Organizational change and quality improvement in nursing homes: approaching success.

Nursing home residents' quality of life (QoL) is directly related to the quality improvement (QI) processes mandated by federal law. This article describes a 3-year longitudinal study of QI process innovations in two nursing homes and highlights details of a successful 6-month initiative. The initial QI initiatives were based on the principles of staff empowerment, enhanced ability through training, and financial incentives.

Perception gap in quality-of-life ratings: an empirical investigation of nursing home residents and caregivers.

Purpose: Several studies have previously documented the existence of a perception gap-the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual factors.

Design And Methods: We calculated the perception gap for 11 quality-of-life domains.

Ability, incentives, and management feedback: organizational change to reduce pressure ulcers in a nursing home.

Objective: Quality improvement (QI) processes in nursing homes are highly variable and often ineffective. This study evaluated an innovative QI process to reduce pressure ulcers (PUs) in a nursing home with a high rate of PUs.

Design: This was a 48-week, longitudinal study comparing the incidence of PUs during 12-week baseline and intervention and post-intervention periods.