title: A conceptual framework for achieving high-quality care in nursing homes.
abstract: Nursing home care accounts for 12% of healthcare expenditures in the United States, yet serious concerns remain about the quality of care provided in these settings. This article describes a comprehensive systems model that views organizational environments as consisting of four interacting dimensions: organizing arrangements, social factors, technology, and physical setting. This model is then used as a conceptual framework (vis-à-vis an extensive literature review) to identify factors that contribute to poor-quality care in nursing homes and to highlight previous research efforts. The literature review also provides a useful framework to guide nursing home administrators and healthcare quality professionals in their implementation of quality improvement processes and serves to help direct future research in this very important arena.
authors.affiliation: University of Arkansas at Little Rock, USA. jgstevenson@ualr.edu
authors.forename: J G
authors.initials: JG
authors.lastname: Stevenson
authors.forename: C
authors.initials: C
authors.lastname: Beck
authors.forename: P
authors.initials: P
authors.lastname: Heacock
authors.forename: S O
authors.initials: SO
authors.lastname: Mercer
authors.forename: P S
authors.initials: PS
authors.lastname: O'Sullivan
authors.forename: J A
authors.initials: JA
authors.lastname: Hoskins
authors.forename: R
authors.initials: R
authors.lastname: Doan
authors.forename: J F
authors.initials: JF
authors.lastname: Schnelle
mesh_terms: D005160:Facility Design and Construction; D006272:Health Facility Environment; D007587:Job Description; D017146:Models, Organizational; D009735:Nursing Homes / Q000592:standards*; D009937:Organizational Objectives; D012931:Social Environment; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States