A System for Managing Staff and Quality of Dementia Care in Assisted Living Facilities

Simmons, Sandra F.; Coelho, Chris S.; Sandler, Andrew; Schnelle, John F.

doi:10.1111/jgs.15463

Cited by 8 publications

(6 citation statements)

References 25 publications

(79 reference statements)

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“…The majority (67.7%) of studies (N=107) described huddles as being used to engage team members in thinking and talking about their work and to improve communication, collaboration, and/or coordination. 6,8,11, Roughly equal numbers of studies described huddles used to identify issues requiring immediate attention or escalation to high-level management for resolution (27.2%; N=43); 1,8,9,21,25,27,29,30,32,37,39,44,53,55,57,59,63,69,75,84,87,93,98,116,122,126,134,144,146,-149,153-162,165,167,171 update team members about safety and quality issues that affect their work, including reviewing prior issues (24.1%; N=38); 6,29,32,40,57,72,73,77,83,87,89,110,111,113,118,122,123,[125][126][127][128][129][130][131][132][133][134][135][136][137][138][139][167][168][169][170][171]173 and plan for or improve processes for future work (22.8%; N=36). 9,31,…”

Section: Huddle Purposementioning

confidence: 99%

“…More than one-third of the studies (37.3%; N=59) were based on a conceptual rationale, 1,6,11,21,23,27,[30][31][32]35,37,42,47,49,53,54,57,58,[61][62][63]66,67,69,70,73,75,78,83,89,90,94,98,107,115,[119][120][121]123,[125][126][127][128]132,133,135,[145][146][147][148]156,159,…”

Section: Theories and Toolsmentioning

confidence: 99%

“…Seventy studies (44.3%) measured clinical care outcomes 1,11,25,27,30,31,34,36,41,[49][50][51]56,63,72,74,86,89,94,97,[99][100][101]128,130,[132][133][134][135][136][137][138][139]141,144,[149][150][151][152]155,[157][158][159][160][161][162][163][164] , of which all reported the huddle had a positive clinical impact. Positive The CUS assertive statements help frontline staff speak up or speak out in uncomfortable situations.…”

Section: Effectiveness Of Huddlesmentioning

confidence: 99%

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Huddles and their effectiveness at the frontlines of clinical care: a scoping review

et al. 2021

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BACKGROUND: Brief, stand-up meetings known as huddles may improve clinical care, but knowledge about huddle implementation and effectiveness at the frontlines is fragmented and setting specific. This work provides a comprehensive overview of huddles used in diverse health care settings, examines the empirical support for huddle effectiveness, and identifies knowledge gaps and opportunities for future research. METHODS: A scoping review was completed by searching the databases PubMed, EBSCOhost, ProQuest, and OvidSP for studies published in English from inception to May 31, 2019. Eligible studies described huddles that (1) took place in a clinical or medical setting providing health care patient services, (2) included frontline staff members, (3) were used to improve care quality, and (4) were studied empirically. Two reviewers independently screened abstracts and full texts; seven reviewers independently abstracted data from full texts. RESULTS: Of 2,185 identified studies, 158 met inclusion criteria. The majority (67.7%) of studies described huddles used to improve team communication, collaboration, and/or coordination. Huddles positively impacted team process outcomes in 67.7% of studies, including improvements in efficiency, process-based functioning, and communication across clinical roles (64.4%); situational awareness and staff perceptions of safety and safety climate (44.6%); and staff satisfaction and engagement (29.7%). Almost half of studies (44.3%) reported huddles positively impacting clinical care outcomes such as patients receiving timely and/or evidence-based assessments and care (31.4%); decreased medical errors and adverse drug events (24.3%); and decreased rates of other negative outcomes (20.0%). DISCUSSION: Huddles involving frontline staff are an increasingly prevalent practice across diverse health care settings. Huddles are generally interdisciplinary and aimed at improving team communication, collaboration, and/or coordination. Data from the scoping review point to the effectiveness of huddles at improving work and team process outcomes and indicate the positive impact of huddles can extend beyond processes to include improvements in clinical outcomes. STUDY REGISTRATION: This scoping review was registered with the Open Science Framework on 18 January 2019 (https://osf.io/bdj2x/).

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Section: Huddle Purposementioning

confidence: 99%

Section: Theories and Toolsmentioning

confidence: 99%

Section: Effectiveness Of Huddlesmentioning

confidence: 99%

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Huddles and their effectiveness at the frontlines of clinical care: a scoping review

et al. 2021

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“…Much of the literature on dementia care in assisted living facilities addresses health service use among residents who live with dementia, managing staff, and state-level regulations for dementia care [ 1 , 14 , 19 – 21 ]. Studies that explicitly investigate the characteristics of assisted living facilities or retirement homes that provide specialized care for dementia (i.e., a dementia care program), and how these characteristics compare to those that do not, has not received sufficient attention.…”

Section: Introductionmentioning

confidence: 99%

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

et al. 2021

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Background Many residents of assisted living facilities live with dementia, but little is known about the characteristics of assisted living facilities that provide specialized care for older adults who live with dementia. In this study, we identify the characteristics of assisted living facilities that offer a dementia care program, compared to those that do not offer such a program. Methods We conducted a population-level cross-sectional study on all licensed assisted living facilities in Ontario, Canada in 2018 (n = 738). Facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of the other 12 provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. Results There were 123 assisted living facilities that offered a dementia care program (16.7% versus 83.3% no dementia care). Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7% versus 21.6% no dementia care) and more than 115 suites (46.3% versus 20.8% no dementia care). All assisted living facilities that offered a dementia care program also offered nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjustment for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding (Prevalence Ratio [PR] 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that offered medical services (PR 1.78, 95% CI 1.00 to 3.17), compared to those that did not. Conclusions A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and offered at least five of the other 12 regulated care services. Our findings deepen the understanding of specialized care for dementia in assisted living facilities.

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“…[12][13][14] Much of the literature on dementia care in assisted living facilities addresses health service use among residents living with dementia, managing staff, and state-level regulations for dementia care. 1,11,[15][16][17] Studies explicitly investigating the characteristics of retirement homes or assisted living facilities that provide specialized care for dementia (i.e., a dementia care program), and how these characteristics compare to those that do not, are absent. The findings from such studies are important for identifying case mix and examining scope and breadth of care for older adults with complex care needs.…”

Section: Introductionmentioning

confidence: 99%

Do Assisted Living Facilities That Offer a Dementia Care Program Differ from Those That Do Not? A Population-Level Cross-Sectional Study in Ontario, Canada

Manis

Rahim

Poss

et al. 2021

Preprint

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Objective: To identify the characteristics of licensed assisted living facilities that provide a dementia care program compared to assisted living facilities that do not provide such a program. Design, Setting, and Participants: Population-level cross-sectional study in Ontario, Canada on all licensed assisted living facilities in 2018 (n = 738). Methods: Data on facility-level characteristics (e.g., resident and suite capacities, etc.) and the provision of other provincially regulated care services (e.g., pharmacist and medical services, skin and wound care, etc.) attributed to licensed assisted living facilities were examined. Multivariable Poisson regression with robust standard errors was used to model the characteristics of assisted living facilities associated with the provision of a dementia care program. Results: There were 123 (16.7%) assisted living facilities that provided a dementia care program. Nearly half of these facilities had a resident capacity exceeding 140 older adults (44.7%) and more than 115 suites (46.3%). All assisted living facilities that provided a dementia care program also provided nursing services, meals, assistance with bathing and hygiene, and administered medications. After adjusting for facility characteristics and other provincially regulated care services, the prevalence of a dementia care program was nearly three times greater in assisted living facilities that offered assistance with feeding than those that did not (Prevalence Ratio [PR] = 2.91, 95% Confidence Interval [CI] 1.98 to 4.29), and almost twice as great among assisted living facilities that provided medical services than those that did not (PR = 1.78, 95% CI 1.00 to 3.17). Conclusions: A dementia care program was more prevalent in assisted living facilities that housed many older adults, had many suites, and provided at least five of the other 12 regulated care services. These findings deepen the understanding of specialized care for dementia in assisted living facilities.

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A System for Managing Staff and Quality of Dementia Care in Assisted Living Facilities

Cited by 8 publications

References 25 publications

Huddles and their effectiveness at the frontlines of clinical care: a scoping review

Huddles and their effectiveness at the frontlines of clinical care: a scoping review

Do assisted living facilities that offer a dementia care program differ from those that do not? A population-level cross-sectional study in Ontario, Canada

Do Assisted Living Facilities That Offer a Dementia Care Program Differ from Those That Do Not? A Population-Level Cross-Sectional Study in Ontario, Canada

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