WE READ HIS PAL CARD AT THE FUNERAL: EVALUATING THE IMPLEMENTATION OF A PERSON-CENTERED COMMUNICATION TOOL

Abstract Background: Person-centered care (PCC) is a philosophy that recognizes “knowing the person” and honoring individual preferences. The purpose of this study was to evaluate the implementation of a novel PCC communication tool in nursing homes (NH). The tool is based on an assessment of NH resident likes and dislikes via the Preferences for Everyday Living Inventory (PELI), which is an evidenced-based, validated instrument used to enhance the delivery of PCC. The Preferences for Activity and Leisure (PAL) Card was developed to communicate residents’ preferences for leisure and activities across care team members. Methods: Providers were recruited to utilize the recreation and leisure items from the PELI to assess resident important preferences and create PAL Cards for 15-20 residents. Providers collected data aligned with the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). Results: Reach and Adoption: A total of n=43 providers registered and n=26 (60%) providers completed the project. Ownership of participating providers included 54% not for profit, 46% for profit, and 8% government owned with an average star rating of 3.7 (SD 1.1) and a range of 1-5. Effectiveness and Implementation: Participants attempted n=424 PAL Cards and completed n=406. The average acceptability of the intervention measure (AIM) was 4.7 (SD 0.4), intervention appropriateness measure (IAM) was 4.5 (SD 0.5), and feasibility of intervention measure (FIM) was 4.6 (SD 0.5). Maintenance: Providers were able to complete 82% of PAL Card placement over the course of 5 months with few cards going missing (<2%). Conclusion: The majority of providers were successful in implementing PAL Cards for residents and reported the intervention as highly acceptable, appropriate, and feasible. The pragmatic PAL Card intervention can assist nursing home providers in meeting PCC regulations and contribute to building relationships between residents, family, and staff.

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Evaluating the Implementation of a Pragmatic Person-Centered Communication Tool in the Nursing Home via the RE-AIM Framework.

10.21203/rs.3.rs-86502/v1 ◽

2020 ◽

Author(s):

Katherine Abbott ◽

Alexandra Heppner ◽

Nytasia Hicks ◽

Abigail Hermesch ◽

Kimberly VanHaitsma

Keyword(s):

Nursing Home ◽

Communication Tool ◽

Building Relationships ◽

Team Members ◽

For Profit ◽

Not For Profit ◽

Centered Care ◽

Evidenced Based ◽

Validated Instrument ◽

Everyday Living

Abstract Background: Person-centered care (PCC) is a philosophy that recognizes “knowing the person” and honoring individual preferences. The purpose of this study was to evaluate the implementation of a novel PCC communication tool in nursing homes (NH). The tool is based on an assessment of NH resident likes and dislikes via the Preferences for Everyday Living Inventory (PELI), which is an evidenced-based, validated instrument used to enhance the delivery of PCC. The Preferences for Activity and Leisure (PAL) Card was developed to communicate residents’ preferences for leisure and activities across care team members. Methods: Providers were recruited to utilize the recreation and leisure items from the PELI to assess resident important preferences and create PAL Cards for 15-20 residents. Providers collected data aligned with the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance). Results: Reach and Adoption: A total of n=43 providers registered and n=26 (60%) providers completed the project. Ownership of participating providers included 54% not for profit, 46% for profit, and 8% government owned with an average star rating of 3.7 (SD 1.1) and a range of 1-5. Effectiveness and Implementation: Participants attempted n=424 PAL Cards and completed n=406. The average acceptability of the intervention measure (AIM) was 4.7 (SD 0.4), intervention appropriateness measure (IAM) was 4.5 (SD 0.5), and feasibility of intervention measure (FIM) was 4.6 (SD 0.5). Maintenance: Providers were able to complete 82% of PAL Card placement over the course of 5 months with few cards going missing (<2%). Conclusion: The majority of providers were successful in implementing PAL Cards for residents and reported the intervention as highly acceptable, appropriate, and feasible. The pragmatic PAL Card intervention can assist nursing home providers in meeting PCC regulations and contribute to building relationships between residents, family, and staff.

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PROVIDER PERSPECTIVES ON IMPLEMENTING A PERSON-CENTERED COMMUNICATION TOOL

Innovation in Aging ◽

10.1093/geroni/igz038.196 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S50-S50

Author(s):

Alexandra Heppner ◽

Nytasia Hicks ◽

Sarina Poth ◽

Kimberly Van Haitsma ◽

Katherine Abbott

Keyword(s):

A Priori ◽

Relative Advantage ◽

Communication Tool ◽

Telephone Interviews ◽

Effective Implementation ◽

Coding Scheme ◽

Provider Perspectives ◽

Evidence Strength ◽

Positive Intervention

Abstract The PAL Card QIP Project sought to understand the intervention characteristics associated with effective implementation. Telephone interviews were conducted with n=26 NH providers who completed the project. Calls were recorded, transcribed verbatim and checked for accuracy. The Consolidated Framework for Implementation Research was utilized as an a priori coding scheme to identify factors associated with effective implementation of the PAL Card project. Major themes emerging from the data related to the evidence strength and quality of the intervention as well as the relative advantage to not assessing preferences (“turns out she doesn't even like TV and we have just been having her watch TV”), adaptability (tailoring for their needs), trialability (expanding offering of intervention after initial success), and complexity of the intervention (sharing the work across departments, difficulty using unfamiliar technology). Providers reported positive intervention characteristics of the PAL cards, however, barriers remain that require additional strategies to successfully implement.

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The Journey of the Purple Butterfly: A Quality Improvement Initiative

American Journal of Hospice and Palliative Medicine® ◽

10.1177/10499091211014164 ◽

2021 ◽

pp. 104990912110141

Author(s):

Jessica O’Brien Gufarotti ◽

Anna Krakowski

Keyword(s):

Quality Improvement ◽

Interdisciplinary Team ◽

Urban Setting ◽

Quality Improvement Initiative ◽

Communication Tool ◽

Patient Centered ◽

Improvement Project ◽

Comfort Care ◽

Team Members ◽

Job Duties

Introduction: Dying in the hospital is not always a good experience for patients and their families. To be more in line with evidence-based practices for healthcare workers to effectively support high quality end of life care, the project team implemented a standardized communication tool to alert interdisciplinary team members of patients on comfort care measures. Methods: Purple Butterfly was a quality improvement project that was implemented at a diverse community hospital in the urban setting. Clinical and non-clinical interdisciplinary team members participated in a pre- and post- implementation survey to assess the need for a standardized communication tool that would alert them of patients who transitioned to comfort care. Results: Pre-implementation, 37% of survey respondents (n = 60) reported they were always aware of the presence of a patient on comfort care measures prior to entering the room. After implementation of a standardized communication tool, 100% (n = 43) of respondents at 9 months, reported that they were always aware of the presence of a patient on comfort care measures prior to entering the room. Additionally, 9 months post-intervention 100% of respondents reported that knowing this contextual information supported them in performing their job duties in a compassionate, patient-centered fashion. Conclusion: Implementation of a standardized communication tool increased awareness for team members, about the presence of patients on comfort care measures prior to entering the room and supported team members to perform their job duties in a compassionate, patient-centered fashion supportive of this patient population.

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Enhancing Your Webside Manner: Optimizing Opportunities for Relationship-Centered Care in Virtual Visits

Journal of Patient Experience ◽

10.1177/2374373520968975 ◽

2020 ◽

Vol 7 (6) ◽

pp. 869-877

Author(s):

Mary Beth Modic ◽

Katie Neuendorf ◽

Amy K Windover

Keyword(s):

Health Care ◽

Communication Strategies ◽

Important Variable ◽

High Quality ◽

Improvement Project ◽

Centered Care ◽

Virtual Visits ◽

Primary Means ◽

Rapid Transmission

In the pandemic of coronavirus disease 2019, virtual visits have become the primary means of delivering efficient, high-quality, and safe health care while Americans are instructed to stay at home until the rapid transmission of the virus abates. An important variable in the quality of any patient–clinician interaction, including virtual visits, is how adroit the clinician is at forming a relationship. This article offers a review of the research that exists on forming a relationship in a virtual visit and the outcomes of a quality improvement project which resulted in the refinement of a “Communication Tip Sheet” that can be used with virtual visits. It also offers several communication strategies predicated on the R.E.D.E. to Communicate model that can be used when providing care virtually.

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Quality improvement primer part 1: Preparing for a quality improvement project in the emergency department

CJEM ◽

10.1017/cem.2017.361 ◽

2017 ◽

Vol 20 (1) ◽

pp. 104-111 ◽

Cited By ~ 12

Author(s):

Lucas B. Chartier ◽

Amy H.Y. Cheng ◽

Antonia S. Stang ◽

Samuel Vaillancourt

Keyword(s):

Quality Improvement ◽

Professional Training ◽

Problem Statement ◽

Improvement Project ◽

Team Members ◽

Root Cause ◽

Change Team ◽

Patient Safety Incidents

ABSTRACTEmergency medicine (EM) providers work in a fast-paced and often hectic environment that has a high risk for patient safety incidents and gaps in the quality of care. These challenges have resulted in opportunities for frontline EM providers to play a role in quality improvement (QI) projects. QI has developed into a mature field with methodologies that can dramatically improve the odds of having a successful project with a sustainable impact. However, this expertise is not yet commonly taught during professional training. In this first of three articles meant as a QI primer for EM clinicians, we will introduce QI methodology and strategic planning using a fictional case study as an example. We will review how to identify a QI problem, define components of an effective problem statement, and identify stakeholders and core change team members. We will also describe three techniques used to perform root cause analyses—Ishikawa diagrams, Pareto charts and process mapping—and how they relate to preparing for a QI project. The next two papers in this series will focus on the execution of the QI project itself using rapid-cycle testing and on the evaluation and sustainability of QI projects.

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Web-Based Perinatal Education for the New Obstetrical Patient: A Quality Improvement Project

The Journal of Perinatal Education ◽

10.1891/1058-1243.27.2.115 ◽

2018 ◽

Vol 27 (2) ◽

pp. 115-120

Author(s):

Kelly Ellington

Keyword(s):

Quality Improvement ◽

Patient Survey ◽

Quality Improvement Project ◽

Web Based ◽

Improvement Project ◽

Provider Satisfaction ◽

Cell Free Fetal Dna ◽

Obstetrical Patient ◽

Centered Care ◽

Evidenced Based

Mixed-methods quality improvement project improved the new obstetrical perinatal education curriculum by cultivating reliable delivery of evidenced-based initiatives linked to successful pregnancy. The web-based format enhanced family-centered care in a teaching format in the comfort of the home. The identification of at-risk populations resulted in improved referral for cell-free fetal DNA screening. A qualitative approach assessed overall provider satisfaction with web-based teaching. The patient survey identified barriers for noncompletion of web-based content. Quantitative data identified completion rate, high-risk populations for referral for advanced screening, and provider satisfaction with web-based curriculum content in a teaching platform linked to the provider’s website.

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Assessment of Individual Student Performance in Online Team Projects

Online Learning ◽

10.24059/olj.v15i3.193 ◽

2011 ◽

Vol 15 (3) ◽

Cited By ~ 3

Author(s):

Jay Alden

Keyword(s):

Student Performance ◽

Group Process ◽

Online Courses ◽

Peer Assessment ◽

Individual Student ◽

Assessment Practice ◽

Group Project ◽

Team Members ◽

Team Projects

The use of team projects has been shown to be beneficial in higher education. There is also general agreement that team efforts should be assessed and that the grading ought to represent both (1) the quality of the product developed jointly by the team as well as (2) the degree of participation and quality of contribution by each individual student involved in the group process. The latter grading requirement has posed a challenge to faculty so the question addressed in this paper is “How should individual team members in online courses be assessed for the extent and quality of their contributions to the group project?” To answer this question, four common team member evaluation practices were reviewed and compared to seven criteria representing positive attributes of an assessment practice in an online learning environment. Whereas the Peer Assessment practice received the greatest support in the literature in face-to-face courses, this study that considered the perceptions of graduate faculty and students recommended the Faculty Review practice as the default assessment

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Change of quality indexes of premixes in the storage process

Pig breeding the interdepartmental subject scientific digest ◽

10.37143/0371-4365-2020-74-13 ◽

2020 ◽

pp. 105-112

Author(s):

Oksana Bitlian ◽

Oksana Kravchenko ◽

Tetiana Kodak ◽

Andrii Onyshchenko ◽

Tetiana Konks

Keyword(s):

Raw Materials ◽

Storage Process ◽

Important Place ◽

Inappropriate Use ◽

Chemical Structures ◽

Copper Zinc ◽

Qualitative Responses ◽

Chelating Compounds ◽

Quality Indexes

The analysis of literature sources shows that the type and material from which the packaging is made has an important place in the system of factors which influence on the storage of feed products and also prevents reducing the quality of raw materials and finished products. Therefore, the purpose of our research is the technological justification of changing the quality indexes of premix samples with salts of trace elements of different chemical nature in the process of storage. For the solution of the tasks, common zootechnical and statistical methods of the research were used. The use of premixes in feeding pigs is based on the fact that they should be used taking into account the biogeochemical properties of the region for which they are calculated. Foods depending on regional properties have a special biochemical composition and excess or lack of individual substances should be offset by the composition of premix. Ignoring this provision necessarily leads to the inappropriate use of BAR, the misbalance of the diet in relation to the physiological needs and inefficiency of the industry. In turn, it requires the purchase and conservation of products for the period of use. Various chemical structures and structures of BAR during the storage process react differently and change qualitative indexes, which leads to a decrease in the productive activity of active substances. It was determined that the humidity of premixes varied within the limits of 12.0-13.0 %, which exceeded the normative, but was not critical, the highest acidity had premix with sulfuric acid salts (6.9 units), the least - premix with lysates (5.7 unit). According to the results of the study, positive qualitative responses were found for the presence of vitamins A, D and B2, macro- and micronutrients: potassium, magnesium, copper, zinc, cobalt, iodine. The above facts of changes in the properties of premixes in the process of storage must be taken into account when providing technological bases for feeding pigs in order to obtain high gains and the quality of manufactured products. Key words: premix, micro-and macro elements, combined fodders, fodder mixes, chelating compounds, feeding, using, pigs' livestock.

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Regulatory requirements and comparison in approval of new and generic drugs in United States of America and Japan:-Implication for Future strategies

Applied Clinical Research Clinical Trials and Regulatory Affairs ◽

10.2174/2213476x07666200808163247 ◽

2020 ◽

Vol 07 ◽

Author(s):

Paramjeet Malik ◽

Neelam Pawar ◽

Kavita Bahmani

Keyword(s):

Generic Drugs ◽

Drug Product ◽

Drug Approval ◽

Approval Process ◽

Regulatory Requirements ◽

Team Members ◽

Regulatory Authorities ◽

Effective Manner ◽

Review Team

: Safety, efficacy and quality of a therapeutic product is the major concern for the pharmaceutical companies. FDA and PMDA are the main regulatory authorities in USA & JAPAN respectively that ensures the maintenance of these required parameters by forming standard guidelines and process for drug approval. These regulatory authorities’ reviews each step of a pharmaceutical drug product from its discovery phase to marketed product. Dossier plays an important role during the approval process of a drug product, as it allows both applicant and review team members to evaluate the data in an effective manner. A dossier consists of five modules containing informative data of various stages of a drug product but in a brief pattern with folders and subfolders. In the present paper, the authors focus on in-depth review of approval process for new and generic drugs in USA and Japan.

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