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The results show that by PEAK 2.0's third year, the program-with its large financial incentive and other potentially important characteristics-succeeded in attracting a large set of nursing homes whose demographics were representative of those in the state. This is important because other studies have found that the adoption of PCC is associated with improved health and well-being for residents.

Purpose of the StudyPerson-centered care (PCC) is intended to improve nursing home residents’ quality of life, but the closer bonds it engenders between residents and staff may also facilitate improvements to residents’ clinical health. Findings on whether adoption ameliorates resident clinical outcomes are conflicting, with some evidence of harm as well as benefit. To provide clearer evidence, the present study made use of Kansas’ PEAK 2.0 Medicaid pay-for-performance (P4P) program, which incents the adoption of PCC. The program is distinctive in training facilities’ staff on adopting PCC through a series of well-defined stages and providing regular feedback about their progress.Design and MethodsA retrospective cohort study was performed with 349 Kansas facilities spread across several well-defined PCC adoption stages, ranging from nonadoption to comprehensive adoption. The outcomes were thirteen 2014–2016 Nursing Home Compare long-stay resident clinical measures and a composite measure incorporating only nonimputed data for those 13 outcomes. Observed facility demographic differences were controlled for with propensity score adjustment. Treatment effect analyses were run with each outcome, with the predictor variable of program stage.ResultsSeven of the 13 clinical measures plus the composite measure indicated better health for residents in homes at higher program stages, relative to those in nonparticipating homes, including a 49% lower prevalence of major depressive symptoms in strongly adopting facilities.ImplicationsThe findings suggest that greater PCC adoption through PEAK participation is associated with better quality of care. Policymakers in other states may want to consider implementing a program modeled on PEAK 2.0.

Introduction The overarching goal of research on physical settings for individuals living with dementia is to identify associations between designed features within the built environment and outcomes of interest. Over the past three decades numerous environmental assessment tools have been developed in several countries, responding to a changing set of care industry values that increasingly prioritize a holistic, quality‐of‐life–driven person‐centered care (PCC) model over a biomedical approach to long‐term care (LTC) provision. This article reviews the diversity, constructs, strengths, and limitations of existing environmental assessment tools and identifies gaps for future tool development. Methods A systematic literature search was conducted using four databases (Medline, CINAHL, PsycInfo, and Avery Index) and terms related to health‐care environments and assessment tools. Results A total of 13 environmental assessment tools for people living with dementia within shared residential settings were identified. Evaluation of the environmental assessment tools includes a synthesis of published data for each tool's reliability, validity, ease of use, interpretability, strengths and weaknesses, as well as a comparison of various tool characteristics including date of development, country of origin, applicable care setting(s), number and variety of measures and underlying constructs, format, and descriptive versus evaluative content. Discussion While the shift to person‐centered values encompasses all aspects of care and care settings, the majority of person‐centered definitions exclude the important role of the designed, physical environment. However, this review of environmental assessment tools clearly demonstrates that newer tools are embracing the full array of PCC values. In the United States, this is shown in the shift from tools designed to assess segregated dementia care settings to tools that integrate the needs and preferences both of individuals living with and without dementia. Next‐generation tools need to specifically address the household model of design. Highlights The overarching goal of research on physical settings for individuals living with dementia is to identify associations between designed features within the built environment and outcomes of interest. A systematic literature search identified a total of 13 environmental assessment tools for people living with dementia within shared residential settings; these tools were then described and evaluated based on reliability, validity, ease of use, interpretability, strengths, and weaknesses. This review of environmental assessment tools clearly demonstrates that newer tools are embracing the full array of person‐centered care values.

This design case is about re-engaging with the fundamental role of the built environment in order to support the educational process and overall learning experience in a private Catholic school. Advanced level interior design students were provided an opportunity to work with a school whose administrator had requested assistance in setting priorities for needed changes to their grade school facility. The current building presented limitations in reflecting the high quality curriculum teachers delivered to their students, and they sought ideas for improvements that would support their goals. The design case describes a sequence of pedagogically based steps that were strategically employed through a service-learning project to help students explore user experience, apply theory, and develop design solutions using an evidence-based research framework. The goal was to plan learning spaces for pre-kindergarten through third grade school children. The interior design students first explored the theoretical perspectives of early childhood education and the role of the built environment as a significant component of the educational process. They then analyzed the existing conditions to create priorities for change, verifying this information with multiple user-groups. A comprehensive design program was developed from this information. Finally, student teams prepared design solutions that visually represented potential answers to the identified problems. Student, faculty, and client perceptions of the design process are presented in text and audio formats. Outcomes of the case study are discussed in the context of the benefits to the various user groups and participants, as well as the value of returning to the fundamentals of the educational experience through the human perceptual and physical interactions with the built environment.