Nursing home quality of personal care and facilities in the USA

Nursing home quality in the U.S.

Hilliard, J. (2005). "The Nursing Home Quality Initiative." Journal of Legal Medicine, Vol. 26, Issue 1.

Hilliard's analysis centers on the Nursing Home Quality Initiative (NHQI), identified as a "strategy designed to bring together regulation, and enforcement, enhanced consumer information, community-based quality improvement initiatives...and partnerships...to improve the overall quality of nursing home care." As one of the most prevalent health care services utilized by American consumers, the need for a better and quality nursing home care becomes an imperative issue. Looking at nursing home care as a service to American consumers, the NHQI as a government initiative is assessed as an effective measure through which specific standards of quality (identified as quality measures or QMs) are identified. The article provides a new perspective of how nursing home care should be -- that is, just like any other service that must be maintained and consistent in quality for its consumers, which is American society.

Anderson, R. et al. (2003). "Nursing home quality, chain affiliation, profit status and performance." Journal of Real Estate Research, Vol. 25, Issue 1.

In this interesting quantitative study on nursing home care, the authors created a model through which nursing home care quality can be best assessed and determined, depending on the nature of the organization or institution that provides this nursing home care. Important findings generated from the study include the significant relationship between efficiency and three important characteristics of nursing homes: (a) profit status of the firm, (b) size of the firm, and - the firm's ability to utilize its rooms. Among the important relationships established in this study is how for-profit nursing homes tend to have lower levels of care quality when compared against non-profit nursing homes. Consistent with this finding is the fact that as nursing home institutions become bigger in size (i.e., quantity of individuals that can be accommodated), the lower the level of care quality becomes. These findings are significant in studying nursing home cares in the U.S. because it provides the economic/financial dimension in analyzing the quality of health care provided among nursing homes. That is, identifying level of influence that changes in and the nature of the institution's finances can have on the quality of care provided for by the said institution.

Calhoun, J. et. al. (2006). "Current marketing practices in the nursing home sectors." Journal of Healthcare Management, Vol. 51, Issue 3.

Looking again at the health care sector as a consumer-centered sector, nursing home care is determined and assessed in terms of the marketing and communication strategies adopted by nursing homes at present. Findings generated from the survey (n=230 nursing homes) showed that while there was intensive communication strategies internally (i.e., communication within and among nursing homes), there has not been much effort shown in addressing nursing home care to the consumers or users of this health service. Moreover, markets targeted by these nursing homes, such as socio-economic classification, gender differences, and geographical differences, among others, are not defined specifically. Once again, this study reflects the gradual development of nursing home care as a consumer-centered service to American society, wherein quality of care becomes more central to health care professionals' and practitioners' determination of nursing home care improvement.

Sherman, F. (2006). "Don't let transitional care fall through the cracks." Geriatrics, Vol. 61, Issue 4.

This article by Sherman brought into fore the issue of inter-facility transfers among sick individuals living in nursing homes and availing of nursing home care. He recommended a change in policy-making when discussing the issue of nursing home care, suggesting the "SIT Act" or the Safe Inter-facility Transfer Act, which will enable health care practitioners to ensure a more comprehensive and well-coordinated communications and management of caring for individuals under nursing home care. The SIT Act is a piece on how nursing home care management can be developed effectively, using only the inter-facility transfer as one of its cases in point.

Zhang, N. (2006). "Minimum nurse staffing ratios for nursing homes." Nursing Economics, Vol. 24, Issue 2.

In this article, one aspect of quality nursing home care is analyzed: nurse staffing ratios in nursing homes. The study provides a critical look at how nursing homes tend to employ only just enough number of nurses, which results to understaffing because of the too many-to-one ratio between patients and nurses. As a result of understaffing, nursing homes suffer in the quality of health care provided to patients, resulting to inefficiency of care given per patient. This study is best looked at as another example of how finance- or budget-based decisions ultimately influence, for the greater part, the quality of nursing home care given to individuals.

Pressure growing for healthcare it adoption." (2006). Healthcare Financial Management, Vol. 60, Issue 1.

As a response to the ever-increasing relevance and significance that Internet and computer technologies (ICTs) have brought to people's lives in the 21st century, a computer-mediated healthcare sector is an impending issue that is brought about by the increasing need to modernize its information systems. Still, in relation to the development of nursing home care institutions as consumer-centered and service-oriented institutions, the pressure of becoming online and it-based becomes tremendous. In line with the trend of looking at the healthcare sector (specifically nursing home care) as a finance- or economy-based sector, this article is significantly related to other articles that look at nursing home care quality through its economic dimension (i.e., effects in efficiency as a result of an electronic database and servicing of nursing home care transactions).

Doctors who have been in practice longer may provide lower quality of care." (2005). MEDSURG Nursing, Vol. 14, Issue 5.

A meta-analysis of relevant literature about the relationship between quality of care provided for by doctors and the length of time the doctor has been in service is quantitatively analyzed. Results of the study showed that the greater the length of years the doctor has committed to medical service, there is a considerable decline in the quality of health care that s/he provides for patients. This finding in this study demonstrates how nursing home care quality is assessed by yet another factor or variable: doctors and the length of time they have spent in service.

Health care quality and outcome guidelines for nursing of children and families: from the AAN expert panel on children and families." (2005). Pediatric Nursing, Vol. 31, Issue 2.

In relation to nursing home care, this article provided for by the American Academy of Nursing (AAN) discusses in detail important information and guidelines that must be adopted in order to ensure quality healthcare among individuals / consumers. While this article is applicable to all individuals seeking healthcare (and not just nursing home care), this article is relevant in that it also viewed those who avail of healthcare as "consumers," recognizing the fact that indeed, more than just a social service, healthcare in general (which includes nursing home care), has become a service that is determined economically. Moreover, this article also illustrates how healthcare has become subjected to the law of supply and demand, wherein the increased demand for healthcare has become the motivation why efficient healthcare management and service must be provided to members of the American society, which are also today's consumers.

Swan, B. (2004). "Access to quality healthcare: links between evidence, nursing language, and informatics." Nursing Economics, Vol. 22, issue 6.

Among the issues discussed in this article most relevant for the researcher is the focus on nursing informatics, which "addresses the management and processing of data, information, and knowledge to support nursing practice and delivery of care." It is again worthy to note that in this analysis, healthcare management is defined in terms of its economy -- either through finances and/or technologies. In this case, healthcare quality is determined through the efficacy of an institution's technology and ability to manage its information database and other operations related to the provision of healthcare.

Tanner, R. (2005). "Legislative activity focuses on nursing home quality and safety." Healthcare Financial Management, Vol. 59, Issue 10.

This article center on the criteria that needs to be satisfied to ensure that a nursing home or healthcare institution is indeed providing quality care to consumers. Among the identified variables to take into consideration in assessing quality healthcare are staffing standards, quality and safety of the institution or nursing home itself, as well as background checks, which means the institution has met the required quality and safety standards required by the federal government. These variables are useful for the research in that they determine the normative standards that healthcare institutions must adhere to when discussing the issue of quality healthcare.

From the journal articles collated for this study, the emergent theme or issue discussed among these is the evident and significant relationship between institutional economics and the improvement of healthcare quality. Institutional economics is identified either as the financial capacity or budget of the institution or the technology used within the healthcare institution. Among the variables included that helped determine the institutional economics in the healthcare sector are information technologies related to database and servicing management, capacity of the healthcare institution to accept patients/consumers in the nursing home, staffing ratio between patients and nurses, as well as the communication and marketing strategies utilized by healthcare institutions./nursing homes.

Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.