Organizational Relationships Between Nursing Homes and Hospitals and Quality of Care During Hospital-Nursing Home Patient Transfers

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 7; pp. 1078 - 1084
• Main Authors: Boockvar, Kenneth S., Burack, Orah R.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.07.2007; Blackwell; Wiley Subscription Services, Inc
• Subjects: Biological and medical sciences; General aspects; Guideline Adherence; Hospital Administration - standards; Hospitals; Humans; Medical sciences; Miscellaneous; New York; Nursing homes; Nursing Homes - organization & administration; Older people; organizational affiliation; Organizational behavior; patient transfer; Patient Transfer - organization & administration; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality Assurance, Health Care - trends; Quality of care; safety management; Surveys and Questionnaires; Transfer Agreement - standards; Transfers; New York; Human; Long stay; hospitals; Nursing home for the aged; Toxicity; Patient; Hospital environment; Management; organizational affiliation; Care; safety management; Quality; Transfer; Hospital; Safety; Homes for the aged; patient transfer; Nursing home; Public health; nursing homes; Affiliation; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01235.x

OBJECTIVES: To identify organizational factors and hospital and nursing home organizational relationships associated with more‐effective processes of care during hospital–nursing home patient transfer. DESIGN: Mailed survey. SETTING: Medicare‐ or Medicaid‐certified nursing homes in New York State. PARTICIPANTS: Nursing home administrators, with input from other nursing home staff. MEASUREMENTS: Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital‐to–nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care. RESULTS: Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital–nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=−0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home. CONCLUSION: No management‐level organizational relationship between nursing home and hospital was associated with better hospital‐to–nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital‐to–nursing home transfer processes.