Success Story: Hopkins Manor Decreases Use of Unnecessary Medications


Success story iconHopkins Manor is a 200-bed skilled nursing facility located in North Providence, Rhode Island – one of the smallest towns in one of the smallest states in the US. They have been family owned and operated since they opened their doors in 1974.

Over the years, Hopkins Manor has prioritized quality improvement efforts in a variety of ways. They have collaborated with the Healthcentric Advisors – the Rhode Island Quality Improvement Organization (QIO) since 2005. Most recently they have had nursing leadership changes. Their former Assistant Director of Nursing is now the Director of Nursing. They have hired a new Assistant Director of Nursing, who is leading their Quality Improvement (QI) efforts and working closely with the New England QIN-QIO Rhode Island team.

In 2009, they earned the American Health Care Association Bronze Award showing their commitment to QI. Hopkins has identified antipsychotics as their focus QI topic. With technical support from the New England QIN-QIO, they have completed a Root Cause Analysis, acquired leadership buy-in, including the medical director and most importantly, have embraced change. They have adopted several strategies, including:

  • Assess the appropriateness of antipsychotic medications upon admission.
  • Review of those elders that are receiving an annual or quarterly Minimum Data Set (MDS) assessment for a possible gradual dose reduction (GDR) during the assessment review period with the interdisciplinary team.
  • Identify increase opportunities for the activity’s staff to be present specifically during the sun-downing hours to offer diversionary activities.
  • Review and refine current bowel and bladder programs.
  • Evaluate pain management programs for those who exhibit behaviors.
  • Monitor behavior flow sheets to target those residents who are no longer exhibiting behavior problems.
  • Discuss progress and re-evaluation at daily meetings.

To date they have made great strides in decreasing their antipsychotic rate:

Facility data is based on nhqi (nursing home quality initiative) data files. State and national means are from publicly reported data available on the nursing home compare website.

They continue to receive technical assistance from the New England QIN-QIO. As an early adopter of the “nursing home culture change” initiative, they are committed to providing an individualized care approach. Their commitment is evident throughout the facility, from their openness to discuss non-pharmacological approaches, restaurant-style dining program and courtyard raised flower beds. These are just a few examples of the programs that the nursing home has implement for those elders that make Hopkins Manor their home.

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