Take it to the resident: A model for engaging longterm stay residents in advance care planning

Published On: 02-11-2021

Advance care planning involves a meaningful conversation about residents’ end of life goals with the health-care team and documenting these wishes in advance directives; however, these conversations are not taking place early enough or with strategies that allow nursing...

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Results of the Missouri Quality Initiative: six-year trends of reducing unnecessary hospitalizations

Published On: 01-01-2021

Objectives: The purpose of this article is to present six-year findings of the Missouri Quality Initiative (MOQI) to reduce unnecessary hospitalizations for long-stay nursing home residents. Design: A CMS funded demonstration project analyzed over 6-years using a single group...

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Advance directives in the nursing home setting: an initiative to increase completion and reduce potentially avoidable hospitalizations

Published On: 01-01-2021

Advance directive (AD) completion can improve transitions between hospitals and skilled nursing facilities (SNF’s). One Centers for Medicare and Medicaid Services (CMS) Innovations Demonstration Project, The Missouri Quality Initiative (MOQI), focused on improving AD documentation and use in sixteen...

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Successfully reducing hospitalizations of nursing home residents: results of the Missouri Quality Initiative

Published On: 11-01-2017

Purpose: The goals of the Missouri Quality Initiative (MOQI) for long-stay nursing home residents were to reduce the frequency of avoidable hospital admissions and readmissions, improve resident health outcomes, improve the process of transitioning between inpatient hospitals and nursing...

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An Interdisciplinary Approach to Promote Older Adult Health

Published On: 11-12-18

An Interdisciplinary Approach to Promote Older Adult Health Over twenty years ago, the University of Missouri formed a broad interdisciplinary team to revolutionize older adult care. Over the years, this team consisted of engineering, nursing, and social work researchers,...

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Tracking personalized functional health in older adults using geriatric assessments

Published On: 10-20-2020

Background: Higher levels of functional health in older adults leads to higher quality of life and improves the ability to age-in-place. Tracking functional health objectively could help clinicians to make decisions for interventions in case of health deterioration. Even...

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Call to action: APRNs in US nursing homes to improve care and reduce costs

Published On: 09-01-2017

Background: Centers for Medicare and Medicaid Innovation Center sponsored the initiative to reduce avoidable hospitalizations among nursing facility residents. Purpose: Missouri Quality Initiative (MOQI) designed inter-professional model in nursing homes with advanced practice registered nurses (APRNs). Method: MOQI APRN...

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An observational study of antipsychotic medication use among long-stay nursing home residents without qualifying diagnoses

Published On: 07-19-2018

Introduction: Antipsychotic use in nursing homes varies widely across the United States; inadequate staffing, skill mix, and geropsychiatric training impede sustained improvement. Aim: This study identified risk factors of antipsychotic use in long-stay residents lacking qualifying or potentially qualifying...

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Reducing avoidable hospitalizations for nursing home residents: role of the Missouri Quality Initiative Intervention Support Team

Published On: 07-01-2020

Hospitalization for nursing home residents is a national concern. Studies suggest the majority of hospital transfers are avoidable, often resulting from poor care processes such as lack of early illness detection, adverse event occurrences, and poor communication between nursing...

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Transitions of care: Perspectives of patients living in long-term care

Published On: 07-01-2020

Across studies, the risk of hospital transfer for nursing home residents is highest for people without documented advance directives and for people with chronic health conditions (eg, diabetes and congestive heart failure), mental health conditions (eg, depression), and limited...

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