Electronic clinical decision support tools can help nursing home staff compile data and spot trends in pressure ulcers and other dangerous, but preventable, conditions.
Nursing home leaders recognize that information technology (IT) has the potential to improve processes of care and resident outcomes. Using IT for clinical decision support is one way to concretely link technology to process through systematic protocols and communications among frontline staff and clinicians.
This issue brief highlights a program called On-Time Quality Improvement (On-Time QI) geared to long-term care facilities. One of its modules, On-Time Pressure Ulcer Prevention (On-Time PrU), was created to more quickly identify residents at high risk for pressure ulcer. It has been implemented in more than 75 nursing homes.
To assess the program's success, administrators, directors of nursing, and directors of QI at six nursing homes that participated in On-Time PrU were interviewed. In addition, facilitators gathered insights from stakeholders in California, New York, and Washington, DC. For nursing homes fully implementing On-Time PrU, there were marked improvements:
- In-house pressure ulcer incidence rates declined in a range of 42% to 55%.
- CMS quality measure for high-risk residents with pressure ulcer declined in a range of 30% to 33%.
- CMS quality measure for weight loss declined in a range of 12% to 18%.
The experts emphasized that successful use of IT to support clinical decisionmaking requires a seamless integration into clinical workflow.
The complete issue brief is available as a Document Download.