“<i>Wish we would have known that!”</i>Communication Breakdown Impedes Person-Centered Care

Kolanowski, Ann; Haitsma, Kimberly Van; Penrod, Janice; Hill, Nikki L.; Yevchak, Andrea

doi:10.1093/geront/gnv014

Cited by 81 publications

(86 citation statements)

References 44 publications

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“…Person‐directed care planning requires that service providers get to know the person whose care plan is being developed, which is emphasised in literature on person‐centred LTC (Iris, DeBacker, Benner, Hammerman, & Ridings, 2012; Kolanowski, Van Haitsma, Penrod, Hill, & Yevchak, 2015) and on care planning among individuals with intellectual disabilities (Ames, 2013; Sanderson, 2013). For example, Ames (2013, p. 13) advises learning disability nurses to consider: “What matters to the person… What happened in the person's past that may affect who he or she is now [and]… With whom the person has important relationships.”…”

Section: Resultsmentioning

confidence: 99%

“…Direct‐care workers are typically not involved in care planning (Kolanowski et al, 2015). This paradigm is also reflected in the broader healthcare culture where patients find it difficult to participate in discussions about their care because they are overwhelmed by too much information, and much of that in jargon they may not understand (Maurer et al, 2012).…”

Section: Resultsmentioning

confidence: 99%

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Person‐directed care planning in nursing homes: A scoping review

Lepore

Scales

Anderson

et al. 2018

Int J Older People Nursing

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AimFederal regulations require nursing homes in the United States to support residents in directing their own care rather than having their care plans developed for them without their engagement, but knowledge of person‐directed approaches to care planning in nursing homes is limited. The purpose of this study was to advance understanding of person‐directed care planning (PDCP).MethodsA multidisciplinary research team conducted a scoping review on individual and family involvement in care planning, including literature from a variety of care contexts. Search results were systematically screened to identify literature that addressed individual or family involvement in care planning as a primary concern, and then analysed using thematic content analysis.ResultsSeveral themes were identified, including definitions of the concept of PDCP, essential elements of PDCP, barriers, facilitators and outcomes. The concept of PDCP is informed by multiple disciplines, including humanist philosophy, disability rights and end‐of‐life care. Essential elements of PDCP include knowing the person, integrating the person's goals in care planning and updating care plans as individuals’ needs or preferences change. Limited time for care planning in nursing homes hinders PDCP. Facilitators include regulatory mandates and humanist social trends. Outcomes of PDCP were found to be positive (e.g., increased independence), but were inconsistently assessed across studies.ConclusionThis study offers pragmatic information that can support PDCP within nursing homes and insights for policy reform that may more effectively support PDCP.Implications for practiceThese findings can be used to guide implementation of PDCP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Person‐directed care planning in nursing homes: A scoping review

Lepore

Scales

Anderson

et al. 2018

Int J Older People Nursing

View full text Add to dashboard Cite

show abstract

“…Electronic medical records and care planning were formal organizational channels through which staff accessed information about resident preferences. However, these may not be the most reliable and efficient means for staff to obtain preference information based upon previous studies (Kolanowski et al, 2015). Therefore, organizations can encourage staff members to explore how they informally learn about resident preferences and develop a systematic way of conveying this information across all shifts and disciplines.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, even in organizations with PCC supportive cultures there is a tendency for direct care workers to revert to care practices that are traditionally focused on tasks related to ‘bed and body work’ (Doyle & Rubinstein, 2013). Communication breakdowns, time, and inadequate staffing are viewed by staff as major barriers to providing PCC (Kolanowski, Van Haitsma, Penrod, Hill, & Yevchak, 2015). Staff believe that ‘word of mouth’ is the most efficient and reliable way to communicate knowledge about residents to one another because reading charts is too time consuming (Kolanowski et al, 2015).…”

Section: Introduction and Rationalementioning

confidence: 99%

“…Communication breakdowns, time, and inadequate staffing are viewed by staff as major barriers to providing PCC (Kolanowski, Van Haitsma, Penrod, Hill, & Yevchak, 2015). Staff believe that ‘word of mouth’ is the most efficient and reliable way to communicate knowledge about residents to one another because reading charts is too time consuming (Kolanowski et al, 2015). However, preferences for communicating PCC information by ‘word of mouth’ sparks concerns for determining the accuracy of the information as well as how information is shared consistently across disciplines and shifts (Kolanowski et al, 2015).…”

Section: Introduction and Rationalementioning

confidence: 99%

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“We Can’t Provide Season Tickets to the Opera”: Staff Perceptions of Providing Preference-Based, Person-Centered Care

Abbott

Heid

Haitsma

2016

Clinical Gerontologist

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Knowledge of a nursing home resident's everyday living preferences provides the foundation for ongoing individualized care planning. Objective The purpose of this study is to identify nursing home (NH) staff perceptions of facilitators and barriers to learning about and meeting residents’ preferences and reasons why staff feel residents change their minds about preferences. Methods Focus group sessions and interviews were conducted with 36 NH staff members working in a facility that has been actively assessing resident preferences for five years. Results Thematic codes classifying facilitators, barriers, and dependencies were identified. Staff shared ways they are able to help meet residents’ preferences as well as barriers to fulfilling resident preferences through their own behaviors, facility characteristics, the social environment, and resident characteristics. In addition, staff believe that residents change their minds about important preferences ‘depending on’ several factors including; global environmental characteristics, social environment, resident characteristics, and general staff perceptions. Conclusions This work identifies key facilitators and barriers to consider when implementing quality improvement efforts designed to improve the person-centered nature of care in nursing homes and is intended to further inform the culture change movement, which aims to transform NHs by empowering staff and delivering person-centered care.

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Testing the evidence integration triangle for implementation of interventions to manage behavioral and psychological symptoms associated with dementia: Protocol for a pragmatic trial

Kolanowski

Haitsma

Galik

et al. 2018

Research in Nursing & Health

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Behavioral and psychological symptoms of dementia (BPSD) include aggression, agitation, resistiveness to care, depression, anxiety, apathy, and hallucinations. BPSD are common in nursing home residents and can be ameliorated using person-centered approaches. Despite regulatory requirements, less than 2% of nursing homes consistently implement person-centered behavioral approaches. In a National Institute of Nursing Research-funded research protocol, we are implementing a pragmatic cluster randomized clinical trial designed to enable staff in nursing homes to reduce BPSD using behavioral approaches while optimizing function, preventing adverse events, and improving quality of life of residents. The implementation is based on use of the Evidence Integration Triangle (EIT), a parsimonious, community-engaged participatory framework that is well suited to the complexity and variability in the nursing home environment. A total of 50 nursing home communities will be randomized to EIT-4-BPSD or education only. Primary Aim 1 is to determine if communities exposed to EIT-4-BPSD demonstrate evidence of implementation evaluated by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) criteria. Primary Aim 2 is to evaluate the feasibility, utility, and cost of the EIT approach in EIT-4-BPSD communities.

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“Wish we would have known that!”Communication Breakdown Impedes Person-Centered Care

Cited by 81 publications

References 44 publications

Person‐directed care planning in nursing homes: A scoping review

Person‐directed care planning in nursing homes: A scoping review

“We Can’t Provide Season Tickets to the Opera”: Staff Perceptions of Providing Preference-Based, Person-Centered Care

Testing the evidence integration triangle for implementation of interventions to manage behavioral and psychological symptoms associated with dementia: Protocol for a pragmatic trial

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