title: State "technical assistance programs" for nursing home quality improvement: variations and potential implications.
abstract: To improve nursing home quality, many states have developed "technical assistance programs" that provide on-site consultation and training for nursing facility staff. We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. As of 2010, 17 states had developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. In conclusion, state technical assistance programs for nursing homes vary in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives.
authors.affiliation: Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, New York 14642, USA. yue_li@urmc.rochester.edu
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
authors.forename: William D
authors.initials: WD
authors.lastname: Spector
authors.forename: Laurent G
authors.initials: LG
authors.lastname: Glance
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
mesh_terms: D000368:Aged; D002017:Budgets; D002568:Certification; D006290:Health Planning Technical Assistance / Q000191:economics / Q000458:organization & administration* / Q000592:standards*; D006302:Health Services Research; D006707:Homes for the Aged / Q000191:economics / Q000458:organization & administration* / Q000592:standards*; D006801:Humans; D007318:Inservice Training / Q000191:economics / Q000458:organization & administration / Q000592:standards; D009735:Nursing Homes / Q000191:economics / Q000458:organization & administration* / Q000592:standards*; D015397:Program Evaluation; D058996:Quality Improvement / Q000191:economics / Q000458:organization & administration* / Q000592:standards*; D014481:United States