The process of selecting a quality nursing home requires that consumers have access to useful, meaningful, and appropriate information about nursing home quality. The purpose of the proposed investigation is to develop and evaluate information strategies to assist consumer use of quality factors in making nursing home choices.
Specific aims i nclude: 1) determine what information consumers use, need, and value in selecting a nursing home; 2) determine what information health care providers use, need, and value in discussing nursing home choices with consumers; 3) determine what information currently in the public domain can be used to assess nursing home quality from consumer and provider viewpoints; 4) create a prototype report card incorporating information from Aims 1, 2 and 3 that can be used to assist consumers when choosing a nursing home; 5) examine consumer and provider responses to the prototype report card, specifically: the quality indicators, usefulness, completeness, cultural appropriateness, and format; and 6) examine whether consumer and provider responses to the prototype report card differ by urgency (timing) of the nursing home selection process.
In Aims 1 and 2, a descriptive qualitative design will employ ethnographic interviews and analytic techniques with a sample of 68 newly admitted older nursing home residents, family members, and healthcare providers in eight rural and urban nursing homes. A descriptive comparative design in Aim 3 will determine the reliability and validity of available quality information. After combining data analysis results of Aims 1, 2, and 3, one or more prototype report cards will be developed (Aim 4) and evaluated with 50 consumers and providers in eight rural and urban focus groups (Aims 5 and 6). The project will include a mix of culturally diverse, rural and urban, vulnerable older persons and families. The significance of this study is the integration of qualitative and quantitative approaches to determining the most useful and relevant indicators of nursing home quality for report card development. Use of systematic consumer quality information will motivate and inform consumers to use quality indicators as a decision tool. Identifying information enabling consumers to make value-based nursing home choices will be useful for other healthcare settings in the continuum of long term care.
