Outcomes of Green House Homes Compared to Other Nursing Homes: What Structures and Processes are Associated with Better Outcomes?

The primary aim of this study is to identify the essential components (structures and processes) of care that relate to resident outcomes in various skilled nursing settings, with a special focus on those structures and processes that are reflected in Green House homes(GH). In addition to examining how outcomes differ by site (i.e., GH homes compared to traditional or high-end culture change nursing homes), we will explore what specific structures (e.g., staff roles, self-managed teams, physical environment features), processes (e.g., time spent in various activities such as assistance with activities of daily living, meals, communications, care planning, socializing with elder), and various combinations of structures and processes, are associated with better outcomes (i.e., avoidable transfers to hospital or emergency department; injurious falls; and pressure ulcer development). Data collection will be in four areas: resident and site characteristics, core processes, and outcomes. Main sources of data include a profile survey, resident Minimum Data Set (M.D.S) 3.0 data, observation of core processes, staff surveys and standardized interviews, and data worksheets completed during on-site visits.

Principal Investigator: Sheryl Zimmerman, Ph.D.

Funding: Robert Wood Johnson Foundation

Total Project Period: 07/01/11-06/30/2014