Nursing Home Quality

Article PDF:

EOL Care 2003.pdf

Abstract:

Introduction: Permanent placement in a Long-Term-Care (LTC) facility following hospitalization or when staying at home is no longer a viable option is the reality for a growing number of Americans. When death is imminent, the specialized knowledge and skill of the hospice team is required and accepted as an important component of end-of-life (EOL) care. The provision of appropriate care at the EOL is contingent on accurate identification of those residents who are approaching the final stage of life. This study describes the prevalence, profile, and survivorship of residents admitted to LTC facilities, using the Minimum Data Set (MDS) designation of being at the EOL.

Article PDF:

Statewide Strat 2003.pdf

Abstract:

Purpose: We describe the development of a statewide strategy to improve resident outcomes in nursing facilities, and we present some evaluative data from this strategy.

Design and Methods: Key components of the strategy include (a) a partnership between the state agency responsible for the nursing home survey and certification and the school of nursing in an academic health sciences center; and (b) on-site clinical
expert technical assistance and support to facilities throughout the state.

Results: The partnership has resulted in state agency staff having information from analysis about resident needs and outcomes in the state and facilities having access to the quarterly electronic "Show-Me Quality Indicator Report." On-site clinical expert technical assistance is now used widely across the state, with 569 site visits conducted in 286 different facilities to help them interpret their quality indicator (QI) reports and implement quality improvement programs; statewide improvements in QI scores have been measured in several key QIs.

Implications: Other states should consider building partnerships with schools
of nursing in an academic health sciences center. Programs using on-site clinical consultation can facilitate improving quality of care in nursing facilities.