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Nursing home quality: what matters to patients
  1. Jennifer Gaudet Hefele
  1. Health, Booz Allen Hamilton, Rockville, Maryland, USA
  1. Correspondence to Jennifer Gaudet Hefele, Health, Booz Allen Hamilton Inc Rockville, Rockville, MD 20852, USA; hefele_jennifer{at}

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A recent BMJ Quality & Safety article and accompanying editorial highlighted key challenges with quality measurement in US nursing homes, including the challenge of identifying the impact of measures on observable patient outcomes and determining what matters in terms of measurement.1 2 Both pieces offer important insights into the issue of measuring what is meaningful and both offer ideas for improvements.

Picking up a thread from the BMJ Quality & Safety editorial, this viewpoint advances the discussion of measuring what matters. However, this viewpoint shifts the focus to measuring what matters to patients. Considering the multiple types of care and people cared for in nursing homes, we can broaden our understanding of ‘patients’ to mean long-stay nursing home residents, short-stay postacute/rehabilitation patients, and families of residents and patients. While the focus of the editorial is on process and outcome measures of quality, the authors acknowledge that measuring quality of life is ‘often paramount’ to nursing home residents.2 Indeed, patient and resident perspective measures are critical for understanding the quality of any particular nursing home.

Patient and resident perspective matters

Although measuring patient perspective matters in all care situations, it is particularly important in the case of nursing homes. Nursing homes can be understood as ‘total institutions’, in which all aspects of an individual’s life are lived out within the facility for that individual’s tenure there.3 For nursing home patients and residents, this means that they eat, sleep, socialise and receive care all within the walls of a nursing home. In this context, it makes sense that understanding patient and resident perspectives—their assessment of their quality of life, their satisfaction with the facility and services, and their experiences with staff and day-to-day life—matters tremendously. Given that families of patients and residents often serve as the voice for ill or impaired loved ones, …

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  • Contributors JGH is the sole author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JGH is an employee of Booz Allen Hamilton and receives regular compensation as part of her employment. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of her employer.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.