A person-centered nursing home approach that focuses on relationships can also turn out impressive data when it comes to clinical practices and quality of care, according to new research.
Two separate projects reported this month show Eden Alternative nursing homes, known for their holistic methods, outperform facilities nationwide on overall 5-star ratings, have fewer substantiated complaints and use fewer antipsychotic drugs than non-Eden facilities.
The first study, conducted by consultant Amy Elliot, Ph.D., compared the 142 nursing homes on the Eden Alternative Registry with all U.S. nursing homes included on Nursing Home Compare. In addition to the overall ratings, Elliot also determined that Eden had higher survey ratings.
A second, grant-funded collaboration with the Tennessee Eden Alternative Coalition also showed that teaching nursing home staff non-pharmacological interventions for those with dementia significantly reduced antipsychotic use among long-term residents.
Homes participating in the three-year study reduced use by 20.7%, while non-participants dropped their usage rate 12.4% over the same time period. Notably, facilities who entered the program in its first-year saw the most improvement with a 26.3% reduction.
“Our hope is that providers that haven’t yet engaged with us understand that implementing the Eden Alternative philosophy, tools and practices isn’t just the right thing to do, it results in a higher performing organization,” Jill Vitale-Aussem, President and CEO of Eden Alternative, told McKnight’s. “The outcomes of these recent analyses, along with other studies that show improved team member retention and financial outcomes, are critical in getting organizations on board with driving cultures of person-directed care.”
Eden is based on resident and staff empowerment and leadership competencies. The approach dates to 1994, yet the organization still has just 142 Medicare/Medicaid-eligible nursing homes in its ranks. Vitale-Aussem said the obstacle to change is often organizational, not financial.
Elliot told McKnight’s the star-ratings comparison was a straight-forward, means-comparison of Eden Registry and all other nursing homes. Though the study did not evaluate payer mix, she noted that 2017 self-reported data showed the average Eden nursing home registry member has a Medicaid census of about 60%.
“Many people are drawn to quick fixes and surface level interventions,” Vitale-Aussem said. “They may think that eliminating scrubs and overhead paging or constructing a new building will fix the problem. But these approaches don’t address the underlying institutional framework.”
She noted that training employees in Eden methods could lead to gains even in buildings that aren’t on the Eden registry. Last year, the organization provided education to about 4,000 people.