Testing the Implementation of a Toolbox to Optimize Data Collection and Data Quality of the National Medical Quality Indicators in Long-term Care Facilities: A Pilot Study Within the National Implementation Programme NIP-Q-UPGRADE
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 22
- 试验地点
- 3
- 主要终点
- Acceptability of the toolbox
研究概览
简要总结
Since 2019, long-term care facilities in Switzerland are obliged by the Federal Insurance Law (KVG, Art. 59a) to report data for the calculation and public reporting of medical quality indicators (MQI). By 2024, this is done in four clinical domains: polypharmacy, pain, malnutrition and the use of physical restraints. This data is used for both monitoring quality of care on a national level and for internal quality of care development. To be valid and reliable, MQI data needs to be collected according to specified measurement instructions. An ethnographic study conducted within the NIP-Q-UPGRADE identified numerous challenges, which can lead to poor data quality.
The overall aim of this pilot study is to test the implementation of a data quality development toolkit concerning the MQI.
The toolkit uses a train-the-trainer strategy. The research team will prepare external training providers to train delegated staff from the long-term care facilities (further called champions), who will then train and support their co-workers to collect reliable MQI data. The research team developed training and support materials and organized an e-mail contact centre for MQI related questions for the participating facilities.
Implementation outcomes will be assessed at two levels: long-term care facilities and the external training providers.
Objectives at the external training provider level:
- To determine the acceptability and feasibility of the training and support materials.
- To determine the fidelity to the training and adaptations made when implementing it.
- To identify the barriers and facilitators for the implementation of the training.
- To measure the costs associated with delivering the training.
Objectives at the long-term care facility level:
- To determine the acceptability and the feasibility of the data quality development toolkit components.
- To determine the fidelity to toolkit components and adaptations made when implementing it.
- To identify the barriers and facilitators for the implementation of the toolkit.
- To measure the costs associated with implementing the toolkit.
详细描述
A one-group experimental study will be performed including a multiple methods evaluation.
Participants will be recruited at two levels:
- the provider responsible for delivering the training to the champions from the long-term care facilities,
- long-term care facilities who will implement the data quality development toolkit and select the champions to be sent to the training.
The external training provider is a company with experience in training staff of long-term care facilities in performing needs assessment with residents and in understanding and using the current MQI. The company will nominate employees to be instructed by the research team (December 2024) on how to conduct the developed training for facility champions. They will take up the organization and conduct of the trainings in three languages all regions of Switzerland. The research team will inform the training participants about the study and the data collection.
At facility level, five to ten long-term care facilities per Swiss language region (German, French and Italian speaking) will be recruited between November and December 2024 to implement the data quality development toolkit (i.e., a max. of 30 facilities in total over all language regions). At least one person per facility will be trained between January and March 2025 to act as a champion in the data quality development toolkit and perform tasks such as training of fellow staff and data quality monitoring (1 full day training onsite, two online trainings of 4h, resp. 2h with 2-4 weeks in-between). Trainings will be language-specific.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 16 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •External training providers:
- •willing to implement trainings as designed by the research team and to all interested long-term care facilities
- •have capacity to provide the trainers and infrastructure for the trainings - agree to non-commercial use of training materials
- •with competence in training staff of long-term care facilities
- •with knowledge on data collection of the current MQIs
- •Long-term care facilities:
- •with a cantonal recognition as a residential long-term care facility
- •willing to implement the toolkit
- •which can nominate at least one champion
- •Long-term care facility employees motivated to take up the role
- •having sufficient knowledge of the residents, infrastructure and processes in the facility (e.g., resident care, needs assessment instrument, electronic health records)
- •Ideally with experience in leadership, staff training, MQI data collection and quality monitoring, e.g., nurse, nurse expert, quality manager, needs assessment instrument manager
- •Management and staff responsible for quality:
- •any level of management staff and staff responsible for quality in long-term care facility e.g., director of nursing, team leader, quality manager
- •directly involved in supporting the implementation of the toolkit or exposed to its content
- •Nursing and care staff:
- •Any level of nursing or care staff e.g., registered nurses, licensed practical nurses, nurse aids involved in collecting data for MQI
- •exposed to the content of the toolkit (i.e., internal trainings, feedback, support materials), e.g., registered nurses, licensed practical nurses, nurse aids
排除标准
- •1. long-term care facilities that are participants of the study "Data Quality and National Quality Indicators in Long-term Care Facilities: a Validation Study and Evaluation Study"
研究组 & 干预措施
Long-term care facilities
All participating facilities will be offered the same toolbox
干预措施: Data quality development toolkit concerning the medical quality indicators (MQI) (Behavioral)
结局指标
主要结局
Acceptability of the toolbox
时间窗: After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.
Acceptability of toolbox components will be assessed in a survey with Acceptability of Intervention Measure (AIM), a 4-item instrument measuring the acceptability of an intervention. Further exploration of acceptability in qualitative interviews and focus groups
Feasibility of the toolbox
时间窗: After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.
Feasibility of toolbox components will be assessed in a survey with Feasibility of Intervention Measure (FIM), a 4-item instrument measuring the feasibility of an intervention. Further exploration of feasibility in qualitative interviews and focus groups.
Implementation fidelity
时间窗: After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.
Degree of fidelity to each component (yes, partial, no) will be measured using a questionnaire survey. Further exploration of implementation fidelity in qualitative interviews and focus groups.
Barriers to the implementation of the toolbox
时间窗: After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.
Barriers to the implementation will be explored in qualitative interviews and focus groups, and categorized according to the Consolidated Framework of Implementation Research (CFIR)
Facilitators to the implementation of the toolbox
时间窗: At 3 months: focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.
Facilitators to the implementation will be explored in qualitative interviews and focus groups, and categorized according to the Consolidated Framework of Implementation Research (CFIR)
Sum of costs associated with implementation of the toolkit in Swiss francs
时间窗: Continuously from baseline training to 3 months after
Costs will be calculated based on time spent on implementation activities per staff group with corresponding hourly salary estimate, recorded in an activity logbook
次要结局
未报告次要终点
研究者
Franziska Zúñiga
Prof. Dr. Franziska Zúñiga
University of Basel