GAINING A LONGITUDINAL UNDERSTANDING OF CULTURE CHANGE PRACTICE ADOPTION IN U.S. NURSING HOMES

• Published in: Innovation in aging Vol. 1; no. suppl_1; p. 285
• Main Authors: Miller, S.C., Bishop, C.E.
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 01.07.2017
• Subjects: Abstracts
• ISSN: 2399-5300; 2399-5300
• DOI: 10.1093/geroni/igx004.1054

Nursing home (NH) culture change strives to improve NH quality through deep systematic change. However, while studies suggest its implementation is associated with improved quality outcomes, empirical evidence of its value is inconclusive due to methodological challenges. To overcome many of these challenges, we designed a panel study using our nationally representative Time 1 (2009/10) survey data from U.S. NHs and newly collected Time 2 survey data from NHs that responded at Time 1. The Time 1 survey focused on the critical domains of Environmental Practices (i.e., homelike environment), Resident Care Practices (i.e., resident-centered/-directed care), and Workplace Practices (i.e., staff empowerment). The Time 2 survey was expanded to include additional items to enhance measurement of these three domains as well as to measure the additional domains of NH Leadership (i.e., modeling and enabling of culture change) and Family and Community (i.e., inclusion/involvement). In early 2016, the Time 2 survey was administered to 2,152 nursing home administrators (NHA). While follow-up is continuing, 834 (39%) NHAs have responded. In this symposium we present findings on the: 1) study’s framework and survey design, including the cognitive-based interviewing performed to identify the NH leader to target at Time 2; 2) change in practice between 2009/10 and 2016; 3) practice in 2016 for the five measured domains; and 4) associations between domain scores and outcomes of interest. Study findings indicate significant improvement in domain scores between Times 1 and 2. Planned research will examine whether these improvements are associated with improvements in quality outcomes.