by James Mittelberger, MD, CMD

We have been busy at CALTCM the past year, successfully growing our role as a clear and visible leader/partner working to improve long term care in California. Looking at our activities, one can see the outlines of our values and vision. Our commitment is to be a part of real improvement in patients’ and providers’ lives, built on themes of interdisciplinary cooperation, partnerships between organizations, principles of quality improvement, and centered on culture change and person-centered care.

In multiple settings CALTCM engagement and leadership has been present. In our depression project we shared intensive coursework with 40 facilities and are currently improving care in six selected partner nursing homes, working to support effective teams at the SNF level. In our INTERACT training boot camps, with close coordination with CAHF, we are training hundreds of SNFs in the principles and specific practices needed to substantially reduce avoidable hospital readmissions. We are coaching a substantial number in the step by step implementation of INTERACT as a QAPI tool.

We are partnering with government, consumer groups, and others in the statewide “partnership to improve dementia care and anti-psychotic medication reduction in nursing homes.” In this project we are working to achieve a 15% reduction in use of anti-psychotics in our nursing homes by the end of this year. CALTCM is the lead medical professional organization involved, bringing pharmacy and medical expertise to the table; we are able to have an important impact on development of constructive approaches to improvement, taking us past regulatory compliance to a focus on improvement of informed consent and patient outcomes.

Our leaders are driving improvements in so many partnerships that I cannot begin to be thorough in my list of partnering organizations. We have been very active in our work with the California Coalition for Compassionate Care, the California POLST Task Force, the California HealthCare Foundation, SCAN, Advancing Excellence, Supporting Initiatives to Reuse Used Medications (SIRUM,) Advancing Excellence, LeadingAge CA (formerly Aging Services), HSAG and other Quality Improvement Organizations across the west. In each of these partnerships we bring a combination of recognized technical expertise with an ability to work across traditional professional boundaries. We have also made meaningful improvements in our website and (we hope) with our communication with our members.

As our Board comes together for our November meeting, I am proud to recognize its efforts. Our Board pays much of its own travel and expenses, and each of us has committed to either arrange or pay a $1000 donation to our organization. Our strategic and operational plans have been key to the success we are enjoying. Now to continue our growth and effectiveness, we need to broaden our engagement from all of you.

As the year-end races toward us, the opportunity to improve health care across the long term care continuum has never been greater. With the California Coordinated Care Initiative there will be ongoing opportunity to better care for patients and leadership opportunities. Please consider a tax-deductible donation to us; please take the time to outreach to other professionals in your area to join, begin to plan teams for attendance at our conference in April. Please contact me or Dan Osterweil to let us know you are interested in stepping forward as a leader.