Field Testing, Refinement, and Psychometric Evaluation of a New Measure of Nursing Home Care Quality (original) (raw)
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International Nursing Review, 2002
Researchers at the University of Missouri-Columbia developed the Observable Indicators of Nursing Home Care Quality instrument to measure the dimensions of nursing home care quality during a brief on-site visit to a nursing home. The instrument has been translated for use in Iceland and used in Canada. Results of the validity and reliability studies using the instrument in 12 nursing homes in Reykjavik, in a large Veterans Home in Ontario with 14 units tested separately, and in 20 nursing homes in Missouri, are promising. High-content validity was observed in all countries, together with excellent inter-rater reliability and coefficient alpha. Testretest reliabilities in Iceland and Missouri were good. Results of the international field test of the Observable Indicators of Nursing Home Care Quality instrument points to the usefulness of such an instrument in measuring nursing home care quality following a quick on-site observation in a nursing facility. The instrument should be used as a facility-wide assessment of quality, rather than for individual units within a facility. We strongly recommend its use by practising nurses in nursing homes to assess quality of care and guide efforts to improve care. We recommend its use by researchers and consumers and further testing of the use of the instrument with regulators.
Nursing Home Quality Indicators : Their Uses and Limitations
2003
N Nu ur rs si in ng g H Ho om me e Q Qu ua al li it ty y I In nd di ic ca at to or rs s: : T Th he ei ir r U Us se es s a an nd d L Li im mi it ta at ti io on ns s The views expressed herein are for information, debate, and discussion, and do not necessarily represent official policies of AARP. FOREWORD The question of how to measure and improve the quality of care in nursing homes has challenged policymakers for decades. In 1989, researchers at the Center for Health Systems Research and Analysis (CHSRA) at the University of Wisconsin began to address that question by identifying quality indicators (QI) based on the information federal law requires nursing homes to collect about each nursing home resident. That information, known as the Minimum Data Set (MDS), forms the basis of each resident's care plan, and, as the CHSRA researchers determined, can also be converted into measures that reveal how well a nursing home is caring for its residents. The CHSRA QI consist of specific ...
BMC Health Services Research, 2021
Background This study aims to describe the validation and optimization of a new instrument designed to comprehensively measure and evaluate the quality of care in nursing homes; the Quality Evaluation Questionnaires for Nursing Homes (QEQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data were collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QEQ-NH. Construct and criterion validity of the three questionnaires were tested with item- and scale analyses. Content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers and 8 professional caregivers). Result...
Journal of the American Geriatrics Society, 2016
There is a general belief that the markers of nursing home quality do not aggregate easily. Identifying consistent and coherent dimensions of quality that usefully summarize the multiplicity of nursing home quality measures is an important goal. It would simplify interpretation and help consumers, their families and advocates to choose nursing facilities. This study uses quality indicators (QIs) from a state nursing home report card to explore the dimensionality of quality in nursing homes and to determine whether aggregation at the resident versus facility level yields the same underlying dimensions. Cross-sectional study. 382 Medicare- and/or Medicaid-certified nursing homes in Minnesota. Residents admitted to the nursing homes during 2011-2012. 16 QIs obtained from the Minimum Data Set 3.0 assessment instrument between 2011 and 2012 were used in the exploratory factor analysis. Factor analysis results suggest four main factors or dimensions to characterize facility performance: c...
2020
Background This study aims to describe the validation and optimization of a new instrument specifically designed to measure and improve the quality of care in nursing homes; the Quality Improvement Questionnaires for Nursing Homes (QIQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data was collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QIQ-NH. The construct and criterion validity of the three questionnaires were tested with item- and scale analyses. The content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers, 8 professional caregivers). Resul...
Identification and evaluation of existing nursing homes quality indicators
Health care financing review, 2002
We summarize work done to identify and evaluate existing quality indicators (QIs) for long-term care (LTC) settings. Indicators operationally defined using routinely collected and computerized patient assessments were identified and then aggregated to characterize the performance of the nursing facility over a specific period of time. Of 143 indicators reviewed, only 22 were recommended for use in comparing performance across facilities. Conceptual and technical issues influence the appropriateness of QIs for different audiences.
Direct assessment of quality of care in a geriatric nursing home
Journal of Applied Behavior Analysis, 1995
Direct observation was used to examine multiple aspects of care provided in a proprietary nursing home. Time samples were taken at random intervals, 7 days per week for 5 weeks, across several categories of environmental and resident conditions as well as staff and resident activity. Results showed a high degee of compliance with predefined standards (based on current federal regulations) for environmental and resident conditions. Overall distributions of resident and staff activity showed results similar to those found in previous studies, with residents spending most of their time engaged in nonsocial activity and staff spending the majority of their time engaged in nonresident work. When data were analyzed across areas of the facility, times of day, and weekdays versus weekends, some differences were noted. Weekend versus weekday comparisons showed higher resident:staff ratios on weekends and more resident inactivity, but no significant differences in environmental or resident conditions. In addition, more frequent resident care, resident interaction, and resident activity were observed in Medicare units than in non-Medicare units. Results are discussed in terms of federal requirements for monitoring the quality of care in nursing homes and the potential use of time sampling expressly for this purpose.
Measuring Nursing Home Quality - The Five-Star Rating System
2010
Since 1998, the U.S. Centers for Medicare and Medicaid Services (CMS) has maintained a website, Nursing Home Compare, which provides detailed quality information about every certified nursing home in the country. In December 2008, CMS greatly enhanced the usability of the website by adding an easy-to-understand 5-star rating. Each nursing home receives one to five stars based on performance in each of three key quality domains (health inspections, reported staffing levels, and quality measures derived from mandated assessments of resident health and well-being) plus an overall quality rating. Calculation of ratings requires integration of information from both facility and resident-level data sources. SAS® was used extensively in analysis to support the development of the rating system, and it is currently used to process data to refresh the ratings each month, based on newly collected data in each domain. This presentation describes the integration of data from various sources and ...
Advances in Measuring Quality of Care in Nursing Homes
Journal of Nursing Care Quality, 2005
The purpose of this column is to discuss innovations and quaiity improvement efforts in a variety of long-term care settings. These issues are of importance to healthcare professionals as our nation faces the burgeoning growth of the aging population, creating increased demand for improved and innovative long-term care services. This column is coordinated by Marilyn J, Rantz, PhD, RN, FAAN, NHA,
2005
OBJECTIVES: To assess how various stakeholders involved with nursing home care rate the importance of various quality-of-life (QoL) items for hypothetical residents with varying types of impairment. DESIGN: A community-based exploratory description of a convenience sample. SETTING: Eleven nursing homes in Florida, New Jersey, and Minnesota. PARTICIPANTS: Samples of registered and licensed nurses (RNs and LPNs), certified nursing assistants (CNAs), activities personnel, social workers, physicians, residents, and family members. MEASUREMENTS: Using a magnitude estimation approach, 17 QoL items were rated in order of importance on each of three hypothetical types of nursing home residents. RESULTS: Overall, there was little variation in the ratings for individual items. Ratings for persons with cognitive impairment were consistently lower. RNs'/LPNs' and CNAs' ratings were generally higher than the others, and physicians' ratings were generally lower. Residents' and families' ratings were generally lower than nurses' ratings. CONCLUSION: All stakeholders considered QoL to be important and felt that it deserves more attention in practice and regulation. A summary QoL score need not be weighted. Respondents (who were not cognitively impaired) considered QoL less important for residents with cognitive impairment. Value differences between those involved in nursing home care deserve more exploration. J