phase ii – lets bust a move bringing the least medicating approach to every california nursing...
TRANSCRIPT
Phase II – Let’s Bust a MovePhase II – Let’s Bust a Move
Bringing the Least Medicating Approach Bringing the Least Medicating Approach to Every California Nursing Hometo Every California Nursing Home
Anthony ChicotelAnthony ChicotelStaff AttorneyStaff AttorneyCalifornia Advocates for Nursing Home ReformCalifornia Advocates for Nursing Home [email protected]@canhr.org
Bringing the Least Medicating Approach Bringing the Least Medicating Approach to Every California Nursing Hometo Every California Nursing Home
Anthony ChicotelAnthony ChicotelStaff AttorneyStaff AttorneyCalifornia Advocates for Nursing Home ReformCalifornia Advocates for Nursing Home [email protected]@canhr.org
Phase I Re-CapPhase I Re-CapLots of good talkLots of good talkLittle collaborative action sinceLittle collaborative action sinceGoal Setting:Goal Setting:
15% AP reduction by Jan. 1, 201315% AP reduction by Jan. 1, 2013 30% AP reduction by July 1, 201330% AP reduction by July 1, 2013
Lots of good talkLots of good talkLittle collaborative action sinceLittle collaborative action sinceGoal Setting:Goal Setting:
15% AP reduction by Jan. 1, 201315% AP reduction by Jan. 1, 2013 30% AP reduction by July 1, 201330% AP reduction by July 1, 2013
How’d We Do?How’d We Do?
Overall AP use:Overall AP use: 44thth Q 2011: 25.26% Q 2011: 25.26%
44thth Q 2012: 23.99% (5.03% reduction) Q 2012: 23.99% (5.03% reduction)
22ndnd Q 2013: 23.20% (8.16% reduction) Q 2013: 23.20% (8.16% reduction)
Overall AP use:Overall AP use: 44thth Q 2011: 25.26% Q 2011: 25.26%
44thth Q 2012: 23.99% (5.03% reduction) Q 2012: 23.99% (5.03% reduction)
22ndnd Q 2013: 23.20% (8.16% reduction) Q 2013: 23.20% (8.16% reduction)
The Good, Bad, and UglyThe Good, Bad, and Ugly
Good: 10-year low; steady progress, Good: 10-year low; steady progress, lower than nat’l avg.; Ventura Countylower than nat’l avg.; Ventura County
Bad: reduction rate lags the nation; we Bad: reduction rate lags the nation; we failed on the goal; failed on the goal;
Ugly: 29 nursing homes with >90% AP Ugly: 29 nursing homes with >90% AP use (more than 48 states use (more than 48 states combinedcombined); 94 ); 94 homes with > 50% usehomes with > 50% use
Good: 10-year low; steady progress, Good: 10-year low; steady progress, lower than nat’l avg.; Ventura Countylower than nat’l avg.; Ventura County
Bad: reduction rate lags the nation; we Bad: reduction rate lags the nation; we failed on the goal; failed on the goal;
Ugly: 29 nursing homes with >90% AP Ugly: 29 nursing homes with >90% AP use (more than 48 states use (more than 48 states combinedcombined); 94 ); 94 homes with > 50% usehomes with > 50% use
CANHR’s TakeCANHR’s Take
Appreciative of the gains and momentumAppreciative of the gains and momentumConcerned that we’re not maximizing our Concerned that we’re not maximizing our
momentmomentOutraged by continued use of chemical Outraged by continued use of chemical
restraintrestraint
Appreciative of the gains and momentumAppreciative of the gains and momentumConcerned that we’re not maximizing our Concerned that we’re not maximizing our
momentmomentOutraged by continued use of chemical Outraged by continued use of chemical
restraintrestraint
AP Use is Often Elder AbuseAP Use is Often Elder Abuse
1)1) MalpracticeMalpractice2)2) BatteryBattery3)3) SufferingSuffering4)4) DeathDeath
We should NOT tolerate this!We should NOT tolerate this!
1)1) MalpracticeMalpractice2)2) BatteryBattery3)3) SufferingSuffering4)4) DeathDeath
We should NOT tolerate this!We should NOT tolerate this!
Next StepsNext Steps
Demand Real EnforcementDemand Real EnforcementDPH / DHCS Collaborative – success?: DPH / DHCS Collaborative – success?:
54.2% AP use in visited facilities in 200954.2% AP use in visited facilities in 2009 48.4% AP use 2Q 2013 (down 12.6%)48.4% AP use 2Q 2013 (down 12.6%) 8 of the 20 facilities have not met state 8 of the 20 facilities have not met state
average in AP reductionaverage in AP reductionCitationsCitations
4 citations citing 72528 since 20044 citations citing 72528 since 2004 0 citations for 72018 since 19990 citations for 72018 since 1999
Demand Real EnforcementDemand Real EnforcementDPH / DHCS Collaborative – success?: DPH / DHCS Collaborative – success?:
54.2% AP use in visited facilities in 200954.2% AP use in visited facilities in 2009 48.4% AP use 2Q 2013 (down 12.6%)48.4% AP use 2Q 2013 (down 12.6%) 8 of the 20 facilities have not met state 8 of the 20 facilities have not met state
average in AP reductionaverage in AP reductionCitationsCitations
4 citations citing 72528 since 20044 citations citing 72528 since 2004 0 citations for 72018 since 19990 citations for 72018 since 1999
Other StepsOther Steps
Target California’s disproportionately Target California’s disproportionately high number of high volume druggershigh number of high volume druggers
Dementia Care ListervDementia Care Listerv
Dementia Care SummitDementia Care Summit
Target California’s disproportionately Target California’s disproportionately high number of high volume druggershigh number of high volume druggers
Dementia Care ListervDementia Care Listerv
Dementia Care SummitDementia Care Summit