Advancing nursing home quality through quality improvement itself.
The traditional approaches to improving the quality of care at U.S. nursing homes--regulation, inspection, and accountability through public reporting--have produced modest results. Greater progress could be made by focusing incentives on broader processes related to improving quality. This could foster a culture of upstream identification and solving of problems that would supplement existing downstream requirements to meet specific safety and care standards.
Werner
Rachel M
RM
Division ofGeneral Internal Medicine,University of PennsylvaniaSchool of Medicine, Philadelphia Veterans Affairs Medical Cente, Philadelphia, Pynnsylvania, USA. rwerner@mail.med.upenn.edu
Konetzka
R Tamara
RT
D014487:Centers for Medicare and Medicaid Services, U.S.; D002983:Clinical Competence; D004465:Economic Competition; D033161:Government Regulation; D018166:Health Care Reform / Q000331:legislation & jurisprudence / Q000592:standards*; D019981:Health Care Sector / Q000191:economics*; D006801:Humans; D009735:Nursing Homes / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods*; D011788:Quality of Life; D012051:Reimbursement Mechanisms; D013597:Systems Analysis; D014481:United States