Quality Improvement in Nursing Homes: A Call to Action

Ouslander, Joseph G.; Patry, Gail; Besdine, Richard W.

doi:10.1016/j.jamda.2007.01.001

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…The results of this pilot study are encouraging for those who wish to carry out bedside level QI in the nursing home sector. There is considerable interest in and activity going on in the QI area in long term care [41][42][43][44][45][46][47]. This QI work has been led by registered healthcare providers and healthcare aides who are commonly directed only to implement new protocols.…”

Section: Discussionmentioning

confidence: 99%

Report of a pilot study of quality improvement in nursing homes led by healthcare aides

Norton¹,

Cranley²,

Cummings³

et al. 2013

EJPCH

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Objective: Healthcare aides (unregulated care providers), who deliver the majority of direct care in Canadian nursing homes, have high levels of emotional exhaustion and cynicism. However, they also have remarkably high levels of job efficacy. Strategies to empower this workforce may reduce cynicism and draw on their high levels of job efficacy. The primary objective of this study was to act as proof-of-principle to determine whether quality improvement teams led by healthcare aides could be established in nursing homes and function on a daily basis. Methods: This study was a pilot test of a complex intervention using a mixed methods approach. We used a combination of education, networking and coaching to engage staff teams in quality improvement in 1 of 3 areas (pain control, skin care or behaviour management). We measured healthcare aides' quality of work life, informal communication and research (best practice) use before and after the intervention. To understand the effect of quality of care at the bedside we used riskadjusted quality indicators derived from Resident Assessment Instrument -Minimum Data Set 2.0 data. Results: A total of 10 teams participated in the intervention. At least 70% of the teams succeeded in learning and applying the improvement model and methods for local measurement. For 50% of the teams, data showed measurable improvement in the clinical areas. There were no significant differences between pre and post measures of survey variables. Conclusions:We have demonstrated the ability of healthcare aides to engage in quality improvement initiatives at the bedside in a collaborative environment and advance our results as an important contribution to person-centered healthcare.

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Section: Discussionmentioning

confidence: 99%

Report of a pilot study of quality improvement in nursing homes led by healthcare aides

Norton¹,

Cranley²,

Cummings³

et al. 2013

EJPCH

View full text Add to dashboard Cite

show abstract

“…The need for increased emphasis on the practice environment while implementing quality improvement initiatives is becoming more apparent. In fact, some have argued that quality improvement initiatives need to be focused less at the health care provider level and more at the organizational level, because many barriers to clinical care emanate from nonclinical sources such as lack of leadership, education, and training (Ouslander, Patry, & Besdine, 2007). Participants reported that the culture in LTC supports change and values research evidence to some extent (mean = 3.43; SD = 1.15), with physicians rating this item the lowest (mean = 2.50; SD = 0.71) compared to the other participant groups.…”

Section: Discussionmentioning

confidence: 99%

Creating Bridges Between Researchers and Long-Term Care Homes to Promote Quality of Life for Residents

et al. 2010

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Improving the quality of life for long-term care (LTC) residents is of vital importance. Researchers need to involve LTC staff in planning and implementing interventions to maximize the likelihood of success. The purposes of this study were to (a) identify barriers and facilitators of LTC homes' readiness to implement evidence-based interventions, and (b) develop strategies to facilitate their implementation. A mixed methods design was used, primarily driven by the qualitative method and supplemented by two smaller, embedded quantitative components. Data were collected from health care providers and administrators using 13 focus groups, 26 interviews, and two surveys. Findings revealed that participants appreciated being involved at early stages of the project, but receptiveness to implementing innovations was influenced by study characteristics and demands within their respective practice environment. Engaging staff at the planning stage facilitated effective communication and helped strategize implementation within the constraints of the system.

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“…Clinical trials show that fall rates respond to multifactorial risk factor reduction when the syndromerelated care is performed by research staff (Tinetti, 2003;Tinetti, Inouye, Gill, & Doucette, 1995). However, when existing NH staff is taught to perform syndrome-related care, similar improvements have not been realized Colón-Emeric, Schenck, et al, 2006;Ouslander, Patry, & Besdine, 2007;Schnelle et al, 2002). Although the problem of falls was used primarily as an exemplar clinical problem in this study, it is an important clinical problem in its own right, with average rate of 1.5 falls/bed/year in U.S. NHs.…”

mentioning

confidence: 99%

Connecting the Learners: Improving Uptake of a Nursing Home Educational Program by Focusing on Staff Interactions

et al. 2013

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Quality Improvement in Nursing Homes: A Call to Action

Cited by 7 publications

References 6 publications

Report of a pilot study of quality improvement in nursing homes led by healthcare aides

Report of a pilot study of quality improvement in nursing homes led by healthcare aides

Creating Bridges Between Researchers and Long-Term Care Homes to Promote Quality of Life for Residents

Connecting the Learners: Improving Uptake of a Nursing Home Educational Program by Focusing on Staff Interactions

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