2015
DOI: 10.3928/00989134-20141216-01
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Implementation of a Heart Failure Quality Initiative in a Skilled Nursing Facility: Lessons Learned

Abstract: Skilled nursing facilities (SNFs) are organizations that represent complex adaptive systems, offering barriers to the implementation of quality improvement (QI) initiatives. The current article describes the authors’ efforts to use the approach of reflective adaptive process to implement a new model of care (i.e., the Skilled Heart Unit Program) for effective heart failure (HF) care in one SNF. A team of stakeholders from the local hospital system and a local SNF was convened to design and implement this new m… Show more

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Cited by 12 publications
(5 citation statements)
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“…26 Furthermore, a SNF HF quality initiative program led to better HF care and enhanced teamwork among the SNF staff in addition to improving staff satisfaction. 27 …”
Section: Discussionmentioning
confidence: 99%
“…26 Furthermore, a SNF HF quality initiative program led to better HF care and enhanced teamwork among the SNF staff in addition to improving staff satisfaction. 27 …”
Section: Discussionmentioning
confidence: 99%
“…One reason for such challenges is the high rates of staff turnover ( Castle, 2006 , Castle and Engberg, 2005 , Gandhi et al., 2021 , Thomas et al., 2013 ), associated with low levels of staff resilience and wellbeing leading to burnout ( Mallon et al., 2023 ). High rates of staff turnover can also directly impact the implementation and sustainability of heart failure guidelines ( Nazir et al., 2015 ), with three of the studies included in this review citing staff turnover as a significant barrier ( Heckman et al., 2018b , Kim et al., 2016 , Sullivan, 2017 ). Most interventions included in this review had a duration of 1-6 months, with only one reporting outcomes at 12-months post baseline ( Hancock et al., 2012 ).…”
Section: Discussionmentioning
confidence: 99%
“…Identifying such facilitators and barriers is a critical step in fostering collaboration between hospitals and post-acute care facilities (2, 6, 1417). Identifying these barriers also responds to calls from national quality improvement efforts for the building of meaningful, mutual health care partnerships that consider factors beyond clinical acuity, including facility culture (11), staff engagement and trust (11, 16), and the financial risks and benefits associated with cost reduction and quality improvement efforts (10). To our knowledge, this is the first time that this type of comprehensive approach has been applied to hospital-to-SNF care transitions in the United States.…”
Section: Discussionmentioning
confidence: 99%