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. 2014 Feb;33(1):75-96.
doi: 10.1177/0733464812463432. Epub 2012 Nov 28.

Medical staff involvement in nursing homes: development of a conceptual model and research agenda

Renée Shield  1 , Marsha Rosenthal, Terrie Wetle, Denise Tyler, Melissa Clark, Orna Intrator
Affiliations

Medical staff involvement in nursing homes: development of a conceptual model and research agenda

Renée Shield et al. J Appl Gerontol. 2014 Feb.

Abstract

Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

Keywords: nursing home medical staff; organizational structure; outcomes of resident care; processes of nursing home care.

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Conflict of interest statement

Conflicts of interest: None declared

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