Communication and effectiveness in a US nursing home quality‐improvement collaborative

Abstract

In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a qualityimprovement collaborative of nursing home clinicians. Survey and interview data were collected from nursing home clinicians participating in a quality-improvement collaborative. Quality-improvement outcomes were evaluated using US Federal and State minimum dataset measures. Models were specified evaluating the relationships between resident outcomes, staff perceptions of communication patterns, and staff perceptions of collaborative effectiveness. Interview data provided deeper understanding of the quantitative findings. Reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings, and where respondents perceived that the collaborative kept them informed and provided new ideas. Clinicians observed that participation in a quality-improvement collaborative positively influenced the ability to share innovative ideas and expand the quality-improvement program within their nursing home. For practitioners, a high level of communication, both inside and outside of meetings, was key to making measurable gains in resident health outcomes.

A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: A qualitative assessment

“…15,18–20 Although less common in nursing homes, there are examples of successful collaboratives focused on reducing depressive symptoms, 21 pain, 22 and falls 23 among nursing home residents. Similarly, this national collaborative, although significantly larger in scale than these other initiatives, resulted in a substantial reduction in CAUTI rates among participating community-based nursing homes.…”

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

“…Four references 326,333,345,397 reported randomised controlled studies evaluating the effectiveness of a communication tool, one 322 had a mixed-methods approach including a pre and post segment, seven references 152,334,340,376,377,383,384 described pre-and post-intervention investigations on a single site and one 339 was a retrospective comparative study of patient transfer records.…”

“…One study took place in Canada, 339 another took place in Australia 334 and the remainder took place in the USA. 152,322,326,333,340,345,376,383,384 All studies were conducted in nursing homes or residential aged care facilities.…”

“…Four studies analysed the effect of standard communication tools, such as INTERACT, 326,383 SBAR 345 and a combined INTERACT II SBAR tool. 376 Two studies evaluated the effect of a quality improvement initiative to enhance clinical care outcomes for the residents, the Empira Quality Improvement falls reduction collaborative, 322 and CONNECT 333 in combination with a falls reduction education (FALLS) programme. 311 Four studies 152,339,340,384 evaluated the effectiveness of standardised transfer forms as a communication platform between nursing homes and hospital emergency departments.…”

“…Two RCTs and a mixed-methods study 322,326,333 from the USA investigated the impacts of complex quality improvement interventions in care homes. They report the views of staff on some measure of communication quality alongside resident outcomes.…”