Long-Term Care Research & Resources
- Nursing Home Workflow Study: Analysis of Staff Workflow in Traditional Nursing Homes and
THE GREEN HOUSE® Project Sites (June 1, 2009)
A new study funded by the Robert Wood Johnson Foundation found that The Green House model’s organizational and staffing redesign delivers more direct care time, a key component of improved quality, without increasing staff hours and maintaining expenses at levels similar to traditional nursing homes. This new, yet to be released, study examines front-line staff daily workflow in skilled nursing settings, including Green House homes, and confirms the model’s design to redeploy, but not increase, staff time. Thirteen organizations, including 27 sites, participated in the study.
According to the study, conducted by the Institute for Clinical Outcomes Research (ICOR) and Health Management Strategies (HMS):
- Total staff hours: The total difference in staff time was approximately 30 minutes less per resident day in Green House homes compared to traditional settings. However, the quality of interaction in a Green House home is stronger. For example, staff in a traditional nursing home spend 45 minutes more simply transporting residents than in a Green House home. Elders in a Green House home receive 1.5 hours more nursing staff time than those living in traditional nursing homes. In Green House homes, fewer staff hours (approximately two hours) are spent on non-nursing services such as food preparation, housekeeping and other support services.
- Direct care time: An elder in a Green House home receives approximately 30 minutes more in direct care activities per day compared to a resident in a traditional setting.
- Engaging elders: The Green House model provides more direct and personalized interaction between caregivers and elders than traditional nursing homes. On average, Green House elders receive 25 minutes of direct engagement outside of assistance with activities of daily living compared to five minutes for residents in a traditional setting.
- Effects of Green House Nursing Homes On Residents' Families (PDF, 396 KB, 17 pages)* - In 2003, Dr. Terry Lum, Dr. Rosalie Kane, and a team of researchers from the University of Minnesota began a two-year study of the first Green House homes in Tupelo, Mississippi, collecting information from residents, primary family caregivers, and staff. This paper details the outcomes related to the residents’ families. The study was published in the Health Care Financing Review, Winter 2008-2009/Volume 30, Number 2, and was funded by the Commonwealth Fund.
- Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program (PDF, 159 KB, 25 pages)* - In 2003, Dr. Rosalie Kane and a team of researchers from the University of Minnesota began a two-year study of the first Green House® homes in Tupelo, Mississippi, collecting information from residents, primary family caregivers, and staff. This paper details the resident outcomes from that study as published in the June 2007 Journal of The American Geriatrics Society (JAGS). The study was funded by the Commonwealth Fund.
- “Making The Green House Model Work in Your Community.” Panel discussion (two hours). American Association of Homes and Services for the Aging – 2007 Annual Meeting, 10/23/07. Representatives from three active Green House® projects discussed the impact that the development of Green House® homes is having on communities and how flexibly the core principles can be applied to meet local needs (e.g., design adaptations, project diversity, financial structuring, operational differences, strategic planning). Panelists: Joyce Ebmeier, Tabitha Health Care Services (Lincoln, NE); Karna Rhodes, St. John’s Lutheran Ministries (Billings, MT); and Barry Berman, Chelsea Jewish Nursing Home (Chelsea, MA). Listen to discussion (Windows Media Player).
- NHRegsPlus -The first iteration of NHRegsPlus is now ready for use. This searchable website was developed by Rosalie A. Kane and Lois J. Cutler at the University of Minnesota with grant funding from the Hulda B and Maurice L Rothschild Foundation in Chicago. The website is intended to make it possible to: search the content of any State's nursing home regulations; compare any State's regulations to the Federal nursing home regulations; compare regulations of all 50 States on hundreds of topics; see what's new in regulations in a specific state or a specific topic; learn a glance how all 50 States regulate new construction; compare State regulatory processes, including waiver & exception policies; find examples of regulatory variations pertinent to resident autonomy, quality of life, and culture change in nursing homes; find up-to-date resources related to nursing home care and nursing home life; review analyses of regulatory variation; separate myth from reality about the relationship between Federal and State nursing home regulations and resident-centered culture change. The website is expected to be useful to federal and state regulators, ombudsman, administrators, architects and developers, educators, culture change agents and professional practitioners in a wide variety of disciplines. Go to http://www.hpm.umn.edu/NHRegsPlus/
For Green House articles, press releases, issue briefs and webcasts, visit our Green House In the News web page.
Note: THE GREEN HOUSE® is a registered trademark. Only projects with an executed sub-license agreement may use the "Green House" term, or a confusingly similar term, in association with a long-term care facility.
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