Study Finds Accreditation Improves Safety Culture at Nursing Homes

Accredited nursing homes report a stronger resident safety culture than nonaccredited facilities, according to a new study published in the May 2012 issue of The Joint Commission Journal on Quality and Patient Safety.

The study shows that senior managers at more than 4,000 facilities across the U.S. identify Joint Commission accreditation as a positive influence on patient safety issues such as staffing, teamwork, training, nonpunitive responses to mistakes, and communication openness. The findings that accreditation stimulates positive changes in safety-related organizational structures and processes are significant, given that few studies have examined the impact of Joint Commission accreditation in nursing homes.

The lead author of the study, Laura M. Wagner, PhD, RN, an assistant professor at the New York University College of Nursing at the Hartford Institute for Geriatric Nursing, notes that the research is both timely and of great importance given that senior managers, such as the nursing home administrators and directors of nursing who were surveyed, can greatly influence the culture of an organization.

It has been suggested that the process of sustaining the level of standards compliance required for accreditation can create a safety-oriented culture within a facility, and our results appear to support this contention, says Wagner. Although there are costs associated with accreditation, these findings suggest that the benefits of voluntary accreditation may ultimately outweigh the extra costs. 

This is the second study by Wagner and her co-authors, Shawna M. McDonald, MSc, and Nicholas G. Castle, PhD, that demonstrates the benefits of Joint Commission accreditation for long-term care organizations and their residents. The article, Impact of Voluntary Accreditation on Deficiency Citations in U.S. Nursing Homes, which appeared in the March 5 issue of the journal The Gerontologist showed that Joint Commission accredited long-term care facilities had fewer survey deficiency citations than nonaccredited facilities. A forthcoming study by Wagner and her co-authors to be published in the journal Policy, Politics & Nursing Practice shows that Joint Commission accredited long term care organizations also had better resident outcomes which continued to improve over time. The article will appear online April 25.