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Sullivan JL, Shwartz M, Gerena-Melia M, Berlowitz D, Burgess JF. Examining the relationship between minimum data set quality indicators and artifacts of culture change tool. Poster session presented at: VA Geriatric and Extended Care Leadership Conference; 2010 Jun 9; Rochester, NY.
Objectives: Consistent with empirical research in non-VA community nursing homes, it is expected that Minimum Data Set 2.0 (MDS) clinical quality indicators should be related to resident-centered care (RCC) practices. As part of a larger VA study to identify and characterize high performing VA Community Living Centers (CLCs) , we examined the relationship between composite measures of quality and culture change, which we report here. Methods: We use the VA Artifacts Tool data from 2008 and 2009 to measure culture change. The composite measure of quality is calculated from the 2008 28 MDS quality indicators (QIs) routinely reported to CLCs by the Office of Geriatrics and Extended Care (GEC). For this analysis, 112 CLC facilities were in the sample. Inclusion criteria for these facilities included having at least one-third long-stay residents as determined by average daily census (more than 90 days length of stay) and having at least 10 residents as the denominator for those QIs for which all residents are eligible. Results: Of the 28 MDS individual QIs, 16 measures had statistically significant correlations with Artifacts Tool domains and/or the total score. Facilities with better composite scores (lower scores) also had statistically significant (p < .05) higher overall Artifacts Tool points (r = -0.22), as well as higher scores on the family and community domain(r = -0.19) and leadership domain (r = -0.22). In addition, the overall composite measure was related at a marginally significant (p < .10) level to the Artifacts Tool outcomes sub-domain(r = -0.17). Conclusions: These preliminary results suggest that there is a relationship between culture change activities and important clinical outcomes which should in fact be conceptually related. There was variation across individual MDS QIs and in the Artifacts Tool correlations, suggesting that results by individual MDS items on their own are difficult to interpret. The composite measure was related to the Culture Change data as expected and shows consistent relationships Impact: Further research is necessary to understand the relationship of culture change activities to both staff and resident quality outcomes. The composite measure is useful in further analysis linking culture change to both resident and staff outcomes.
