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 Impact Of Asset Age/Fiscal Viability On Selected Measures Of Quality In Hospitals

2011 ◽  
Vol 3 (11) ◽  
Author(s):  
Jim Morey ◽  
Gary Scherzer ◽  
Hoseoup Lee
Keyword(s):  
New York ◽  
Quality Of Care ◽  
Statistical Models ◽  
Quality Index ◽  
Institutional Care ◽  
Font Size ◽  
Financial Variables ◽  
Donabedian Model ◽  
Index Effect

<p class="MsoNormal" style="text-align: justify; margin: 0in 34.2pt 0pt 0.5in;"><span style="font-size: 10pt;"><span style="font-family: Times New Roman;">Seventy-three New York hospitals were examined to determine if a relationship between age of assets, fiscal viability and quality of care existed.<span style="mso-spacerun: yes;">&nbsp; </span>These factors were examined for 2002 for each of the hospitals selected.<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 outcomes and procedural measures that may be used to measure specific aspects of institutional care.<span style="mso-spacerun: yes;">&nbsp; </span>The premise that age of assets and fiscal viability will influence quality is gleaned from the Donabedian Model in which he proposed three domains important to the quality of health care.<span style="mso-spacerun: yes;">&nbsp; </span>Utilizing both the financial and quality of care indices, the following statistical models were prepared: Effect of asset age on fiscal viability index, Effect of asset age on individual fiscal viability measures, and Effect of asset age and fiscal viability index on quality index<span style="mso-spacerun: yes;">&nbsp; </span></span></span></p>

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 Hospital nurse staffing and staff–patient interactions: an observational study

2019 ◽  
Vol 28 (9) ◽  
pp. 706-713 ◽  
Author(s):  
Jackie Bridges ◽  
Peter Griffiths ◽  
Emily Oliver ◽  
Ruth M Pickering
Keyword(s):  
Nurse Staffing ◽  
Care Quality ◽  
Multilevel Regression ◽  
Negative Interaction ◽  
Skill Mix ◽  
Staffing Levels ◽  
Patient Interactions ◽  
Number Of Patients ◽  
The Relationship

BackgroundExisting evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nurse staffing and staff–patient interactions.SettingSix wards at two English National Health Service hospitals.MethodsWe observed 238 hours of care (n=270 patients). Staff–patient interactions were rated using the Quality of Interactions Schedule. RN, healthcare assistant (HCA) and patient numbers were used to calculate patient-to-staff ratios. Multilevel regression models explored the association between staffing levels, skill mix and the chance of an interaction being rated as ‘negative’ quality, rate at which patients experienced interactions and total amount of time patients spent interacting with staff per observed hour.Results10% of the 3076 observed interactions were rated as negative. The odds of a negative interaction increased significantly as the number of patients per RN increased (p=0.035, OR of 2.82 for ≥8 patients/RN compared with >6 to <8 patients/RN). A similar pattern was observed for HCA staffing but the relationship was not significant (p=0.056). When RN staffing was low, the odds of a negative interaction increased with higher HCA staffing. Rate of interactions per patient hour, but not total amount of interaction time, was related to RN and HCA staffing levels.ConclusionLow RN staffing levels are associated with changes in quality and quantity of staff–patient interactions. When RN staffing is low, increases in assistant staff levels are not associated with improved quality of staff–patient interactions. Beneficial effects from adding assistant staff are likely to be dependent on having sufficient RNs to supervise, limiting the scope for substitution.

Does Investor-Ownership of Nursing Homes Compromise the Quality of Care?

2002 ◽  
Vol 32 (2) ◽  
pp. 315-325 ◽  
Author(s):  
Charlene Harrington ◽  
Steffie Woolhandler ◽  
Joseph Mullan ◽  
Helen Carrillo ◽  
David U. Himmelstein
Keyword(s):  
Quality Of Care ◽  
Nursing Homes ◽  
Skilled Nursing Facility ◽  
Nurse Staffing ◽  
Care Quality ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Staffing Ratios ◽  
The Impact

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.

Dietary Service Staffing Impact Nutritional Quality in Nursing Homes

2017 ◽  
Vol 38 (5) ◽  
pp. 639-655 ◽  
Author(s):  
Kelly M. Smith ◽  
Kali S. Thomas ◽  
Shanthi Johnson ◽  
Hongdao Meng ◽  
Kathryn Hyer
Keyword(s):  
Nursing Homes ◽  
Online Survey ◽  
Certified Nursing Assistants ◽  
Staffing Levels ◽  
Nutrition Services ◽  
Service Staff ◽  
Food And Nutrition ◽  
The Impact ◽  
The Relationship

Objective: To examine the relationship between dietary service staff and dietary deficiency citations in nursing homes (NHs). Method: 2007-2011 Online Survey and Certification and Reporting data for 14,881 freestanding NHs were used to examine the relationship between dietary service staff and the probability of receiving a dietary service–related deficiency citation. An unconditional logit model with random effects was employed. Results: Findings suggest that higher staffing levels for dietitians (odds ratio [OR] = .955; p < .01), dietary service personnel (OR = .996; p < .01), and certified nursing assistants (CNAs; OR = .981; p < .05) decrease the likelihood of receiving a dietary service deficiency citation. Conclusion: Higher levels of dietary service and CNA staffing levels have the potential to improve the quality of nutritional care in NHs. Findings help substantiate the Centers for Medicare and Medicaid Services’ proposed rules for more stringent Food and Nutrition Services in the NH setting and signify the need for further research relative to the impact of dietary service staff on nutritional and clinical outcomes.

scholarly journals Nurse staffing and patient-perceived quality of nursing care: a cross-sectional analysis of survey and administrative data in German hospitals

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051133
Author(s):  
Vera Winter ◽  
Karina Dietermann ◽  
Udo Schneider ◽  
Jonas Schreyögg
Keyword(s):  
Nursing Care ◽  
Nurse Staffing ◽  
Perceived Quality ◽  
Secondary Outcome ◽  
Skill Mix ◽  
Staffing Levels ◽  
Hospital Units ◽  
The Impact ◽  
Quality Of Nursing

ObjectiveTo examine the impact of nurse staffing on patient-perceived quality of nursing care. We differentiate nurse staffing levels and nursing skill mix as two facets of nurse staffing and use a multidimensional instrument for patient-perceived quality of nursing care. We investigate non-linear and interaction effects.SettingThe study setting was 3458 hospital units in 1017 hospitals in Germany.ParticipantsWe contacted 212 554 patients discharged from non-paediatric, non-intensive and non-psychiatric hospital units who stayed at least two nights in the hospital between January and October 2019. Of those, 30 174 responded, yielding a response rate of 14.2%. Our sample included only those patients. After excluding extreme values for our nurse staffing variables and removing observations with missing values, our final sample comprised 28 136 patients ranging from 18 to 97 years of age (average: 61.12 years) who had been discharged from 3458 distinct hospital units in 1017 hospitals.Primary and secondary outcome measuresPatient-perceived quality of nursing care (general nursing care, guidance provided by nurses, and patient loyalty to the hospital).ResultsFor all three dimensions of patient-perceived quality of nursing care, we found that they significantly decreased as (1) nurse staffing levels decreased (with decreasing marginal effects) and (2) the proportion of assistant nurses in a hospital unit increased. The association between nurse staffing levels and quality of nursing care was more pronounced among patients who were less clinically complex, were admitted to smaller hospitals or were admitted to medical units.ConclusionsOur results indicate that, in addition to nurse staffing levels, nursing skill mix is crucial for providing the best possible quality of nursing care from the patient perspective and both should be considered when designing policies such as minimum staffing regulations to improve the quality of nursing care in hospitals.

scholarly journals Case Study: A Comparative Analysis Of Financial And Quality Indicators Of Nursing Homes That Have Closed And Nursing Homes That Have Remained Open

2011 ◽  
Vol 4 (11) ◽  
pp. 27
Author(s):  
Jim Morey ◽  
Ken Wallis ◽  
Hoseoup Lee ◽  
Gary Scherzer ◽  
Robert Orilio
Keyword(s):  
New York ◽  
Comparative Analysis ◽  
Nursing Homes ◽  
Quality Index ◽  
Institutional Care ◽  
Financial Variables ◽  
Significant Difference ◽  
Care Index

Eight New York nursing homes, 4 open and 4 closed, were chosen at random for analysis. They were examined to determine if a relationship between age of assets, fiscal viability and quality of care existed. Three years of data for each nursing home was selected Several financial variables were used to construct a fiscal viability index; and a patient care index was created from selected measures that are used to measure specific aspects of institutional care. The premise was that the constructed indices will demonstrate a significant difference between closed nursing homes and homes remaining open. The analysis found that fiscal viability index could be a significant factor to differentiate the two groups of nursing homes, but the quality index showed no significant difference between the two groups.

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