Quality measurement in long term care (LTC) presents many challenges: the lack of a uniform definition of quality, the existence of multiple domains for measurement, a multitude of potential perspectives, and regulatory influences that emphasize measurement only of poor quality. Research efforts have yet to solve the issues of measurement, however, operators of nursing homes must use the current state of the art in quality measurement as the basis for their quality improvement efforts. This project was commissioned by management of a large integrated delivery system with a robust network of LTC facilities who wished to implement a continuous quality improvement (CQI) process based on a measurement tool that provides a comprehensive resident-centered assessment of quality. The objectives of this project, therefore, were to identify domains of quality, select and adapt validated instruments for measurement within each domain, to pilot test a data collection process, and to develop an operational quality profiling report format for nursing home facilities. Using an expert panel and the LTC research literature, an operational measurement tool was developed consisting of four domains of quality: organizational, clinical, environmental and social. A pilot study in two nursing facilities demonstrated that the data collection process could be operationalized within tight resource and budgetary constraints. The development of an operational quality assessment tool enables management to take a consistent view of diverse institutions, focusing in detail on quality of care as it is perceived by residents. It allows evaluation of trends over time and comparison to external norms.
Learning Objectives: N/A
Keywords: Nursing Homes, Quality Improvement
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Name of institution and pilot sites would be masked
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.