title: A survey of nursing home organizational characteristics associated with potentially avoidable hospital transfers and care quality in one large British Columbia health region.
abstract: Hospitalization of nursing home residents can be futile as well as costly, and now evidence indicates that treating nursing home residents in place produces better outcomes for some conditions. We examined facility organizational characteristics that previous research showed are associated with potentially avoidable hospital transfers and with better care quality. Accordingly, we conducted a cross-sectional survey of nursing home directors of care in Vancouver Coastal Health, a large health region in British Columbia. The survey addressed staffing levels and organization, physician access, end-of-life care, and factors influencing facility-to-hospital transfers. Many of the modifiable organizational characteristics associated in the literature with potentially avoidable hospital transfers and better care quality are present in nursing homes in British Columbia. However, their presence is not universal, and some features, especially the organization of physician care and end-of-life planning and services, are particularly lacking.
authors.affiliation: Department of Family Practice, University of British Columbia (UBC). mrgret@mail.ubc.ca
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: McGregor
authors.forename: Jennifer
authors.initials: J
authors.lastname: Baumbusch
authors.forename: Riyad B
authors.initials: RB
authors.lastname: Abu-Laban
authors.forename: Kimberlyn M
authors.initials: KM
authors.lastname: McGrail
authors.forename: Dug
authors.initials: D
authors.lastname: Andrusiek
authors.forename: Judith
authors.initials: J
authors.lastname: Globerman
authors.forename: Shannon
authors.initials: S
authors.lastname: Berg
authors.forename: Michelle B
authors.initials: MB
authors.lastname: Cox
authors.forename: Kia
authors.initials: K
authors.lastname: Salomons
authors.forename: Jan
authors.initials: J
authors.lastname: Volker
authors.forename: Lisa
authors.initials: L
authors.lastname: Ronald
mesh_terms: D000368:Aged; D001955:British Columbia; D003430:Cross-Sectional Studies; D003625:Data Collection; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration*; D010360:Patient Transfer / Q000458:organization & administration*; D011787:Quality of Health Care / Q000592:standards*