Will Quality Measures Debunk Quality Care in the Nursing Home Industry?

2021 ◽  
Vol 5 (1) ◽  
pp. 18-28
Author(s):  
Elaine R. Winston ◽  
Alexander Pelaez ◽  
B. Dawn Medlin
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Performance Metrics ◽  
Quality Care ◽  
Surprising Result ◽  
Business Analytics ◽  
Healthcare Organizations ◽  
Healthcare Data ◽  
The Government ◽  
Nursing Home Industry

This research analyzes publicly available information on the quality of services delivered by healthcare organizations. The accessibility and transparency of healthcare data is exponentially growing. Due to the complexity of different provider groups in healthcare, the focus is on the nursing home industry. A key objective of this research is to explore any association among the government-defined quality ratings, cost-effectiveness, and quality care provided by a nursing home. Quality and performance metrics for all nursing homes that receive reimbursements from CMS is in the public domain. The CMS purports that nursing homes with high overall star ratings provide excellent healthcare to their residents. A surprising result from this study found high-quality-rated nursing homes with more nurse hours per resident provided lower quality care than nursing homes, which had lower nursing hours per resident. The research also suggests that healthcare organizations, such as nursing homes, acquire business analytics (BA) capabilities for specific government metrics.

Ethics and quality care in nursing homes: Relatives’ experiences

2017 ◽  
Vol 26 (3) ◽  
pp. 767-777 ◽  
Author(s):  
Rita Jakobsen ◽  
Gerd Sylvi Sellevold ◽  
Veslemøy Egede-Nissen ◽  
Venke Sørlie
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Staff ◽  
Quality Care ◽  
Science Data ◽  
Data Services ◽  
Nursing Home Patients ◽  
Positive Experiences ◽  
Close Relatives

Background: A total of 71,000 people in Norway suffer from some form of dementia in 2013, of whom approximately 30,000 are in nursing homes. Several studies focus on the experiences of those who have close relatives and who are staying in a nursing home. Results show that a greater focus on cooperation between nursing staff and relatives is a central prerequisite for an increased level of care. Benefits of developing systematic collaboration practices include relief for nursing staff, less stress, and greater mutual understanding. Going through studies focusing on the experiences of nursing home patients’ relatives, negative experiences are in the majority. In this study, relatives are invited to share positive experiences regarding the care of their loved ones; a slightly different perspective, in other words. Aim: The aim of the study is to investigate relatives of persons with dementia’s experiences with quality care in nursing homes. Method: The study is a part of a larger project called Hospice values in the care for persons with dementia and is based on a qualitative design where data are generated through narrative interviews. The chosen method of analysis is the phenomenological–hermeneutical method for the study of lived experiences. Participants and research context: Participants in the project were eight relatives of persons with dementia who were living in nursing homes, long-term residences. The sampling was targeted, enrolment happened through collective invitation. All relatives interested were included. Ethical considerations: The Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services approve the study. Findings: Findings show that relatives have certain expectations as to how their loved ones ought to be met and looked after at the nursing home. The results show that in those cases where the expectations were met, the relatives’ experiences were associated with engagement, inclusion and a good atmosphere. When the expectations were not met, the relatives experienced powerlessness, distrust and guilt. Discussion: The results are discussed considering the concepts of trust, power and asymmetry. Conclusion: When asked about experiences with quality care, the relatives spoke both of expectations met and of expectations not met. Results in this study are important knowledge for developing units where performing quality care is the overall aim.

Advance directives and physicians’ orders in nursing home residents with dementia in Flanders, Belgium: prevalence and associated outcomes

2012 ◽  
Vol 24 (7) ◽  
pp. 1133-1143 ◽  
Author(s):  
An Vandervoort ◽  
Lieve van den Block ◽  
Jenny T. van der Steen ◽  
Robert Vander Stichele ◽  
Johan Bilsen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Care Planning ◽  
Legal Representative ◽  
Cross Sectional ◽  
Diagnosis Of Dementia

ABSTRACTBackground: Advance care planning (ACP) is an important element of high-quality care in nursing homes, especially for residents having dementia who are often incompetent in decision-making toward the end of life. The aim of this study was describe the prevalence of documented ACP among nursing home residents with dementia in Flanders, Belgium, and associated clinical characteristics and outcomes.Methods: All 594 nursing homes in Flanders were asked to participate in a retrospective cross-sectional postmortem survey in 2006. Participating homes identified all residents who had died over the last two months. A structured questionnaire was mailed to the nurses closely involved in the deceased resident's care regarding the diagnosis of dementia and documented care planning, i.e. advance patient directives, authorization of a legal representative, and general practitioners’ treatment orders (GP orders).Results: In 345 nursing homes (58% response rate), nurses identified 764 deceased residents with dementia of whom 62% had some type of documented care plan, i.e. advance patient directives in 3%, a legal representative in 8%, and GP orders in 59%. Multivariate logistic regression showed that the presence of GP orders was positively associated with receiving specialist palliative care in the nursing home (OR 3.10; CI, 2.07–4.65). Chances of dying in a hospital were lower if there was a GP order (OR 0.38; CI, 0.21–0.70).Conclusions: Whereas GP orders are relatively common among residents with dementia, advance patient directives and a legal representative are relatively uncommon. Nursing home residents receiving palliative care are more likely to have a GP order. GP orders may affect place of death.

scholarly journals Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

2021 ◽  
pp. 1-9
Author(s):  
Peiyan Ho ◽  
Rachel Chin Yee Cheong ◽  
Siew Pei Ong ◽  
Carol Fusek ◽  
Shiou Liang Wee ◽  
...  
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Nursing Homes ◽  
Quality Care ◽  
Well Being ◽  
Care Quality ◽  
Care Recipient ◽  
Staff Retention ◽  
Term Care

<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.

Expectations and Needs of Families in Nursing Homes: An Integrative Review

2020 ◽  
pp. 107755872090718
Author(s):  
Charlotte Havreng-Théry ◽  
Julie Giner-Perot ◽  
Philippe Zawieja ◽  
François Bertin-Hugault ◽  
Joël Belmin ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Quality Care ◽  
Nursing Home Residents ◽  
Integrative Review ◽  
Mutual Trust ◽  
Review Of The Literature ◽  
Strength Based ◽  
New Type ◽  
Relationship Of

A better understanding of the expectations and needs of the families of nursing home residents is needed for a constructive and sustainable relationship of mutual trust. The objective of this study was to understand the expectations of families of nursing home residents described in the literature. A systematic integrative review of the literature was conducted. After a rigorous selection made by two researchers, independently, 53 articles were selected out of 1,094 results. The expectations of families are quality care, consideration complying with human dignity of the resident, collaboration, honesty, and mutual confidence that ties together families, staff, and physicians. This study reveals that families consider themselves as a strength for a resident’s support services, in line with Gottlieb’s strength-based approach. This approach offers promising implications for practice and for a new type of management in nursing homes based on strong values.

scholarly journals KEBERHARGAAN DIRI DAN RESILIENSI SEBAGAI PREDIKTOR SUCCESSFUL AGING PADA LANSIA DI PANTI WREDA

2019 ◽  
pp. 102-116
Author(s):  
Dewi Agrianti Ralampi ◽  
Christiana Hari Soetjiningsih
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Successful Aging ◽  
The Elderly ◽  
Self Esteem ◽  
The Self ◽  
Central Java ◽  
Resilience Scale ◽  
The Government ◽  
Bahasa Indonesia

Abstract – This study aimed to determine self-esteem and resilience as the predictors of successful aging among the elderly in nursing homes. This study used quantitative approach, participated by 127 elderly participants who live in nursing homes located in five cities in Central Java (Salatiga, Semarang, Surakarta, Magelang, and Pekalongan) (Mage = 74.57; SD = 7.49). This study utilized The Connor-Davidson Resilience Scale (to measure the level of resilience) and Rosenberg Self-esteem Scale (to measure the self-esteem) which were translated into Indonesian language. Successful Aging Scale were based on the Rowe and Kahn’s theory (1987) of successful aging. The results indicated that there was a significant effect of self-esteem and resilience simultaneously (F = 10.975; p = .000) on successful aging, suggesting that self-esteem and resilience are predictors of successful aging. The results of this study could serve as a reference for the government and nursing home managements to improve successful aging of the elderly who live in nursing homes. Abstrak — Penelitian ini bertujuan untuk menentukan self-esteem (keberhargaan diri) dan resiliensi sebagai prediktor successful aging pada lansia di panti wreda. Penelitian ini menggunakan metode kuantitatif dengan jumlah partisipan sebanyak 127 lansia yang tinggal di panti wreda di lima kota di Jawa Tengah (Salatiga, Semarang, Surakarta, Magelang, dan Pekalongan) (Musia= 74.57; SD = 7.49). Penelitian ini menggunakan skala The Connor-Davidson Resillience Scale (untuk mengukur tingkat resiliensi) dan Rosenberg Self-esteem Scale (untuk mengukur keberhargaan diri) yang diterjemahkan ke dalam Bahasa Indonesia. Skala Successful Aging dibuat oleh penulis berdasarkan teori successful aging dari Rowe dan Kahn (1987). Hasil menunjukkan bahwa ada pengaruh signifikan dari keberhargaan diri dan resiliensi secara simultan (F = 10.975; p = .000) terhadap successful aging, mengindikasikan bahwa keberhargaan diri dan resiliensi merupakan prediktor successful aging. Hasil dari penelitian ini dapat menjadi salah satu acuan bagi pemerintah dan pengelola panti wreda untuk meningkatkan successful aging lansia yang tinggal di panti wreda. 

scholarly journals What Is The Impact Of Job Burnout On Nursing Home Administrators?

2018 ◽  
Vol 13 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Felicia L. Wilson
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Emotional Exhaustion ◽  
Response Rate ◽  
The State ◽  
Job Burnout ◽  
Nursing Home Administrators ◽  
Professional Efficacy ◽  
The Impact ◽  
Nursing Home Industry

The nursing home industry is facing a crisis that appears to only get worse as each year progresses. The issue at hand is attracting and retaining qualified nursing home administrators to run efficient nursing homes. There is an overwhelming amount of data that highlights the devastating effects of job burnout on professionals. Job burnout has been found to impact the longevity of professionals. The purpose of this research was to examine the impact of job burnout among Georgia’s nursing home administrators. Participants in the study were licensed nursing home administrators (N= 363) who are employed in the state of Georgia. I received 141 completed surveys for a response rate of 38%. This study found that nursing home administrators show moderate levels emotional exhaustion, low cynicism, and high professional efficacy.

scholarly journals Management challenges faced by administrators at dementia care nursing homes in China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 952-952
Author(s):  
Lin Jiang ◽  
Fei Sun ◽  
Robin Bonifas ◽  
David Hodge
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Coping Strategies ◽  
Religious Affiliation ◽  
Management Strategies ◽  
Dementia Care ◽  
Structured Interviews ◽  
Term Care ◽  
External Resources ◽  
The Government

Abstract Currently, more than 10 million Chinese older adults have been diagnosed with dementia, a number that is expected to increase as the population in China rapidly ages. Yet, little research exists on dementia care in Chinese long-term care facilities. Our research addresses this gap in the knowledge-base by examining the challenges nursing home directors encounter as well as the coping strategies they employ to deal with these challenges. Twenty-one facility directors employed by faith-based nursing homes across 14 provinces in China participated in this study. Semi-structured interviews were conducted in respondents’ native language via phone or in person. Most respondents reported a religious affiliation, and about half were female and had been facility directors for more than four years. Two researchers fluent in Mandarin and English coded interview transcripts; thematic analysis was conducted to identify patterns in the data. The results indicated four primary challenges, which pertained to recruiting and retaining nursing staff, funding, lacking support from the government, and conflicts with family members. The coping strategies included obtaining and using external resources such as volunteer visitors, operationalizing personal spiritual beliefs, and providing training to improve skills and empathy among employees. This study contributes to nursing home practice by expanding our knowledge of culturally relevant dementia management strategies in China. Suggestions to address management challenges from a policy and practical perspective include clear and sustainable financial support from the government, staff training, and staff-resident ratio regulations, seeking external resources, and integrating spiritual strategies into problem management and service quality improvement.

Assuring Quality in Nursing Homes: The Black Box of Administrative and Clinical Leadership --a Scoping Review

2020 ◽  
Author(s):  
Elena O Siegel ◽  
Heather M Young
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Scoping Review ◽  
Research Policy ◽  
Quality Care ◽  
Black Box ◽  
Future Research ◽  
Nursing Home Administrators ◽  
Policy Practice ◽  
Role Structure

Abstract Background and Objectives Licensed nursing home administrators (NHA) and directors of nursing (DON) are responsible for nursing home quality and assuring optimal performance and job satisfaction/retention of their nursing home workforce. NHA/DON-focused studies have generated important foundational knowledge over the last three decades; yet, targeted research is needed to understand and apply the complexities of the black box of this top management team. This scoping review identifies, reviews, synthesizes and maps the topical areas of research in NHA/DON positions in US nursing homes. Research Design and Methods We conducted searches of five databases, yielding 3,479 records; screening/review yielded 88 unique records analyzed using Donabedian’s structure-process-outcome model (Donabedian, 2003) as an organizing framework. Results Most papers (n=40) focused on role characteristics, 23 examined approaches to management and leadership, 24 focused on perceptions about the role, and the remaining 12 examined role structure. The role-related themes linked to outcomes (n=42), processes (n=27) and structures (n=30). Discussion and Implications We highlight important gaps for future research and offer a call to action for research, policy, practice, and education collaborations to accelerate the rate of research and translate the findings into best practices for NHA/DON to lead and manage the nursing home workforce and build capacity to ensure person-centered, high quality care. Based on foundational descriptive studies, it is time to use what is known to design and implement interventions that enhance the capacity of NHA/DON to improve the structures, processes and outcomes of nursing homes.

scholarly journals Involve Residents to Ensure Person-Centered Nursing Home Care During Crises Like the COVID-19 Outbreak

2021 ◽  
pp. 145-151
Author(s):  
Katrien Luijkx ◽  
Meriam Janssen ◽  
Annerieke Stoop ◽  
Leonieke van Boekel ◽  
Marjolein Verbiest
Keyword(s):  
Decision Making ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Social Needs ◽  
Nursing Home Care ◽  
Physical And Mental Health ◽  
Centered Care ◽  
The Government ◽  
Health Nursing

AbstractNursing homes aim to provide person-centered care and recognize residents as unique individuals with their own histories, life goals, and preferences. The life expectancy of nursing home residents is rather limited. Nursing homes have been hit hard by COVID-19 because of an increased risk of death and a total nursing home lockdown from March 19 until the end of May 2020. Although social relationships are a basic human need and the fulfillment of social needs is essential for both physical and mental health, nursing home residents were no longer allowed to meet their loved ones. This decision was taken without involving residents and their loved ones and without considering the psychosocial impact of such measures for residents and their loved ones. When visitors were again allowed in the nursing homes, this was valued highly. To enable decent decision-making, we call both the government and nursing homes to involve residents and their families in decision-making. It is essential to know how residents weigh the risk of a COVID-19 infection and the possible implication of them opposing social isolation. We have to adapt to a new common and need to stop talking about residents and their loved ones and start talking with them.

Survey of Cloud Computing in Healthcare Sector

2017 ◽  
Vol 7 (7) ◽  
pp. 337
Author(s):  
S. Karthiga Devi ◽  
B. Arputhamary
Keyword(s):  
Cloud Computing ◽  
Healthcare Providers ◽  
High Volume ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Cloud Infrastructure ◽  
Healthcare Organizations ◽  
Privacy And Security ◽  
Healthcare Data ◽  
Number Of Patients

Today the volume of healthcare data generated increased rapidly because of the number of patients in each hospital increasing.  These data are most important for decision making and delivering the best care for patients. Healthcare providers are now faced with collecting, managing, storing and securing huge amounts of sensitive protected health information. As a result, an increasing number of healthcare organizations are turning to cloud based services. Cloud computing offers a viable, secure alternative to premise based healthcare solutions. The infrastructure of Cloud is characterized by a high volume storage and a high throughput. The privacy and security are the two most important concerns in cloud-based healthcare services. Healthcare organization should have electronic medical records in order to use the cloud infrastructure. This paper surveys the challenges of cloud in healthcare and benefits of cloud techniques in health care industries.

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