Publications & Presentations

Video: Full introduction of the Wisconsin Coalition for Collaborative Excellence in Assisted Living (WCCEAL) and the eQuality data system
This is a 25 minute video presentation which was originally given in 2021 summarizing the WCCEAL coalition and it’s online data reporting system.

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The following paper was published in the Journal of the American Medical Directors Association (JAMDA):

Implementing Large-Scale Data-Driven Quality Improvement in Assisted Living
Ramly, E., Parks, R., Fishler, T., Ford II, J. H., Zimmerman, D., & Nordman-Oliveira, S. (2022). Implementing large-scale data-driven quality improvement in assisted living. Journal of the American Medical Directors Association, 23(2), 280-287.

This award-winning publication is the first implementation study of large-scale data-driven quality improvement in assisted living, reporting implementation outcomes, core components, and implementation strategies building on a decade-long public-private collaboration.

Edmond Ramly, PhD, MS, received the William E. Scheckler, MD, Outstanding Research Publication Award (faculty or staff) for this publication in 2022.

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WCCEAL collects data and provides reports for hundreds of assisted living communities across Wisconsin. These insights help providers, partners, and policymakers understand trends, identify areas for improvement, and strengthen the quality of care for residents.

Falls and Injuries in Assisted Living

Data from 2019 to 2023 show clear differences in fall patterns across assisted living communities.

• Communities primarily serving residents with Alzheimer’s or dementia reported 114 falls per 10,000 resident days compared to 38 per 10,000 in other communities.
• Overall, 11.6 percent of falls led to injury, lower than national averages reported for nursing homes at 26 to 48 percent.
• Assisted living residents tend to experience more frequent but less severe falls, highlighting the need for population specific prevention strategies.

Source: Khan, Parks, Ramly, and Nordman-Oliveira (APHA 2024)
Link: https://apha.confex.com/apha/2024/meetingapp.cgi/Paper/554384

Improving Falls Prevention

A statewide study found that falls prevention programs and assessments vary widely among assisted living communities.

• More than half of surveyed communities had no formal falls prevention program in place.
• About three out of four included basic risk factors such as gait, balance, and fall history in their assessments.
• The study led to the development of a standardized Falls Prevention Process, a step-by-step guide that helps communities assess risk, engage residents, and track outcomes.

Source: Coughlin, Nordman-Oliveira, Schlaak, and Ford (Journal of Applied Gerontology, 2017)
Link: https://doi.org/10.1177/0733464817748776

WCCEAL Participation

Since 2013, the WCCEAL data driven quality improvement system has supported better care across the state.

• More than 800 communities representing over 20,000 residents have participated in the collaborative.
• Ninety-two percent of members successfully submitted data for at least one quarter, and 88 percent maintained full participation each quarter.
• The system provides quarterly feedback reports, benchmarking tools, and sponsor-led coaching to guide continuous improvement.
• It was integrated into Wisconsin’s Medicaid quality incentive programs, bolstering long-term sustainability and statewide impact.

Source: Ramly, Parks, Fishler, Ford, Zimmerman, and Nordman-Oliveira (JAMDA, 2022)
Link: https://doi.org/10.1016/j.jamda.2021.12.025

Resident Wellbeing and Engagement

Pilot studies show how personalized, non-drug interventions can improve quality of life for residents with dementia.

• Residents who regularly used personalized music and tablet activities showed significant improvements in quality of life over a 3-month period.
• Staff observed lower agitation and reduced use of behavioral medications for some residents.
• The results support ongoing investment in person centered, technology supported care.

Source: Ford, Dodds, Hyland, and Potteiger (JMIR Aging, 2019)
Link: https://doi.org/10.2196/11599