Does leadership, staff communication and teamwork impact the quality of care for dying patients in nursing homes? That’s the question Dean Sarah Thompson and her research team at the University of Nebraska Medical Center and the University of Kansas Medical Center were attempting to answer with their National Institutes of Health R01 grant: The impact of quality end-of-life care in nursing homes. The recently completed study examined organizational variables in nursing homes and whether those influence quality of end-of-life care for patients.
The study, which involved 85 nursing homes, more than 5,000 staff members and 1,240 family members, measured the quality of dying in terms of residents’ symptom distress, residents’ preferences honored, family satisfaction with care, resident-family centered care, and caregiver strain. The research team examined organizational factors, such as the percentage of Medicare and Medicaid residents along with staffing factors including the tenure of the director of nursing and nursing home administrator, the education and skill mix of staff, the knowledge of and engagement in palliative care, as well as staff leadership, communication and teamwork.
Initial results indicate that the stability of the nursing home’s leadership and the staff’s knowledge and engagement in palliative care practice have a direct impact on the quality of dying. The team is still writing up the results and publishing their findings.