Overview of the Hospital
The case study focuses in Alden Terrace Convalescent Hospital, a nursing home located in the county of Los Angeles in the state of California. The hospital, previously known as Alden Terrace Cvlt Hosp, operates under the license from L.A. County West District Office. The nursing home is registered under the license category of a skilled nursing facility. The facility has a rating of 2 or lower in all categories except quality measures where every other facility is rated as much above average. As a result, Alden Terrace Convalescent Hospital is ranked the 73 rd highest, which is a major concern for patients and other stakeholders based on classification of the hospital as a large facility by virtue of its 210 certified bed capacity. In addition, the facility is currently 95% full and has 188 residents. The hospital ownership is as for profit corporation registered under the legal business name Alden Enterprises Inc. the nursing home runs a number of programs by virtue of its location including a continuing retirement community, Medicaid, and Medicare.
Quality Performance of the Nursing Home
Quality performance of Alden Terrace Convalescent Hospital is reflected in its overall rating which is much below average. The standard health inspection results show that though no complaint inspection were lodged against the hospital between august 2016 and July 2017, the facility had 14 deficiencies in total, which is way above the state and national averages of 12.2 and 7.3 deficiencies respectively. According to the Common Wealth Fund sponsored study by Shih and Schoenbaum (2007) patients and health providers are in a consensus that high-quality care is a critical component of a high performing health system, a discourse shared by many other stakeholders. Based on this argument, it is evident that Alden Terrace Convalescent Hospital has a poor performance quality.
Delegate your assignment to our experts and they will do the rest.
The report in indicates that deficiencies in mistreatment and administration were non-existent, resident assessment and resident rights had one deficiency each, nutrition and dietary and pharmacies services contributed 2 deficiencies each, while 4 deficiencies were found in each of quality care and environment. The parameters employed to conduct inspection represent the dynamics of hospital performance which is measured based on the degree of improvement or deterioration in quality and service over time (Kroch, Duan, Silow-Carroll et al. , 2007). The poor quality of performance in reflected in care outcomes.
For instance, though the long stay residents’ rates are lower than the state average, the facility’s short stay rates exceed average state levels. The inspection report elaborates that a significant number of residents were at risk of minimal harm of potential for actual harm while undergoing different medical processes. Given the need for zero tolerance to avoidable deficiencies in a health settings, one can argue that the high number of deficiencies for Alden Terrace Convalescent Hospital is intolerable, hence the need for redress. However, factors contributing to low rating of the hospital may not be perceived to be very gross. This is evidenced by penalty report showing that the nursing home has not received any penalties in the last three years, nor has it received any payment denials (Medicare.gov).
Safety performance of the Nursing Home
It is important to point out that data is unavailable for average safety performance at the national, state, or facility level from the resources examine as per the inspection. Similarly, the inspection report presents and exhaustive list of prospective safety deficiencies, but not a single deficiency was found. Among the most critical areas inspected were building and construction deficiencies, hazardous areas, exit and exit access, illumination and emergency power, fire alarm systems, smoking regulations, laboratories deficiencies, electrical deficiencies, and medical gases and anesthetizing areas deficiencies. This leads to the conclusion that majority of safety issues in relation to the nursing home performance originated from the quality of services delivery where deficiencies with minimal harm or the potential to cause harm were reported under different categories. The absence of citation or penalties accrued by the facility is testimony that the hospital has plausible safety frameworks that have been implemented to the required standards.
Quality Improvement Strategies
Oversight and regulatory frameworks exist across the health sector, but they have done little in preventing the deterioration of service provision at Alden Terrace Convalescent Hospital to levels that re problematic as per the overall rating. The need for improvement is imperative, but Wiener (2003) cautions that adoption of strategies for improvement requires substantially more resources and increases the costs of operation in addition to other factors such as uneven political saliency on nursing issues, emphasis on regulation, and sophisticated strategies for non-existent nursing homes.
In a study examining the role of provision of nursing facilities with comparative quality information and education on quality performance and improvement of clinical practices, Rantz, Popejoy, Petroski et al. (2001) demonstrated marked improvement in outcomes of patients in facilities that implemented the strategy. Simply put, communication is vital to quality performance. In Alden Terrace Convalescent Hospital case, inspectors found that the nursing home failed to ensure that care provided built residents’ dignity and respect for individuality. Sharing of quality information would ensure understanding of the residents’ needs based on the setting hence ensuring they are met in an acceptable professional manner.
The worst performance as per the report was on nutrition and dietary where the facility failed ensure that menus met the residents’ nutritional needs, and to store, prepare, and cook food in a clean and safe place. It is important to recognize that nurses are not specialists in all matters of health, hence the need for a professional consultant to oversee each department to ensure development and implementation of frameworks that improve service provision. In this case, a nutritionist specialist is necessary to offer guidance in matters of diet and food preparation. The nursing home must also institute internal regulatory and auditing mechanism to ensure compliance with set procedures in all departmental levels.
Safety Improvement Strategies
As evidenced in the previous section, no deficiencies were found in all categories of factors being inspected. This implies the nursing handling of safety measures is competent. However, the facility cannot afford to stagnate as efforts are needed to ensure all safety measures are upgraded depending on evolving residents’ needs and new guidelines by the regulators. Safety improvement should be a progressive undertaking to ensure sustained excellence in services provision.
References
Kroch, E. A., Duan, M., Silow-Carroll, S., & Meyer, J. A. (2007). Hospital Performance Improvement: Trends in Quality and Efficiency. A Quantitative Analysis of Performance Improvement in US Hospitals, The Commonwealth Fund .
Medicare.gov. Nursing home profile: Alden Terrace Convalescent Hospital. Nursing Home Compare. https://www.medicare.gov/nursinghomecompare/profile.html#profTab=4&ID=056237&Distn=0.0&state=CA&lat=0&lng=0.
Rantz, M. J., Popejoy, L., Petroski, G. F., Madsen, R. W., Mehr, D. R., Zwygart-Stauffacher, M., ... & Porter, R. (2001). Randomized clinical trial of a quality improvement intervention in nursing homes. The Gerontologist , 41 (4), 525-538.
Shih, A., & Schoenbaum, S.C. (2007). Measuring hospital performance: The importance of process measures. The Common Wealth Fund. Retrieved 26/9/2017 from: http://www.commonwealthfund.org/~/media/files/publications/data-brief/2007/jul/measuring-hospital-performance--the-importance-of-process-measures/1046_shih_measuring_hosp_performance_process-pdf.pdf.
Wiener, J. M. (2003). An assessment of strategies for improving quality of care in nursing homes. The Gerontologist , 43 (suppl_2), 19-27.
