Who Are the Innovators? Nursing Homes Implementing Culture Change

Grabowski, David C.; Elliot, Amy; Leitzell, Brigitt; Cohen, Lauren W.; Zimmerman, Sheryl

doi:10.1093/geront/gnt144

Cited by 70 publications

(89 citation statements)

References 15 publications

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“…Vincent Mor and others have characterized this disparity as the two tiers of nursing home care in the United States. 35,36 The “lower” tier includes nursing homes that largely serve Medicaid recipients, are for profit, are located in the poorest areas of the country, and have a history of care deficiencies. 35,36 …”

Section: Challenges To Implementing Innovationsmentioning

confidence: 99%

“…36,37 Some of the reasons why culture change does not take place in less wealthy nursing homes are leadership turnover and the lack of infrastructure needed to initiate it. 36 …”

Section: Challenges To Implementing Innovationsmentioning

confidence: 99%

“…36 This is one potential way to reduce the disparity in culture change between resource-rich and resource-poor nursing homes. In particular, increased state Medicaid payments to nursing homes have been associated with environmental improvements such as single rooms and staff compensation packages that are indicative of culture change.…”

Section: Potential Policy Solutionsmentioning

confidence: 99%

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Alzheimer’s Disease And Nursing Homes

Gaugler

Davila

et al. 2014

Health Affairs

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Close to two-thirds of all US nursing home residents have some type of cognitive impairment such as Alzheimer’s disease, and the quality of care and quality of life of these people has long been called into question. In this overview we first clarify the ongoing importance of nursing home care for people with Alzheimer’s, even as policy makers “rebalance” long-term supports and services with home and community-based programs. We next identify the components of optimal care for people with Alzheimer’s in nursing homes, and we highlight care innovations already in use. Finally, we summarize policy-relevant challenges to implementing best practices and innovations and explore potential policy solutions. Federal and state policy makers have a critical role to play in ensuring that nursing home residents with Alzheimer’s disease have access to the appropriate, high-quality care that they and their families expect.

show abstract

Section: Challenges To Implementing Innovationsmentioning

confidence: 99%

“…36,37 Some of the reasons why culture change does not take place in less wealthy nursing homes are leadership turnover and the lack of infrastructure needed to initiate it. 36 …”

Section: Challenges To Implementing Innovationsmentioning

confidence: 99%

Section: Potential Policy Solutionsmentioning

confidence: 99%

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Alzheimer’s Disease And Nursing Homes

Gaugler

Davila

et al. 2014

Health Affairs

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“…The majority of these studies focused on improving the working environment for nurses; recognizing the different types of demands on RN's given the type of patients they treat, improving team and organizational culture, incorporating volunteers into the service structure, improving the administration of drugs, and utilizing technology where they can (4,6,33,41,45,46). Organizational processes are particularly interesting.…”

Section: Analysis Of Level 3: the Working Environmentmentioning

confidence: 99%

Demystifying eldercare: Managing and innovating from a public-entity's perspective

Schultz

André

Sjøvold³

2014

International Journal of Healthcare Management

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Abstract:The aim of this paper is to help managers in public positions make better sense out of the exponential developments currently surfacing in eldercare. This industry has been blessed and cursed by its rapid development; blessed as there is a plethora of both technological and service type innovations, but cursed because there is so much development that trying to understand, organize, and stay updated with it all becomes nearly impossible. This article will help demystify these innovations, making it easier for public organizations to manage this process. A review of the literature yielded 1,384 relevant hits, 207 articles had substantial relevance, and 67 articles were selected as fitting within the framework of this study. We found that when these 67 articles are reviewed together, in the framework of eldercare, and from the lens of a public-entity, a typology for managing innovation within eldercare emerges. When viewing eldercare in this framework, suddenly managing eldercare innovation becomes simpler as one can understand where existing and new developments fit within the overall system. The core of this typology is contingent on maintaining an appropriate balance between 3 facets; the quality of care, the working environment, and societal efficiency. This balance is extremely important as these three facets are generally inversely proportional to each other. When a problem or opportunity emerges within a municipality, managers can now predetermine the impact that the proposed solution will have on the overall system, and likely make better decisions on what to invest in.

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“…Following adjustment of case mix and similar resident selection factors, there was no statistical difference in length of stay between for-profit and not-for-profit post-acute care providers, although there were considerable differences in non-adjusted comparisons. Vincent Mor and others have argued that there are currently "two tiers" of nursing homes that appear to contribute to disparities, with those residing in not-for-profit facilities (among other factors) potentially having access to better quality of care (see Grabowski, Elliot, Leitzell, Cohen, & Zimmerman, 2014;Mor, Zinn, Angelelli, Teno, & Miller, 2004). Bowblis, Horowitz, and Brunt (2016) provide an important piece of evidence to either contribute to or challenge the notion of two tiers of nursing home quality.…”

mentioning

confidence: 99%