The first national survey to measure "culture change" within the U.S. nursing home industry finds positive signs that long-term care facilities are beginning to transform themselves from hospital-like to home-like facilities, where residents' needs and preferences—not institutional imperatives—come first.
As reported in the Commonwealth Fund report, Culture Change in Nursing Homes: How Far Have We Come?, many nursing homes have adopted at least some practices associated with "resident-centered" care, such as involving residents in decisions related to their daily activities and giving direct-care workers a greater say in the care of their residents. At the same time, critical structural and management changes have been slow to arrive.
Although The Nursing Home Reform Act, passed in 1987, established residents' rights and quality standards for nursing homes nationwide, serious concerns remain about quality of care, and quality of life, for nursing home residents. The Commonwealth Fund 2007 National Survey of Nursing Homes was fielded to examine the penetration of the culture change movement at the national level and measure the extent to which nursing homes are adopting culture change principles and practicing resident-centered care.
According to the results, at least one-third of nursing home administrators say they are actually doing something to try to make their facilities resident-centered. For example, they are giving residents more choice in determining their daily routine and empowering frontline workers to make decisions in the day-to-day care of the residents they serve. Another quarter of homes, while they have not yet begun the transformation, at least have leaders within the facility who are committed to the principles of resident-centered care.
To hear more about the survey's findings and current efforts to spread culture change, view the webinar (archived) hosted on May 20 by the Picker/Commonwealth Fund Program on Quality of Care for Frail Elders and the Pioneer Network.