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Care in California Nursing Homes Improves Under Medicare Quality Initiative
Date:5/12/2008

Facilities working with Lumetra significantly reduce use of restraints

SAN FRANCISCO, May 12 /PRNewswire-USNewswire/ -- Patients in California nursing homes working with Lumetra are less likely to be physically restrained, according to data collected as part of the national Medicare Nursing Home Quality Initiative.

Nursing facilities across California have reduced their use of restraints noticeably since 2004, but those homes working directly with Lumetra during an 18 month-long patient-centered care collaborative have shown considerable reductions in the use of physical restraints. Nursing homes participating in Lumetra's Quality Improvement Collaborative showed, overall, an average 52% reduction in the use of restraints. Homes in the Collaborative that had been designated by the Center for Medicare & Medicaid (CMS) as "poor performing" showed an improvement of 55% average rate of reduction.

Comparative state-wide numbers from all California nursing homes showed declines of less than 26% for restraint use. California nursing home residents are twice as likely to be restrained as residents in nursing homes nationally (10% vs. 5%).

"This Quality Improvement Collaborative focused on de-institutionalizing the nursing home culture and implementing the principles of person-centered care," says Lumetra's David Farrell, Director of the company's Care Continuum program. "Combined with evidence-based best clinical practices, the curriculum, along with the hard work by the providers to change their systems of care, led to these unprecedented levels of improvement."

Lumetra worked with 138 California Nursing Homes over 18 months to focus on reducing restraint use using a person-centered care collaborative. Consultants met with teams in each home, challenging them to eliminate just one physical restraint a week at their facility (a deliberately do-able goal). A graph for each home tracked the cumulative number of residents that would be restraint-free at the end of each week if the homes met the challenge, and at each learning session the homes learned how they were doing trended over time. They also learned how their results compared to other homes participating in the collaborative.

From the start and throughout the program, evidence-based materials and tools were shared with participating homes online, in workshops, in teleconferences and on-site consultations. Lumetra's ongoing involvement on the Quality Improvement Subcommittee of the California Association of Healthcare Facilities (CAHF) and the Quality Advisory Committee for restraint reduction of the National Citizens' Coalition for Nursing Home Reform (NCCNHR) in California helps promote the goal of improving nursing home care on a broader scale.

Lumetra is a non-profit independent consulting organization dedicated to improving the quality, safety, efficiency, and integrity of healthcare. Lumetra provides an array of professional services that include medical review, health information technology, quality evaluation and improvement, marketing and communications, and data analysis to private and public entities. As California's Medicare Quality Improvement Organization, Lumetra works with healthcare providers across the state to ensure that every person receives the right care, every time. For more information, please visit http://www.lumetra.com.


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