Reflections on Making a Difference in Oklahoma

April 21, 2015
The Eden Alternative



Hank Hartsell is the Deputy Commissioner of Protective Health Services for the Oklahoma State Department of Health (OSDH). OSDH has granted funds to help representatives of Oklahoma nursing homes learn more about reducing antipsychotics for those who live with dementia.

I would like to offer encouragement to nursing facility owners and administrators who are thinking about attending or engaging staff members in the new grant-funded project entitled Creating a Culture of Person-Directed Dementia Care.  This project brings Dementia Beyond Drugs training back to Oklahoma in combination with some other learning opportunities. I can appreciate that your current workload may leave you feeling overwhelmed, and things you tried that did not work may have discouraged you.  If you have not yet watched “The Villages of Southern Hills:  A Champion for Change,” please do.  I show it every chance I get when I talk to groups about the work Oklahoma nursing facilities are doing to improve the lives of their residents.  Far better than I can, it illustrates why every facility should join this effort to serve residents with dementia.

As you know, The Eden Alternative has an excellent national reputation for promoting culture change and helping facilities deliver person-centered care.  The Oklahoma Foundation for Medical Quality for years has been an outstanding leader in quality improvement – most recently as a collaborator on the Oklahoma Partnership to Improve Dementia Care in Nursing Homes.  I am excited about the positive changes we will see statewide after new skills gained from this project are implemented in your facilities.

In 2011, Oklahoma had the nation’s 48th highest rate of antipsychotic drug use among nursing facility residents.  After three years of effort, the use of antipsychotic drugs in Oklahoma has dropped by roughly 26% and your national ranking has improved to 38th.   Congratulations and thanks to the facilities and staff who helped to improve the lives of more than 1,000 residents with dementia.

Still there is need for improvement.  While Oklahoma has been getting better, so has the rest of the country.  Oklahoma’s rate of antipsychotic drug use for nursing facility residents has closed the gap since 2011, but it is still one to two percentage points above the national average.  And as with any quality improvement initiative, if the effort is not continuous you can wake up six months or a year down the road and find that outcomes are trending in the wrong direction again.

This grant-funded opportunity requires participating nursing homes to register two of your staff members in 1 of 2 educational tracks. There are also 50 seats specified for ombudsmen and surveyors in the project’s Dementia Beyond Drugs training component. Both the Centers for Medicare & Medicaid Services and the Oklahoma State Department of Health approved this training project as a non-regulatory approach to benefit nursing facility residents.  We hope you will take advantage of this opportunity to learn how to improve the quality of care and life for your residents.

Thank you for the hard work you do caring for Oklahomans who live in nursing facilities, and best wishes for your success.

Video courtesy of OFMQ.

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