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- Title
Culture Change and Nursing Home Quality of Care.
- Authors
Grabowski, David C.; O’Malley, A. James; Afendulis, Christopher C.; Caudry, Daryl J.; Elliot, Amy; Zimmerman, Sheryl
- Abstract
Purpose of the Study: Culture change models are intended to improve the quality of life for nursing home residents, but the impact of these models on quality of care is unknown. We evaluated the impact of the implementation of nursing home culture change on the quality of care, as measured by staffing, health-related survey deficiencies, and Minimum Data Set (MDS) quality indicators. Design and Methods: From the Pioneer Network, we have data on whether facilities were identified by experts as “culture change” providers in 2004 and 2009. Using administrative data, we employed a panel-based regression approach in which we compared pre–post quality outcomes in facilities adopting culture change between 2004 and 2009 against pre–post quality outcomes for a propensity score-matched comparison group of nonadopters. Results: Nursing homes that were identified as culture change adopters exhibited a 14.6% decrease in health-related survey deficiency citations relative to comparable nonadopting homes, while experiencing no significant change in nurse staffing or various MDS quality indicators. Implications: This research represents the first large-scale longitudinal evaluation of the association of culture change and nursing home quality of care. Based on the survey deficiency results, nursing homes that were identified as culture change adopters were associated with better care although the surveyors were not blind to the nursing home’s culture change efforts. This finding suggests culture change may have the potential to improve MDS-based quality outcomes, but this has not yet been observed.
- Subjects
CLINICAL medicine; CORPORATE culture; DATABASE management; MEDICAL quality control; NURSING care facilities; ORGANIZATIONAL change; RESEARCH funding; KEY performance indicators (Management); DATA analysis software
- Publication
Gerontologist, 2014, Vol 54, Issue Suppl_1, pS35
- ISSN
0016-9013
- Publication type
Article
- DOI
10.1093/geront/gnt143