Strong QM performance requires more than reacting to reports each month - it requires intentional leadership & interdisciplinary teamwork.
Quality Measures (QMs) are more than numbers on a report. In long-term care, they reflect the quality of care residents receive every day and influence public perception, survey outcomes, referrals, and overall facility reputation. Strong QM performance requires more than reacting to reports each month - it requires intentional leadership, interdisciplinary teamwork, and consistent frontline execution.
Facilities that successfully improve Quality Measures understand an important principle: better outcomes happen when systems improve, communication strengthens, and staff remain focused on prevention rather than reaction.
Quality Measures impact:
- Resident quality of life and clinical outcomes
- Family confidence and satisfaction
- Referral relationships and hospital partnerships
- Survey preparedness
- Public ratings and reputation
- Staff accountability and performance improvement efforts
The goal should never be to “work the numbers.” The goal is to improve the care processes that naturally lead to stronger outcomes.
Facilities often see the greatest progress when they start with a focused review of measures that are both clinically meaningful and highly influenced by daily documentation and interdisciplinary follow-up. For example, teams should routinely review whether UTIs are coded only when the record supports the criteria, whether catheter use is supported by appropriate clinical documentation and applicable diagnoses, whether falls with major injury are coded accurately and consistently, and whether weight loss, pressure injuries, antipsychotic use, and functional decline are being addressed through timely assessment, care planning, and follow-up.
This type of review should not be approached as a coding exercise alone. The most effective QM improvement efforts connect the measure back to resident-specific care processes: Was the change identified early? Was the provider notified? Were interventions updated? Was the care plan followed? Did the team evaluate whether the intervention was effective?
Five Specific Ways Facilities Can Improve Quality Measure Scores
1. Identify the “Why” Behind the Numbers
Many facilities review QM reports without fully analyzing the root causes driving poor performance.
Instead of simply noting a high falls rate or increased antipsychotic use, leadership should ask:
- Are care plans individualized?
- Are interventions being followed consistently?
- Is communication occurring between shifts?
- Are staff recognizing changes in condition early enough?
- Are residents receiving the right support at the right time?
Data without analysis leads to frustration. Data with meaningful investigation leads to improvement.
2. Strengthen Interdisciplinary Team Communication
Quality outcomes improve when departments work together rather than independently.
Nursing, therapy, dietary, activities, social services, housekeeping, and medical providers all influence resident outcomes. Regular interdisciplinary discussions should focus on:
- Residents at high risk for decline
- Falls trends and prevention strategies
- Weight loss concerns
- Skin integrity risks
- Rehospitalization triggers
- Behavioral changes
Facilities with strong QM scores often have strong communication systems.
3. Focus on Early Identification and Prevention
The best way to improve Quality Measures is to prevent problems before they escalate.
Facilities should develop systems that help staff recognize subtle changes early, including:
- Declining appetite
- Increased confusion
- Mobility changes
- New skin concerns
- Behavioral shifts
- Increased assistance needs
Early intervention prevents avoidable declines and improves multiple Quality Measures simultaneously.
4. Engage Frontline Staff in Quality Improvement
Frontline caregivers have some of the greatest influence on Quality Measure outcomes, yet they are often left out of improvement planning.
Certified nursing assistants and bedside staff should:
- Understand facility QM goals
- Receive education on how their actions affect outcomes
- Be encouraged to report concerns early
- Participate in problem-solving discussions
When frontline staff understand the connection between daily care and facility outcomes, accountability and consistency improve significantly.
5. Audit for Consistency - Not Just Compliance
Many facilities conduct audits only after a concern develops. Strong organizations use proactive auditing to ensure systems are working consistently.
Examples include:
- Dining observation audits
- Skin check tracking
- Call light response monitoring
- Documentation accuracy reviews
- Restorative nursing participation checks
- Fall intervention follow-up audits
The purpose of auditing is not to “catch mistakes.” It is to identify gaps early and support improvement before negative outcomes occur.
Improving Quality Measures is not about quick fixes or temporary survey preparation. Sustainable improvement happens through:
- Consistent leadership presence
- Staff education and engagement
- Strong communication
- Prevention-focused systems
- Accountability with support
- Daily attention to resident-centered care
Facilities that improve Quality Measures successfully create cultures where quality is discussed regularly, problems are addressed early, and every department understands its role in resident outcomes.
At its core, Quality Measure improvement is not about the score itself, it is about ensuring residents receive the safest, highest-quality care possible every single day.
