Culture change pays off by increasing the quality of care in nursing homes, according to a new study from Brown University.

Researchers involved 824 skilled nursing facilities, sending a survey to directors of nursing. They then looked at those facilities that had introduced culture change between 2005 and 2010, taking out facilities that were early adopters or that had not adopted culture change. In each group, researchers examined results of 13 quality measures to see if they improved or worsened in the year after culture change introduction, controlling for issues such as case mix.

It found that those with culture change did much better in bladder training and in reducing restraint use, as well as improving on residents with feeding tubes or pressure  ulcers. Facilities employing culture change also reduced resident hospitalization rates. There was no change in fall percentages, however.

Results were published online Saturday in the Journal of the American Geriatrics Society.