Inside Quality Management at GuideStar Eldercare
In nursing homes, Quality Management (QM) practices are designed to promote an analytical, evidence-based model of resident care. QM empowers care teams and leaders alike as they aim to ensure the highest level of care. The QM process can pinpoint any challenging areas and lead to continuous improvement. It provides an essential framework for achieving regulatory compliance with CMS standards. Findings can fuel innovation, too, as all of us in the industry look to tackle challenges and raise the bar on quality of life for those in our care. On behalf of each our clients, GuideStar takes a proactive role in managing QM for neurology, psychiatry, and behavioral health services.
Guiding QM at GuideStar Eldercare is Brendan Daley, MD, Assistant Medical Director for Corporate Administration. With extensive experience in quality initiatives, Daley also holds the Certified Professional in Healthcare Quality (CPHQ) credential. His QM leadership role includes leading quality initiatives, updating training manuals, auditing medical records, and reviewing outcomes for actionable improvements.
QM: staff preparation & support
Becoming a clinician at GuideStar begins with extensive orientation and a 90-day training period before clinicians begin to practice independently. A clinical management infrastructure composed of Clinical Area Managers, Clinical Directors, and Clinical Vice Presidents ensures that oversight and support are available to all.
With board-certified physicians specializing in areas such as neurology, psychiatry, and general medicine, along with geriatric clinical psychologists, GuideStar provides comprehensive consulting resources to all practicing clinicians. Collaborative, multi-disciplinary care is a hallmark of the GuideStar care model.
GuideStar also supports clinicians in the shared commitment to leading-edge care by funding participation in continuing education activities. In-house, GuideStar leaders distribute professional publications that inform practice, provide ongoing training, and hold regular “Clinically Speaking” webinars about updates to our clinical practices and protocols.
Documentation
Essential to survey success, our standards for medical record documentation mirror CMS guidance. We ensure the proper steps in assessment, diagnosis, and ongoing care to comply with CMS standards, with thorough documentation to support diagnoses, treatments, non-pharmacological interventions, and gradual dose reduction (GDR) activity. A clear, standards-compliant rationale for each clinical decision is evident in documentation.
Audits & data analysis
GuideStar performs diagnostic and pharmacological audits both internally and as part of its defined quality management process for all client organizations. Findings are made available to Account Managers to help our partner facilities. In our corporate partnerships, we conduct regular business reviews with leadership for a collaborative opportunity to review needs and act on any concerns that may arise.
GuideStar closely monitors CMS data points—both nationally and in states where we serve—in order to benchmark and analyze quality management in key areas such as rate of antipsychotic usage, Emergency Department visits, hospitalizations, and other CMS-defined metrics. Everyone benefits: Gauging our collaborative work with facility teams while also benchmarking data more broadly allows us to define needs and hone successful practices that help each client facility succeed.
Analyzing data points and trend lines provides essential reality checks that both inform and validate our care practices. In a recent research article in Annals of Long-Term Care, we reported that the GuideStar neurology-based integrated clinical care program significantly reduced acute inpatient psychiatric and emergency department (ED) admissions. Previous research documented that a neurology-forward care model reduced use of antipsychotics by 68%.
In our ongoing QM program, we closely monitor defined metrics and conduct audits for each facility we serve. At the same time, serving hundreds of nursing home facilities in six states allows us to zoom out for even greater insight. We find precision in the details and perspective in the big picture, with actionable results that elevate the quality of life for our shared residents living in nursing homes today.