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Supporting Massachusetts Nursing Homes through the SPOT Initiative


  • Effective QAPI programs are essential to improve nursing home residents’ quality of life/care.
  • Abt provided QAPI training and technical assistance (TA) to nursing home teams.
  • Pre-post-program results demonstrated an improvement in overall and domain-specific QAPI scores.
The Challenge

Effective quality assurance and performance improvement (QAPI) programs can prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers; they are essential to improving and maintaining the quality of life and quality of care of nursing home residents. Abt Associates provided QAPI training and TA to staff of selected nursing home teams across Massachusetts. Abt subject matter experts (SMEs) worked with the teams to develop and implement effective performance improvement projects (PIPs). Common PIP topics included falls, skin maintenance, and infection control.

The Approach

Abt selected nursing homes whose state reporting scores showed the greatest opportunity for improvement.  To identify topics of greatest benefit to participants, and to evaluate program impact, we modified and administered a QAPI assessment tool that had been utilized before we joined the initiative. The Abt Team also conducted pre/post-program staff interviews, and supported participating nursing homes through virtual learning sessions, on-site TA, telephone outreach, and email support. The Team compiled and disseminated a SPOT workbook.

The Results

Abt experts helped nursing home teams in 59 of the 60 nursing homes (one was undergoing change in ownership and dropped out) develop and implement a PIP selected by each nursing home team. The PIP focused on an opportunity for improvement, such as infection control, falls, pressure ulcers, and staff communications. Follow-up interviews indicated that the majority of SPOT nursing homes were continuing to implement the PIP that they developed with Abt. Assessment results demonstrated that, on average, there was an improvement in QAPI scores in each subsequent year overall, and within each of four QAPI domains.