Have you thought about the role of the medical director in your facility lately? One of the challenges in the delivery of care to residents is to sort out their care and medical needs. A team approach is the best way for a nursing home to provide care to its residents. Front-line staff provide direct care, nurses and therapists provide necessary and medically-prescribed care, and the attending physician responds to the resident's medical needs. What about the facility's medical director? What is its role and how should this fit into your facility?
The requirements of this Tag state that:
1) The facility must designate a physician to serve as medical director.
2) The medical director is responsible for:
i) Implementation of resident care policies, and,
ii) Coordination of medical care in the facility.
Why should nursing homes adhere to these requirements? To answer this question, we should try to find data to support the effectiveness of medical directors in nursing homes. Fortunately, such data exists in relation to CMDs.
In 2009, Fredrick N. Rowland, PhD, MD, CMD, published an article in the Journal of the American Medical Directors Association entitled,
"Impact of Medical Director Certification on Nursing Home Quality of Care.
" The study examined a standardized quality score among facilities with fully certified medical directors and found a 15 percent improvement in quality. The conclusion was that,
"the presence of CMDs is an independent predictor of quality in U.S. nursing homes.
" Still, the study was not perfect. The control group probably contained facilities with CMDs that had not been reported as such, which would have diluted the impact of the study. It is therefore quite possible that CMDs have a greater impact on quality in nursing facilities!
What can a facility do to assist their medical director in obtaining their CMD? First, they should encourage and support membership in The Society for Post-Acute and Long-Term Care Medicine (AMDA). Second, they should support membership in their state
s AMDA chapter (Florida Society for Post-Acute and Long-Term Care Medicine [FMDA] in Florida). Finally, they should encourage their medical director to complete the Core Curriculum on Medical Direction (
). Let's all work to close the loop on delivering the highest quality of care to the residents of nursing facilities. Value the role of your medical director and support that person in obtaining a CMD!