The power of the mind and heart are not to be understimated.
Chronic pain is one of the most costly and frustrating experiences felt by millions. But as we find so often in study after study, there is much more in addition to traditional medical care that can add substantial quality to life.
Nursing home residents across the country have benefited from improvements in pain management as a result of a two-year project sponsored by the Centers for Medicare & Medicaid Services (CMS). Interim quality measures data indicate the participating homes have improved their management of residents’ pain by about 45%, according to CMS officials leading the project. Paul McGann, MD, FRCPC, with CMS, observed, “This effort shows quantitatively what we can accomplish when we all share our knowledge and data across disciplines and organizations to improve the care people receive in nursing homes.”
David Gifford, MD, MPH, Chief Medical Officer for Quality Partners of Rhode Island, the Medicare Quality Improvement Organization (QIO) for Rhode Island, said that the participating nursing home companies that initiated the project include some of the largest long-term care organizations in the United States. According to Dr. Gifford, participating nursing homes were able to significantly improve their performance on managing residents’ pain through work on the project, called the Corporate Nursing Home Improvement Collaborative (CNHIC). “This project brings home the importance of assessing every nursing home resident closely, and responding with a creative, personal approach that meets the residents’ unique needs and experience,” Dr. Gifford said.
In addition to improving their assessment and treatment of pain through pharmacological agents, the nursing home staff participating in the project also safely and effectively employed non-pharmacological approaches to reduce pain including exercise, physical therapy, music and aroma therapy, hydro-therapy (whirl pools), use of comfort items like a treasured blanket, and massage.
CMS initiated the CNHIC at the request of nursing home companies interested in collaborating to improve quality of care. Companies participating in the project included: Beverly Healthcare, Genesis HealthCare, HCR Manor Care, Kindred Healthcare, Mariner Health Care, Sovereign Health Care, SunBridge Healthcare Corporation, and Trans Healthcare, Inc. The companies pledged to continue to work individually and together to ensure gains achieved through the project are maintained and serve as a stepping-stone to future improvements in many other nursing homes.
The project is coordinated by the Colorado Foundation for Medical Care and Quality Partners of Rhode Island, both non-profit QIOs that contract with Medicare. The project is funded by CMS, an agency of the U.S. Department of Health and Human Services. In addition to sponsoring this project, CMS also sponsors the Nursing Home Quality Initiative (NHQI), a broader effort designed to improve the care delivered at all nursing homes that accept Medicare or Medicaid payment.
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