New Toolkit to Measure Quality of Person-Centered Care: Development and Pilot Evaluation With Nursing Home Communities

Haitsma, Kimberly Van; Crespy, Scott D.; Humes, Sarah; Elliot, Amy; Mihelic, Adrienne; Scott, Carol; Curyto, Kim; Spector, Abby; Eshraghi, Karen; Duntzee, Christina; Heid, Allison R.; Abbott, Katherine

doi:10.1016/j.jamda.2014.02.004

Cited by 54 publications

(48 citation statements)

References 13 publications

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“…The MOUTh intervention may provide a way for NH staff to deliver evidence-based oral hygiene within the context of person-centered, relationship-based care (Dewar & Nolan, 2013; Nolan et al, 2004; Van Haitsma et al, 2014). Not only was mouth care accomplished, it was completed in a manner enjoyable to the NH resident and MCP.…”

Section: Discussion and Nursing Implicationsmentioning

confidence: 99%

“…However, NH environments are slowly changing. These changes are fueled by (a) the Centers for Medicare and Medicaid’s expectation that PCC be delivered in facilities (Van Haitsma et al, 2014) and (b) the need for non-drug interventions for dementia-related behaviors. Nurses working in these facilities may find the adoption of the MOUTh intervention a welcome additional tool for meeting both directives.…”

Section: Limitationsmentioning

confidence: 99%

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Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care

Jablonski¹,

Kolanowski²,

Winstead³

et al. 2016

J Gerontol Nurs

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The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize care-resistant behavior to provide mouth care to older adult with dementia. The original intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), matured during the clinical trial study into a relationship-centered intervention with emphasis on developing strategies that support residents behavioral health and staff involved in care. Relationships that were initially pragmatic (i.e., focused on the task of completing mouth care) developed into more personal and responsive relationships that involved deeper engagement between mouth care providers and nursing home (NH) residents. Mouth care was accomplished and completed in a manner enjoyable to NH residents and mouth care providers. The MOUTh intervention may also concurrently affirm the dignity and personhood of the care recipient because of its emphasis on connecting with older adults.

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Section: Discussion and Nursing Implicationsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care

Jablonski¹,

Kolanowski²,

Winstead³

et al. 2016

J Gerontol Nurs

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“…Hearing, visual, cognitive, and functional impairments greatly restrict staff ability to fulfill preferences. It is in these situations that Certified Therapeutic Recreation Specialists (CTRS) can thoughtfully adapt activities to meet resident important preferences based upon physical, functional, and cognitive limitations (Van Haitsma et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

“…MDS coordinators, who are typically nurses, are responsible for completing the MDS assessment (Straker & Bailor, 2008). In 2013, Advancing Excellence in America's Nursing Homes, a campaign to advance the quality of care in NHs, released a PCC toolkit that took the MDS preference assessment one step further to look at preference congruence (Van Haitsma et al, 2014). Preference congruence is an indicator of how well preferences align with care delivered and was measured through the reports of satisfaction by residents.…”

Section: Introduction and Rationalementioning

confidence: 99%

“We Can’t Provide Season Tickets to the Opera”: Staff Perceptions of Providing Preference-Based, Person-Centered Care

Abbott

Heid

Haitsma

2016

Clinical Gerontologist

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Knowledge of a nursing home resident's everyday living preferences provides the foundation for ongoing individualized care planning. Objective The purpose of this study is to identify nursing home (NH) staff perceptions of facilitators and barriers to learning about and meeting residents’ preferences and reasons why staff feel residents change their minds about preferences. Methods Focus group sessions and interviews were conducted with 36 NH staff members working in a facility that has been actively assessing resident preferences for five years. Results Thematic codes classifying facilitators, barriers, and dependencies were identified. Staff shared ways they are able to help meet residents’ preferences as well as barriers to fulfilling resident preferences through their own behaviors, facility characteristics, the social environment, and resident characteristics. In addition, staff believe that residents change their minds about important preferences ‘depending on’ several factors including; global environmental characteristics, social environment, resident characteristics, and general staff perceptions. Conclusions This work identifies key facilitators and barriers to consider when implementing quality improvement efforts designed to improve the person-centered nature of care in nursing homes and is intended to further inform the culture change movement, which aims to transform NHs by empowering staff and delivering person-centered care.

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“…Creating change in individual and collective staff behavior is, however, essential for the success of a person-centered care initiative (Gaudet, 2011). Work in other areas, such as in measuring the fulfillment of nursing home resident preferences, has documented the need for tools that are easy to use and provide quick overviews for frontline staff (Van Haitsma, et al, 2014; Van Haitsma, et al, 2016). Simple person-centered care tools are, therefore, also needed to help frontline staff assess their performance of these skills and identify potential areas for improvement.…”

Section: Introductionmentioning

confidence: 99%

Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

Hartmann¹,

Palmer²,

Mills³

et al. 2017

Psychological Services

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Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pre-testing of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This paper provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care.

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New Toolkit to Measure Quality of Person-Centered Care: Development and Pilot Evaluation With Nursing Home Communities

Cited by 54 publications

References 13 publications

Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care

Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care

“We Can’t Provide Season Tickets to the Opera”: Staff Perceptions of Providing Preference-Based, Person-Centered Care

Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

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