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May 12, 2005

Business technique applied to nursing home care

A new study suggests that simple techniques commonly used in business can reduce one of the most financially and physically debilitating conditions in the nursing home industry.

Nearly one quarter of patients in some nursing homes suffer from pressure ulcers, or bed sores, one of the leading health threats in nursing home care. In addition, pressure ulcers in the United States cost more than $1 billion annually in treatment costs and personal injury liability payments by nursing facilities.

The study, conducted by researchers at Pitt and the VA Pittsburgh Health Care System, was funded by the Agency for Healthcare Research and Quality with a grant of $800,000. It was conducted at a 136-bed, not-for-profit nursing home.

The study shows that the incidence of pressure ulcers could be reduced significantly by introducing nursing home care staff to tightly measured quality improvement processes.

Vikas Mittal, professor at the Katz Graduate School of Business, said: “Our study used a three-pronged approach. First we had to increase the ability of the nursing home staff to recognize the onset of an ulcer. We did this for the home’s entire staff and not just its medical personnel.”

The team used interactive training software that enabled the staff to train at their own convenience.

“Second, we developed a financial incentive plan for the workers,” Mittal said. “The use of financial incentives, though common in business, is somewhat of a rarity in the health care field.”

Third, Mittal said, the team developed a real-time feedback system to measure the training of staff and the level of pressure ulcer reduction.

Over a 12-week period, reducing the incidence of ulcers to below 3 percent yielded a savings of more than $40,000 while the financial incentives totaled just one quarter of that cost.

Mittal and Jules Rosen, principal investigator and professor of psychiatry in the School of Medicine, said they are unaware of such business techniques being applied or so interwoven into a system of medical intervention and care.

The financial incentive model has long been used in different industries, especially those where customer satisfaction is important. The outcomes of the study suggest that financial incentives for nursing home workers create a win-win situation for all involved, the study team said.

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