Benchmarking Implementation of a Computerized System for Long-term Care

Abstract

The purpose of this study was to apply a benchmarking methodology to identify the most effective approaches used by long-term care facilities in implementing new computerized resident assessment instrument/minimum data set (RAI/MDS) systems and to develop implementation protocols based on these "best practices." Site visits were conducted with 3 long-term care facilities, selected on the basis of a national search. Facility directors, directors of nursing, information system managers, and frontline staff at each facility were targeted, and questionnaires were developed for each to assess factors viewed as important to successful implementation. A convergence was found in recommended action steps reported across sites to facilitate introduction and implementation of new RAI/MDS software. An example of how benchmarking results were used to develop an implementation plan is provided. Benchmarking provided a useful methodology for identifying best practices to guide implementation planing for adoption of a new computerized RAI/MDS system in the current trial. The benchmarking steps described are replicable and can be used to guide implementation of other new systems in the nursing home setting.

Health Information Technology in Nursing Homes

“…The decision to purchase and use a commercial MDS product can be seen as either a way to meet the requirements for electronic data submission or as part of a larger IT strategy that encompasses IS and HIT. These decisions may depend on considerations such as staffing levels and knowledge about ISs (Nahm, Mills, & Feege, 2006;Ossip-Klein et al, 2002) and compatibility issues (Wolff & Sydor, 1999). An electronic system for nursing notes must meet state and federal regulatory requirements for proper record keeping (Zuber, 2002).…”

Temporal and Geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0

“…Larger facilities and multi-facility chains purchased or developed specialized software with a wide variety of capabilities, some automatically generating resident care plans so facilities were in compliance with regulations, others that automatically updated unchanged fields for quarterly assessments and still others that checked for data internal consistency[10]. For facilities that engaged in data based quality improvement efforts, there was the possibility for checking the accuracy and consistency of their data, but there is little evidence that this was a common practice[11,12].…”