Improving Nursing Home Care Through Feedback On PerfoRMance Data (INFORM)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 119
- 主要终点
- Formal Interactions (FI)
研究概览
简要总结
This project will evaluate three different strategies to get research findings back to managers of care units in nursing homes. Feedback will be provided in a timely and effective way so that it results in improvements in organizational context (modifiable features of the care unit work environment, such as Formal Interactions, Informal Interactions, Social Capital or Slack Time), quality of care providers' work life (e.g., burnout, job satisfaction, general health) and quality of care. Three feedback packages will be tested to determine the strategy that is most effective at fostering improvements and is also cost-effective. The project will be carried out in nursing homes in Alberta and British Columbia. The information developed will contribute to better care for Canadian seniors who spend their final years in a nursing home.
详细描述
Background:
The purpose of this project is to systematically evaluate a tailored intervention targeting the leaders of clinical microsystems (care units) in residential long term care (nursing home - NH) settings. The intervention is designed to feedback performance data for improvement. This project is a key element of a long term program of research (Translating Research in Elder Care - TREC) focused on advancing knowledge translation science. TREC's goal is to improve quality of care, and in so doing, improve quality of life for older adults in NHs and work life for their care providers. TREC specifically focuses on the important role of organizational context (modifiable elements of the work environment) at the clinical microsystem (clinical unit) level in NHs.
Aims:
- Evaluate and compare a standard feedback and 2 assisted, goal-directed feedback strategies
- Assess sustainability and long term effects of each strategy
- Refine a practical assisted feedback strategy for use in NHs targeting the leaders of clinical microsystems
Design: Pragmatic, three-arm, parallel, cluster-randomized trial; stratified permuted block randomization; baseline assessment, 1-year intervention period, post-intervention assessment and 1-year long-term follow up. NHs will be randomly assigned to Standard Feedback (SF), Basic Assisted Feedback (BAF) or Enhanced Assisted Feedback (EAF).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Participant, Outcomes Assessor)
盲法说明
Participants and outcome assessors are blinded to study arm assignment
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participates in the Translating Research in Elder Care program
- •Located in on of the following health regions in Alberta and British Columbia: Alberta North, Alberta South, Fraser Health, Interior Health
- •At least one care unit in the facility with 10 or more care aide responses to our TREC survey
- •Care aide responses can be assigned to a care unit in the facility as defined by TREC (TREC microsystem)
排除标准
- •Does not participate in TREC
- •Not located in the above named health regions
- •No care unit in the facility with 10 or more care aide responses to our TREC survey
- •Care aide responses cannot be assigned to a TREC defined microsystem
- •Care Units:
- •Inclusion Criteria:
- •10 or more care aide responses to our TREC survey
- •Clearly identifiable unit leader (can also lead other units)
- •Stable leadership over the last year
- •Exclusion Criteria:
- •Less than 10 care aide responses to our TREC survey
- •No clearly identifiable unit leader
- •No stable leadership over the last year
- •Care Professionals:
- •Inclusion Criteria:
- •Leader of one or more included care units (care managers, directors of care)
- •Assistant leader of one or more included care units
- •Quality improvement specialist or clinical educator/instructor of one or more included care units
- •Employed in the facility
- •Has been covering in this role on this unit for 1 year or more
- •Leaders can bring care providers with no formal leadership or expert position (e.g., care aide, nurses, allied health providers) to the workshops
- •Exclusion Criteria:
- •Not employed in the facility (e.g., casual)
- •Has been covering in this role on this unit for less than 1 year
结局指标
主要结局
Formal Interactions (FI)
时间窗: Long-term follow up, up to 6 months (January-June 2019)
FI is one of ten concepts included in the Alberta Context Tool (ACT). It is defined as "formal exchanges that occur between individuals working within an organization (unit) through scheduled activities that can promote the transfer of knowledge." FI includes four items asking care aides how often, in the last typical month, they participated in (a) team meetings about residents, (b) family conferences, (c) change-of-shift report, and (d) continuing education (conferences, courses) outside the nursing home (rated from 1=never to 5=almost always). To score FI, scores of each item are recoded (1 and 2 =\> 0; 3 =\> .5; 4 and 5 =\> 1) and summed up. FI therefore is scored with values ranging from 0 to 4, and averaged.
次要结局
- Evaluation (Unit Feedback)(Long-term follow up, up to 6 months (January-June 2019))
- Social Capital(Long-term follow up, up to 6 months (January-June 2019))
- Organizational Slack (OS) Time(Long-term follow up, up to 6 months (January-June 2019))
- Psychological Empowerment Scale(Long-term follow up, up to 6 months (January-June 2019))
- Job Satisfaction (Michigan Organizational Assessment Questionnaire Job Satisfaction Subscale - MOAQ-JSS-3)(Long-term follow up, up to 6 months (January-June 2019))
- Instrumental Research Use (IRU)(Long-term follow up, up to 6 months (January-June 2019))
- Conceptual Research Use (CRU)(Long-term follow up, up to 6 months (January-June 2019))
- Prevalence of Worsening Pain(Long-term follow up, up to 6 months (January-June 2019))
- Prevalence of Declining Behavioral Symptoms(Long-term follow up, up to 6 months (January-June 2019))
研究者
Carole Estabrooks
Professor & Canada Research Chair in Knowledge Translation
University of Alberta