New York Times Letter: Improving Quality of Care in Nursing Homes

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In this Oct. 1, 2008 Letter to the Editor published in The New York Times, Commonwealth Fund assistant vice president Mary Jane Koren, M.D., M.P.H., wrote that new reports on nursing home violations point to a need for better quality in the industry.


To the Editor: Recent reports on nursing home deficiencies raise important questions about how better quality can be achieved. While regulations are important mechanisms for holding nursing homes to basic standards, they haven't proved effective at lifting performance over that minimum threshold. Several voluntary efforts that receive grants from the Commonwealth Fund are currently working to help nursing homes achieve the care and quality of life that residents and their families have every right to expect. The "culture change" movement, led by the Pioneer Network, has for more than a decade worked to focus care around the needs and expectations of residents themselves. A national quality campaign, Advancing Excellence, has signed up more than 7,100 nursing homes to work on measurably improving care in eight goal areas. Since its inception two years ago, homes in the campaign have achieved faster improvement on selected clinical goals than nonparticipants. Transforming the industry in a systematic way will require that all those interested in nursing homes--health care providers, staff members, consumers and regulators--work together to improve quality. Mary Jane Koren New York, Oct. 1, 2008

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