Rapid Cycles (Continuous Quality Improvement), an Essential Part of the Medical Director's Role

Journal of the American Medical Directors Association

Volumn 9, Issue 8, 2008, Pages 535-538

  Morley, John E ^a  

^a SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

VITAMIN D; WARFARIN;

ADMINISTRATIVE PERSONNEL; AGITATION; ANALGESIA; COGNITIVE DEFECT; DEPRESSION; DIETARY INTAKE; EDITORIAL; EDUCATION PROGRAM; EMERGENCY WARD; EXERCISE; FALLING; GERIATRIC DEPRESSION SCALE; HEALTH CARE FACILITY; HEALTH CARE MANAGEMENT; HEALTH CARE PERSONNEL; HEALTH CARE QUALITY; HEALTH PROGRAM; HUMAN; INTERPERSONAL COMMUNICATION; MEDICAID; MEDICAL LITERATURE; MEDICARE; NURSING EDUCATION; NURSING HOME; NURSING HOME PATIENT; PATIENT CARE; PERSONNEL MANAGEMENT; PHARMACIST; PRESCRIPTION; QUALITY CONTROL; RISK REDUCTION; URINE INCONTINENCE; VITAMIN BLOOD LEVEL; WEIGHT REDUCTION; WORK SCHEDULE;

EID: 52749086415     PISSN: 15258610     EISSN: 15389375     Source Type: Journal    
DOI: 10.1016/j.jamda.2008.08.001     Document Type: Editorial

References (83)

1. Morley J.E., Flaherty J.H., and Thomas D.R. Geriatricians, continuous quality improvement, and improved care for older persons. J Gerontol A Biol Sci Med Sci 58 (2003) M809-M812
2. Schnelle J.F. Continuous quality improvement in nursing homes: Public relations or a reality?. J Am Med Dir Assoc 8 (2007) S2-S5
3. Berlowitz D.R., Young G.J., Hickey E.C., et al. Quality improvement implementation in the nursing home. Health Serv Res 38 (2003) 65-83
4. Mukamel D.B., Glance L.G., Li Y., et al. Does risk adjustment of the CMS quality measures for nursing homes matter?. Med Care 46 (2008) 532-541
5. Arling G., Lewis T., Kane R.L., et al. Improving quality assessment through multilevel modeling: The case of nursing home compare. Health Serv Res 42 (2007) 1177-1199
6. Taunton R.L., Piamjariyakul U., Gajewski B., et al. Care planning integrity in nursing facilities. Nurs Res 57 (2008) 271-282
7. Schnelle J.F., Cadogan M.P., Yoshii J., et al. The minimum data set urinary incontinence quality indicators: Do they reflect differences in care processes related to incontinence?. Med Care 41 (2003) 909-922
8. Bates-Jensen B.M., Simmons S.F., Schnelle J.F., and Alessi C. Evaluating the accuracy of minimum data set bed-mobility ratings against independent performance assessments: Systematic error and directions for improvement. Gerontologist 45 (2005) 731-738
9. Del Rio R.A., Goldman M., Kapella B.K., et al. The accuracy of Minimum Data Set diagnoses in describing recent hospitalization at acute care facilities. J Am Med Dir Assoc 7 (2006) 212-218
10. Monteleoni C., and Clark E. Using rapid-cycle quality improvement methodology to reduce feeding tubes in patients with advanced dementia: Before and after study. BMJ 329 (2004) 491-494
11. Hastings S.N., Whitson H.E., White H.K., et al. After-hours calls from long-term care facilities in a geriatric medicine training program. J Am Geriatr Soc 55 (2007) 1989-1994
12. Whitson H.E., Hastings S.S.N., Lekan D.A., et al. A quality improvement program to enhance after-hours telephone communication between nurses and physicians in a long-term care facility. J Am Geriatr Soc 56 (2008) 1080-1086
13. Hastings S.N., Whitson H.E., White H.K., et al. Development and implementation of the TrAC (Tracking After-hours Calls) database: A tool to collect longitudinal data on after-hours telephone calls in long-term care. J Am Med Dir Assoc 8 (2007) 178-182
14. Terrell K.M., and Miller D.K. Challenges in transitional care between nursing homes and emergency departments. J Am Med Dir Assoc 7 (2006) 499-505
15. McFetridge B., Gillespie M., Goode D., and Melby V. An exploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit. Nurs Crit Care 12 (2007) 261-269
16. Jones J.S., Swyer P.R., White L.J., and Firman R. Patient transfer from nursing home to emergency department: Outcomes and policy implications. Acad Emerg Med 4 (1997) 908-915
17. Morley J.E. Falls and fractures. J Am Med Dir Assoc 8 (2007) 276-278
18. Dharmarajan T.S. Falls and fractures linked to anemia, delirium, osteomalacia, medications, and more: The path to success is strewn with obstacles!. J Am Med Dir Assoc 8 (2007) 549-550
19. Zarowitz B.J., Stefanacci R., Hollenack K., and O'Shea T. The application of evidence-based principles of care in older persons (issue I): Management of osteoporosis. J Am Med Dir Assoc 8 (2007) e51-e57
20. Munir J., Wright R.J., and Carr D.B. A quality improvement study on calcium and vitamin D supplementation in long-term care. J Am Med Dir Assoc 8 (2007) e19-e23
21. Drinka P.J., Krause P.F., Nest L.J., and Goodman B.M. Determinants of vitamin D levels in nursing home residents. J Am Med Dir Assoc 8 (2007) 76-79
22. Hamid Z., Riggs A., Spencer T., et al. Vitamin D deficiency in residents of academic long-term care facilities despite having been prescribed vitamin D. J Am Med Dir Assoc 8 (2007) 71-75
23. Morley J.E. Should all long-term care residents receive vitamin D?. J Am Med Dir Assoc 8 (2007) 69-70
24. Drinka P.J. The importance of parathyroid hormone and vitamin D status in the treatment of osteoporosis and renal insufficiency. J Am Med Dir Assoc 7 (2006) S5-S9
25. Wright R.M. Use of osteoporosis medications in older nursing facility residents. J Am Med Dir Assoc 8 (2007) 453-457
26. Kamel H.K. Update of osteoporosis management in long-term care: Focus on bisphosphonates. J Am Med Dir Assoc 8 (2007) 434-440
27. Duque G., Mallet L., Roberts A., et al. To treat or not to treat, that is the question: Proceedings of the Quebec symposium for the treatment of Osteoporosis in long-term care institutions.Saint-Hyacinthe, Quebec, November 5, 2004. J Am Med Dir Assoc 8 (2007) e67-e73
28. Iwanczyk L., Weintraub N.T., and Rubenstein L.Z. Orthostatic hypotension in the nursing home setting. J Am Med Dir Assoc 7 (2006) 163-167
29. Taylor J.A., Parmelee P., Brown H., et al. A model quality improvement program for the management of falls in nursing homes. J Am Med Dir Assoc 8 (2007) S26-S36
30. Montero-Odasso M., Levinson P., Gore B., et al. A flowchart system to improve fall data documentation in a long-term care institution: A pilot study. J Am Med Dir Assoc 8 (2007) 300-306
31. Weinberg A.D., Altman J.S., and Pals J.K. Quality improvement case study: Warfarin sodium interactions. J Am Med Dir Assoc 7 (2006) 315-318
32. Chafin C.C., Ritter B.A., James A., and Self T.H. Hospital admission due to warfarin potentiation by TMP-SMX. Nurse Pract 25 (2000) 73-75
33. Gheno G., and Cinetto L. Levofloxacin-warfarin interaction. Eur J Clin Pharmacol 57 (2001) 427
34. Dharmarajan T.S., Varma S., Akkaladevi S., et al. To anticoagulate or not to anticoagulate?. A common dilemma for the provider: Physicians' opinion poll based on a case study of an older long-term care facility resident with dementia and atrial fibrillation. J Am Med Dir Assoc 7 (2006) 23-28
35. Thomas D.R. Managing pressure ulcers: Learning to give up cherished dogma. J Am Med Dir Assoc 8 (2007) 347-348
36. Jones K.R., and Fennie K. Factors influencing pressure ulcer healing in adults over 50: An exploratory study. J Am Med Dir Assoc 8 (2007) 378-387
37. Berlowitz D.R., and Frantz R.A. Implementing best practices in pressure ulcer care: The role of continuous quality improvement. J Am Med Dir Assoc 8 (2007) S37-S41
38. Zuckerman I.H., Langenberg P., Baumgarten M., et al. Inappropriate drug use and risk of transition to nursing homes among community-dwelling older adults. Med Care 44 (2006) 722-730
39. Glew C.M., and Rentler R.J. Use of proton pump inhibitors and other acid suppressive medications in newly admitted nursing facility patients. J Am Med Dir Assoc 8 (2007) 607-609
40. Takahashi P.Y., and North F. Pilot study of inappropriate medications and balance: A study in a continuous care center. J Am Med Dir Assoc 8 (2007) 545
41. Jervis L.L., Shore J., Hutt E., and Manson S.M. Suboptimal pharmacotherapy in a tribal nursing home. J Am Med Dir Assoc 8 (2007) 1-7
42. Swagerty D., Brickley R., American Medical Directors Association, and American Society of Consultant Pharmacists. American Medical Directors Association and American Society of Consultant Pharmacists joint position statement on the Beers List of Potentially Inappropriate Medications in Older Adults. J Am Med Dir Assoc 6 (2005) 80-86
43. Teno J.M., Kabumoto G., Wetle T., et al. Daily pain that was excruciating at some time in the previous week: Prevalence, characteristics, and outcomes in nursing home residents. J Am Geriatr Soc 52 (2004) 762-767
44. Tait R.C., and Chibnall J.T. Under-treatment of pain in dementia: Assessment is key. J Am Med Dir Assoc 9 (2008) 372-374
45. Keeney C.E., Scharfenberger J.A., O'Brien J.G., et al. Initiating and sustaining a standardized pain management program in long-term care facilities. J Am Med Dir Assoc 9 (2008) 347-353
46. Sawyer P., Lillis J.P., Bodner E.V., and Allman R.M. Substantial daily pain among nursing home residents. J Am Med Dir Assoc 8 (2007) 158-165
47. Hollenack K.A., Cranmer K.W., Zarowitz J.B., and O'Shea T. The application of evidence-based principles of care in older persons (issue 4): Pain management. J Am Med Dir Assoc 7 (2006) 514-522
48. Gallagher R., Drance E., and Higginbotham S. Finding the person behind the pain: Chronic pain management in a patient with traumatic brain injury. J Am Med Dir Assoc 7 (2006) 432-434
49. Cipher D.J., Clifford P.A., and Roper K.D. Behavioral manifestations of pain in the demented elderly. J Am Med Dir Assoc 7 (2006) 355-365
50. Buhr G.T., and White H.K. Quality improvement initiative for chronic pain assessment and management in the nursing home: A pilot study. J Am Med Dir Assoc 7 (2006) 246-253
51. Schuler M.S., Becker S., Kaspar R., et al. Psychometric properties of the German "Pain Assessment in Advanced Dementia Scale" (PAINAD-G) in nursing home residents. J Am Med Dir Assoc 8 (2007) 388-395
52. Baier R.R., Gifford D.R., Patry G., et al. Ameliorating pain in nursing homes: A collaborative quality-improvement project. J Am Geriatr Soc 52 (2004) 1988-1995
53. Zarowitz B.J., and Ouslander J.G. The application of evidence-based principles of care in older persons (issue 6): Urinary incontinence. J Am Med Dir Assoc 8 (2007) 35-45
54. Ouslander J.G. Quality improvement initiatives for urinary incontinence in nursing homes. J Am Med Dir Assoc 8 (2007) S6-S11
55. Schnelle J.F., and Ousland J.G. CMS guidelines and improving continence care in nursing homes: The role of the medical director. J Am Med Dir Assoc 7 (2006) 131-132
56. Lawhorne L.W., Ouslander J.G., Parmelee P.A., et al. Urinary incontinence: A neglected geriatric syndrome in nursing facilities. J Am Med Dir Assoc 9 (2008) 29-35
57. Etheridge F., Tannenbaum C., and Couturier Y. A systemwide formula for continence care: Overcoming barriers, clarifying solutions, and defining team members' roles. J Am Med Dir Assoc 9 (2008) 178-189
58. Morley J.E. Weight loss in the nursing home. J Am Med Dir Assoc 8 (2007) 201-204
59. Morley J.E. Weight loss in older persons: New therapeutic approaches. Curr Pharm Des 13 (2007) 3637-3647
60. Thakur M., and Blazer D.G. Depression in long-term care. J Am Med Dir Assoc 9 (2008) 82-87
61. Harris Y. Depression as a risk factor for nursing home admission among older individuals. J Am Med Dir Assoc 8 (2007) 14-20
62. Cabrera M.A., Mesas A.E., Garcia A.R., and de Andrade S.M. Malnutrition and depression among community-dwelling elderly people. J Am Med Dir Assoc 8 (2007) 582-584
63. Morley J.E., and Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc 42 (1994) 583-585
64. Morley J.E., and Thomas D.R. Cachexia: New advances in the management of wasting diseases. J Am Med Dir Assoc 9 (2008) 205-210
65. Yeh S.S., Lovitt S., and Schuster M.W. Pharmacological treatment of geriatric cachexia: Evidence and safety in perspective. J Am Med Dir Assoc 8 (2007) 363-377
66. Morley J.E. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci 56 (2001) 81-88
67. Morley J.E., and Silver A.J. Nutritional issues in nursing home care. Ann Intern Med 123 (1995) 850-859
68. Wilson M.M., Purushothaman R., and Morley J.E. Effect of liquid dietary supplements on energy intake in the elderly. Am J Clin Nutr 75 (2002) 944-947
69. Simmons S.F. Quality improvement for feeding assistance care in nursing homes. J Am Med Dir Assoc 8 (2007) S12-S17
70. Chang J.C., Finucane T.E., Christmas C., et al. Nutrition and involuntary weight loss: A pilot study of an educational intervention for nursing home surveyors. J Am Med Dir Assoc 8 (2007) 110-114
71. Aoyama L., Weintraub N., and Reuben D.B. Is weight loss in the nursing home a reversible problem?. J Am Med Dir Assoc 7 (2006) S66-S72
72. Keller H.H., Gibbs-Ward A., Randall-Simpson J., et al. Meal rounds: An essential aspect of quality nutrition services in long-term care. J Am Med Dir Assoc 7 (2006) 40-45
73. Morley J.E. The magic of exercise. J Am Med Dir Assoc 9 (2008) 375-377
74. Colberg S.R., Somma C.T., and Sechrist S.R. Physical activity participation may offset some of the negative impact of diabetes on cognitive function. J Am Med Dir Assoc 9 (2008) 434-438
75. Hui E.K., and Rubenstein L.Z. Promoting physical activity and exercise in older adults. J Am Med Dir Assoc 7 (2006) 310-314
76. Volicer L., Simard J., Pupa J.H., et al. Effects of continuous activity programming on behavioral symptoms of dementia. J Am Med Dir Assoc 7 (2006) 426-431
77. Handler S.M., Perera S., Olshansky E.F., et al. Identifying modifiable barriers to medication error reporting in the nursing home setting. J Am Med Dir Assoc 8 (2007) 568-574
78. Morley J.E. Caring for the vulnerable elderly: Are available quality indicators appropriate?. J Am Med Dir Assoc 9 (2008) 1-3
79. Chang J.C., Finucane T.E., Christmas C., et al. Nutrition and involuntary weight loss: A pilot study of an educational intervention for nursing home surveyors. J Am Med Dir Assoc 8 (2007) 110-114
80. Mor V. Defining and measuring quality outcomes in long-term care. J Am Med Dir Assoc 8 (2007) e129-e137
81. Schnelle J.F., Ouslander J.G., and Simmons S.F. Direct observations of nursing home care quality: Does care change when observed?. J Am Med Dir Assoc 7 (2006) 541-544
82. Shah M.N., Fairbanks R.J., and Lerner E.B. Cardiac arrests in skilled nursing facilities: Continuing room for improvement?. J Am Med Dir Assoc 7 (2006) 350-354
83. Morley J.E., Flaherty J.H., and Thomas D.R. Geriatricians, continuous quality improvement, and improved care for older persons. J Gerontol A Biol Sci Med Sci 58 (2003) M809-M812