Environmental Attributes of Person-Centered Care

Abstract

Implementation of person-centered care (PCC) in nursing homes requires multiple strategies related to organizational, operational, and environmental practices. Understanding the details of the combinations of these practices and the environmental features that work in co-occurrence will be critical in advancing and sustaining meaningful change for residents and staff in long-term care settings. This presentation will describe the strategies and processes for conducting detailed environmental assessments on ten nursing homes participating in a pay-for-performance program linked to PCC in Kansas (PEAK). Unlike assessment instruments that score facilities based on a checklist of attributes, this assessment strategy was designed to provide a descriptive narrative of the combination of organizational, operational, and environmental variables present. Results of the assessments demonstrate that there are environmental features that are integral to patterns of effective and meaningful organizational and operational practices. Spatial characteristics that distinguish facilities that have achieved high-levels of PCC will be demonstrated.

The relationship between person-centered care in nursing homes and COVID-19 infection, hospitalization, and mortality rates

“…Person-centered care practices, however, have been shown to be implemented in a broad cross-section of environments, settings, provider types, and geographic locations. 14 , 15 The outcomes of these person-centered efforts have had positive impacts on both quality of health 4 and quality of life. 2 This study suggests that person-centered care may also benefit infection prevention and related outcomes, as witnessed through the COVID-19 data.…”

The Environmental Audit Screening Evaluation: Establishing Reliability and Validity of an Evidence-Based Design Tool

“…What are the most important features of the HH model that work together, either individually or collectively, to afford the best outcomes for residents and staff? It is also important to note that some providers who have traditional types of buildings are working to adopt more PCC practices, but they are likely to fall short of creating many of the experiences of resident autonomy or a home-like environment because the design of physical spaces does not support these affordances ( Kaup et al, 2020 ).…”

“…PCC is a set of values that can be adopted in myriad ways and to a greater or lesser extent. It includes policies, practices, systems, and the designed environment ( Grabowski, Elliot, et al, 2014 ; Grabowski, O’Malley, et al, 2014 ; Shier et al, 2014 ; Hermer et al, 2018b ; Kaup et al, 2020 ; White et al, 2008 ). At its most extreme expression, new care communities are designed to reflect a house in terms of scale (8–12 residents) with familiar residential spaces (functional residential kitchens, living rooms with fireplaces, a majority of private rooms with ensuite bathrooms, and direct access to outside spaces).…”