Thursday, August 13, 2009

University of Michigan School of Health Study: Nursing Homes Chains hurt patient care

ANN ARBOR, Mich.—Standard marketing and strategic planning practices can hurt patient care throughout a nursing home chain, but only if too much emphasis is placed on such administrative standards to the detriment of clinical and facility standards, a new study indicates.

Research from the University of Michigan School of Public Health suggests that one of the strengths of a nursing home chain—the ability to standardize and perfect administrative practices throughout the chain—also can hurt patient care.

"Consumers need ways to identify what is a good or bad nursing home when making choices about where to place a loved one," said Jane Banaszak-Holl, corresponding author on the study. "Right now, we have an easier time distinguishing the quality in McDonalds versus Boston Market than we have distinguishing how, for example, a Sun-owned nursing home differs from a Beverly Enterprises nursing home."

Chain-owned nursing homes are the predominant type of institutional care provided in the United States, yet studies have shown that the patient care received in chain-owned nursing homes is generally not on par with the patient care received in nonprofit and singly-owned nursing homes. However, little is known about their management structure other than the fact that chain ownership has a significant impact on patient care. This study examines one aspect of management structure.

"If they (chain-owned nursing homes) are really not as good, we need to think about how to improve them," said Akiko Kamimura, a U-M doctoral student in Health Management and Policy at the School of Public Health, and first author of the study.

The study suggests that corporate standardization of clinical and facility processes improved resident care, but that corporate standardization of administrative processes hurt patient care.
..... "What is problematic is a shift away from community values and local needs, and an overly strong emphasis on administrative rather than clinical outcomes."


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