Survey: Workers say SNFs need staffing improvements, better mistake responses

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Most nursing homes could improve on their staffing levels and the way that supervisors respond to mistakes, according to a recently released federal survey of facility staff.

The 2016 Nursing Home Survey on Patient Safety Culture, released last week by the Agency for Healthcare Research and Quality, surveyed staff members in 209 skilled nursing facilities on 12 different items relating to organizational culture and patient safety.

Most nursing home staff that completed the survey reported that their overall perceptions of resident safety, as well as the feedback and communication about incidents, were positive. Eighty-six percent of respondents said they felt residents were well cared for and safe, while 85% said they felt positively in the way their facilities talked about and reported potentially harmful incidents.

The survey found two measures to have the most potential for improvement for nursing homes: staffing, and nonpunitive response to mistakes. Less than half of those surveyed (48%) positively responded about their facilities' staffing levels, while 54% said staff are treated fairly — not blamed — when they make and report a mistake.

The way in which staff responded to the safety measures also varied by their positions, with administrators or managers submitting the highest number of positive responses. Nursing assistants and aides had the lowest number of positive responses. The two groups of employees differed the most on the survey components regarding communication openness, with a gap of 30 percentage points.

The survey report's authors recommended facilities pledge to “take the next steps” to turn the survey's results into real improvements.

“Often, the perceived failure of surveys to create lasting change is actually due to faulty or nonexistent action planning or survey follow-up,” the authors wrote. “Organizations may find it useful to brainstorm the potential barriers that make it difficult to implement initiatives, and strategies to overcome them.”

Click here to read the AHRQ's full 2016 Nursing Home Survey on Patient Safety Culture.