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Performance Improvement in the Long-Term–Care Setting Building on the Foundation of Infection Control

Published online by Cambridge University Press:  02 January 2015

Kurt B. Stevenson*
Qualis Health, Boise, Idaho; and the Division of Clinical Epidemiology, Department of Medicine, University of Utah School of Medicine, Sait Lake City, Utah
Mark Loeb
Qualis Health, Boise, Idaho; and the Division of Clinical Epidemiology, Department of Medicine, University of Utah School of Medicine, Sait Lake City, Utah
Qualis Health, 720 Park Boulevard, Suite 120, Boise, ID 83712-7756


Infection control programs were among the first organized efforts to improve the quality of healthcare delivered to patients and are an excellent model for the development of other healthcare performance improvement activities. Whether labeled as infection control, quality improvement, or patient safety, performance improvement initiatives share similar methods and principles. The quality of care in long-term–care facilities (LTCFs) has been scrutinized foryears and has received renewed attention with the recent initiation of public reporting of quality measures by Medicare. This article reviews the principles of performance improvement, discusses the importance of employing evidence-based interventions, and emphasizes the value of local performance improvement in LTCFs. Residents of LTCFs remain at high risk for the development of nosocomial infections, and among performance improvement initiatives, infection control is recom-mended as a high priority for all LTCFs. Fortunately, infection control contains the essential elements for performance improvement, and a successful infection control program can provide the foun-dation for expanding performance improvement throughout the LTCF. There is still much that needs to be done to determine the best clinical practices for LTCFs, and this should remain a priority for future research. Furthermore, efforts should continue to apply these principles at the local level to ensure that all residents of LTCFs receive the best care possible.

Topics in Long-Term Care
Copyright © The Society for Healthcare Epidemiology of America 2004

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