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Nursing Facility Quality Improvement Collaborative

The Medicaid Nursing Facility Quality Improvement Collaborative is a 5-year quality initiative that's based on the Institute for Health Care improvement’s Breakthrough Series model and the Plan-Do-Study-Act (PDSA) Cycle Review.

Sponsored by the District of Columbia Department of Health Care Finance and led by Comagine Health, the initiative’s aim is to improve the quality and safety of resident care by engaging 15 local nursing homes in system-level improvement such as team building and/or staff stabilization through rapid-cycle improvement initiatives. The initiative provides individualized technical assistance and learning and coaching sessions to nursing facilities to assess their readiness to participate in the DHCF’s pay-for-performance program.

Collaborative members work together and individually to test system changes for improving quality, identify gaps in care, check beneficiaries’ satisfaction, encourage innovation, share successful practices and strategies, and build tools for participating in pay-for-performance programs.

Collaborative Model

The Collaborative is based on the Institute for Healthcare Improvement’s Breakthrough Series model:

  1. Prework
  2. Learning Sessions
  3. Action Periods
  4. Outcomes Congress

Topics of Focus

The Collaborative uses one-year cycles to focus on subjects such as:

  • End of life
  • Quality Assurance and Performance Improvement
  • Minimum Data Set
  • Facility system-level topics, including:
    • Staff stability
    • Consistent assignment
    • Team building
  • Clinical topics related to quality measures:
    • Bowel or bladder incontinence
  • Care transitions
  • Readmissions
  • Interventions relevant to findings and gaps identified by the consumer assessment of health care providers and systems surveys


Comagine Health

Lenai Moore, RN, BSHCA
Quality Improvement Consultant
206-364-9700, ext. 2992

D.C. Department of Health Care Finance

Derdire “De” Coleman
Management Analyst, Division of Quality and Health Outcomes