Page 19 - Report to the Community - 2015-2017

LONG TERM CARE RESEARCH Effective Warfarin Dosing Strategies the quality of life for our nursing home residents by

Presented: Tuesday, December 18, 2012
educating the staff on the principles of the “Mouth
Elaine Hylek, M.D., MPH, Professor of Medicine Care Without a Battle Program” developed by Dr. Phil-
The Foundation is committed to increasing • 12 skilled nursing facilities in New York conducted Boston University School of Medicine lip Sloane. The project is providing on-site and remote
the research agenda of the long-term care the following interventions phased in descending Intended audience: Medical Directors, Physicians education, as well as Coaching to Nurses and CNAs
field through continued partnerships and order of perceived clinical impact: working with the aging population on Warfarin on techniques and barriers to good oral care. Dental

collaborations with academic and industry o Collection of 3 months of retrospective data Hygienists are being utilized for residents’ pre and post
experts to advance evidence based Objectives: oral health assessments and as coaches in each of the
o Administrative policy and procedure review
approaches to providing care in skilled Identify the optimal INR target values and ranges for project SNF across the state.
o Pharmacy Fax request INR Draw
nursing and assisted living facilities. elderly patients who require warfarin therapy in
o Education program for RNs, MDs, and QI Teams| accordance with new practice guidelines and to To disseminate the program’s results and resources and
describe effective dosing strategies to improve time plan for further replication, the FQC will host a state-
Warfarin Safety Study Conclusion: in therapeutic range. wide conference in partnership with the Schuyler Center
Anticoagulation management was suboptimal at base- for Analysis and Advocacy. The FQC is also collaborat-
The Foundation for Quality Care received a research
line and improvements were not seen despite repeated Mouthcare Without A Battle ing with the University of North Carolina at Chapel Hill
grant for Medline Industries, Inc. from their “Prevention
attempts to implement a structured, sequential inter- to conduct an evaluation of the program with expert
Above All Discovery Grants Program” in 2012. As a The FQC received a two-year grant (2017-2019) from
vention. This highlighted the need for continuing edu- guidance from the advisory board.
result of a collaborative effort with the FQC and the the New York State Health Foundation the Mouth Care
cation for physicians on the current practice standards
Island Peer Review Organization (IPRO), the State’s Without a Battle: Improving Oral Health Care for Older
for anticoagulation therapy and expert discussions
Quality Improvement Organization, a study was Adults in Nursing Homes Project. The FQC is imple-
utilizing case studies to highlight the actual outcomes
undertaken with the primary purpose to increase the menting the project in a total of 24 nursing homes from
and risks associated with over or under prescribing
proportion of anticoagulated patients receiving INR the Buffalo, Syracuse and Long Island Regions. This
practices.
testing within 3-7 days of a warfarin-antibiotic inter- project’s goal is to improve daily oral health care and
action “event” (i.e. receiving warfarin and prescribed
Sustainable Resources:
interacting antibiotic).
Foundation for Quality Care Teleconference
Simple Steps for Quality Anticoagulation
Study Design: Therapy in LTC: Doing the Right Thing Every Time
• Randomized, one treatment arm community interven- Presented: February 28, 2013

tion trial with three sequential levels of intervention. Darren Triller, Senior Director | PharmD
IPRO REGIONAL OFFICE
• Retrospective data collection and analysis of primary 20 Corporate Woods Boulevard
outcome measure (timely INT) allowed participant Albany, NY 12211
facilities to service as their own controls, and serial
prospective data analysis allowed comparisons of Nursing Anticoagulation Basics
intervention components. Presented: February 13, 2013

Darren Triller, Senior Director | PharmD
• Interventions were targeted toward all residents IPRO REGIONAL OFFICE

receiving warfarin while under the care of a 20 Corporate Woods Boulevard
participant facility. Albany, NY 12211

15 THE FOUNDATION FOR QUALITY CARE 16