Cost-Effective Adjustments to Nursing Home Staffing to Improve Quality

2018 ◽  
Vol 77 (3) ◽  
pp. 274-284 ◽  
Author(s):  
John R. Bowblis ◽  
Amy Restorick Roberts
Keyword(s):  
Nursing Home ◽  
Social Services ◽  
Health Care Providers ◽  
Social Service ◽  
Cost Effective ◽  
Improve Quality ◽  
Care Providers ◽  
Quality Improvements ◽  
Service Staff

Health care providers face fixed reimbursement rates from government sources and need to carefully adjust staffing to achieve the highest quality within a given cost structure. With data from the Certification and Survey Provider Enhanced Reports (1999-2015), this study holistically examined how staffing levels affect two publicly reported measures of quality in the nursing home industry, the number of deficiency citations and the deficiency score. While higher staffing consistently yielded better quality, the largest quality improvements resulted from increasing administrative registered nurses and social service staffing. After adjusting for wages, the most cost-effective investment for improving overall deficiency outcomes was increasing social services. Deficiencies related to quality of care were improved most by increasing administrative nursing and social service staff. Quality of life deficiencies were improved most by increasing social service and activities staff. Approaches to improve quality through staffing adjustments should target specific types of staff to maximize return on investment.

scholarly journals Supervisory Leaders in Aging: One-Year Practice Change Outcomes of Innovative Training Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 19-19
Author(s):  
Daniel Kaplan ◽  
Barbara Silverstone ◽  
Keith Chan ◽  
Amanda Spishak-Thomas
Keyword(s):  
Best Practices ◽  
Social Services ◽  
Social Service ◽  
Well Being ◽  
Practice Change ◽  
Staff Retention ◽  
The Social ◽  
Service Staff ◽  
One Year

Abstract Social services for older adults are instrumental in addressing vulnerabilities associated with aging. Yet, practitioners report needing expanded geriatric knowledge and enhanced supervision. Agency-based supervision is essential to skilled practice and staff retention, directly impacting the quality of services delivered by the teams they support. The Supervisory Leaders in Aging (SLA) program of the National Association of Social Workers (NASW) was designed to strengthen supervision of the social service workforce. The SLA program, adopted in four states (IL, FL, MD, and NY), trained 134 MSW supervisors who support 1,200 social service staff, aimed at enhancing the well-being of 264,000 clients annually. This paper reports newly available final outcomes data from the 3-year implementation study of SLA. Trainees self-rated use of relevant supervisory best-practices was measured with novel 30-item instrument which captured frequency in use of supervisory best practices. The measure was administered prior to the first session and at three and twelve months after the final session. Comparisons of ratings across time periods demonstrate a range of positive and significant increases at the end of program workshops (0.12–0.56; mean of 0.30 points) and after one year (0.18–0.53; mean of 0.34 points). Supervisory best practices were maintained by those who already engaged in these behaviors, and participants who previously underutilized best practices adopted and maintained these behaviors as a result of the workshops. Implications of this tested model for enhancing workforce capacity will be discussed, including variation of impacts by supervisor characteristics and retention of learning gains over time.

Survey of Community-Based Programs Serving U.S. Families With Huntington’s Disease: Perceived Barriers and Facilitators in the Residential Placement Process

2008 ◽  
Vol 9 (2) ◽  
pp. 65-74 ◽  
Author(s):  
Anthony J. Lechich ◽  
Deborah Lovecky ◽  
Carol Moskowitz ◽  
Sybil Montas ◽  
Ayana Duckett ◽  
...  
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Social Services ◽  
Residential Care ◽  
Health Care Providers ◽  
Long Term Care ◽  
Care Providers ◽  
Term Care ◽  
Service Staff

This article describes the contours of the residential care placement experience for social service staff, health care providers, and their client families of patients with Huntington’s disease. The purpose of this study was to determine the factors, conditions, and barriers encountered by outpatient clinical staff and families in the transition to skilled nursing care. A Long-Term Care Contact Survey was developed to (a) gather information about long-term care referral sites; (b) determine the factors considered in choosing a facility; (c) describe the factors that hindered the transition to long-term care; (d) describe conditions prior to institutionalization; and (e) determine research interest. The study found that large cohorts of patients with Huntington’s disease in residential care are scarce. A lack of confidence in the available options suggests the need for increased support for educational and social services to facility staff. Speech/swallowing therapy and physical therapy as placement facilitators reflect salient issues of latter stages of the disease, implicating funding support needs. Families facing this transition require long-term guidance for financial, caregiving, and psychosocial issues.

scholarly journals Validated pre-discharge survey of patient satisfaction in orthopaedic care

2019 ◽  
Vol 5 (5) ◽  
pp. 888 ◽  
Author(s):  
Ravi Kant Jain ◽  
Adhir Jain ◽  
Neeraj Jain
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
Cost Effective ◽  
P Value ◽  
Care Providers ◽  
Chi Square ◽  
Orthopaedic Care ◽  
Satisfaction Rates

<p class="abstract"><strong>Background:</strong> Worldwide, increasing concern has been given to the assessment of patient satisfaction survey as a method of monitor of the quality of health care provision in the health institutions. The study aimed to assess the level of patient satisfaction with preoperative and postoperative surgical services and its associated factors. Study includes Experience of 17 questionnaires.</p><p class="abstract"><strong>Methods:</strong> A total of 507 indoor patients were taken on a random basis full filing the inclusion and exclusion criteria, over a period of 1 year from December 2017 to January 2018. Firstly, we applied Cronbach's alpha to know the reliability of survey questionnaire, then we collected the final data. Association between two non-parametric variables was seen using Pearson’s chi-square test. A p value of less than 0.05 was taken as statistically significant. Data was analysed using SPSS 21.0.<strong></strong></p><p class="abstract"><strong>Results:</strong> Patients with good satisfaction rates were 60.2%. We found that males are more satisfied then females with Pearson Chi-square value=8.033, df=1, p value=0.005. Patients with age of above 80 years and between age group of 21-40 years have comparatively lower satisfaction rates with Pearson Chi-square value=33.265, df=4, P value=0.000.</p><p class="abstract"><strong>Conclusions:</strong> Assessing patients’ satisfaction rates can be a simple and cost effective technique for evaluating the services provided by health care providers and institutions and should be conducted periodically to detect carelessness and bring about overall improvement in the quality of care provided. This should be generalised and universally accepted.</p><p class="Default"> </p>

Client characteristics and satisfaction with the quality of primary health-care services in Calabar, Nigeria

2020 ◽  
Vol 3 ◽  
pp. 1-8
Author(s):  
H. C. Okeke ◽  
P. Bassey ◽  
O. A. Oduwole ◽  
A. Adindu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Client Satisfaction ◽  
Demographic Characteristics ◽  
Care Providers ◽  
Client Characteristics ◽  
Study Objective ◽  
Primary Health

Different mix of clients visit primary health care (PHC) facilities, and the quality of services is critical even in rural communities. The study objective was to determine the relationship between socio-demographic characteristics and client satisfaction with the quality of PHC services in Calabar Municipality, Cross River State, Nigeria. Specifically to describe aspects of the health facilities that affect client satisfaction; determine the health-care providers’ attitude that influences client satisfaction; and determine the socio-demographic characteristics that influence client satisfaction with PHC services. A cross-sectional survey was adopted. Ten PHCs and 500 clients utilizing services in PHC centers in Calabar Municipality were randomly selected. Clients overall satisfaction with PHC services was high (80.8%). Divorced clients were less (75.0%) satisfied than the singles and the married counterparts (81%), respectively. Clients that were more literate as well as those with higher income were less satisfied, 68.0% and 50.0%, respectively, compared to the less educated and lower-income clients, 92.0% and 85.0% respectively. These differences in satisfaction were statistically significant (P = 0.001). Hence, it was shown that client characteristics such as income and literacy level show a significant negative relationship with the clients satisfaction with the quality of PHC services in Calabar Municipality.

Medical Informatics and the Quality of Health: New Approaches to Support Patient Care

2003 ◽  
Vol 42 (02) ◽  
pp. 185-189 ◽  
Author(s):  
R. Haux ◽  
C. Kulikowski ◽  
A. Bohne ◽  
R. Brandner ◽  
B. Brigl ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Health Care Providers ◽  
Medical Knowledge ◽  
Lessons Learned ◽  
Care Providers ◽  
Access To Health Services ◽  
Leading Role ◽  
Future Challenges

Summary Objectives: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of excellent papers on medical informatics research which have been recently published (www.yearbook.uni-hd.de). The 2003 Yearbook of Medical Informatics took as its theme the role of medical informatics for the quality of health care. In this paper, we will discuss challenges for health care, and the lessons learned from editing IMIA Yearbook 2003. Results and Conclusions: Modern information processing methodology and information and communication technology have strongly influenced our societies and health care. As a consequence of this, medical informatics as a discipline has taken a leading role in the further development of health care. This involves developing information systems that enhance opportunities for global access to health services and medical knowledge. Informatics methodology and technology will facilitate high quality of care in aging societies, and will decrease the possibilities of health care errors. It will also enable the dissemination of the latest medical and health information on the web to consumers and health care providers alike. The selected papers of the IMIA Yearbook 2003 present clear examples and future challenges, and they highlight how various sub-disciplines of medical informatics can contribute to this.

scholarly journals Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

2021 ◽  
Author(s):  
Eva Visser ◽  
Brenda Leontine Den Oudsten ◽  
Taco Gosens ◽  
Paul Lodder ◽  
Jolanda De Vries
Keyword(s):  
Quality Of Life ◽  
Latent Class Analysis ◽  
Health Care Providers ◽  
Psychological Health ◽  
Latent Class ◽  
Stress Disorder ◽  
Class Analysis ◽  
Care Providers ◽  
Physical Trauma

Abstract Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.

scholarly journals Providers’ View on the First Kidney Transplantation Center in Ethiopia: Experience From Past to Present

2021 ◽  
Vol 8 ◽  
pp. 233339282110183
Author(s):  
Tariku Shimels ◽  
Abrham Getachew ◽  
Mekdim Tadesse ◽  
Alison Thompson
Keyword(s):  
Kidney Transplantation ◽  
Renal Transplant ◽  
Health Care Providers ◽  
Study Data ◽  
Care Providers ◽  
Transplant Center ◽  
Transplantation Center ◽  
Stage Renal Disease ◽  
End Stage

Introduction: Transplantation is the optimal management for patients with end-stage renal disease. In Ethiopia, the first national kidney transplantation center was opened at St. Paul’s Hospital Millennium Medical College in September 2015. The aim of this study was to explore providers’ views and experiences of the past to present at this center. Methods: A qualitative study design was employed from 1st November to 15th December, 2019. To ensure that appropriate informants would provide rich study data, 8 health care providers and top management members were purposefully chosen for in-depth interviews. A maximum variation sampling method was considered to include a representative sample of informants. Interviews were digitally audio-recorded, and transcribed verbatim. Transcribed data was coded and analyzed using Qualitative Data Analysis (QDA) Minor Lite software and Microsoft-Excel. Result: The participants (5 males and 3 females) approached were from different departments of the renal transplant center, and the main hospital. Eight main themes and 18 sub-themes were generated initially from all interviews totaling to 109 index codes. Further evaluation and recoding retained 5 main themes, and 14 sub-themes. The main themes are; challenges experienced during and after launching the center, commitment, sympathy and satisfaction, outcomes of renal transplant, actions to improve the quality of service, and how the transplant center should operate. Providers claim that they discharge their responsibilities through proper commitment and compassion, paying no attention to incentive packages. They also explained that renal transplantation would have all the outcomes related to economic, humanistic and clinical facets. Conclusion and Recommendation: A multitude of challenges were faced during and after the establishment of the first renal transplant center in Ethiopia. Providers discharge their responsibility through a proper compassion for patients. Concerned stakeholders should actively collaborate to improve the quality of renal transplant services in the center.

scholarly journals What methods and challenges for taking account of context when transferring complex interventions?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Villadsen ◽  
S Dias
Keyword(s):  
Public Health ◽  
Health Care ◽  
Reproductive Health ◽  
Health Care Providers ◽  
Complex Interventions ◽  
Health Interventions ◽  
Care Providers ◽  
Public Health Interventions ◽  
Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

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