group of chronic care and special care populations (dialysis and ventilator dependent care) living in the facility.
The IPRO generated PU data tracking tool was introduced in the facility and the PU team tracked and trended all PUs (both admitted with and new nosocomial); subsequently drilling down the data to best interpret and make the most effective use of the information (i.e. days to heal). In addition, staff was instructed on the ADL extensive assistance component of the MDS (Bed Mobility and Transfer) and how it relates to correctly identifying the high risk PU population. Across all shifts, weekly interdisciplinary review of QI/QM reports and PU data tracking tool statistics were performed. Emanating from this, unit coordinators took responsibility for unit specific wounds and spearheaded improvement, prevention, and treatment initiatives.
The interdisciplinary group interaction, implementation of teams, and use of PU data resulted in positive outcomes including:
- 33% improvement in the PU QM rate from Q204 to Q107,
- 53% decrease (monthly comparison December 2006 and August 2007) in the number of new nosocomial PUs,
- 42% decrease in total wounds (December 2006 - August 2007), and
- 42% improvement in days to heal nosocomial Stage 2 PUs (December 2006 and June 2007).
It is apparent that Woodmere's quality improvement interventions, practices, and positive outcomes have significantly contributed to an enhanced quality of life for the residents residing in the facility.
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