UCSF researchers have identified the most useful dimensions for measuring and reporting nursing home quality. They report that an annual survey used to evaluate quality in U.S. nursing homes should be simplified to focus on the most critical dimensions of care.
Using data from annual surveys for all nursing facilities in the U.S., the researchers found that 40 survey items (or 20 percent) of 185 items now used for evaluation account for 58 % of all deficiencies actually issued by state inspectors to U.S. nursing facilities.
The 40 items can be grouped into eight major dimensions of quality, according to Joseph Mullan, PhD, assistant professor of social and behavioral sciences in the UCSF School of Nursing and lead author on the paper, which appears in the September issue of Research On Aging.
“These eight categories are the most important for reporting information to consumers about the quality of nursing home care,” said Mullan. He explained that the smaller checklist will ease the work load of inspectors as well.
The eight categories include:
* Quality of care - maintaining good nutrition and hydration; preventing or treating pressure ulcers, incontinence, and weight loss; and maintaining independence
* Preventing abuse and the use of physical restraints
* Assessing health needs accurately and providing appropriate care
* Protecting resident’s rights
* Providing a safe, clean and hazard-free environment
* Meeting resident nutritional needs
* Proper administration of drugs
* A staff that meets minimum state and federal standards
The streamlined dimensions are currently being used to evaluate nursing homes on the official U.S. government site for Medicare information: http://www.medicare.gov/nhcompare/home.asp
Charlene Harrington, PhD, professor of social and behavioral sciences in the UCSF School of Nursing and co-investigator on the report, added that the information from this study also will be used to develop a new consumer information website for California, funded by the California HealthCare Foundation. The foundation’s mission is to expand access to affordable, quality health care for underserved individuals and communities and to promote fundamental improvements in the health status of the people of California.
The study was funded by the Agency for Healthcare Research and Quality (AHRQ). Agency research provides evidence-based information to improve the quality of health care services and to help people make more informed decisions. AHRQ was formerly known as the Agency for Health Care Policy and Research.