Abstract
Nursing home (NH) providers would benefit from adopting evidence-based measures for
gathering and utilizing resident preference information in their daily care activities.
However, providers face barriers when implementing assessment tools used to promote
person-centered care (PCC). Although Agile methodology is not commonly used in NH
settings, this case study shows how it can be used to achieve the goal of delivering
preference-based, PCC, within a large NH. We present a road map for breaking down
care processes, prioritizing, and implementing iterative plan, do, study, act cycles
using Agile methodology to enhance group collaboration on quality improvement cycles,
to achieve our goal of providing preference-based PCC. We first determined if care
plans reflected each resident’s important preferences, developed a method for tracking
whether residents attended activities that matched their preferences, and determined
if residents were satisfied that their preferences were being met. These efforts had
positive effects throughout the NH particularly when COVID-19 limited visitors and
significantly modified staff workflow. Specifically, Agile processes helped staff
to know how to honor preferences during quarantines which necessitated a shift to
individualized (and not group) approaches for meeting preferences for social contact,
comfort, and belonging. The ready availability of preference-based reporting was critical
to quickly informing new staff on how to meet residents’ most important preferences.
Based on lessons learned, we describe a developmental approach that other providers
can consider for adoption. Implications of this work are discussed in terms of the
need for provider training in Agile methodologies to support iterative improvements,
the need for policies that reimburse providers for their efforts, and additional research
around workflow processes.
Keywords
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Article info
Publication history
Published online: June 14, 2022
Footnotes
This work was partially supported by the VA Office of Academic Affiliation Advanced Fellowship in Health Services Research (Dr. Madrigal; Center of Innovation in Long-Term Services and Supports, Providence VA Medical Center).
The authors declare no conflicts of interest.
Identification
Copyright
© 2022 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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September 28, 2022
September 2022: Person-Centered Care, Trauma Informed Care, New Onset Seizures, and Transitions to Home Care
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Topics: Person-Centered Care, Trauma Informed Care, New Onset Seizures, and Transitions to Home Care
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