AHRQ Launches Network to Prevent COVID-19 in Nursing Homes Nationwide

OCT

2020

Gopal Khanna, M.B.A., and

David Meyers, M.D.

This week, we were proud to announce a new AHRQ ECHO National Nursing Home COVID-19 Action Network. Through a partnership led by the University of New Mexico's ECHO Institute and the Institute for Healthcare Improvement, this Network will make free training and mentoring available to the more than 15,000 nursing homes nationwide to help prevent COVID-19 among residents and staff.

The new network is being created as part of a $5 billion Department of Health and Human Services (HHS) effort to support nursing homes through the Provider Relief Fund authorized earlier this year under the Coronavirus Aid, Relief, and Economic Security (CARES) Act. As part of this initiative, HHS has distributed $2.5 billion to help fund testing, personal protective equipment, and nursing home staffing. Another $2 billion is being made available for Medicare- and Medicaid-certified nursing homes that demonstrate improvement in infection control throughout the fall. Through an investment of up to $237 million, this AHRQ initiative will help nursing homes increase the implementation of evidence-based safety practices to reduce COVID-19 infections.

As HHS Secretary Alex Azar said, we've learned that improving infection control in many nursing homes "is not a matter of will but of skill."

Nursing home residents are especially vulnerable to SARS-COV-2 (COVID-19) due to their age, their underlying frailty, and their communal living conditions. And nursing home staff who care for them are among the most needed and most at-risk essential workers. It is estimated that over 57,000 nursing home residents and staff have died from COVID-19, representing more than one-quarter of the Nation's known COVID-19 deaths.

AHRQ is uniquely positioned to leverage our expertise and research in evidence implementation, patient safety, and practice improvement to help nursing home staff prevent healthcare-associated infections. AHRQ funded the initial establishment and evaluation of Project ECHO (Extension for Community Healthcare Outcomes) beginning in 2004. The new Network's training program will use the evidence-based ECHO Model, an interactive, case-based approach based on adult learning principles.

In addition, AHRQ's Comprehensive Unit-based Safety Program (CUSP) is being used around the country every day to help nursing home staff keep residents safe from various infections, including COVID-19. A CUSP toolkit to prevent infections, including catheter-associated urinary tract infections (CAUTIs), is already being used in more than 400 nursing homes in 38 States, and AHRQ's Nursing Home Antimicrobial Stewardship Guide and a program designed to prevent falls among nursing home residents have shown great success.

The ECHO Institute is already recruiting academic medical centers and large health systems across the country to serve as training centers for local nursing homes who volunteer to participate in the AHRQ ECHO National Nursing Home COVID-19 Action Network. The 16-week training program will use a standardized curriculum developed by the Institute for Healthcare Improvement, and nursing homes that actively participate are eligible to receive $6,000 to cover staff training time. Nursing home teams that are interested in participating may join one of several introductory webinars

in the coming week and learn more or sign-up

to participate.

Topics that will be addressed by the Network include best practices in the use of personal protective equipment, COVID-19 testing, clinical management of mild cases of COVID-19, as well as managing social isolation during the pandemic. Key leaders from Leading Age and the American Health Care Association/National Center for Assisted Living have already endorsed the initiative and are strongly encouraging nursing homes to participate.

We know that expanding the use of proven safety practices will directly benefit nursing home residents and staff members and help save lives. AHRQ has a proven track record of producing science and research to address critical needs such as responding to COVID-19 and achieving 21st century care for all Americans. We are pleased to be working with the ECHO Institute and Institute for Healthcare Improvement on this critically important new initiative.

Mr. Khanna is Director of AHRQ and Dr. Meyers is Deputy Director.