title: Exploratory study of nursing home factors associated with successful implementation of clinical decision support tools for pressure ulcer prevention.
abstract: OBJECTIVE
  To determine those factors that are associated with nursing homes' success in implementing the On-Time quality improvement (QI) for pressure ulcer prevention program and integrating health information technology (HIT) tools into practice at the unit level.
  
  
  METHODS
  Observational study with quantitative analysis of nursing home characteristics, team participation levels, and implementation milestones collected as part of a QI program.
  
  
  METHODS
  Fourteen nursing homes in Washington, District of Columbia, participating in the On-Time Pressure Ulcer Prevention program.
  
  
  METHODS
  The nursing home level of implementation was measured by counting the number of implementation milestones achieved after at least 9 months of implementation effort.
  
  
  RESULTS
  After at least 9 months of implementation effort, 36% of the nursing homes achieved level III, a high level of implementation, of the On-Time QI-HIT program. Factors significantly associated with high implementation were high level of involvement from the administrator or director of nursing, high level of nurse manager participation, presence of in-house dietitian, high level of participation of staff educator and QI personnel, presence of an internal champion, and team's openness to redesign. One factor that was identified as a barrier to high level of implementation was higher numbers of health inspection deficiencies per bed.
  
  
  CONCLUSIONS
  The learning from On-Time QI offers several lessons associated with facility factors that contribute to high level of implementation of a QI-HIT program in a nursing home.
authors: Health Management Strategies, Austin, Texas, USA.
authors: Siobhan
authors: S
authors: Sharkey
authors: Sandra
authors: S
authors: Hudak
authors: Susan D
authors: SD
authors: Horn
authors: Ryan
authors: R
authors: Barrett
authors: William
authors: W
authors: Spector
authors: Rhona
authors: R
authors: Limcangco
mesh_terms: D003661:Decision Support Techniques; D063005:Health Information Systems; D006801:Humans; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000517:prevention & control*; D015397:Program Evaluation; D058996:Quality Improvement