A new grant from the National Institute on Aging will allow Susan Miller and colleagues in the School of Public Health to gather important evidence about whether the consumer, government, and nursing home industry movement of “culture change” is delivering on the promise of improved resident care.

PROVIDENCE, R.I. [Brown University] — Nursing homes have a potential path to providing better quality resident-directed care, but so far researchers have not been able to provide strong evidence to say whether the movement dubbed “culture change” improves quality of care and life in nursing homes. With a new grant of more than $1.7 million from the National Institute on Aging, Susan Miller, professor (research) of health services, policy and practice, will lead an effort to gather the definitive evidence needed by policymakers, regulators, industry, and patients and their advocates.

Culture change is a rethinking of nursing home operations and structure to allow a more residential lifestyle for residents, more resident choice in schedules and activities, and more front-line staff input into care management. In a study published last year, Miller and colleagues found some evidence that care quality improved in homes that invested in culture change extensively in 2009 and 2010.

Now they will build on that work by studying a diverse national sample of U.S. nursing homes to see whether increased implementation of culture change practices between 2009-10 and 2015-16 is associated with improved quality.

“Our previously collected nationally representative survey data is unique, and this NIA award enables us to use this baseline knowledge to conduct longitudinal research with the potential to positively impact nursing home care and to inform state Medicaid policies,” Miller said. “We’re excited to have this opportunity to resurvey nursing home administrators nationally to learn how their facilities’ implementation of culture change practices has changed over time and how this change may have influenced quality.”