A Catalyst: After Nursing Home Study, Medical Group Offers Remedies
In the wake of a new report raising questions about the treatment of patients in nursing homes, the American Medical Directors Association (AMDA) outlined the ways it intends to be part of the solution.
When a U.S. Department of Health and Human Services report came out last week documenting the incidence of preventable “adverse events” that harm patients in nursing homes, it raised major concerns about the quality of care these patients receive.
But rather than treat the report as a setback, the association that represents professionals in the field of long-term-care medicine announced how it is working to be part of the solution, offering a list of steps it is taking to help solve the problems the report brought to light. More details:
The issues raised: One-third of Medicare patients in more than 600 skilled nursing facilities in the study suffered “a medication error, infection, or some other type of harm related to their treatment,” and physician reviewers found that 59 percent of the adverse events were “clearly or likely preventable,” according to a summary of the HHS inspector general’s report by ProPublica. According to patient safety experts, this is a higher rate than hospitals, despite the fact that error rates at hospitals receive more attention. “Because many of the events that we identified were preventable, our study confirms the need and opportunity for [skilled nursing facilities] to significantly reduce the incidence of resident harm events,” the IG noted in the study’s summary.
An association’s take: The American Medical Directors Association praised the study for its “thoughtful assessment” of the post-acute, long-term care environment. “There has been a lack of data surrounding harmful events specific to this setting, and this report should serve as a springboard for a national discussion on the care of frail elders and how it can be improved. Also absent have been educational and quality measurement tools specific to the setting,” AMDA said in a statement. AMDA President Jonathan Evans told ProPublica that the study reflects significant problems with infrastructure. “You have a system of long-term care that’s trying to retrofit to be a system for post-acute care,” he said. “The resources to care for them and commitment from those sending them from one facility to another haven’t kept pace.”
Steps being taken: AMDA outlined steps the association is taking to help improve patient safety in post-acute care and long-term care facilities. They include improving physician training; building information resources “focusing on prevention, diagnosis, and treatment of many adverse events”; pinpointing tests or procedures that are unnecessary or even dangerous; and providing physician quality recommendations to the HHS Centers for Medicare and Medicaid Services.