While many aspects of nursing home care have improved over time, numerous issues persist.
Presently, a potpourri of approaches and a push to “fix” the problem have overshadowed
efforts to correctly define the issues and identify their diverse causes.
Together, the two segments of this fourth and final article (divided between this
month's issue and the next one) in the series identify strategies that should tie
reform efforts together. This Segment 1 of Article 4 discusses the need to judge initiatives
and proposals by how well they support and/or promote critical elements such as the
care delivery process and clinical problem solving and decision making activities.
It also covers the need to critically scrutinize and modify the conventional wisdom
and to suppress “political correctness” thatcontinues to inhibit vital critical inquiry
and dialogue that are needed to define issues correctly and make further progress.
Ultimately, relatively uncomplicated and inexpensive strategies have the potential
to bring dramatic progress. But there needs to be more willingness to rethink the
issues and reconsider current approaches.
Keywords
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Article info
Publication history
Published online: January 13, 2010
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© 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
