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Table 1 Recommended Approaches to Quality Improvement in the Nursing Home Setting

From: Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

Approaches  
Form partnerships with nursing home stakeholders
Establish relationship with State Survey Agency (SSA)
Promote the use of quality measures in quality improvement
Engage physicians and medical directors in quality improvement
Teach principles of quality improvement to all nursing home staff, including direct care staff
Serve as a facilitator in bringing nursing homes together to share successful strategies and practical tips on implementing change
Provide one-on-one assistance to nursing homes
Convert the regulatory compliance culture to a quality improvement culture
Address high rates of staff turnover and position vacancies in nursing homes