Quality Improvement Implementation in the Nursing Home

• Published in: Health services research 2003-02, Vol.38 (1p1), p.65-83
• Main Authors: Berlowitz, Dan R., Young, Gary J., Hickey, Elaine C., Saliba, Debra, Mittman, Brian S., Czarnowski, Elaine, Simon, Barbara, Anderson, Jennifer J., Ash, Arlene S., Rubenstein, Lisa V., Moskowitz, MarkA
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Corporate culture; Cross-Sectional Studies; decubitus ulcers; Female; Homes for the Aged - standards; Humans; Job satisfaction; Linear Models; Male; Middle Aged; Multivariate Analysis; Nursing homes; Nursing Homes - standards; Organizational Culture; Organizational Innovation; Outcome Assessment (Health Care); Pressure Ulcer - epidemiology; Pressure Ulcer - therapy; Pressure ulcers; Quality and Outcomes of Care; Quality Assurance, Health Care - methods; Quality Assurance, Health Care - organization & administration; Quality improvement; Quality management; quality of care; Quality of service; Studies; Total Quality Management - methods; Total Quality Management - organization & administration; United States; United States Department of Veterans Affairs; Veterans - statistics & numerical data; Virginia - epidemiology
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.00105

Objective. To examine quality improvement (QI) implementation in nursing homes, its association with organizational culture, and its effects on pressure ulcer care. Data Sources/Study Settings. Primary data were collected from staff at 35 nursing homes maintained by the Department of Veterans Affairs (VA) on measures related to QI implementation and organizational culture. These data were combined with information obtained from ions of medical records and analyses of an existing database. Study Design. A cross‐sectional analysis of the association among the different measures was performed. Data Collection/Extraction Methods. Completed surveys containing information on QI implementation, organizational culture, employee satisfaction, and perceived adoption of guidelines were obtained from 1,065 nursing home staff. Adherence to best practices related to pressure ulcer prevention was ed from medical records. Risk‐adjusted rates of pressure ulcer development were calculated from an administrative database. Principal Findings. Nursing homes differed significantly (p