CONTROLLED TRIAL OF ADVANCE CARE PLANNING IN NURSING HOMES IN AUSTRALIA

Abstract

This article makes the case that many nursing home programs labeled as continuous quality improvement (CQI) efforts do not use trademark methods that have made CQI so effective in other settings. Confusion about the distinction between quality assurance and quality improvement is one barrier to implementing effective CQI programs in nursing homes. Another is that federal regulations and reporting systems prompt nursing homes to focus on outcomes as opposed to care processes. 1 Nursing Home Compare. Medicare: The official US government site for people with Medicare web site 2002. Available at: http://www.medicare.gov/NHCOmpare/home.asp. Accessed August 2006. Google Scholar Indeed, data available about care process quality in nursing homes are useful only for regulatory compliance and, perhaps, quality assurance activities designed to avoid survey deficiencies. A radical change in how care processes are documented is needed if CQI is to become a reality in nursing homes, rather than an empty program label. This article discusses how care processes related to daily care provision can be efficiently measured and the data used in CQI programs. It focuses especially on daily care processes implemented by nurse aides because of their paramount importance for enhancing quality of care and life and because research suggests that consumers view this care as both important and problematic.