New toolkit to measure quality of person-centered care: development and pilot evaluation with nursing home communities.
BACKGROUND
Increasingly, nursing home (NH) providers are adopting a person-centered care (PCC) philosophy; yet, they currently lack methods to measure their progress toward this goal. Few PCC tools meet criteria for ease of use and feasibility in NHs. The purpose of this article is to report on the development of the concept and measurement of preference congruence among NH residents (phase 1), its refinement into a set of quality indicators by Advancing Excellence in America's Nursing Homes (phase 2), and its pilot evaluation in a sample of 12 early adopting NHs prior to national rollout (phase 3). The recommended toolkit for providers to use to measure PCC consists of (1) interview materials for 16 personal care and activity preferences from Minimum Data Set 3.0, plus follow-up questions that ask residents how satisfied they are with fulfillment of important preferences; and (2) an easy to use Excel spreadsheet that calculates graphic displays of quality measures of preference congruence and care conference attendance for an individual, household or NH. Twelve NHs interviewed residents (N = 146) using the toolkit; 10 also completed a follow-up survey and 9 took part in an interview evaluating their experience.


RESULTS
NH staff gave strong positive ratings to the toolkit. All would recommend it to other NHs. Staff reported that the toolkit helped them identify opportunities to improve PCC (100%), and found that the Excel tool was comprehensive (100%), easy to use (90%), and provided high quality information (100%). Providers anticipated using the toolkit to strengthen staff training as well as to enhance care planning, programming and quality improvement.


CONCLUSIONS
The no-cost PCC toolkit provides a new means to measure the quality of PCC delivery. As of February 2014, over 700 nursing homes have selected the Advancing Excellence in America's Nursing Homes PCC goal as a focus for quality improvement. The toolkit enables providers to incorporate quality improvement by moving beyond anecdote, and advancing more systematically toward honoring resident preferences.
Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA. Electronic address: kvanhaitsma@abramsoncenter.org.
Kimberly
K
Van Haitsma
Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Scott
S
Crespy
Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Sarah
S
Humes
Pioneer Network, Rochester, NY.
Amy
A
Elliot
CFMC, Englewood, CO.
Adrienne
A
Mihelic
Advancing Excellence in America's Nursing Homes, Washington, DC.
Carol
C
Scott
VA Western New York Healthcare System, Batavia, NY.
Kim
K
Curyto
Spector Consulting, Bala Cynwyd, PA.
Abby
A
Spector
Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Karen
K
Eshraghi
Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Christina
C
Duntzee
Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Allison Reamy
AR
Heid
Polisher Research Institute, Madlyn and Leonard Abramson Center for Jewish Life, North Wales, PA.
Katherine
K
Abbott
D000368:Aged; D006801:Humans; D007407:Interviews as Topic; D009735:Nursing Homes / Q000592:standards*; D018802:Patient-Centered Care / Q000592:standards*; D010865:Pilot Projects; D016730:Program Development; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014481:United States
Person-centered care; measures; nursing home; preference congruence; preferences