The Quality Improvement Program for Missouri’s Long-Term Care Facilities (QIPMO) will send gerontologic nurse specialists to Missouri nursing facilities. They will provide information and assistance related to clinical issues of interest to long-term care staff. QIPMO is a cooperative program between the MU Sinclair School of Nursing and the Missouri Department of Health and Senior Services (DHSS) with funding by DHSS using the Missouri Quality of Care fund (Senate bill 556). QIPMO nurses are not surveyors from the Department of Health and Senior Services. The site visits are treated confidentially.

If your facility is in Missouri, QIPMO nurse consultants will help refine your quality improvement programs. Members of the QIPMO team can also help you learn to download, read, and interpret your state and federal MDS quarterly reports and help simplify the quarterly MDS data. The nurses can also provide clinical practice consultations and in-service training sessions for your staff to help improve nursing care in those areas where you would like to see improvement.

Better care, better quality: reducing avoidable hospitalizations of nursing home residents

Written By: Rantz, M.J., Flesner, M.K., Franklin, J., Galambos, C., Pudlowski, J., Pritchett, A., Alexander, G., & Lueckenotte, A.

The MOQI Intervention Model3 illustrates the key components of the intervention. An APRN guides the intervention delivering care to the residents and training the facility staff to improve their skills. An MOQI intervention team assists with medical care, care...

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Randomized clinical trial of a quality improvement intervention in nursing homes

Written By: Rantz, M.J., Popejoy, L, Petroski, G.F., Madsen, R.W., Mehr, D.R., Zwygart-Stauffacher, M., Hicks, L.L., Grando, V., Wipke-Tevis, D.D., Bostick, J., Porter, R., Conn, V.S., & Maas, M.

Purpose: The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical...

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Integrating advanced practice registered nurses into nursing homes: The Missouri Quality Initiative experience

Written By: Vogelsmeier, A., Popejoy, L., Rantz, M., Flesner, M., Lueckenotte, A., & Alexander, G.

THERE are nearly 1.5 million older adults residing in nursing homes (NH) across the United States. Reducing avoidable hospitalizations among vulnerable NH residents has become a national priority. Estimates suggest more than $14 billion of Medicare funding is spent annually on hospitalizations for this vulnerable population....

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Staff perceptions of social work student contributions to home health care services at an independent living facility

Written By: Galambos, C., Starr, J., Musterman, K., & Rantz, M.

This exploratory qualitative study examined staff perceptions of social work student contributions to client services, family and client communication, and staff workload in an independent living setting for older adults. Ten employees who had contact with the students, clients...

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Nursing home quality, cost, staffing, and staff-mix

Written By: Rantz, M.J., Hicks, L., Grando, V.T., Petroski, G.F., Madsen, R.W., Mehr, D.R., Conn, V., Zwygart-Stauffacher, M., Scott, J., Flesner, M., Bostick, J., Porter, R., & Maas, M.

The purpose of this study was to describe the processes of care, organizational attributes, cost of care, staffing level, and staff mix in a sample of Missouri homes with good, average, and poor resident outcomes. In facilities with good...

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Assessing contributors to cost of care in nursing homes

Written By: Hicks, L.L., Rantz, M. J., Petroski, G.F., Madsen, R.W., Conn, V.S., Mehr, D., & Porter, R.

In 1994 12.7% of the population was 65 and over, while 10.6% were 85 and over. Expenditures for nursing homes reached $72.3 billion in 1994 (much of which is tax-supported) accounting for 8.7% of all personal health money spent....

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Setting thresholds for quality indicators derived from MDS data for nursing home quality improvement reports: An update

Written By: Rantz, M. J., Petroski, G., Madsen, R., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M. & Grando, V

Determining meaningful thresholds to reinforce excellent performance and flag potential problem areas in nursing home care is critical for preparing reports for nursing homes to use in their quality improvement programs. This article builds on the work of an...

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Setting thresholds for MDS quality indicators for nursing home quality improvement reports

Written By: Rantz, M. J., Petroski, G.F., Madsen, R.W., Scott, J., Mehr, D., Popejoy, L., Hicks, L., Porter, R., Zwygart-Stauffacher, M., & Grando, V.

An important area of inquiry in quality measurement when using quality indicators (QIs) lies in determining what thresholds indicate good and poor resident outcomes. In July 1996, a cross-section of 13 clinical care personnel from nursing homes participated on...

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Advances in measuring quality of care in nursing homes: a new tool for providers, consumers, regulators, and researchers

Written By: Rantz, M.J., Zwygart-Stauffacher, M., & Flesner, M.

Over the past 12 years, members of the Minimum Data Set (MDS) and Quality Research Team at the University of Missouri-Columbia have been working with the Missouri Department of Health and Senior Services to improve care in Missouri nursing...

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Field testing, refinement and psychometric evaluation of a new measure of nursing home care quality

Written By: Rantz, M., Zwygart-Stauffacher, M., Mehr, D., Petroski, G., Owen, S., & Madsen, R

The primary aim of this NINR-NIH-funded field test in 407 nursing homes in 3 states was to complete the development of and conduct psychometric testing for the Observable Indicators of Nursing Home Care Quality Instrument (Observable Indicators, OIQ). The...

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Improving quality of care in nursing facilities: The gerontological clinical nurse specialist as research nurse consultant

Written By: Popejoy, L.L., Rantz, M.J., Conn, V., Wipke-Tevis, D., Grando, V., & Porter, R.

It is becoming increasingly common for nursing facilities to use Quality Indicators (QI) derived from Minimum Data Set (MDS) data for quality improvement initiatives within their facilities. It is not known how much support facilities need to effectively review...

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Impact of nurse practitioners on health outcomes of Medicare and Medicaid patients

Written By: Oliver, G.M., Pennington, L., Revelle, S., & Rantz, M.

Strengthening healthcare overall is essential to the health of our nation and promoting access to healthcare as well as controlling healthcare costs in a quality cost-effective manner. Nurse practitioners have demonstrated in prior research to be effective and cost-effective...

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QIPMO Video

Written By: Strata Commun

Wonder what QIPMO is all about? Click here for a quick and informative video! Strata Commun

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Care Improvement Program Saves Nursing Homes Millions

Marilyn Rantz, professor in the MU Sinclair School of Nursing completed a three-year analysis of the Quality Improvement Program of Missouri (QIPMO) and found significant improvements in overall care quality of residents in participating facilities. Medical News Today. May...

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Improvements in Missouri Nursing Homes Using QIPMO Services

The Quality Improvement Program for Missouri (QIPMO) is a cooperative service of the University of Missouri Sinclair School of Nursing and the Missouri Department of Health and Senior Services. (2008)

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Pain management in nursing homes: What do quality measures tell us?

Written By: Russell, T., Madsen, R., Flesner, M.K., & Rantz, M.

Pain management for older adults residing in nursing homes continues to present multifaceted challenges to health care practitioners and researchers. This study, which focuses on improvement in pain assessment and management, is a secondary analysis of data from a...

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Randomized multilevel intervention to improve outcomes of residents in nursing homes in need of improvement

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Hicks, L., Mehr, D., Flesner, M., Petroski, G.F., Madsen, R.W., & Scott-Cawiezell, J.

Objectives: A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Design/Setting/Participants: Intervention facilities (N ¼ 29) received...

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The influence of teams to sustain quality improvement in nursing homes that “need improvement”

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Flesner, M., Hicks, L., Mehr, D., Russell, T., & Minner, D.

Objectives: Qualitatively describe the use of team and group processes in intervention facilities participating in a study targeted to improve quality of care in nursing homes “in need of improvement.” Design/setting/participants: A randomized, two-group, repeated-measures design was used to...

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Challenges of using quality improvement methods in nursing homes that “need improvement”

Written By: Rantz, M.J., Zwygart-Stauffacher, M., Flesner, M., Hicks, L., Mehr, D., Russell, T., & Minner, D.

Objectives: Qualitatively describe the adoption of strategies and challenges experienced by intervention facilities participating in a study targeted to improve quality of care in nursing homes “in need of improvement”. To describe how staff use federal quality indicator/quality measure...

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Initiative to test a multidisciplinary model with advanced practice nurses to reduce avoidable hospitalizations among nursing facility residents

Written By: Rantz, M., Alexander, G., Galambos, C., Vogelsmeier, A., Popejoy, L., Flesner, M., Lueckenotte, A., Crecelius, C., & Zwygart-Stauffacher, M.

Consider the current reality for Mrs Florence Jones, a woman of advanced age and mild dementia in a long-term care facility, who insists everyone call her “Flossie”:On May 1, Karen, the nurse aide taking care of Flossie, needs to...

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Stability and sensitivity of nursing home quality indicators

Written By: Rantz, M.J., Hicks, L. Petroski, G.F., Madsen, R.W., Mehr, D.R., Conn, V., Zwygart-Stauffacher, M., & Mass, M.

The issues of stability and sensitivity of indicators to actually detect differences in quality of care in nursing facilities are not only of concern to researchers, but also to public policy makers, who are reporting indicators to providers and...

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Nursing home quality and pressure ulcer prevention and management strategies

Written By: Wipke-Tevis, D.D., Williams, D.A., Rantz, M.J., Popejoy, L.L., Madsen, R.W., Petroski, G.F., & Vogelsmeier, A.A

OBJECTIVES: To measure pressure ulcer quality indicator (QI) scores and to describe the self-reported skin integrity assessment, pressure ulcer risk assessment, and pressure ulcer prevention and treatment practices in long-term care facilities (LTCFs). DESIGN: Retrospective analysis of a large data set...

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A statewide strategy to improve quality of care in nursing facilities

Written By: Rantz, M.J., Vogelsmeier, A., Manion, P., Minner, D., Markway, B., Conn, V., Aud, M.A., & Mehr, D.R.

We describe the development of a statewide strategy to improve resident outcomes in nursing facilities, and we present some evaluative data from this strategy. Key components of the strategy include (a) a partnership between the state agency responsible for...

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Back to the fundamentals of care: A road map to improve nursing home care quality

Written By: Rantz, M.J. & Zwygart-Stauffacher, M.

See PDF. Rantz, M.J., & Zwygart-Stauffacher, M. (2004). Back to the fundamentals of care: A road map to improve nursing home care quality. Journal of Nursing Care Quality, 19(2), 92-94. Journal of Nursing Care Quality

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Entrepreneurial program of research and service to improve nursing home care

Written By: Rantz, M., Mehr, D., Hicks, L., Scott-Cawiezell, J., Petroski, G.F., Madsen, R.W., Porter, R., & Zwygart-Stauffacher, M.

This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of...

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Improving care in nursing homes using quality measures/indicators and complexity science

Written By: Rantz, M.J., Flesner, M.K., Zwygart-Stauffacher, M.

The authors report on a NIH multilevel intervention study (n=58; 29 intervention, 29 control) performed in a Midwestern state over a 2 year time frame. Complexity science was the theoretical model used to analyze the observations made by research...

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Helping nursing homes “at risk” for quality problems: a statewide evaluation

Written By: Rantz, M.J., Cheshire, D., Flesner, M., Petroski, G.F., Hicks, L., Alexander, G., Aud, M.A., Siem, C., Nguyen, K., Boland, C., & Thomas, S.

Nearly everyone has some life experiences or opinions based on media about nursing homes and the need for quality improvement. States and federal agencies spend enormous amounts of time regulating and surveying nursing homes, but quality problems persist. In...

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