What is LeadingAge Quality First?Quality First is a philosophy of quality and a framework for earning public trust in aging services. It is a renewal of our commitment to help older adults and their loved ones live their lives to their fullest potential. Quality First is about involving all stakeholders in the process, including the people we serve and their families.
Does Quality First include all types of aging-services providers?Yes. Quality First applies to the continuum of aging services: adult day services, home health, community services, senior housing, assisted living residences, continuing care retirement communities and nursing homes. Large and small, urban and rural organizations have adopted LeadingAge Quality First. All LeadingAge members can improve performance by using LeadingAge Quality First in areas such as continuous quality improvement, better human resources management and risk management.
Moreover, we all need to work to help consumers better understand their aging-services options and increase trust in aging services.
What are the major components of Quality First?The core of LeadingAge Quality First is the 10 Elements of Quality. These are both comprehensive, in that they cover all aspects of aging-services organizations, and easy-to-understand for staff and board members, as well as consumers.
- Commitment
- Governance and Accountability
- Leading-Edge Care and Services
- Community Involvement
- Continuous Quality Improvement
- Human Resources Development
- Consumer-Friendly Information
- Consumer Participation
- Research Findings and Education
- Public Trust and Consumer Confidence
Is signing the Quality First Covenant a condition of LeadingAge membership?No, but LeadingAge Quality First is consistent with the LeadingAge membership creed, so it is anticipated that LeadingAge members will sign the Quality First Covenant.
Is there any reason not to sign the Quality First Covenant?The only reasons not to sign the Quality First Covenant are if your organization is not familiar with, supportive of and/or committed to Quality First. If any of these are the case, you may want to review the Quality First materials on the LeadingAge Web site. If you have questions, contact your state association or Patrick Hunter, Information & Services Coordinator, 202-783-2242.
What is the difference between LeadingAge Quality First and the Advancing Excellence in America’s Nursing Homes Campaign?LeadingAge Quality First is a philosophy of quality and a framework for earning public trust in aging services. It is a renewal of our commitment to help older adults and their loved ones live their lives to their fullest potential. Advancing Excellence in America’s Nursing Homes builds on the success of other quality initiatives like Quality First and has measurable goals to improve quality of life for residents and staff in nursing homes.
Our organization is quality. Why should we participate in LeadingAge Quality First?Most aging-services providers are quality organizations. However, many stakeholders in aging services often do not put quality first. Congress and the state governments often put cost first. Federal and state health and housing agencies often put rules first. Some consumers even put punishment first. In the face of a doubting public, a critical media and a skeptical Congress, we need to declare our value as a field and distinguish ourselves as not-for-profit, aging-services providers.
What does LeadingAge mean by “quality improvement?”Quality improvement is both a philosophy and a management method based on the belief that improvement is always possible. It ensures organizations gear their policies and practices at every level to the provision of quality care and services. Aging-services organizations achieve quality improvement by establishing processes that enable them to continually assess what they do and how they do it, whether it be monitoring a resident’s or client’s needs, training staff, or changing the culture of an organization.
Staff at every level must be active in quality improvement; Quality First is not “somebody else’s job.”
Will participating in Quality First increase exposure to liability claims?According to LeadingAge’s legal counsel, “The type of candid self-assessment and quality improvement process required under the Quality First program is a proven—and arguably the best—method for reducing liability on a long-term basis.” However, no one can predict how courts and juries would view a particular defendant’s participation in Quality First (or, for that matter, lack of participation). However, counsel pointed out that concerns about what courts may or may not do “should not cause LeadingAge
members not to execute the Quality First Covenant.”
How is LeadingAge Quality First different from accreditation, regulations and ratings for aging-services organizations?Quality First is a self-guided process, based on a commitment to continually assess and improve quality in all aspects of operations, governance, care and services. Accreditation by an independent, third party is a mechanism that provides certification, through an onsite review, that an organization is adhering to specific standards.
Your organization can be involved with both accreditation and LeadingAge Quality First. Some LeadingAge members are actively involved in Quality First in preparation for accreditation. Some accredited organizations are actively involved in Quality First as a way of further advancing quality in their organizations.
Regulations and ratings are ways that external, often governmental, entities set standards and/or assess performance of aging-services providers.
Where can I find the LeadingAge Quality First Covenant?Click here to download the Quality First Covenant.
Who should take the lead on Quality First in my organization?It is clear that organizations that are most successful with Quality First can easily identify a leader. Who that leader is depends on your organization. It could be the director of a division or the appointed chair of the Quality First committee in your organization. Think about the people who have taken the lead in other initiatives in your organization; one of them may be the best person to be the Quality First leader.
However, the person leading LeadingAge Quality First in your organization should understand the vision of Quality First, demonstrate a commitment to Quality First, and communicate effectively with all stakeholders, resident/clients, staff, board of trustees, etc. Furthermore, this leader must have the time to plan, define what is needed and spearhead getting results.
What assessment tools are available?There are a variety of assessment tools and guides on the LeadingAge web site to help you on your Quality First journey. The Advancing Excellence in America’s Nursing Homes Campaign provides additional tools that nursing homes can use to track and benchmark progress. The campaign uses both clinical quality and organization improvement goals to help nursing homes with their quality improvement programs.
How will we know we have been successful with Quality First?LeadingAge Quality First is not prescriptive; there is not one “right way” or a specific set of benchmarks. You can pursue LeadingAge Quality First to identify areas of strength and for growth at a pace that works for your organization. You will undoubtedly identify many things you are doing well. Celebrate and congratulate yourselves!
However, you will also reveal aspects of your organization that you can improve. Welcome that, and develop a plan to improve that works for your organization. One LeadingAge member speculated, “we will never achieve quality, and that is perfectly okay.” As the science and standards of quality of care and quality of life change, we must keep at it; quality improvement is an ongoing process. However, there are milestones along the way that will gauge how well we are doing.
What support can I expect from LeadingAge in implementing and achieving Quality First for my organization?LeadingAge provides a wide range of guidelines and tools to help you make the most of Quality First in your organization. Many of these are available on LeadingAge’s Web site. In addition, LeadingAge has incorporated the Quality First 10 Elements of Quality throughout our conferences and other programs and services for members to make it easier for you to integrate Quality First in your organization.
Who will be monitoring what we do?Quality First is self-monitoring. By signing the Quality First Covenant and making a commitment to quality, you should set your own benchmarks—and “raise the quality bar.” We are not short on good intentions, but rather on realized solutions to difficult problems. Nevertheless, as a Quality First signatory, you should expect to see continuing improvements in your organization.
What difference has Quality First made since it started?Covenant signers have implemented many programs because of LeadingAge Quality First; therefore, the difference is visible within their organizations. Furthermore, some Covenant signers have shared their Quality First implementation stories with LeadingAge. Each organization’s Quality First journey is different; however, discovering how other providers are implementing Quality First in their organizations is an invaluable resource to LeadingAge members. LeadingAge Quality First is the way LeadingAge fulfills its mission to expand the world of possibilities for aging. As such, Quality First is the framework members use to meet the needs of the people they serve and it is integrated into all of LeadingAge’s programs. Quality First has resulted in no new regulations for nursing homes and moved the conversation away from crime and punishment to quality and innovation. Moreover, the longevity of Quality First has made it credible with policymakers.
Whom can I contact for more information about Quality First?Many of your colleagues who have signed the Quality First Covenant have a great deal of knowledge. Some of them are making presentations at state association and LeadingAge conferences. Many state associations have staff that can provide guidance about LeadingAge Quality First. At LeadingAge, you can contact Patrick Hunter, Information and Services Coordinator, 202-783-2242.