LTCI’s Approach

The Long Term Care Institute, Inc. uses a systems approach to assess the effectiveness, reliability and thoroughness of quality of care systems currently in place within healthcare organizations or individual facilities/centers.

The assessment of these systems is based on current standards of professional practice, quality assurance and performance improvement goals and Federal regulations.

LTCI incorporates a multi-step process to review elements of current systems in use by a health care organization or individual facility/center.  LTCI examines the quality assurance and performance improvement systems and individual care delivery areas to help determine how the organization (and levels of the organization) or individual facility/center develops, implements, maintains and improves its systems. LTCI combines individual resident/patient level care findings, facility/center level findings and overall organization findings through direct care observation, staff and resident/patient interviews and record reviews.  LTCI uses a five step process of systems issue identification, which includes the following:

  • Identify problems
    • Review the resident/patient level assessment process and care delivery.
    • Facility/center level review of the use of data to determine possible problems.
    • If applicable, review at the organization level the use of data to determine possible problems and the effectiveness of regions/districts of the organization.
  • Determine the nature and extent of problems
    • Review of resident/patient level root cause analysis and problem-solving through the care planning process.
    • Review facility/center level root cause analysis of identified problems and magnitude of problems.
    • If applicable, review region/district and organization level root cause analysis, and use of aggregate data to determine the scope of organizational problems and the effectiveness of regions/districts.
  • Develop interventions
    • Review how interventions for identified problems are developed at the resident/patient level.
    • Review how facility/center level strategies for addressing and correcting problems are developed.
    • If applicable, review region/district and organization’s ability to develop interventions at individual facility/center and organization wide levels.
  • Implement intervention
    • Review how developed approaches and interventions are applied at the resident/patient level.
    • Review facility/center level execution of developed interventions.
    • If applicable, review the region/district and organization’s oversight and execution of developed strategies.
  • Evaluate and monitor interventions
    • Review how implemented interventions are evaluated and monitored at the resident/patient care delivery level.
    • Review how the applied intervention is assessed and monitored by the facility/center quality assurance/performance improvement committee.
    • If applicable, review how the organization evaluates the effectiveness of the intervention implemented at a single facility/center, region/district or organization wide, and review the quality assurance and performance improvement activities at the facility/center, region/district and organizational level.