Question

What are the major strengths and weaknesses of the nursing home survey process in assuring that residents have high levels of quality of care and quality of life?

Answer 1

Strengths and weaknesses of the nursing home survey process in assuring that residents have high levels of quality of care and quality of life.

INTRODUCTION:

A Strength and weakness analysis in a clinic, nursing home or other health care establishment can be a simple and yet effective tool for ensuring that all appropriate factors are considered.

Strengths refers to the factors that are likely to have a positive effect on achieving the nursing home’s objectives.

Weaknesses refers to the factors that are likely to have a negative effect on (or be a barrier to) achieving the nursing home’s objectives.

Nursing Home Surveys generally include two separate instruments for nursing home residents: one for those who live in a nursing home and another for those who have been discharged after a short stay.

Strengths of the nursing home survey process assures that residents have high levels of quality of care and quality of life.

Strengths are the attributes which can enhance the ability to achieve the goals and objectives of the health care center. Nursing home survey process helps to assess whether the:

• Environment is safe and comfortable for the patient.
• Care delivered to the patient is of atmost quality.
• Therapeutic communication is being maintained.
• Patients are treated with respect and individual attention is being given.
• Patients and family members are given the autonomy to accept/deny treatment and to opt for the best medical services, without and compulsion.
• Nursing homes participating in Medicare and Medicaid programs remain in substantial compliance with the Medicaid/Medicare care requirements.
• All deficiencies are addressed promptly.
• Residents receive the care and services they need to meet their highest practicable level of functioning.
• Deficiencies alleged by staff, residents or family members confirmed through records, interviews and observations are addressed to.
• deficiency status constitutes immediate jeopardy or actual harm, whether the deficiency is isolated, constitutes a pattern or is widespread.
• To give data to the nursing home to help them in their quality improvement efforts.

Weaknesses

• No single quality indicator represents the overall quality of a nursing home (i.e., a global measure).
• Quality assessment tools assess what is being done and not necessarily the appropriateness of what is being done.

• Quality assessment tools are often criticized as representing measures of documentation rather than actual care.

• A large and confusing number of sets of quality indicators are prevalent which creates confusion in promptly assessing whether quality care is delivered.

• For relatively rare outcomes, quality indicators have limited ability (power) to detect real differences in quality.

• The poor quality levels that seem to exist in many nursing homes may be a function of the quality process itself.

• Outcome measures are often statistically manipulated to account for.