scholarly journals THE RELATIONSHIP BETWEEN STAFFING AND QUALITY FOR CARE HOME RESIDENTS: A REALIST REVIEW

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S381-S381
Author(s):  
Karen Spilsbury ◽  
Kirsty Haunch
Keyword(s):  
Quality Of Care ◽  
Care Home ◽  
Realist Review ◽  
Team Size ◽  
Work Package ◽  
Staffing Levels ◽  
The Uk ◽  
The Relationship ◽  
Individual Commitment

Abstract In recent years, quality of care in the sector has come under increasing scrutiny, and practice and policy concerns have been raised about staffing levels, recruitment and retention. Beyond broad recognition that ‘staff influence quality’, little is known about the care home workforce and its relationship to quality. We are undertaking the first study in the UK to address this important question, considering quality from a range of perspectives. One work package comprises a realist review to develop theoretical explanations of how, why and in what circumstances staffing promotes quality for residents and relatives. We will present three mechanisms that promote quality - individual commitment to resident focused care, reciprocity in the team, and a mandate to be creative and flexible to meet residents’ needs. We will consider the contexts required to trigger these mechanisms – staffing numbers, stability of the team, size of the team, and clear leadership.

scholarly journals RELATIONSHIP BETWEEN CARE HOME STAFFING AND QUALITY OF CARE: A MIXED-METHODS APPROACH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S242-S242
Author(s):  
Karen Spilsbury ◽  
Andy Charlwood ◽  
Danat Valizade ◽  
Kirsty Haunch
Keyword(s):  
Quality Of Care ◽  
Observational Study ◽  
Care Home ◽  
Data Sets ◽  
Mixed Methods Approach ◽  
Using Data ◽  
The Uk ◽  
First Time ◽  
Individual Commitment

Abstract Beyond broad recognition that ‘staff influence quality’, little is known about the care home workforce and its relationship to quality. Our study examines this relationship for the first time in the UK. Quality is a complex, contested and dynamic concept: we have operationalised this concept using data collected at national and organisational levels to measure quality, as well as considering the views of quality of different stakeholders. We will present interim findings from this study’s work packages (due to complete in July 2020), including: (1) our review which has developed theoretical explanations of how, why and in what circumstances staffing promotes quality for residents and relatives; and (2) our observational study using routine administrative data sets at national and provider level. Key findings include the importance of experience and stability of care hoe staff, as well as how care is delivered (individual commitment, team reciprocity and organisational mandate).

scholarly journals Impact Of Nurse Unionization On Fiscal Viability And Selected Measures Of Quality In Hospitals

2011 ◽  
Vol 6 (3) ◽  
Author(s):  
Jim Morey ◽  
Gary Scherzer ◽  
Hoseoup Lee ◽  
Kenneth Wallis ◽  
Laura Francis Gladney
Keyword(s):  
New York ◽  
Quality Of Care ◽  
Institutional Care ◽  
Nurse Staffing ◽  
Financial Variables ◽  
Staffing Levels ◽  
Union Status ◽  
The Impact ◽  
The Relationship

<p class="MsoNormal" style="margin: 0in 0.5in 0pt;"><span style="font-size: 10pt;"><span style="font-family: Times New Roman;">Seventy-three New York hospitals were examined to determine if a difference existed between hospitals with nursing unions versus those without as it pertains to fiscal viability and quality of care.<span style="mso-spacerun: yes;">&nbsp; </span>Several financial variables were used to construct a fiscal viability index; and a quality index was created from selected mortality and procedural measures that may be used to measure specific aspects of institutional care.<span style="mso-spacerun: yes;">&nbsp; </span>The premise that the union status of a hospital&rsquo;s nursing staff will influence fiscal viability and quality is based on the impact that unionization may have on staffing and cost per patient.<span style="mso-spacerun: yes;">&nbsp; </span>The literature is replete with studies that assess the relationship between nurse staffing levels and quality.<span style="mso-spacerun: yes;">&nbsp; </span>In some cases there is a clear and compelling relationship, but in others, it is indeterminate. <span style="mso-spacerun: yes;">&nbsp;</span>Utilizing union status, selected employee variables, and financial and quality of care indices, four statistical models were prepared to explain these the interaction of these variables <span style="mso-spacerun: yes;">&nbsp;</span></span></span></p>

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

scholarly journals Quality of Care Provided by Family Caregivers of Older People With Dementia: Measurement and Interpretations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 152-152
Author(s):  
Afeez Hazzan
Keyword(s):  
Quality Of Care ◽  
Older People ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Primary Reason ◽  
People With Dementia ◽  
High Level ◽  
The Impact ◽  
The Relationship

Abstract Family caregivers of older people living with dementia are relatives, friends, or neighbors who provide assistance related to this condition, but who are unpaid for the services they provide. Although caregiving could be personally rewarding, many caregivers report a high level of strain. Compared to caregivers of older adults who do not have dementia, family caregivers of older people living with dementia report lower quality-of-life (QoL). In a published systematic review examining the relationship between family caregiver QoL and the quality of care provided, only one study was found to be somewhat relevant. The study suggested that the primary reason for an absence of research into the link between family caregiver QoL and quality of care was the absence of a questionnaire for measuring quality of care in dementia. Therefore, any attempt to investigate the impact of caregiver QoL on the care provided to older people with dementia must first address the lack of an instrument to measure quality of care. To address this issue, we interviewed approximately 20 family caregivers in order to elicit feedback on measurements and interpretation of the quality of care provided by family caregivers of older people living with dementia. Content analysis of the interview transcripts revealed that the quality of relationships with family, caregiver availability to provide or supervise care, and availability of paid or volunteer help are important for the quality of care provided. These results have important implications, particularly for the development of an instrument to measure quality of care in dementia.

scholarly journals Analyzing Nursing Home Complaints: From Substantiated Allegation to Deficiency Citations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-83
Author(s):  
Kallol Kumar Bhattacharyya ◽  
Lindsay Peterson ◽  
John Bowblis ◽  
Kathryn Hyer
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Staff Training ◽  
Policy And Practice ◽  
Abuse And Neglect ◽  
The Relationship ◽  
Investigation Process

Abstract Complaints provide important information to consumers about nursing homes (NHs). Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. Our data were drawn from federally collected NH complaint and inspection records. Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. These results suggest that the compliant investigation process warrants further investigation. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed.

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