1.

Record Nr.

UNINA9910778675203321

Titolo

Improving the quality of care in nursing homes / / Committee on Nursing Home Regulation, Institute of Medicine

Pubbl/distr/stampa

Washington, D.C. : , : National Academy Press, , 1986

ISBN

1-280-22169-0

9786610221691

0-309-55484-5

0-585-14434-6

Descrizione fisica

1 online resource (431 pages)

Disciplina

362.1/6

Soggetti

Old age homes - Standards - United States

Nursing homes - Standards - United States

Lingua di pubblicazione

Inglese

Formato

Materiale a stampa

Livello bibliografico

Monografia

Note generali

"Report of a study conducted under contract no. 500-83-0054 with the Health Care Financing Administration"--T.p. verso.

"Publication IOM-85-10"--T.p. verso.

Nota di bibliografia

Includes bibliography: p. 213-237 and index.

Nota di contenuto

Improving the Quality of Care in Nursing Homes; Copyright; Preface; Acknowledgments; Contents; 1 Introduction and Summary ; PURPOSE OF THE STUDY; THE PUBLIC POLICY CONTEXT OF THE STUDY; PERSPECTIVE ON THE ISSUES; The Role of Nursing Homes; Quality of Care and Quality of Life; The Regulatory System; Other Factors Affecting Quality of Care in Nursing Homes; Other Regulatory Policies; Consumers, the Community, and Nursing Home Management and Staff; CONCLUSIONS; SUMMARY OF RECOMMENDATIONS; Regulatory Criteria; Monitoring Nursing Home Performance; Enforcing Compliance with Federal Standards

Other Factors Affecting Quality of Care and Quality of Life in Nursing Homes; Issues Requiring Further Study; Information Systems; Medicaid Payment Policies; Nursing Home Bed Supply; Staffing of Nursing Homes; Single- Versus Multiple-Occupancy Rooms; 2 Concepts of Quality, Quality Assessment, and Quality Assurance ; QUALITY OF CARE IN NURSING HOMES; Characteristics of the Residents; Care Needs; The Care Setting; Requirements for High-Quality Care; Planning And



Providing Care; QUALITY OF LIFE; QUALITY ASSESSMENT CRITERIA; Structure; Process; Outcomes; ASSESSING QUALITY OF CARE

Functional Competency/Impairment; Intellectual Impairment/Behavioral Problems; PERSPECTIVE ON QUALITY ASSURANCE; INTERPRETING AND USING INFORMATION FOR QUALITY ASSURANCE; Measurement of Care Quality; Standards; Case Mix; Standard Instruments; National, Regional, and Local Uses; QUALITY ASSURANCE AND THE REGULATORY SYSTEM; 3 Regulatory Criteria ; THE ISSUES; CONSOLIDATING THE TWO SETS OF CRITERIA; RESIDENT ASSESSMENT; REVISING AND STRENGTHENING THE CONDITIONS AND STANDARDS; Quality of Life; Quality of Care; Residents' Rights; Administration; Training of Nurse's Aides; Discrimination

Notification; Participation; Access; Physical Environment; NOTE ON STAFFING STANDARDS; General; Social Services; Licensed and Registered Nurses; 4 Monitoring Nursing Home Performance ; THE ISSUES; PROBLEMS WITH THE SURVEY PROCESS; Predictability; Inefficiency; Paper Compliance; Insensitivity to Resident Needs; Inconsistency; Isolation from Related Monitoring Processes; Variable State Regulatory Capacity; REDESIGNING THE SURVEY PROCESS; Consolidation of Medicare and Medicaid Survey Procedures; Timing and Frequency of Surveys; Two-Stage Survey Approach; The Resident Assessment Audit

The Standard Survey; The Extended Survey; Case-Mix Referencing; Key Indicators; Triggering an Extended Survey: Scoring and Decision-Making; Survey Data Sources; Coordination with Complaint Programs; Consumer Involvement; Positive Incentives; Continuing Improvement of the Survey Process; Reliability and Validity of Instruments and Procedures; Consistency of Survey Results; PACS: AN NEW HCFA SURVEY PROTOCOL; INCREASING STATE REGULATORY CAPACITY; Federal Funding of Certification Activities; State Surveyor Qualifications; Federal Training Support; Dissemination of Research and Evaluation Results; Federal Oversight and Sanctioning Responsibilities