Randomized clinical trial of a quality improvement intervention in nursing homes.
Gerontologist
; 41(4): 525-38, 2001 Aug.
Article
en En
| MEDLINE
| ID: mdl-11490051
PURPOSE: The purpose of the study was to determine if simply providing nursing facilities with comparative quality performance information and education about quality improvement would improve clinical practices and subsequently improve resident outcomes, or if a stronger intervention, expert clinical consultation with nursing facility staff, is needed. DESIGN AND METHODS: Nursing facilities (n = 113) were randomly assigned to one of three groups: workshop and feedback reports only, workshop and feedback reports with clinical consultation, and control. Minimum Data Set (MDS) Quality Indicator (QI) feedback reports were prepared and sent quarterly to each facility in intervention groups for a year. Clinical consultation by a gerontological clinical nurse specialist (GCNS) was offered to those in the second group. RESULTS: With the exception of MDS QI 27 (little or no activity), no significant differences in resident assessment measures were detected between the groups of facilities. However, outcomes of residents in nursing homes that actually took advantage of the clinical consultation of the GCNS demonstrated trends in improvements in QIs measuring falls, behavioral symptoms, little or no activity, and pressure ulcers (overall and for low-risk residents). IMPLICATIONS: Simply providing comparative performance feedback is not enough to improve resident outcomes. It appears that only those nursing homes that sought the additional intensive support of the GCNS were able to effect enough change in clinical practice to improve resident outcomes significantly.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Garantía de la Calidad de Atención de Salud
/
Indicadores de Calidad de la Atención de Salud
/
Hogares para Ancianos
/
Casas de Salud
Tipo de estudio:
Clinical_trials
Límite:
Aged
/
Aged80
/
Humans
Idioma:
En
Revista:
Gerontologist
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos