QIO Helps Idaho and Washington Nursing Homes Minimize the Use of Restraints

Reducing the use of physical restraints improves the quality of life for nursing home residents by enabling freedom of movement and increasing physical activity. Qualis Health, the QIO for Idaho and Washington, convened a group of 17 nursing homes from across the two states in a Learning and Action Network (LAN) to work on strategies to decrease the use of restraints. A LAN brings together communities to problem-solve, learn from one another, and create solutions to improve how care is delivered.

The objective of the restraint reduction LAN, which began in August 2011 was to help participating nursing homes achieve an aggregate rate of restraint use among residents less than or equal to 3 percent by September 2012 and sustain that reduction through December 2012.

For the LAN to succeed in its efforts, it was important for participating nursing homes to involve all staff, even those not responsible for direct patient care, and to ensure consistent assignment of staff to residents. It also was important to educate staff and families about restraint reduction.

With guidance from Qualis Health, the LAN prepared aim statements, prepared action worksheets and learned to use Run Charts to track improvements. One of the most significant activities was the sharing of success stories via webinars. Fifteen nursing homes shared their plans and interventions over the year, providing valuable ideas and a forum for discussion.

The aggregate physical restraint rate for the Physical Restraint LAN at the beginning of 2011 was 10 percent. The LAN finished with an aggregate rate of 1.6 percent through October 2012, representing a relative improvement of 84 percent. Additionally, five of the participating nursing homes were restraint-free at the time of re-measurement.