April 27, 2012

New Study Examines Culture of Safety at Nursing Homes

by Levin & Perconti

The Joint Commission Journal on Quality and Patient Safety recently published a story on the culture of safety that does (or does not) exists at certain nursing homes. Obviously, this research has very clear implications on the prevalence and prevention efforts of nursing home neglect and abuse. The comprehensive study can be read in full here.

Essentially, the research effort sought to connect accreditation by an independent non-profit organization called the Joint Commission and the improvements in quality of care and safety cultures at nursing homes. Used in this way, “safety culture” refers to “patterns of attitudes and behaviors observed in health care.” Each Chicago nursing home neglect lawyer at our firm has worked on countless cases were nursing home neglect was alleged which, at the end of the day, could be traced back in some way to inadequate facility commitment to maximizing safety protocols each and every day.

In the past, research has confirmed that accreditation from the Joint Commission led to better safety initiatives and better patient outcomes at hospitals. This new research sought to test the same concept in nursing homes. A few previous efforts had studied some aspects of nursing home accreditation. One of those efforts found that accredited facilities had fewer inappropriate medication prescriptions, fewer medication errors, and less restraint-use. All of these outcomes are welcome, strongly indicating that the accreditation standards outlined by the Joint Commissions should be pursued by all facilities with a commitment to maximizing quality of care for their residents.

This latest research sought to expand on those previous efforts by examining the effect of accreditation on the overall safety culture at the facilities, beyond just individual adverse outcomes or instances of nursing home neglect. The effort was centered on thousands of surveys with senior managers, caregivers, and residents, at various long-term care facilities throughout the country.

What did they find?

At a basic level, expectedly, those facilities that are accredited by the non-profit organization indicated a more favorable resident safety culture when compared to non-accredited facilities. This basic finding held even when various other factors were taken into account which might affect safety commitments. Those other factors include profit status, organizational structures, and staffing levels. Each Illinois nursing home abuse lawyer at our firm knows this doesn’t meant that staffing and profit-status don’t affect care levels—they do. Instead, this suggests that even for-profit facilities with low staffing levels can comparatively improve their own care by seeking out Joint Commission accreditation. Yet, receiving accreditation often requires changes in staffing levels and procedures, often limiting the workload of each individual staff member.

In addition, the research effort found that residents themselves in nursing homes that were accredited had their feedback responded to more favorably. This was expected considering that the Joint Commissions standards in this regard demand prompt and significant attention be paid to all resident complaints, particularly as they relate to “sentinel events." This requirement demands that facilities conduct a thorough analysis of the incident, develop action plans to prevent similar harms in the future, and then properly monitor that plan’s implementation.


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