The TNT program was an all-inclusive, financially supported collaboration between the Los Angeles County Department of Public Health (LAC DPH) and LAC Skilled Nursing Facilities (SNFs) with the overall goal of improving safety and care for residents, staff, and visitors. This program aimed to empower SNF staff to initiate and maintain quality improvement projects within their facilities, leading to high quality care for their residents and family satisfaction. During the Live Program, participating LA County SNFs were trained in a variety of areas within quality assurance and performance improvement (QAPI) and infection prevention and control (IPC). SNFs were led through the foundations of QAPI and IPC, then bridged into developing their own sustainable QAPI and IPC projects.
All LAC SNFs (including Pasadena) were eligible to participate in the 9-month TNT Program, which ended on March 10, 2023.
To access the TNT Program report, please click here.
- Identify, analyze, and list gaps in facility IPC practices.
- Develop and implement a sustainable QAPI project based on identified IPC gaps.
- Empower a variety of facility staff to participate in QAPI projects.
Quality Improvement and QAPI Foundations
IPC Foundations, Hand Hygiene, QAPI project
Additional QAPI project
|07/06/22 - 08/26/22
|10/05/22 - 11/23/22
|01/11/23 - 03/10/23
Please click here to see the detailed schedule.
Please click here to see the full list.
The TNT Program hosted weekly Didactic sessions in a variety of areas within quality assurance and performance improvement and infection prevention and control for Skilled Nursing Facilities (SNFs) in Los Angeles County (LAC) that were enrolled to participate in the Program.
Although the 9-month live TNT Program has ended, all training content is available for all interested parties from LAC and non-LAC SNFs to review and use. Didactic session recordings, slides and Q&As from each week of trainings can be found below.
During the live Program, Designated Participants from SNFs enrolled in the TNT Program, were eligible to receive Certificate of Completion or CEUs upon successful completion of a post-session evaluation quiz; however, the quizzes have now closed, and no other CEUs or Certificates will be issued.
Please note: While playing the recording directly from this website, you may experience an issue with the audio and video not being aligned. If you experience this, it is recommended to download the recording and viewing the downloaded version instead of playing the recording directly from the website.
Unit 1: Past Sessions
Unit 2: Past Sessions
Unit 3: Past Sessions
Small Group Sessions:
The TNT Program also hosted monthly Small Group sessions. These sessions served as an open forum for individuals from participating facilities to engage and share experiences with their peers, and to learn from one another. These sessions were facilitated by LAC DPH infection preventionists, nurse consultants and physicians. During these sessions, facilitators provided support, and helped start and guide a discussion. Facilitators used a predetermined list of question to get started; however, they were encouraged to follow the group’s needs and use the Discussion Questions as needed.
A sample of Small Group Discussion Questions can be found here .
- A3 Project Template
- COVID-19 Vaccine Tracker Template (for Residents)
- COVID-19 Vaccine Tracker Template (for Staff)
- Environmental Rounds Worksheet for Infection Prevention
- Hand Hygiene Handout
- HSAG Process Measure Tracker and Trend Chart
- Measure Development Form
- SNF Quality Dashboard
- Webex Tutorial for TNT Participants
- Who Cleans What and When Template (LACDPH)
- Agency for Healthcare Research and Quality (AHRQ)
- AHRQ Fishbone Diagram Template
- AHRQ 5 Whys and Fishbone Diagram Job Aid
- APIC: Environmental Services | CDC STRIVE Program
- CDPH Monitoring Adherence Tool
- CDPH ESP Pamphlet for SNFs
- CDPH ESP Website
- McGeer Criteria
- NHSN Resources (from Session 6: Data Quality and Best Practices)
- QI Storyboards
- Reportable Diseases and Conditions (LACDPH)
- Transmission Based Precautions (LACDPH)
- 8 Sided Folding Technique (YouTube Video)
Enrollment is closed. TNT Program was a 9-month Program that ended on March 10, 2023.
- Submission of a completed Facility Commitment Form, where up to 3 individuals per facility could be designated to participate in the Program. Form must have been submitted no later than June 21, 2022.
- Submission of a completed Participant Commitment Form by all Designated Participants.
- Improve and expand your resident culture of safety.
- Improve facility-wide hand hygiene adherence rates.
- Improve environmental services (EVS) adherence rates.
- Decrease healthcare-associated infections (HAIs).
- *Certificate of successful completion for the facility.
- *Financial support of $16,000 for the facility.
- Fluorescent marker kit (e.g., Glo-germ gel).
- Continuing education units (CEUs).
- For licensed Designated Participants (e.g., RNs, LVNs, MDs).
- Certificates of Completion.
- For non-licensed Designated Participants.
*Upon successful completion of the Program
- Signed Facility and Participant Commitment Forms.
- Attendance of at least 80% of total live Didactic sessions held remotely (at least 18 out of 23 sessions).
- Attendance of one Small Group session per month during the Units.
- Active participation and engagement in Didactic sessions and Small Group discussions held remotely.
- Submission of a filled out A3 final project at the end of Unit 3.
- Recommended attendance of weekly Office Hour held remotely.
The TNT training program is 9 months total in length, consisting of three 2-month long Units of weekly Didactic sessions and monthly Small Group sessions with a 1-month break in between each Unit. Both Didactic and Small Group sessions during the Units will be 1 hour long each and will be held remotely. The program will start on 07/06/2022 and will end on March 03/10/2023.
To enroll in the program, the following items are required:
- Submission of a Facility Commitment Form. (After the form is submitted, your facility will receive an email with enrollment confirmation). In the form, the facility must designate participants who will attend the TNT training program. One participant must be an Infection Preventionist. The facility may designate two additional participants (or three additional participants if including the facility Administrator), totaling up to four participants per facility.
- Submission of a Participant Commitment Form for each Designated Participant. Each individual listed in the Facility Commitment Form as a Designated Participant will receive an email with instructions. They must submit their completed form as soon as possible prior to the start of the program.
If any of your Designated Participants can no longer participate in the training sessions for any reason, please email TNTEducation@ph.lacounty.gov immediately to notify of the change. Also, notify us if you will designate another individual as a replacement. Please remember, to be eligible for the program one participant must be an Infection Preventionist (IP), so if your IP leaves, you must designate a new IP as soon as possible.
Yes, after the Facility Commitment Form is submitted, you will receive an email confirmation.
The expectations of each facility and Designate Participant include:
- Signed Facility Commitment Form.
- Facility designation of up to three participants (or up to four if one is the facility Administrator) to attend the sessions. One Designated Participant must be an Infection Preventionist.
- Signed Participant Commitment Forms.
- Each enrolled facility must
meet the attendance requirements.
- At least one Designated Participant from each facility must attend at least 18 live Didactic sessions during the 9-month period and must successfully complete a post-session evaluation quiz after each session they attend. The Didactic sessions will be 1-hour live sessions held remotely.
- At least one Designated Participant per facility must attend one Small Group session per month during each of the 2-month Units. The session will be held remotely.
- Designated participants to actively participate and engage in Didactic and Small Group sessions.
- Submit a final project at the end of Unit 3.
- Recommended attendance of weekly Office Hour by any of the Designated Participants.
Yes, multiple SNFs from Los Angeles County (including Pasadena) can participate even if they have the same administrator. However, the Administrator can only receive credit for attendance as a Designated Participant for only one of the facilities and must designate other participants for the other facilities.
Any staff member is eligible to be a Designated Participant for the facility, but at least one participant must be the Infection Preventionist. We recommend DON, DSD and Facility Administrator as other possible participants, but the ultimate choice is up to each facility. (Note: Although more staff can attend Didactic sessions or utilize the resources available on the TNT website, only the Designated Participants will receive the session invitation links and will receive credit for their attendance). (Please note: each Designated Participant can be designated to participate by only one facility).
The expectation is that the same Designated Participants will attend all three units of trainings, but if there are any changes in staffing, please contact TNTEducation@ph.lacounty.gov as soon as possible. Please notify us prior to the next training session, if possible.
No, one individual cannot be a Designated Participant for multiple facilities. Each participant may be designated by only one facility. Participants may represent multiple facilities, but they will receive credit for attendance only for the facility that designated them to participate.
All live Didactic, Small Group and Office Hour sessions will be held remotely.
We will meet on Wednesdays at 1:30pm 2:30pm for our weekly live Didactic sessions. Each facility will also be required to attend one Small Group session (1 hour long) during one week of each month. The week of Small Group will vary for each facility. Each facility will receive an invitation to the Small Group they will be scheduled for. All sessions will be held remotely. Once per week, there will also be an optional Office Hour held remotely. The Office Hours during Unit 2 and Unit 3 will be held on Fridays 1:00 1:30pm (except on November 11 and November 25 there will be no Office Hour due to the Holidays).
Each facility is required to dedicate 5 hours per month (four 1-hour weekly Didactic sessions and one 1-hour Small Group). It is up to the facility s discretion which Designated Participant(s) will attend the sessions, but it must be one of the Designated Participants listed by the facility. In addition, there will be an optional Office Hour every week.
Yes, your facility will be listed on the DPH TNT website. Please visit the TNT website to see the list.
If you want your facility to be removed from the list, please email TNTEducation@ph.lacounty.gov with your request.
No, it is not required for your facility to be listed. Upon registering for the program, your facility will automatically be listed on the TNT website, but if you would like your facility removed from the website, please email TNTeducation@ph.lacounty.gov with your request.
The list of registered facilities will be updated each week during enrollment. You can expect to see your facility listed on the TNT website the week after you register.
Your facility will receive the financial support after the successful completion of the entire 9-month program has been confirmed. Several weeks after the end of the TNT Program, SNFs will receive an email communication with more information about the support they are eligible for.
Each Designated Participant will be asked to log into the sessions with their full name and email address. If the Designated Participant uses the Call-in option and does not enter their full name and email address to log into the session, they are expected to enter their full name and email in the session chat so that their attendance can be verified. For those individuals who use the Call-in option to connect with a mic and audio, it is strongly recommended that they also log into the session using another device and enter their full name and email address so their attendance can be recorded.
To confirm attendance, TNT administrative team must have a record of your attendance either from the information you entered when logging in or entered in the chat during the session. This applies to both Didactic and Small Group sessions.
For successful completion of the Program, your facility must also complete an Environmental Cleaning and Disinfection final project in addition to meeting the minimum live session attendance requirements. The time commitment for the final project will vary depending on the type of project each SNF selects to complete for their facility. The project is expected to be started during Unit 3. The filled out A3 must be submitted by 5pm on Monday, February 27, 2023 via TNTEducation@ph.lacounty.gov email address. While the project may not be completed by February 27th, all components of your A3 must be filled out. Please include your Plan, what you expect to Do, what you expect to see (Check), and how you will continue your project (Act).
A blank A3 form can be found on the TNT website in the Resources section.
Yes, your facility will receive a certificate of completion once your facility successfully completes the Program. To successfully complete the Program, at least one of your Designated Participants must be present during at least 18 of the live Didactic sessions over the 9- month period and for one Small Group session each month during the 2-month Units. Each Designated Participant who attends a live Didactic session must successfully complete a post-session evaluation quiz to receive credit for their attendance. All sessions will be held remotely. Your facility must also submit a proof of the final project completion at the end of Unit 3.
Yes, the facility Designated Participants can receive CEUs or Certificates of Completion. Designated Participants must attend the live weekly Didactic sessions or watch the recordings of the Didactic sessions AND successfully complete a post-session evaluation quiz after completing each training session to be eligible to receive CEUs or Certificate of Completion. (Please note: the option for recording only applies to individual CEUs and certificates but cannot count toward the facility attendance requirement. To meet facility attendance requirement, the Designated Participant must be present during the live sessions and must successfully complete a post-session evaluation quiz).
Up to four Designated Participants (if the facility Administrator is also a Designated Participant) from each Skilled Nursing Facility are eligible to attend and receive CEUs or Certificates of Completion. Please note, only the participants who are Designated Participants listed by the facility are eligible for CEUs or Certificates of Completion.
CEUs are available for Designated Participants who are physicians or are licensed nurses such as LVNs and RNs. Unlicensed Designated Participants who are not eligible for CEUs, will receive a Certificate of Completion. Designated Participants who have other types of licenses may contact their licensing board to see if they can convert the TNT Program Certificate of Completion into a CEU for their license.
The TNT Program is only issuing CEUs for attending the weekly Didactic sessions. Please refer to the CBIC website for information on converting CEUs to IPUs cbic.org/CBIC/Certification-FAQs/Recertificationby-IPUs.htm.
No, you will not be eligible for a CEU or a Certificate of Completion if you do not complete the post-session evaluation quiz. Designated Participants must successfully complete the post-session evaluation quiz (receive minimum score of 80%) after each Didactic session they attend to receive CEUs or Certificates of Completion.
After submitting the quiz, Designated Participants will be able to review their score and re-submit their responses if they did not meet the minimum passing score requirement. After the submission of the quiz, the participants will also receive an email informing them whether they did or did not pass the quiz. To receive the email, the Designated Participants must accurately enter their email address when completing the quiz.
A staff member who is not a Designated Participant can watch the recorded training sessions; however, they will not be eligible to receive a CEU or a Certificate of Completion.
CEUs or Certificate of Completion will be distributed to each Designated Participant within a few weeks after each of the 2- month Unit of sessions end.
If your facility is unable to commit to participating in the TNT Program, you can still utilize the training content and resources available on the TNT website. Additional resources can be found on the CDC website at: cms.gov/Medicare/Provider-Enrollment-andCertification/QAPI/qapiresources.
Designated Participants need a computer with an internet connection and dedicated time for their participation.
Yes, all of the Designated Participants can log in using the facility credentials. As long as they remain in the session during the entire time, your facility will receive credit for attendance. However, the individual Designated Participants will not receive individual credit for attendance. If the Designated Participants want individual attendance credit to be eligible for CEUs or Certificates of Completion, they must log in using their own full name and email address.
Presentation slides for each Didactic session will be attached to the email reminder sent to all Designated Participants prior to each Didactic session. After each session, the slides, the session recordings and Questions and Answers will be available on the TNT website within a week following each session.
To receive credit for attendance and be eligible to receive a CEU or a Certificate of Completion, you must be present during at least 50 minutes of the 1-hour session. The session will be locked 10 minutes after the start of the session. Late arrivals may be permitted to join, but credit for attendance will only be given to those who were present in the session for at least 50 minutes. However, if you missed a Didactic session and would like to review the content from that session, please visit the TNT website where you can find the session recordings, slides, post-session evaluation quiz links and Q&A within a week after each session. (Please note, all quizzes will be closed and removed from the TNT website 1 week after the end of each Unit.)
Post-session evaluation quizzes will be open during the entirety of each 2-month long Units. Designated Participants who have attended the live Didactic sessions or have watched the recordings and have not yet completed the quiz can use the links on the TNT website to complete them at any time during the Unit. However, when the 2-month Unit ends, all session quiz links for that Unit will be closed one week after the last session and no new submissions will be allowed after that time. This information will be announced at different times during the TNT Didactic sessions and will be listed on the TNT website until the quiz closure date.
At the end of each month during the Units, additional Small Group makeup sessions will be held for facilities that were unable to attend the Small Group session they were scheduled for that month. Each facility will be invited to one makeup Small Group session per month during the Units. At the end of Unit 3 in March, a limited number of additional Small Group sessions will be held for SNFs that have missed a Small Group session during the 9-month program and would like a makeup opportunity in order to get back on track for successful completion of the TNT Program. Each facility is eligible to attend only one Makeup Small Group session in March. The SNFs that have attended all Small Group sessions or those that have missed too many sessions and will not meet the minimum attendance requirement even if they attend a makeup session will not be invited to a March Makeup Small Group session.
During Unit 3, two additional Special Didactic sessions will be held increasing the number of sessions from 7 to 9 for that Unit. March 10 will mark the new end date for Unit 3. This change will not affect the requirement that SNFs must attend minimum of 18 sessions to be in good standing toward successful completion of the program. The additional sessions can serve as opportunities for extra credit to make up any Didactic sessions missed during the 9-month program. Attendance of one or two sessions beyond the originally scheduled 7 sessions may count toward one or two missed Didactic sessions respectively and can be applied to any missed sessions during the entire program. To receive credit for attendance, Designated Participants must attend the entire 1-hour session and must successfully complete the post-session evaluation quiz.
The TNT Program was a 9-month long 3-Unit Program that was held between July 2022 and March 2023. The Program enrollment deadline was June 21, 2022. The Program has already ended; therefore, new SNFs are no longer able to enroll in the Program. However, the training content for all 3 Units is available on the TNT website and all interested parties are encouraged to review and utilize the information and the resources.
Yes, anyone interested in the content can utilize the slides, training recordings, Q&As, resources and tools available on the TNT website.
No, CEUs or Certificates of Completion were only available for Designated Participants from SNFs that were enrolled to participate in the Program. To receive CEUs or Certificates, participants were required to successfully pass post-session evaluation quizzes, which closed 1 week after the end of the Program.
Click here to see Frequently Asked Questions in a PDF form.