For The Health of It
  Smaller Care Facilities Have Better Patient Outcomes!   

The real reason that one picks a facility is obviously to receive care. But the finding of a facility that will meet your needs and is poised to meet the tasks at hand is hard to determine. Some of the indicators often used to choose facilities are noise, cleanness, odor and general appearance. I consider these very important issues and recommend that you take these into account as they speak to overall management. However, this article hopes to point out two other obvious yet often overlooked assessment criteria's.

The goal of the facility is to have good patient outcomes. There are basics of care and processes surrounding each type of facility that staff consistently do no matter their facility size: helping patients with ambulation, nutrition and hydration, and toileting and bowel regularity; preventing skin breakdown; and managing pain, etc. But the component that is most likely to bring the greatest quality to these tasks is - staff to patient familiarity, something more likely in a smaller facility - in essence, a result of greater levels of individuality in care.

Some might feel that it takes a larger facility with its larger revenue catchments to be able to pay for such attention to details, but would you believe that there is evidence that "good quality care may actually cost less".  In one of many studies, "small facilities of 60 beds or less were more likely to have good patient outcomes", when compared to larger facilities. This can happen; in that the numbers of people that fill department head positions in a 40 bed facility are the same as are required in a 99 bed facility, yet the number of patients the department heads serves and overseas is more than doubled in the 99 bed facility.

Quality care and positive outcomes are more likely, in that the staff of smaller facilities know more personally the patients and thus are able to adjust care issues more quickly and individually. Additionally, smaller facilities might have fewer burdens with policy and processes that impend change and quicker adjustments in care. In the quality assurance processes, patient outcomes (success or failure of treatment) are measured at various times during care and at the time of discharge. Overall, "smaller facilities are having better outcomes".

What should this tell the consumer? It means, look for a facility that can bring the most personalized care possible, measured by factors of facility size/staffing and accommodation.

Dr. Ron Brown has administered various heath care facilities for the past thirty years and is best known locally for his development and opening of Country Crest in Oroville in 2002. Currently he oversees facility management of Paradise Skilled Nursing in Paradise and Shadowbrook Health Care in Oroville.  He can be contacted at  or
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