Term Paper on "Nursing Home Quality of Personal and Facility in the USA"

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Nursing home quality in the U.S.

Hilliard, J. (2005). "The Nursing Home Quality Initiative." Journal of Legal Medicine, Vol. 26, Issue 1.

Hilliard's analysis centers on the Nursing Home Quality Initiative (NHQI), identified as a "strategy designed to bring together regulation, and enforcement, enhanced consumer information, community-based quality improvement initiatives...and partnerships...to improve the overall quality of nursing home care." As one of the most prevalent health care services utilized by American consumers, the need for a better and quality nursing home care becomes an imperative issue. Looking at nursing home care as a service to American consumers, the NHQI as a government initiative is assessed as an effective measure through which specific standards of quality (identified as quality measures or QMs) are identified. The article provides a new perspective of how nursing home care should be -- that is, just like any other service that must be maintained and consistent in quality for its consumers, which is American society.

Anderson, R. et al. (2003). "Nursing home quality, chain affiliation, profit status and performance." Journal of Real Estate Research, Vol. 25, Issue 1.

In this interesting quantitative study on nursing home care, the authors created a model through which nursing home care quality can be best assessed and determined, depending on the nature of the organization or institution that provides this nursing home care. Important findings generated from the study include the significant relationship between efficiency and three important characteristics of nursing homes: (a) profit status of the firm

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, (b) size of the firm, and - the firm's ability to utilize its rooms. Among the important relationships established in this study is how for-profit nursing homes tend to have lower levels of care quality when compared against non-profit nursing homes. Consistent with this finding is the fact that as nursing home institutions become bigger in size (i.e., quantity of individuals that can be accommodated), the lower the level of care quality becomes. These findings are significant in studying nursing home cares in the U.S. because it provides the economic/financial dimension in analyzing the quality of health care provided among nursing homes. That is, identifying level of influence that changes in and the nature of the institution's finances can have on the quality of care provided for by the said institution.

Calhoun, J. et. al. (2006). "Current marketing practices in the nursing home sectors." Journal of Healthcare Management, Vol. 51, Issue 3.

Looking again at the health care sector as a consumer-centered sector, nursing home care is determined and assessed in terms of the marketing and communication strategies adopted by nursing homes at present. Findings generated from the survey (n=230 nursing homes) showed that while there was intensive communication strategies internally (i.e., communication within and among nursing homes), there has not been much effort shown in addressing nursing home care to the consumers or users of this health service. Moreover, markets targeted by these nursing homes, such as socio-economic classification, gender differences, and geographical differences, among others, are not defined specifically. Once again, this study reflects the gradual development of nursing home care as a consumer-centered service to American society, wherein quality of care becomes more central to health care professionals' and practitioners' determination of nursing home care improvement.

Sherman, F. (2006). "Don't let transitional care fall through the cracks." Geriatrics, Vol. 61, Issue 4.

This article by Sherman brought into fore the issue of inter-facility transfers among sick individuals living in nursing homes and availing of nursing home care. He recommended a change in policy-making when discussing the issue of nursing home care, suggesting the "SIT Act" or the Safe Inter-facility Transfer Act, which will enable health care practitioners to ensure a more comprehensive and well-coordinated communications and management of caring for individuals under nursing home care. The SIT Act is a piece on how nursing home care management can be developed effectively, using only the inter-facility transfer as one of its cases in point.

Zhang, N. (2006). "Minimum nurse staffing ratios for nursing homes." Nursing Economics, Vol. 24, Issue 2.

In this article, one aspect of quality nursing home care is analyzed: nurse staffing ratios in nursing homes. The study provides a critical look at how nursing homes tend to employ only just enough number of nurses, which results to understaffing because of the too many-to-one ratio between patients and nurses. As a result of understaffing, nursing homes suffer in the quality of health care provided to patients, resulting to inefficiency of care given per patient. This study is best looked at as another example of how finance- or budget-based decisions ultimately influence, for the greater part, the quality of nursing home care given to individuals.

Pressure growing for healthcare it adoption." (2006). Healthcare Financial Management, Vol. 60, Issue 1.

As a response to the ever-increasing relevance and significance that Internet and computer technologies (ICTs) have brought to people's lives in the 21st century, a computer-mediated healthcare sector is an impending issue that is brought about by the increasing need to modernize its information systems. Still, in relation to the development of nursing home care institutions as consumer-centered and service-oriented institutions, the pressure of becoming online and it-based becomes tremendous. In line with the trend of looking at the healthcare sector (specifically nursing home care) as a finance- or economy-based sector, this article is significantly related to other articles that look at nursing home care quality through its economic dimension (i.e., effects in efficiency as a result of an electronic database and servicing of nursing home care transactions).

Doctors who have been in practice longer may provide lower quality of care." (2005). MEDSURG Nursing, Vol. 14, Issue 5.

A meta-analysis of relevant literature about the relationship between quality of care provided for by doctors and the length of time the doctor has been in service is quantitatively analyzed. Results of the study showed that the greater the length of years the doctor has committed to medical service, there is a considerable decline in the quality of health care that s/he provides for patients. This finding in this study demonstrates how nursing home care quality is assessed by yet another factor or variable: doctors and the length of time they have spent in service.

Health care quality and outcome guidelines for nursing of children and families: from the AAN expert panel on children and families." (2005). Pediatric Nursing, Vol. 31, Issue 2.

In relation to nursing home care, this article provided for by the American Academy of Nursing (AAN) discusses in detail important information and guidelines that must be adopted in order to ensure quality healthcare among individuals / consumers. While this article is applicable to all individuals seeking healthcare (and not just nursing home care), this article is relevant in that it also viewed those who avail of healthcare as "consumers," recognizing the fact that indeed, more than just a social service, healthcare in general (which includes nursing home care), has become a service that is determined economically. Moreover, this article also illustrates how healthcare has become subjected to the law of supply and demand, wherein the increased demand for healthcare has become the motivation why efficient healthcare management and service must be provided to members of the American society, which are also today's consumers.

Swan, B. (2004). "Access to quality healthcare: links between evidence, nursing language, and informatics." Nursing Economics, Vol. 22, issue 6.

Among the issues discussed in this article most relevant for the researcher is the focus on nursing informatics, which "addresses the management and processing of data, information, and knowledge to support nursing practice and delivery of care." It is again worthy to note that in this analysis, healthcare management is defined in terms of its economy -- either through finances and/or technologies. In this case, healthcare quality is determined through the efficacy of an institution's technology and ability to manage its information database and other operations related to the provision of healthcare.

Tanner, R. (2005). "Legislative activity focuses on nursing home quality and safety." Healthcare Financial Management, Vol. 59, Issue 10.

This article center on the criteria that needs to be satisfied to ensure that a nursing home or healthcare institution is indeed providing quality care to consumers. Among the identified variables to take into consideration in assessing quality healthcare are staffing standards, quality and safety of the institution or nursing home itself, as well as background checks, which means the institution has met the required quality and safety standards required by the federal government. These variables are useful for the research in that they determine the normative standards that healthcare institutions must adhere to when discussing the issue of quality healthcare.

From the journal articles collated for this study, the emergent theme or issue discussed among these is the evident and significant relationship between institutional economics and the improvement of healthcare quality. Institutional economics is identified either as the financial capacity or budget of the institution or the technology used within the healthcare institution. Among the variables included that helped determine the institutional economics… READ MORE

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Quoted Instructions for "Nursing Home Quality of Personal and Facility in the USA" Assignment:

“

Literature Review:

Directions:

You will prepare a literature review on a current issue in gerontology. I recommend that you select an issue that you feel is important to older adults, and one that needs more attention than that already is addressed in this course (I chose "Nursing home quality of personal and facility in the USA" Your literature review assignment has several components:

1. An annotated bibliography including a minimum of 15 academic references (journal articles or books) plus 10 websites that address the same topic. For each source annotated, you are expected to provide a complete reference and a one paragraph summary of what can be learned from that source; I will e-mail you a example of the format of the review that is required.

2. A 250 - 500 word summary what can be learned by reviewing this literature including a comparison of what can be learned from all the sources taken collectively. This summary must consider the limitations of what can be learned from websites alone;

3. A 250- 500 word analysis of this literature in consideration of the extent to which gender, race, and social class contribute to controversy surrounding the issue you have studied;

4. You will use your first three products to prepare a short series of (5-10) open-ended questions. You will then check what you think you have learned by conducting a short interview with an older adult about the issue you have been studying. You are encouraged to submit your initial literature review to the instructor and a draft of your interview questions for feedback before proceeding to interview the older adult. You will then write a short summary of 200-500 words commenting on what if anything your interviewee taught you that was not previously revealed in the literature.

The format of the literaure review I want is the following:

Literature Review International Issues on Health Care

1 - U.S. Health Care Spending in an International Context, Uwe E. Reinhardt, Peter S. Hussey and Gerard F. Anderson, Health Affairs, 23 (3): 10–25, May/June 2004.

This study uses the most recent data from the Organization for Economic Cooperation and Development to explore why U.S. health care costs are so much greater than costs in other countries with much older populations. The authors point to several reasons for higher U.S. health costs: the fragmented financing system entails higher administrative costs; health care providers have greater market power than health care purchasers, allowing prices to soar above levels of other countries where the government exercises collective bargaining power; and the U.S. provides a more specialized, intensive form of care.

2 - Disease Management Programs in Germany's Statutory Health Insurance System, Reinhard Busse, Health Affairs, 23 (3): 56–57, May/June 2004.

This study focuses on the introduction of disease management programs in 2002 into the Germany's statutory health insurance pools, which cover about 88 percent of the population. An earlier reform had introduced consumer choice among the various "sick funds," resulting in adverse selection and disadvantaging the chronically ill. Disease management was introduced to help improve quality and cost-effectiveness of treatment for chronic conditions, specifically by setting evidence-based guidelines for treatment and drug formularies and by better coordinating care. The author notes that this approach may be of interest in the United States, where adverse selection has thus far hindered managed care efforts among the Medicare population.

3 - How Does the Quality of Care Compare in Five Countries?, Peter S. Hussey, Gerard F. Anderson, Robin Osborn et al., Health Affairs, 23 (3): 89–99, May/June 2004.

This article reports on efforts of the Commonwealth Fund International Working Group on Quality Indicators to compare the quality of care among different countries. The group used 21 indicators—such as five-year cancer survival rates, breast cancer screening rates, asthma mortality rates, and others—to compare the quality of care in Australia, Canada, New Zealand, the United Kingdom, and the United States. None of the countries consistently scored best or worst overall. For example, Australia scored highly on many of the indicators (cancer survival, breast cancer screening, asthma mortality) but had higher incidences of pertussis, or whooping cough, than other countries. In Canada, 30-day case fatality rates from acute myocardial infarction were higher than Australia and New Zealand in older age groups, but kidney and liver transplant survival rates were better than in the other countries. Rates of cancer survival were not as high as other countries in the U.K., while suicide rates were notably lower than other countries. By contrast, suicide rates in New Zealand—particularly among young people—were much higher than elsewhere. Breast cancer five-year survival rates and cervical cancer screening rates were highest in the U.S., and asthma mortality rates were increasing while they were decreasing in the other four countries.

and so on.

Thank you and please contact me if you have any questions. We do not want to rewrite it.

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