POLICY WITHOUT TECHNOLOGY - A BARRIER TO IMPROVING NURSING-HOME CARE

Standards of care are written for nursing homes without a realistic as sessment of whether there is an intervention protocol or resources to meet these standards. This situation produces unfair pressures on nurs ing home providers, who read with paper compliance strategies, and cre ates a barrier to implementing new interventions that do meet care sta ndards once they are developed. This article explores this barrier and illustrates examples of interventions that have been attempted in nur sing homes using a continuous quality improvement model. The developme nt of quality indicators based on assessment data available in all nur sing homes is a step toward making the survey process more focused on outcomes rather than on paper compliance. Much more research is needed to design effective clinical interventions and to provide nursing hom es with the technologies necessary to target them. Internal nursing ho me quality assurance programs based on principles of continuous qualit y improvement, with reinforcement from the external survey process, ar e suggested as a strategy to maintain clinically effective interventio ns. Applied research centers based in long-term care facilities should be supported in order to accomplish such research designed to improve the care and quality of life of our increasing frail nursing home pop ulation.