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NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY

Transforming nursing home (NH) cultures—from impersonal institutions to enriching communities where residents and employees thrive—requires multifaceted change. NHs deploy an array of culture change (CC) practices, in three core domains: resident-centered care, staff empowerment, and physical enviro...

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Autores principales: Lepore, Michael J, Lima, Julie C, Clark, Melissa A, Gozalo, Pedro L, Miller, Susan C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6845707/
http://dx.doi.org/10.1093/geroni/igz038.240
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author Lepore, Michael J
Lima, Julie C
Clark, Melissa A
Gozalo, Pedro L
Miller, Susan C
author_facet Lepore, Michael J
Lima, Julie C
Clark, Melissa A
Gozalo, Pedro L
Miller, Susan C
author_sort Lepore, Michael J
collection PubMed
description Transforming nursing home (NH) cultures—from impersonal institutions to enriching communities where residents and employees thrive—requires multifaceted change. NHs deploy an array of culture change (CC) practices, in three core domains: resident-centered care, staff empowerment, and physical environment. This study uses novel data on CC practice from a nationally representative panel of NHs (N=1,585) surveyed in 2009/2010 and 2016/2017. To understand how changes in practice adoption may relate to quality changes we linked longitudinal data on the CC practice domain scores for resident-centered care, staff empowerment, and physical environment and on NH deficiencies relating to health and quality of life (QoL) and combined these with Certification and Survey Provider Enhanced Reporting baseline data. Multinomial logistic regressions incorporating survey weights and inverse probability of weight (to address CC selection) estimated the relative risk ratios (RRR) of increased CC practice corresponding with NHs having fewer or no change in deficiencies, versus increased deficiencies. NHs with much increase in staff empowerment scores had a higher likelihood of no change (compared to an increase) in health deficiencies (RRR 2.0; 95% CI 1.15, 3.61) and severe health deficiencies (RRR 2.03; 95% CI 1.05, 3.93). With a RRR of 1.63, NHs with any improvement in resident-centered care scores appeared to have a higher likelihood of no change (compared to an increase) in QoL deficiencies but statistical significance was not reached (p=0.11). This study provides some support for the benefits of CC practices, and in particular, supports the importance of staff empowerment practices in NHs.
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spelling pubmed-68457072019-11-15 NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY Lepore, Michael J Lima, Julie C Clark, Melissa A Gozalo, Pedro L Miller, Susan C Innov Aging Session 740 (Paper) Transforming nursing home (NH) cultures—from impersonal institutions to enriching communities where residents and employees thrive—requires multifaceted change. NHs deploy an array of culture change (CC) practices, in three core domains: resident-centered care, staff empowerment, and physical environment. This study uses novel data on CC practice from a nationally representative panel of NHs (N=1,585) surveyed in 2009/2010 and 2016/2017. To understand how changes in practice adoption may relate to quality changes we linked longitudinal data on the CC practice domain scores for resident-centered care, staff empowerment, and physical environment and on NH deficiencies relating to health and quality of life (QoL) and combined these with Certification and Survey Provider Enhanced Reporting baseline data. Multinomial logistic regressions incorporating survey weights and inverse probability of weight (to address CC selection) estimated the relative risk ratios (RRR) of increased CC practice corresponding with NHs having fewer or no change in deficiencies, versus increased deficiencies. NHs with much increase in staff empowerment scores had a higher likelihood of no change (compared to an increase) in health deficiencies (RRR 2.0; 95% CI 1.15, 3.61) and severe health deficiencies (RRR 2.03; 95% CI 1.05, 3.93). With a RRR of 1.63, NHs with any improvement in resident-centered care scores appeared to have a higher likelihood of no change (compared to an increase) in QoL deficiencies but statistical significance was not reached (p=0.11). This study provides some support for the benefits of CC practices, and in particular, supports the importance of staff empowerment practices in NHs. Oxford University Press 2019-11-08 /pmc/articles/PMC6845707/ http://dx.doi.org/10.1093/geroni/igz038.240 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Session 740 (Paper)
Lepore, Michael J
Lima, Julie C
Clark, Melissa A
Gozalo, Pedro L
Miller, Susan C
NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title_full NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title_fullStr NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title_full_unstemmed NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title_short NURSING HOME CULTURE CHANGE AND QUALITY OF LIFE AND HEALTH DEFICIENCIES: NATIONWIDE PANEL STUDY
title_sort nursing home culture change and quality of life and health deficiencies: nationwide panel study
topic Session 740 (Paper)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6845707/
http://dx.doi.org/10.1093/geroni/igz038.240
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