A Time-Ordered, Systems Approach to Quality Assurance in Long-Term Care

1991 ◽  
Vol 10 (1) ◽  
pp. 19-34 ◽  
Author(s):  
Sheila J. Atchley
2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 88-88
Author(s):  
Mikaela Wheeler ◽  
Karen Abbey ◽  
Sandra Capra

Abstract As population’s age and the need for long term care (LTC) increases, so too does the focus on the costs to provide that care. Providing food, oral nutrition supplements and meals, can be a considerable expense to a home. The objective of this research was to develop a valid foodservice costing tool (FCT), to calculate the real cost of providing foods and meals in LTC. Current costing methodologies are not specific to LTC and do not account for all costs of a foodservice, including staff, procurement and nutrition supplements. An initial tool was developed using the systems approach in conjunction with literature and professional knowledge. This was piloted in real world contexts, using volunteer LTC homes. Four iterations of the tool were completed to assess its feasibility in calculating costs and useability. Managers were interviewed after completing the tool to gather an understanding of how the tool was interpreted and to refine completion. Following feedback, the resulting tool consists of nine sections, measuring both costs incurred in meal production and service as well as analysis of staff workloads. Preliminary results show consistency between homes within Australia, indicating that the true cost is much higher than that reported in the literature to date. The development of a comprehensive, usable tool which captures the total cost of foodservice allows homes to accurately report and understand costs from a systems level. This information can be used to demonstrate cost effectiveness of a foodservice and the potential to justify and plan future system changes.


2019 ◽  
Vol 34 (3) ◽  
pp. 206-214
Author(s):  
Edward L. Schneider ◽  
Jung Ki Kim ◽  
Diana Hyun ◽  
Anjali Lobana ◽  
Rick Smith ◽  
...  

AIM: The most frequent use of medications in the geriatric population occurs in skilled nursing facilities. This quality assurance study prospectively examines the high number of prescriptions ordered for long-term nursing facility residents throughout their first year after admission. METHODS: The investigators prospectively followed 101 consecutive long-term-stay older adult residents at the Joyce Eisenberg Keefer Medical Center, a nursing facility of Los Angeles Jewish Home for the Aging (LAJH) over a 12-month period. Preadmission prescriptions were obtained for 91 residents, as well as prescriptions at 1 week, 1 month, 3 months, 6 months, and 1 year after admission. The number of prescriptions by staff physicians and outside physicians was examined. RESULTS: Over the 12 months following admission, the mean number of scheduled prescriptions increased significantly from 11.1 prior to admission to 13.0 by 6 months and to 13.3 by 12 months (P-value < 0.05). The residents who were hospitalized during the 12 months of observation received significantly more scheduled, as needed, and total prescriptions than those not hospitalized. Physicians employed full time by LAJH ordered significantly fewer additional prescriptions than physicians with outside practices. The patients of the staff physicians also had fewer hospitalizations than those of the outside physicians. CONCLUSION: This quality assurance study reveals a statistically significant increase in the number of prescriptions made in a long-term care setting over a 12-month prospective study. Patients of staff physicians received fewer prescriptions and were hospitalized less frequently than patients of physicians who practiced outside LAJH.


1989 ◽  
Vol 15 (5) ◽  
pp. 156-162 ◽  
Author(s):  
Paul D. Phillips ◽  
Robert A. Applebaum ◽  
Sheila J. Atchley ◽  
Rosalie McGinnis

Medical Care ◽  
1978 ◽  
Vol 16 (9) ◽  
pp. 796-797
Author(s):  
Sidney Katz

1991 ◽  
Vol 13 (3) ◽  
pp. 38
Author(s):  
Joan LeSage ◽  
Diana Y Barhyte

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