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Long-Term and Post-Acute Care

Long-term and post-acute care (LTPAC) facilities are essential to the Partnership to Reimagine Health Care. Comagine Health is working with centers across our six-state QIN-QIO region — Idaho, Nevada, New Mexico, Oregon, Utah and Washington — to improve resident outcomes and care processes through innovative quality improvement initiatives and data-driven approaches.

We offer direct technical assistance, collaborative and educational events, and evidence-based resources to help nursing homes:

  • Improve quality scores
  • Decrease opioid misuse
  • Increase access to behavioral health services
  • Prioritize patient safety through antibiotic stewardship
  • Boost vaccination rates
  • Implement infection prevention best practices
  • Reduce readmissions and other unnecessary emergency department visits

We also assist facilities with translating policy — including keeping them informed of the latest changes to Medicare regulations — implementing innovative activities that support their QAPI plans, and developing strategies that can effectively address gaps in care.

Comagine Health regularly creates and curates LTPAC resources for your use. We have a robust library of relevant toolkits, guides, checklists and assessments that can help your facility succeed. We also feature most recordings of virtual events on our YouTube channel.

Below you will find comprehensive resource bundles that group resources resulting from months-long interventions designed to educate nursing home providers on several priority issues, including infection prevention, care transitions, medication management, behavioral health and staff resiliency.

Driving Clinical Excellence During Unstable Times

This learning series is designed to help nursing facilities ensure they have an effective system and processes in place to support QAPI activities, opportunities to learn best practices from peers and options for testing changes leading to improvements in those processes.

Several tools are available to complement this collaborative:

Introduction and Building the 'Why'

This session orients participants to the collaborative learning series format and introduces strategies for leading improvement efforts during challenging times (i.e., pandemic, staff shortages and turnover, etc.). Participants are encouraged to review available data sources to guide focus for improvement. To support operational understanding of the concepts, a case study is presented for discussion.

Exploring Your Data

This session guides centers to look more closely at current data practices for collecting, analyzing, and sharing data for the purposes of:

  • Improving care processes and clinical outcomes

  • Creating transparency about care processes and clinical outcomes

  • Learning as an organization to continuously improve and sustain improvements

  • Potentially increasing staff retention as a result of engagement with improvement activities

WATCH: Driving Clinical Excellence Mastery Session 1a presentation

Plan to Prioritize

This session promotes a standardized approach to prioritizing identified improvement opportunities and using this process to communicate the need for change with staff to create a shared vision for improvement. Participants are given the opportunity to identify how they responded to the COVID-19 pandemic by quickly implementing necessary changes for patient care and safety, and explore how these types of responses can be incorporated into ongoing approaches for quality improvement through their QAPI program. The session concludes with discussion on how to use the 15-minute-a-day approach to engage staff in quality improvement discussions.

Creating a Compelling Case for Change

This session promotes a standardized approach to prioritizing identified improvement opportunities using the Prioritization Worksheet for Performance Improvement Projects. Participants are guided in using this information to develop and communicate a message about the need for change with staff to create a shared vision for improvement. Discussion questions are posed to focus on the standardized prioritization approach. Content briefly addresses Identifying and engaging change champions.

Looking Beyond COVID-19:
Detecting Change in Resident Condition

Early detection of and timely response to resident change in condition may prevent complications and reduce transfers to the ER or hospital. Developing the skills of your clinical and nonclinical staff in this area has significant positive impacts on patient safety and well-being. Below are key summary points of each element of this process and ready-to-use tools for staff training and implementation of concepts.

Where to begin: Take this Self-Assessment to determine where to start and what areas might need the most attention.

Knowing Your Residents and Recognizing Baseline

Knowing a resident’s baseline is a critical first step in being able to recognize signs indicating decline or an acute change in condition so you can institute timely interventions. Use the following summary guides, resources and training tools to help all staff be alert and responsive to changes.

Communicating Concerns

Effective, timely communication and psychological safety in identifying potential concerns are vital to the goal of safe, quality care. Use the following summary guides, resources and training materials to establish processes that will enhance team performance and promote a culture of safety.

Nursing Assessment

Quality assessments and care planning are core nursing responsibilities and can often mean the difference between favorable and unfavorable care outcomes. Use the following guides, resources and recordings to help your staff gain the needed clinical competencies and ensure they are clear on their roles in the assessment process.

Monitoring and Reassessing the Resident

Ongoing monitoring and reassessment of the resident is essential to determining the effectiveness of their current plan of care as well as to ascertain whether the plan needs modification to meet continuing needs or address new needs. Use the below resources to establish safeguards to ensure your monitoring processes are consistent and effective. 

Documentation and Resident Response to Interventions

Documentation in the medical record is essential. It provides a chronological account of the residents' experiences while in your care, is used to create and manage treatment and care plans, provides a mechanism for communicating information about the residents’ past and current medical and functional status between caregivers and across disciplines and care settings, and is a legal record that may be used in risk management and in defense for litigation. Use the summaries, resources and tools below to help your staff better meet professional documentation standards and ensure quality.

Quality Improvement Review of Transfers

While emergency department transfers and hospital admissions/readmissions may be necessary to respond to a resident's urgent health crisis, data show that a percentage of these transfers are potentially preventable. Quality reviews can help providers identify trends that point to gaps in care processes, systems or communication among team members that may contribute to unnecessary transfers. Use the summary document and resources below to help your staff uncover patterns and identify opportunities for improvement.

Performance Improvement

Comagine Health has curated quality improvement tools that can help you examine processes, uncover root causes and implement needed change. Offerings include a root cause analysis tool, an A3 Report template and a PDSA worksheet to help you get started.

Staff Resiliency

Patient safety and individual/organizational resilience are linked. Attention to staff well-being is crucial to the healthy functioning of your center during this prolonged crisis. Use the curated resources and tool below to support your organization and team’s resilience and explore ways to strengthen these areas.

Half-Hour Hot Topics

Comagine Health’s Half-Hour Hot Topics was a 2020 webinar series designed to support the efforts of long-term care (LTC) teams by introducing innovative ideas that make resident care more efficient and effective, all in a 30-minute timeframe. These topic-focused trainings tailored to LTC providers are now available on-demand to accommodate busy schedules.

Preventing Adverse Events in Nursing Homes: Working Together to Keep Residents Safe, Part 1

Join Jennifer Pettis, MS, RN, CNE, WCC, associate director for NICHE, and Comagine Health for the first segment of a two-part deep dive into common adverse events in nursing homes and the personal and financial costs of these incidents.

Preventing Adverse Events in Nursing Homes: Working Together to Keep Residents Safe, Part 2

Join Jennifer Pettis, MS, RN, CNE, WCC, associate director for NICHE, and Comagine Health for the second segment of a two-part series on adverse events. In Part 2, Ms. Pettis discusses tools for examining facility protocols and investigating adverse events as well as evidence-based prevention practices.

Clinical Pearls of Transdermal Fentanyl (Duragesic®) and Other Opioids: A Pharmacist’s Perspective

Join Rebecca DeMoss, PharmD, of PharMerica and Comagine Health to gain a pharmacist’s perspective on prescribing patterns, monitoring and “pearls of wisdom” for maintaining resident safety (and yours) when these medications are used.

Care Planning for Suicidal Threats, Self-Harming Behaviors and Other Urgent Behavioral Health Concerns

This session, featuring Janet Holboke, MSW, LCSW, older adult behavioral health specialist at Greater Oregon Behavioral Health Inc., defines emergent vs. non-emergent mental health concerns, offers a variety of staff training and care plan strategies for residents with recurrent behavioral health emergencies, and identifies strategies for working with community mental health treatment partners.

Navigating Crucial Conversations in the COVID Era

Join Elizabeth Ross with Compassus Hospice and Comagine Health for tips and guidance on how to navigate end-of-life conversations during stressful times, including the COVID-19 pandemic.

Boosting Your Mental Health During a Crisis

Join Dr. M. Alexis Kennedy, trauma researcher at UNLV and founder of Compassion Recharge, for part 1 of a two-part series on mental health as she explores practical steps for boosting your resilience and wellness amid COVID-19 burnout.

Recharging Compassion and Minimizing Burnout

Join Dr. M. Alexis Kennedy, trauma researcher at UNLV and founder of Compassion Recharge, for part 2 of a two-part series on mental health as she explores practical steps for boosting your resilience and wellness amid COVID-19 burnout.

Medication Management to Prevent, Detect and Report Adverse Drug Events

Join William Simonson, PharmD, BCGP, FASCP, independent consultant clinical pharmacist, and Comagine Health as we explore strategies for preventing, detecting, reporting and minimizing the potential consequences of adverse drug events (ADEs).

COVID and Beyond — Delirium Best Practices

Join Donna Marie Fick, PhD, RN, FGSA, FAAN, Elouise Ross Eberly professor at The Pennsylvania State University College of Nursing and director of the Penn State Center for Geriatric Nursing Excellence, to gain knowledge and tools that essential caregivers can use at the bedside to recognize and manage symptoms of delirium.

Keys to Flu Vaccine Promotion: Resources for Communicating the Importance of the Flu Vaccine to Patients, Clients and Employees

During this special hour-long session, representatives from Immunize Nevada and the Nevada State Immunization Program discuss best practices for providers for how to make a strong flu vaccine recommendation, address common flu vaccine misconceptions, and offer information for how to encourage flu vaccination in your health care facility and in the workplace.