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Journal Publishes Supplement Devoted to Culture Change

February 27, 2014

A special supplement to the February issue of the The Gerontologist is devoted to culture change and includes the most comprehensive study yet demonstrating culture change’s positive effect on care quality.

The study uses data from the Pioneer Network to identify 251 nursing homes that have adopted culture change values between 2004 and 2009.

Health-related survey deficiency citations fell by 14.6 percent in culture change facilities during those years, relative to a control group of non-culture change nursing homes.

“This study, representing perhaps the most comprehensive evaluation of nursing home culture change to date, found that the adoption of culture change, as defined by expert opinion, was associated with fewer government-assigned health related deficiency citations,” said David Grabowski, the lead author of the report and an associate professor at Harvard Medical School‘s Department of Health Care Policy.

“From a policy perspective, these results are consistent with the 2009 revisions to the Centers for Medicare & Medicaid Services‘ Interpretive Guidelines for nursing home surveyors that included an increased focus on resident choice and autonomy,” he continued.

Grabowski was also the lead author on another study published in the supplement, entitled “Who Are the Innovators?” The study looks for characteristics shared by facilities that have adopted culture change.

The researchers found that large, nonprofit nursing homes are more likely to be identified as having implemented culture change. Additionally, “culture change” facilities were more likely to have fewer Medicaid and Medicare residents and higher levels of nurse and nurse aide staffing.

Other articles published in the Gerontologist supplement examine the effect of The Green House model on direct-care workers, and tell the story of a coalition of long-term care stakeholders in Arkansas that intends to implement culture change throughout the state.

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