Culture change and nursing home quality of care. Grabowski, D., C., O'Malley, A., J., Afendulis, C., C., Caudry, D., J., Elliot, A., & Zimmerman, S. The Gerontologist, 54 Suppl 1:S35-S45, Oxford University Press, 2014.
Culture change and nursing home quality of care [link]Website  abstract   bibtex   
Unlabelled: 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.;
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 title = {Culture change and nursing home quality of care},
 type = {article},
 year = {2014},
 identifiers = {[object Object]},
 keywords = {Nursing homes,Person-centered care,Quality of care},
 pages = {S35-S45},
 volume = {54 Suppl 1},
 websites = {http://login.ezproxy.library.ualberta.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=24443604&site=ehost-live&scope=site},
 publisher = {Oxford University Press},
 city = {Address correspondence to David C. Grabowski, Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue, Boston, MA 02115-5899. E-mail: grabowski@med.harvard.edu.},
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 notes = {ID: 24443604; Accession Number: 24443604. Language: English. Date Created: 20140120. Update Code: 20140122. Publication Type: Journal Article. Journal ID: 0375327. Publication Model: Print. Cited Medium: Internet. NLM ISO Abbr: Gerontologist. Linking ISSN: 00169013. Subset: In-Data-Review; IM; Date of Electronic Publication: 20140201. Current Imprints: Publication: 2009- : Cary, NC : Oxford University Press; Original Imprints: Publication: St. Louis, Gerontological Society.},
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 abstract = {Unlabelled: 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.;},
 bibtype = {article},
 author = {Grabowski, David C and O'Malley, A James and Afendulis, Christopher C and Caudry, Daryl J and Elliot, Amy and Zimmerman, Sheryl},
 journal = {The Gerontologist}
}

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