The official journal of the National Association for Healthcare Quality
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November/December 2005 Table of Contents
FEATURE ARTICLES
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Abstract: 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. After 18 months without measurable success, the QI process was modified to include real-time feedback. Two not-for-profit nursing homes participated in this study to explore the effect of organizational change in nursing homes on residents’ quality of care and QoL and staff members’ job satisfaction. At 6-month intervals, residents and staff participated in structured assessments of residents’ QoL and quality of care and staff members’ job satisfaction. When the QI process was modified to include real-time feedback, there was a significant reduction in the rate of new pressure ulcers, stage 2 or greater (p < .05), in one of the facilities that had struggled with this problem for more than 18 months. By examining QI processes in nursing homes, the researchers were able to identify some of the obstacles to improving quality of care and QoL. Only when the element of real-time feed-back was introduced, in combination with enhanced staff abilities and financial incentives, were substantial improvements seen in key clinical outcomes.
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Abstract: Interview techniques have evolved to include objective testing and situational assessment methods, and an applicant for a quality leadership role in today’s market may encounter these new techniques. For an organization, the use of an updated interview process provides greater insight into an applicant’s knowledge, skills, and abilities. This article offers an overview of these processes, insights for organizations and leaders to consider in developing assessment strategies, and tips for quality leaders who encounter testing and situational assessment methods during a career search. A case study is provided on the use of job simulations for recruitment of both a senior director for quality and performance improvement and a data management administrator in a regional medical center.
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Interview with a Quality Leader: Robert McArtor on MaineHealth and the Maine Quality Forum Initiative
Susan C. Boisvert
Abstract: Robert McArtor, MD MPH, is chief medical officer of MaineHealth, Maine’s largest and most complex integrated delivery system. He has also chaired the Maine Quality Forum Advisory Council since its inception.
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The Quality of Preventive Medical Care for Homeless Veterans with Mental Illness
James McGuire, Robert Rosenheck
Abstract: This study compared receipt of primary care prevention services among homeless and nonhomeless veterans who received Veterans Affairs medical care services and found that targeted efforts are needed to facilitate access by recently homeless veterans.
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Hospital-Level Correlation Between Clinical and Service Quality Performance for Heart Failure Treatment
Sabina B. Gesell, Paul Alexander Clark, Deirdre E. Mylod, Robert J. Wolosin, Maxwell Drain, Pe-ter Lanser, Melvin F. Hall
Abstract: A national cross-sectional study correlates the satisfaction ratings of heart failure patients and the Centers for Medicare & Medicaid Services’ process-based quality measures for heart failure treatment for 32 hospitals.
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