Continuous quality improvement as an innovation: which nursing facilities adopt it?
OBJECTIVE
We identify environmental and organizational predictors that best discriminate between formal continuous quality improvement (CQI) adopters and nonadopters in nursing homes (NHs) and create a diagnostic profile for facility administrators and policy makers to promote CQI.


METHODS
We performed a cross-sectional survey of licensed NH administrators in New Jersey in 1999, using The Nursing Care Quality Improvement Survey ( Zinn, Weech, & Brannon, 1998) and The New Jersey NH Profiles Chart. We also performed a discriminant analysis. Of 350 NHs, 46% returned completed questionnaires.


RESULTS
Using variance innovation, resource dependence, and institutional perspectives for our framework, we found that new requirements, environmental competition, organizational time and structural facilitators, and manager training made statistically significant contributions to discriminating between formal CQI adopters and nonadopters.


CONCLUSIONS
Regardless of size, NHs adopt formal CQI to meet external expectations of new regulations and accreditation criteria. CQI adoption is facilitated by information systems, flexible use of personnel, and team supports, as well as CQI training for managers. This profile of adopters can guide administrators and policy makers in promoting CQI for NHs, and it can help NHs already interested in CQI focus internal resources on key facilitators.
Lucas
Judith A
JA
APN-Rutgers, The State University of New Jersey, Institute for Health, Health Care Policy, and Aging Research, 30 College Avenue, New Brunswick, NJ 08901-1293, USA. Jlucas@ihhcpar.rutgers.edu
Avi-Itzhak
Tamara
T
Robinson
Joanne P
JP
Morris
Catherine G
CG
Koren
Mary Jane
MJ
Reinhard
Susan C
SC
D004059:Diffusion of Innovation; D009735:Nursing Homes / Q000592:standards*; D011050:Policy Making; D017749:Total Quality Management; D014481:United States