Improving the Quality of Care in Nursing Homes: An Evidence-Based Approach

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JHU Press, Aug 24, 2010 - Law - 137 pages
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The landmark Nursing Home Care Reform Act of 1987 mandated basic standards of care to ensure the physical, mental, and psychosocial well-being of residents. Yet little has changed since it was enacted. High-quality facilities continue to provide good care, while poorly operated ones remain substandard. This volume offers an evidence-based framework for improving care in nursing homes.

Taking a broad perspective, the authors review the history, development, and current state of care in nursing homes. After defining the concept of "quality" in the home, they assess an array of qualitative and quantitative statistical data to identify inconsistencies found among U.S. facilities. Individual chapters focus on varied aspects of care and the ways in which it is measured, including a thorough review of such key mechanisms as the Online Survey, Certification, and Reporting (OSCAR) data network and the Structure-Process-Outcome (SPO) model.

The book also examines specific factors related to measuring and improving care, including government encouragements and sanctions, staffing policies, and the integration of technology into practice. Throughout, the authors give recommendations grounded in sound methodology and real-world experience.

This service-oriented guide supplies vital tools, informed tips, and provocative ideas for professionals, students, and policy makers involved in gerontology and geriatrics.

 

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Contents

Nursing Homes in the United States
1
Chapter 1 The Quality of Care in Nursing Homes
6
Chapter 2 Measuring the Quality of Care
17
Chapter 3 Factors Contributing to the Variability in the Quality of Care
33
Chapter 4 Persistent Citations for the Deficiency of Pressure Ulcers
46
Chapter 5 Factors Influencing Residents Outcomes
59
Chapter 6 Policies regarding Minimum Staffing Levels
76
Chapter 7 The Relationship between Efficiency and the Quality of Care
81
Chapter 8 Improving Performance and the Quality of Life through Health Informatics
90
Synthesis Prospects and Future Directions
105
Helpful Websites for Clinical Knowledge Management and the Quality of Care
115
References
119
Index
133
Copyright

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About the author (2010)

Thomas T. H. Wan, Ph.D., M.H.S., is a professor of public affairs, health management and informatics, and medicine at the University of Central Florida. He has written extensively about health care and health management and is the author of Monitoring Health Care Quality and Evidence-Based Health Care Management. Gerald-Mark Breen, Ph.D., was an instructor and research associate in the Doctoral Program in Public Affairs at the University of Central Florida before his death in 2010. Ning Jackie Zhang, M.D., Ph.D., M.P.H., is an associate professor in the College of Health and Public Affairs at the University of Central Florida. Lynn Unruh, Ph.D., R.N., is an associate professor in the Department of Health Management and Informatics at the University of Central Florida.

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