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Editorial| Volume 22, ISSUE 8, P1670-1671, August 2021

Innovation and Quality Improvement: Safe or Sabotage in Nursing Homes?

  • Cari Levy
    Correspondence
    Address correspondence to Cari Levy, MD, PhD, Division of Health Care Policy & Research, University of Colorado at Denver HSC, 13611 E Colfax Ave, Aurora, CO 80045, USA.
    Affiliations
    Division of Health Care Policy & Research, University of Colorado–Anschutz Medical Campus, Aurora, CO, USA

    Hospice and Palliative Care, VA Eastern Colorado Healthcare System, Department of Veterans Affairs, Aurora, CO, USA
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  • David Au
    Affiliations
    Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA, USA

    VA Puget Sound Health Care System Health Services Research and Development, Seattle, WA, USA
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  • Mustafa Ozkaynak
    Affiliations
    College of Nursing, University of Colorado–Anschutz Medical Campus, Aurora, CO, USA
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      High mortality among nursing home residents in the COVID-19 pandemic has laid bare the vulnerabilities of our current health care system and is inspiring conversations about how to transform nursing home care to improve quality of life and quality of work, including a JAMDA Call for Papers focused on “Reimagining Long-Term Care.”
      Reimagining long-term care: Call for manuscript submissions.
      • Centers for Medicare & Medicaid Services
      COVID-19 nursing home data.
      • Bowers B.J.
      • Chu C.H.
      • Wu B.
      • et al.
      What COVID-19 innovations can teach us about improving quality of life in long-term care.
      As researchers and policy makers recruit nursing homes for partnership in studies of transformation, an assessment of organizational strain of these communities will be essential. Organizational strain is defined as the high probability of severe failure that occurs when resources required by research or quality improvement studies cannot be provided by the organization.
      • Wood S.
      • Ghezzi V.
      • Barbaranelli C.
      • et al.
      Assessing the risk of stress in organizations: Getting the measure of organizational-level stressors.
      This is necessary not only to identify organizations well equipped to participate in research but also to protect safety in organizations that lack appropriate resources as the pandemic added strain to already burdened, under-resourced health care settings.
      • White E.M.
      • Wetle T.F.
      • Reddy A.
      • Baier R.R.
      Front-line nursing home staff experiences during the COVID-19 pandemic.
      We posit that, just as individuals have a hierarchy of needs, so too do organizations and we risk compromising safety by adding new initiatives when basic needs are not satisfied.
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