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News From the Society

        Quality Awards Present Opportunity for Exploration, Discovery

        The best ideas often start with an acute observation or an interesting question. The Foundation for Post-Acute and Long-Term Care Medicine Quality Awards, presented during the Society’s Annual Conference earlier this year, seek to highlight innovative answers.
        Society member Joe Boero, MD, CMD, from Park Manor Nursing Home in Wisconsin, launched a study when staff noticed that they using more antibiotics for respiratory infections than for urinary tract infections. He accepted the 2016 QIHO (Quality Improvement and Health Outcomes) Award on behalf of his facility for “Finding Pneumo: Antibiotic Stewardship Principles Used in a QAPI Project to Decrease Inappropriate Antibiotic Use in Respiratory Tract Infection in a Long-Term Care Facility in Northern Wisconsin-A Case Study.”
        Dr. Boero and his team set a goal of defining facility best practice surveillance criteria for respiratory infection. “We developed very black and white criteria that describes when a resident should and shouldn’t get an antibiotic for a respiratory infection. We then educated nursing staff about these facility policies. Then we trained our staff to utilize physician communication scripts for changes of condition scenarios in respiratory tract infection,” he said.
        The Foundation QI Awards are important tools for enabling practitioners to share their successes with their colleagues. “It is a wonderful move by the Foundation to solicit homegrown projects that potentially can spotlight creative, innovative projects generated at the local level. Down the road, these might spark unique applications to solve projects in similar facilities that are exposed to these projects,” Dr. Boero told Caring.
        Jeremiah Lopez, MD, recipient of the 2016 Foundation QI Award for “Urinary Tract Infections in Long Term Care Residents: Improving Quality,” agreed about the impact of this honor.
        “Having an unrestricted grant from the Foundation gave this project more credibility. Like many other award winners, Dr. Lopez’s project started with an alarming observation. At Sparrow/Ingham County Medical, the “rates of UTIs were almost double those of the state and the country. We determined that loose diagnostic criteria were being applied. So we tightened the criteria and made it a practice to focus on treating individual patients and not the labs.”
        Not only did the project enable his facility to reduce antibiotic use and UTI rates, it also was good experience for Dr. Lopez. “Moving forward, I am more confident in my ability to do QI,” he said. “I now can apply this to different areas to improve outcomes.” The project also provided the facility with a better opportunity to discuss palliative care and antibiotic use with families. This is essential, he said, as “families definitely need some education. They often are upset or concerned if mom or dad doesn’t get an antibiotic when he or she exhibits signs of a UTI.”
        Kelly Ryan, MD, and Daniel Goltz, MD, accepted a QIHO Award on behalf of Eno Point Assisted Living in Durham, NC, for “Connecting Residents with Dementia to their Autobiographic Soundtrack with Personalized Music;” Hourig Karalian, MS, RN, and Matthew Russo, LNHA, accepted the QIHO Award won by the Armenian Nursing & Rehabilitation Center for “Resolving Polypharmacy in a Long-Term Care Setting Using an Evidence-Based, Interdisciplinary Approach;” and Marian McNamara, RN, MSN, accepted the award on behalf of Sea View Hospital Rehabilitation Center and Home for “Achieving Positive Clinical Outcomes by Minimizing Hypoglycemic Episodes Associated with Anti-Diabetic Agents.”
        The QIHO Awards recognize programs implemented by medical directors and care teams that have demonstrated quality improvement and enhanced quality of life for their LTC facility residents. Award winners receive $1,000. To apply or for more information, go to www.paltcfoundation.org/index.php/our-work/recognize-awards. The deadline is Nov. 17.
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        Left: Kelly Ryan and Daniel Goltz accept their award from Paul Katz; right: Joe Boero accepts his award on antibiotic stewardship.From left:
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        Award winners Matthew Russo, Hourig Karalian, Jeremiah Lopez, and Marian McNamara.

        Society Leaders Climb the Hill, Return with Connections, Influence

        With a contentious election just weeks away, Society leaders hit Capitol Hill to address issues including advance care planning and the 3-day inpatient stay requirement. They also made and cemented connections with legislators and their staffs. “We had several goals going in, and we accomplished a lot,” said Society public policy consultant lobbyist Susan Emmer. She observed that in addition to discussing key issues, participants were successful in helping to ensure that Congressional members and staff understand who medical directors and other post-acute and long-term care clinicians are, what they do, and how the Society and its members can serve as resources and advocates.
        Society leaders met with Rep. Jim Renacci (R-OH), Rep. David Price (D-NC), Rep. Robert Hurt (R-VA), Sen. Sherrod Brown (D-OH), and Rep. Seth Moulton (D-MA). In addition to visiting participants’ representatives’ offices, the group met with staff from the Senate Finance Committee, Senate Special Committee on Aging, and the House Committee on Ways and Means. They specifically addressed three bills: The Improving Access to Medicare Coverage Act (S. 843, H.R. 1571), The Care Planning Act (S. 1549), and The Personalize Your Care Act (H.R. 5555).
        “Most didn’t know much about the Society, so we had a chance to educate them,” said Society Board of Director member David Nace, MD, CMD. He met with staff in three of his Pennsylvania representatives’ offices, and he was pleased with the results. “They all seemed interested in hearing our viewpoints, especially when they realized that our priority is ensuring the best, most efficient quality of care for the nation’s elders and others in PA/LTC facilities,” he said. He even made some new friends — in one office where he was expecting some opposition, he was able to share the Society’s viewpoints and get the organization and its issues on their radar screen. “I made a connection with one staffer by talking about some local issues in the state. Before I left, I was offering to give his kids flu shots.”
        Some staff even remembered the Society from past visits. As Wayne Saltsman, MD, PhD, CMD, Society board member from Massachusetts, said, “Someone from the Senate Special Committee on Aging asked how things were going with the DEA [Drug Enforcement Administration] nurse-as-agent issue. We were pleasantly surprised that she remembered us and that this was one of our issues. It was a nice reminder that these visits really do make a difference.”
        Dr. Saltsman and other participants agreed that the trip was well worth the effort. “It was rewarding to be part of the process. It’s nice to know that they’re listening to us on the Hill and that they appreciate us,” he said. “Particularly, the personal stories we shared about our work and patients really got their attention. They all have parents and grandparents, so what we have to say resonates with them.”
        Karl Steinberg, MD, CMD, editor in chief of Caring for the Ages and chair of the Society’s Public Policy Committee, urged all Society members to reach out to their representatives, either in DC or in their home offices. “You are not just some person on the street,” he said. “You are a constituent, someone who votes in their district. And being a health care provider carries clout with legislators. It pays to cultivate those relationships and have contacts in legislative offices.”
        It’s all about developing relationships, agreed Ms. Emmer. “It’s a long-term game. Don’t anticipate quick relationship building and instant results. Instead, make an investment of time and effort and work with us to get results.” The Society’s public policy team can answer questions about issues and fill you in on policy details. To take action now, visit the Society’s grassroots advocacy page at http://cqrcengage.com/amda/home.
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        Society members school legislators on the Hill: Top row (from left): Wayne S. Saltsman, Mary P. Evans; middle row: Cari R. Levy, David A. Nace, Thomas Lehner; bottom row: Heidi K. White, Michele Bellantoni, Society President Susan M. Levy.

        Don’t Miss These Events

        November 4, 2016
        Caring in the Carolinas
        Concord, NC
        Contact: Randy Long
        November 10–13, 2016
        AMDA Core Curriculum on Medical Direction in Post-Acute and Long-Term Care: Part II
        La Jolla, CA
        Contact: Registrar
        Phone: 410-992-3116
        November 11–12, 2016
        Mid-Atlantic Society for Post-Acute and Long-Term Care Medicine 2016 Annual Meeting
        Linthicum Heights, MD
        Contact: Lawrence Devadason
        Phone: 410-539-0872 x3367
        November 30, 2016
        Society Live Webinar: Antibiotic Stewardship
        Contact: Society Registrar
        Phone: 410-992-3116
        January 28, 2017
        Alabama Society for Post-Acute and Long-Term Care 2017 Mid-Winter Conference
        Birmingham, AL
        Contact: Jennifer Hayes
        March 16–19, 2017
        Society 2017 Annual Conference
        Phoenix, AZ
        Contact: Society Registrar
        Phone: 410-992-3116

        Society Launches New Vlog

        Join Society leaders such as Executive Director Christopher Laxton, CAE, on the Society’s new vlog, Navigating PA/LTC, for a monthly chat on issues, events, and thoughts impacting those who live and work in the PA/LTC world. Mr. Laxton addresses residents’ voting rights in the premier vlog. See it at www.paltc.org/publications/paltc-residents-right-vote.

        Advocacy Gets Results

        A few days after Society leaders visited the Hill, Heidi White, MD, CMD, MHS, MEd, received word from the office of Congressman David Price’s office that he would be co-sponsoring H.R. 5555. In an email to Dr. White, his legislative assistant thanked her for bringing the bill to the Representative’s attention. This demonstrates the tremendous value of connecting with legislators and their staffs. As Society Public Policy Director Alex Bardakh, MPP, said, “Building constituent relationships with members of Congress is key to advancing the Society’s public policy goals, and our members play an integral role in that effort.”
        “Constituency can be powerful,” Ms. Emmer added. “We have been able to build some long-term policy relationships and help people understand how what we do is unique and how we can work with them down the road.”