Nursing Home COVID-19 Action Network ECHO

The Indiana Nursing Home COVID-19 Action Network (NNHCAN) ECHO ran from November 2020 - August 2021 in two phases. The program served 211 long-term care facilities throughout Indiana. This ECHO program was geared specifically for nursing home leadership to build capacity related to COVID-19 and protect residents and staff.

Phase I of the program included 16 weekly sessions for 8 cohorts designed to assist with the most pressing COVID-related needs. These cohorts had staggered starts from November 2020 to February 2021 and wrapped up this Spring.

Phase II consisted of weekly sessions comprised of three cohorts that facility leaders could join. These sessions aimed at stopping the spread, vaccinations, supporting the needs of residents and families, and leadership behaviors to support nursing home teams. Phase II concluded on August 31, 2021.

Nursing facilities that joined the interactive community of practice worked to advance improvements in COVID-19 preparedness, safety, and infection control.

The Nursing Home COVID-19 Action Network (NHCAN) ECHO program was funded by the Agency for Healthcare Research and Quality.

Goals

Our goal was to help nursing homes implement evidence-based best practices to:

Keep the virus from entering nursing homes where it has not entered
Identify residents and staff who have been infected with the virus early
Prevent the spread of the virus between staff, residents, and visitors
Provide safe and appropriate care to residents with mild and asymptomatic cases of the virus
Ensure staff have the knowledge, skills, and confidence to implement best-practice safety measures to protect residents and themselves
Reduce social isolation for residents, families, and staff during these difficult times

Approach

This initiative operated as a 16-week interactive virtual community of practice utilizing the ECHO model. The ECHO model uses complex ideas and guided mentorship to provide an “all teach, all learn” environment. The weekly sessions were designed to create space to hear directly from nursing home staff about the challenges that they faced through discussion of real cases. All participants were encouraged to share best practices and learn from their peers – while benefiting from the guidance of nursing home and quality improvement experts.

Partners

The major partners with Indiana University School of Medicine and Fairbanks School of Public Health on this project were the University of Indianapolis (Dr. Ellen Miller), the University of Southern Indiana (Dr. Katie Ehlman), and Parkview Health (Dr. Jeff Boord). Parkview led two of our cohorts in the first phase. University of Indianapolis led two cohorts in the first phase and one in the phase over the summer; USI led one cohort in the first phase and collaborated in sessions this summer.

IU Richard M. Fairbanks School of Public Health
IU School of Medicine
Parkview Hospital
Regenstrief Institute
University of Indianapolis Center for Aging & Community
University of Southern Indiana

Overview of the Program

This project was a total of 42 weeks, 180 sessions, with over 250 hours of content. 400 recorded sessions were viewed as well.
3,285 Health Facility Administrator CEU credits were issued – a HUGE thank you to IHCA for their tremendous support of this additional benefit to participants.
At the final count, 243 facilities in Indiana participated in NHCAN ECHO. In addition, we had facilities from Ohio and Illinois who joined some sessions.
From these facilities, 730 unique people participated in sessions. One-third of the participants were RNs and 28% were administrators.
For the first 16-week phase, facilities that participated in 13 sessions were able to receive $6,000 in compensation. Thus far, Indiana facilities have received $876,000 (146 facilities) from ECHO and we are working to help additional facilities get their paperwork submitted as well.
We also gave away nearly $5,000 in gift cards to participants in the final weeks of the program.
An IHI Quality Improvement Coach participated in every single ECHO session, to support the application of the material.
Subject matter experts from across Indiana, drawn from nursing home leadership, infectious disease, geriatrics, and public health, from academia, government, and industry presented at all sessions.
The content covered multiple topics including infection control, social isolation, leadership, building staff morale, and encouraging uptake of the vaccines. In addition, participants shared their strategies and solutions to common challenges with each other. Our team used the content as a guide, but continuously updated and adapted it based on feedback and what was happening on the ground.

Special Acknowledgments

In order to provide relevant content, we needed to be closely tied to what was happening day to day in the long-term care facilities. For that, we learned from participants in sessions, but also from several key leaders in the long-term care facilities in our state who gave us regular input. Becky Bartle (LeadingAge), Lori Davenport (IHCA), and Kara Dawson (QSource) were instrumental in this program. Thank you also to Brenda Buroker (IDOH) and Mitzi Daffron (QSource) for regularly sharing updates with us on issues they were seeing and hearing at facilities.

Nursing Home COVID-19 Action Network ECHO