scholarly journals STAFFING AND CARE QUALITY OF NURSING HOMES IN KOREA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S702-S702
Author(s):  
Hee Seung Lee

Abstract Staffing has been regarded as the most important factor for the quality of care service in nursing homes. Korea introduced Long-Term Care Insurance (LTCI) in 2008. The payment system of LTCI has incentivized LTC facilities based on the staffing level of LTC facilities. This study aims to investigate whether staffing is associated with quality of care. The effect of staffing on care quality was assessed using ordered logit analysis. Staffing data in 2015 were retrieved from claim data in the National Health Insurance Service. The publicly reported care service quality grade in 2015 was used as a proxy for care quality. Staffing of registered nurses (RN) and social workers were strongly associated with the care quality. As the number of RNs per residents additionally increased, the LTC facilities were more likely to receive better grades (OR=16851.54, p<0.000). The effect of social workers’ staffing was significant for the care service quality, even though the effect size of smaller than that of RNs (OR=345.87, p<0.000). However, staffing in other professions such as nurse assistants (NA) and personal care workers (PCW) was insignificantly associated with care quality. The effect of staffing on service quality might not be profession-neutral. RN staffing affects most in care quality in Korea. Still, the possibility remains that PCWs or NAs could serve for indirect care services such as cooking or cleaning because of short staffing in indirect care services. This finding could be considered when designing financial incentives for nursing homes in Korea as well as other countries.

2014 ◽  
Vol 3 (6) ◽  
pp. 20 ◽  
Author(s):  
Ezekiel Taiwo Adebayo ◽  
Bola Ayodele Adesina ◽  
Lilian Ejije Ahaji ◽  
Nurudeen Ayoola Hussein

Dental care services are available in many urban communities worldwide where discerning and sophisticated clients expect quality care. Many available studies evaluated satisfaction rather than quality of dental care; others did not reveal the patients’ perception of gaps in the quality of care. Service quality (SERVQUAL) tool assesses quality of service based on the dimensions of tangibles, reliability, responsiveness, assurance and empathy as described by Parasuraman et al. (1985). The aim of this study was to assess the gaps in quality of dental care in a Nigerian government owned dental clinic using an unweighted SERVQUAL tool to determine the difference between expectations and perceptions of patients. Consenting patients seen during the study period were given a 32-items questionnaire divided equally between expectations and perception of quality of dental care services received. Out of 112 questionnaires analysed, patients had the most expectation for neatness (4.69 ± 0.85) and least for pain free treatment (3.76 ± 1.16). Highest perception was for knowledgeable clinic staff (4.34 ± 0.71) while support to enable staff work well was the least perceived quality (3.73 ± 0.86). Overall, among the 5 dimensions of quality, there were marked statistically significant quality gaps in assurance (p = .0001) and tangibles (p = .0006). This study showed that patients in a Nigerian government-owned dental clinic, there is need for greater attention to be paid to assurance, tangibles and reliability dimensions of service quality to improve patient perceptions.


2002 ◽  
Vol 32 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Charlene Harrington ◽  
Steffie Woolhandler ◽  
Joseph Mullan ◽  
Helen Carrillo ◽  
David U. Himmelstein

Quality problems have long plagued the nursing home industry. While two-thirds of U.S. nursing homes are investor-owned, few studies have examined the impact of investor-ownership on the quality of care. The authors analyzed 1998 data from inspections of 13,693 nursing facilities representing virtually all U.S. nursing homes. They grouped deficiency citations issued by inspectors into three categories (“quality of care,” “quality of life,” and “other”) and compared deficiency rates in investor-owned, nonprofit, and public nursing homes. A multivariate model was used to control for case mix, percentage of residents covered by Medicaid, whether the facility was hospital-based, whether it was a skilled nursing facility for Medicare only, chain ownership, and location by state. The study also assessed nurse staffing. The authors found that investor-owned nursing homes provide worse care and less nursing care than nonprofit or public homes. Investor-owned facilities averaged 5.89 deficiencies per home, 46.5 percent higher than nonprofit and 43.0 percent higher than public facilities, and also had more of each category of deficiency. In the multivariate analysis, investor-ownership predicted 0.679 additional deficiencies per home; chain-ownership predicted an additional 0.633 deficiencies per home. Nurse staffing ratios were markedly lower at investor-owned homes.


2021 ◽  
Author(s):  
Joyce Siette ◽  
Mikaela L. Jorgensen ◽  
Andrew Georgiou ◽  
Laura Dodds ◽  
Tom McClean ◽  
...  

Abstract Background Measuring person-centred outcomes and using this information to improve service delivery is a challenge for many care providers. We aimed to identify predictors of QoL among older adults receiving community-based aged care services and examine variation across different community care service outlets.Methods A retrospective sample of 1141 Australians aged ≥ 60 years receiving community-based care services from a large service provider within 19 service outlets. Clients’ QoL was captured using the ICEpop CAPability Index. QoL scores and predictors of QoL (i.e.sociodemographic, social participation and service use) were extracted from clients’ electronic records and examined using multivariable regression.Funnel plots were used to examine variation in risk-adjusted QoL scores across service outlets.Results Mean age was 81.5 years (SD = 8) and 75.5% were women. Clients had a mean QoL score of 0.81 (range 0–1, SD = 0.15). After accounting for other factors, being older (p < 0.01), having lower-level care needs (p < 0.01), receiving services which met needs for assistance with activities of daily living (p < 0.01), and having higher levels of social participation (p < 0.001) were associated with higher QoL scores. Of the 19 service outlets, 21% (n = 4) had lower mean risk-adjusted QoL scores than expected (< 95% control limits) and 16% (n = 3) had higher mean scores than expected.Conclusion Using QoL as an indicator to compare care quality may be feasible, with appropriate risk adjustment. Implementing QoL tools allows providers to measure and monitor their performance and service outcomes, as well as identify clients with poor quality of life who may need extra support.Trial registration: Australian and New Zealand clinical trial registry number: ACTRN12617001212347. Registered 18/08/2017


Author(s):  
Peiyan Ho ◽  
Rachel Chin Yee Cheong ◽  
Siew Pei Ong ◽  
Carol Fusek ◽  
Shiou Liang Wee ◽  
...  

<b><i>Background:</i></b> Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. <b><i>Objectives:</i></b> To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents’ well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). <b><i>Methods:</i></b> Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents’ well-being and staff attrition were measured before and after PCC implementation. <b><i>Results:</i></b> There were statistically significant improvements in resident well-being (Δ = 0.44, <i>p</i> = 0.029), Positive Engagement Potential (Δ = 0.17, <i>p</i> = 0.002), and Occupational Diversity (Δ = 0.12, <i>p</i> = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. <b><i>Conclusions:</i></b> Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Brigitte Lalude Asante ◽  
Franziska Zúñiga ◽  
Lauriane Favez

Abstract Background Leadership has a vital role regarding quality of care in nursing homes. However, few studies have explored upper-level managers’ views on how to assure that residents receive high quality of care. Therefore, this study’s aim was to examine how managers of top-quality nursing homes define, develop and maintain high-quality of care. Method We used interpretive description, an inductive, qualitative approach. Our research included 13 semi-structured interviews with 19 managers. We analyzed their input using reflexive thematic analysis, which is an iterative approach. Results Quality development and maintenance are cyclic processes. Managers in high-performing nursing homes lead with high commitment towards a person-centred quality of care, creating appropriate working conditions and continuously co-creating a vision and the realization of quality of care together with employees. Conclusions This study confirms that, in high-performing nursing homes, a person-centered approach—one where both residents and employees are at the center—is essential for quality development and maintenance. The most effective managers exemplify “person centeredness”: they lead by example and promote quality-focused working conditions. Such strategies motivate employees to provide person-centered care. As this means focusing on residents’ needs, it results in high care quality.


Author(s):  
Anna Beata Rosiek ◽  
Krzysztof Leksowski

This article describes a model of health-care services that ensure the high quality of health-care service and effective brand creation for a hospital. The problems described here that are connected to improving the quality of health care in Poland indicates that high quality of health care builds a positive and strong image of a health-care unit on the medical market. The contents of this article involve basic definitions of quality in health care and also the way the quality is understood and perceived from patient’s and hospital’s point of view. The article also describes a health care quality model, to which health care units should aspire in order to create a positive picture of said units, simultaneously improving and maintaining high quality of health care services. The article investigates the quality factors of health care services, which influence the healthcare units’ brand, its functioning on the market and patient-perceived quality of services. The described management model, which ensures efficient brand-building of healthcare units through services’ quality, takes into account changes in healthcare system and does so in order to ensure the improvement in healthcare units’ functioning.


2020 ◽  
Vol 7 (6) ◽  
pp. 1678-1684
Author(s):  
Jaya Aysola ◽  
Chang Xu ◽  
Hairong Huo ◽  
Rachel M Werner

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.


2021 ◽  
Vol 10 (1) ◽  
pp. 41
Author(s):  
Yi-Luo Wang ◽  
Ying Duan ◽  
Ying Zhang

With the increase of the aging of the population in china, the demand of the elderly continues to increase, which has brought great challenges to the elderly care service industry. As a new type of elderly care service, home-based care services directly affect the quality of the elderly&rsquo;s health and daily life in their later years. Therefore, improving the product and quality of elderly care services has become the goal and purpose of the development of home-based care service for aged. This article uses Cite Space software to perform visual analysis of keyword clustering on existing literature, and concludes that scholars focus on the integration of medical care, social elderly care service system, service quality, and influencing factors, but the impact of service quality models and indicator systems is low. Then through the integration and induction of scholars&rsquo; research progress on home care services, existing problems in service quality, and service quality evaluation index systems, in order to continue to innovate on the basis of existing knowledge, improve the service quality index system, and focus on combing process indicators with outcome indicators effectively, thereby improving the quality of community home care services.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032558
Author(s):  
Ashley Sheffel ◽  
Scott Zeger ◽  
Rebecca Heidkamp ◽  
Melinda Kay Munos

IntroductionMeasuring quality of care in low-income and middle-income countries is complicated by the lack of a standard, universally accepted definition for ‘quality’ for any particular service, as well as limited guidance on which indicators to include in measures of quality of care, and how to incorporate those indicators into summary indices. The aim of this paper is to develop, characterise and compare a set of antenatal care (ANC) indices for facility readiness and provision of care.MethodsWe created nine indices for facility readiness using three methods for selecting items and three methods for combining items. In addition, we created three indices for provision of care using one method for selecting items and three methods for combining items. For each index, we calculated descriptive statistics, categorised the continuous index scores using tercile cut points to assess comparability of facility classification, and examined the variability and distribution of scores.ResultsOur results showed that, within a country, the indices were quite similar in terms of mean index score, facility classification, coefficient of variation, floor and ceiling effects, and the inclusion of items in an index with a range of variability. Notably, the indices created using principal components analysis to combine the items were the most different from the other indices. In addition, the index created by taking a weighted average of a core set of items had lower agreement with the other indices when looking at facility classification.ConclusionsAs improving quality of care becomes integral to global efforts to produce better health outcomes, demand for guidance on creating standardised measures of service quality will grow. This study provides health systems researchers with a comparison of methodologies commonly used to create summary indices of ANC service quality and it highlights the similarities and differences between methods.


2021 ◽  
Vol 6 (1) ◽  
pp. 29-36
Author(s):  
Rana Gholamzadeh Nikjoo ◽  
◽  
Mitra Eyvazi Torchi ◽  
Yegane Partovi ◽  
Akbar Javan Biparva ◽  
...  

Background: Environmental characteristics, as well as the quality of health care services provided to older adults group, are among significant determinants of elderly quality of life. The present study was done to assess the quality of services delivered to elderly residents in nursing homes located in Tabriz, Iran in 2019. Materials & Methods: This cross-sectional study was conducted on the elderly living in nursing homes in Tabriz, Iran, of whom 74 residents met the inclusion criteria and were included. The researchers referred to the nursing homes and recruited the participants with regard to the inclusion and exclusion criteria. Results: Out of the 74 older adults, 35 and 39 cases were respectively male and female. The largest age group (43.2%) was related to those between 60 and 69 years old. Also, 71.6% of the elderly had been residing in nursing homes for 6-20 months. The rate of service quality in terms of the medical, psychological, welfare, and social domains was 66%, 48%, 68%, and 65%, respectively. Besides, no significant relationship was observed between demographic variables and total scores of service quality (P>0.05). Conclusion: Paying attention to psychological services, including providing counseling and social work services, adapting the centers, and creating recreational departments can lead to an increase in psychological quality and ultimately, overall service quality.


Sign in / Sign up

Export Citation Format

Share Document