Daily Editors' Notes

When we talk about providing good care, what do we really mean?

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John O'Connor
John O'Connor

In case you haven't noticed, “quality” is quite the buzzword in long-term care these days.

Earlier this week, the HHS Inspector General indicated that promoting quality care in long-term care settings will be one of his leading challenges.

This followed an announcement that University of Missouri researchers will examine how information technology systems can help improve quality.

 “Quality” was also frequently discussed at educational sessions tied into the recent LeadingAge and American Health Care Association conventions.

This focus on quality is certainly a welcome shift. For most of the past few decades, “quality” and “nursing homes” were rarely mentioned in the same sentence – unless the word “bad” was also thrown in. So we're making progress.

Consumers want quality care for their parents, regulators want to see it to justify tax-dollar and policy investments, and providers want to deliver it in order to stay in business. You'd think that with all this energy directed at quality, there would be general consensus about what it truly means. Turns out that quality is one of those things that is often in the mind of the beholder.

Part of the challenge is that red tape and other bureaucratic language often gets in the way. Consider: When you take care of a sick youngster at home, are you trying to help that child reach her or his “highest practicable level of well being”? Of course not. Yet that is exactly what federal regulations direct nursing homes to accomplish with residents. And we wonder why common ground is so hard to find.

Perhaps we need to simplify things a bit. Maybe instead of divining the various incantations of “quality,” we should be asking a more fundamental question: What makes for good care?

I have a few opinions here. I believe it starts with the Hippocratic Oath: First, do no harm. Beyond that, residents deserve a danger-free living environment, decent food, required care and medicine, to be treated with dignity — and to interact with qualified caregivers who actually, well, care. Some meaningful activities and other outlets would also be nice. And if the place doesn't look like a warehouse for the pre-dead, so much the better.

Yes, that may be setting the bar pretty low. Sadly, I've seen many operators fail to provide even this modicum of care. My guess is that you have as well.

But my perspective has not been forged on the front lines. Yours has. And I would love to hear your thoughts on this simple question: What makes for good long-term care? You can simply type in your thoughts below.

Your reply can be a single suggestion, or something more expansive. Either way, I'm looking forward to some good answers.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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