Abstract
The purposes of this study were to evaluate the quality management system in U. S. nursing homes, and to examine possible applications of the U.S. experiences to nursing homes in Japan. Twelve staff members including managers at three nursing homes in California were interviewed. Most participants stated that the quality management system would contribute to improving the quality of care in nursing homes. This study revealed six factors in improving the quality of care in nursing homes using the quality management system: 1) nursing home's obligation to submit assessment data, 2) selection of the elements in agreement with nursing homes, 3) development of methods which improve the process of care at the resident level, 4) development of quality indicator/measures which compare the quality of care among nursing homes, 5) application of Quality Indicators to the nursing home inspection process, and 6) disclosure of nursing home information to the public. However, there were some challenges, including risk adjustment of Quality Indicators. This study suggests the following for Japan: 1) examining of a data collecting process, 2) developing comparable process/outcome indicators among nursing homes, 3) reconsidering of the inspection process.
