The extent of quality improvement activities in nursing homes.

The quality of nursing home care has long been a cause for concern. The federal government has recently launched the Nursing Home Quality Initiative, in which Quality Improvement Organizations assist nursing homes in quality improvement (QI) activities. In addressing how well nursing homes are prepared for QI, this article examines the sort of QI activities that nursing homes are currently undertaking and the preparation of Administrators and Directors of Nursing to lead QI efforts. Drawing on data from surveys of 2 random samples of Kansas nursing homes, the article concludes that questions about QI activities in nursing homes tend to elicit socially acceptable answers unless the questions are carefully structured; that few nursing homes appear to have functioning QI programs; and that high leadership turnover and limited leadership training make it difficult for nursing homes to sustain effective QI programs.