scholarly journals BEHAVIORAL DESIGN: A NOVEL APPROACH TO CREATING ADVANCE DIRECTIVE INTERVENTIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S131-S132
Author(s):  
Elise Tarbi ◽  
Brianna Morgan ◽  
Jason Sloan
Keyword(s):  
Design Thinking ◽  
Choice Overload ◽  
Term Care ◽  
Novel Approach ◽  
Limited Effectiveness ◽  
Behavioral Aspects ◽  
Behavioral Design ◽  
Study Team ◽  
Ambiguity Effect

Abstract The 1.7 million older adults receiving long-term services often do not receive end of life care consistent with their wishes. Advance directives (ADs) can help, yet only one-third of Americans have completed ADs. The limited effectiveness of traditional interventions to increase AD completion may be because they do not address the behavioral aspects of advance care planning. Behavioral Design is an innovative approach that combines design thinking and behavioral economics to identify predictable behavioral bottlenecks and create real-time solutions. This study used Behavioral Design to address low AD completion rates of long-term care residents. Consistent with the Behavioral Design process, an interdisciplinary team compiled evidence from 10 diverse data sources to identify behavioral bottlenecks to AD completion. These barriers were analyzed using the cognitive bias codex to determine behavioral levers for intervention. Informed by these findings, the study team designed multicomponent interventions to address behavioral aspects of AD completion. Four behavioral bottlenecks incorporating ten behaviorally mediated causes for lack of AD completion were identified. For example, AD completion is affected by complexity mediated by hassle factor, choice overload, and ambiguity effect. Three interventions were designed to address these behaviorally mediated causes. For example, the intervention HeAD Start would provide a simple, easy to read AD (addressing choice overload) to residents upon admission (addressing hassle factor) with scheduled follow-up by trained staff (addressing ambiguity effect). Behavioral Design incorporates design thinking and leverages behavioral economic principles to create behaviorally mediated AD interventions. Next steps include testing behaviorally informed designs in practice.

Requirements-Based Design of Serious Games and Learning Software

2019 ◽  
pp. 1-34
Author(s):  
Brock Randall Dubbels
Keyword(s):  
Design Thinking ◽  
Care Facility ◽  
Serious Game ◽  
Multiple Traits ◽  
Term Care ◽  
Long Term Care Facility ◽  
Learning Software ◽  
Newly Hired

A serious game can be entertaining and enjoyable, but it is designed to facilitate the acquisition of skills and knowledge performance in the workplace, classroom, or therapeutic context. Claims of improvement can be validated through assessments successful, measurable practice beyond the game experience, the targeted context of the workplace, classroom, or clinical using the same tools as multiple traits and multiple measure (MTMM) models. This chapter provides a post-mortem describing the development of the initial design and development of a measurable model to inform the design requirements for validation for a serious game. In this chapter, the reader will gain insight into the implementation of lean process, design thinking, and field observations for generative research. This data informs the assessments and measurement of performance, validated through the MTMM model criteria for requirements. The emphasis examines the role of research insights for onboarding and professional development of newly hired certified nursing assistants in a long-term care facility.

A novel approach to deprescribing in long-term care settings: The SMART campaign

2017 ◽  
Vol 13 (6) ◽  
pp. 1202-1203 ◽  
Author(s):  
Kathleen Abrahamson ◽  
Arif Nazir ◽  
Karis Pressler
Keyword(s):  
Long Term Care ◽  
Term Care ◽  
Novel Approach

Preparedness in Long-Term Care: A Novel Approach to Address Gaps in Evacuation Tracking

2016 ◽  
Vol 11 (1) ◽  
pp. 28-30
Author(s):  
Emilie Y Prot ◽  
Bruce Clements
Keyword(s):  
Disaster Preparedness ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Initial Response ◽  
Term Care ◽  
Medical Needs ◽  
Novel Approach ◽  
Major Disaster ◽  
Disaster Preparedness And Response

AbstractWith an aging population, the number of elderly individuals residing in long-term care (LTC) facilities will continue to grow and pose unique challenges to disaster preparedness and response. With this rapidly growing vulnerable population, it becomes imperative to identify enhanced and novel preparedness strategies and measures. LTC residents not only have complicated medical needs, including the timing of dispensing multiple medications, but frequently have cognitive and mobility deficits as well. In nearly every major disaster, elderly populations have suffered disproportionate morbidity and mortality. This is often due to elderly evacuees getting overlooked in the chaos of an initial response. Instituting measures to rapidly recognize this population in a crowd during an evacuation will reduce their risk. This commentary reviews the LTC facility evacuation challenges of the 2013 explosion of the West Fertilizer Company plant in West, Texas, and offers a novel solution of mandating the wearing of pink vests by all nursing home residents in case of an evacuation. The pink vests quickly alert disaster rescue and response workers of LTC residents with special needs. (Disaster Med Public Health Preparedness. 2017;11:28–30)

scholarly journals Effects of a Novel Approach to Reducing Costly Hospitalizations of Nursing Home Residents

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 760-760
Author(s):  
Ruth Tappen ◽  
David Wolf ◽  
Karen Southard
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Care Quality ◽  
Patient Centered ◽  
Term Care ◽  
Preventable Hospitalizations ◽  
Skin Breakdown ◽  
Novel Approach ◽  
Acute Changes

Abstract The reduction of preventable hospitalizations from long term care facilities has been identified by CMS as an important measure of quality, both in terms of resident outcomes and nursing home performance. As many as one-quarter of individuals admitted to nursing homes from acute care are rehospitalized within the month placing them at high risk for increased falls, delirium, skin breakdown, nosocomial infection and the like and costing an estimate $4.3 billion annually. To address this well documented threat to care quality, CMS has imposed significant penalties for excessive readmissions on facilities with high rehospitalization rates. An important contributor to these preventable readmissions is resident and family insistence on the transfer. Early efforts to reduce potentially preventable hospitalization of nursing home residents focused on developing systems to identify and respond to acute changes in condition before hospitalization becomes necessary. Reports from facility staff, however, brought to our attention the additional problem of resident and family insistence on transfer despite provider recommendations to the contrary. A series of funded studies to understand this problem, develop a solution and test the effectiveness of this solution will be reported by an interdisciplinary team. We begin with description of the development and clinical trial of Go to the Hospital or Stay Here?, an evidence-based, patient-centered decision aid, with individual residents and families, followed by a pilot test of facility-wide implementation; then an eight state regional dissemination supported by CMS and participating states and finally a discussion of best practices for effective implementation of the Guide.

A Novel Approach to Oral Health Assessment Training for Dietitians in Long-Term Care Settings in Israel

2014 ◽  
Vol 29 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Rebecca A. Brody ◽  
Riva Touger-Decker ◽  
Diane Rigassio Radler ◽  
J. Scott Parrott ◽  
Shelly Elbaum Rachman ◽  
...  
Keyword(s):  
Oral Health ◽  
Long Term Care ◽  
Health Assessment ◽  
Term Care ◽  
Novel Approach ◽  
Assessment Training

scholarly journals COVID-19 and the Long-Term Care Ombudsman Program: Findings From a National Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 87-87
Author(s):  
Lori Smetanka ◽  
Chenguang Du ◽  
Pamela Teaster ◽  
Kathryn Ratliff
Keyword(s):  
Research Team ◽  
Long Term Care ◽  
National Study ◽  
Term Care ◽  
Study Team ◽  
The Media ◽  
State And Local

Abstract The purpose of our study was to explore changes for long-term care ombudsman programs across the country in response to the COVID-19 pandemic. The study team explored the effect of COVID-19 on programs: cases, resident engagement, complaint Investigation and resolution, services, complaints, changes in visitation, and preparedness plans. The research team developed survey items and beta-tested them with state and local LTCOs prior to distributing the survey nationally to State Long-Term Care Ombudsman and Local Long-Term Care Ombudsman in order to characterize experiences of the participants. From 62 state LLTC respondents we learned there were 81.0% fewer cases received, 97.36% were less able to engage with residents, 78.95% were less involved in the engagement of residents in complaint investigation and resolution and there were 71.05% fewer activities involved in investigations. Not surprisingly, there was an 80.0% increase in information that the LTCO provided to the media.

scholarly journals Using Stories to Integrate Gerontology Content Into an Introductory Design (Architecture) Course

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 2-2
Author(s):  
Gail Towsley ◽  
Jim Agutter ◽  
Antonius Tsai ◽  
Jareth Archer ◽  
Sarah Sovereen ◽  
...  
Keyword(s):  
Older Adults ◽  
Design Process ◽  
Assisted Living ◽  
Design Thinking ◽  
Long Term Care ◽  
Meaning Making ◽  
Group Project ◽  
Term Care ◽  
Art Business

Abstract We describe how a partnership between design and gerontology introduces students to concepts of legacy, meaning making and empathy in an undergraduate design course. Introduction to Design Thinking is offered through the Multi-disciplinary Design Program at the University of Utah and is a class that explores concepts such as the design process, human-centered design, rapid prototyping and multidisciplinary team dynamics. In collaboration with faculty from design, medicine and gerontology, the course addresses real-world problems by navigating across disciplines such as art, business, engineering, science, and gerontology. Five phases of the design process are introduced: Observation (collecting material), Analysis (finding patterns and insight), Ideation (solution exploration), Refinement, and Implementation (communication). To apply these processes, students engage in a group project where they interact with older adults residing in long term care (e.g., assisted living). Students undergo HIPAA training and didactic lectures covering narrative interviewing and aging content such as long term care and generativity prepare students for interacting with residents. Throughout the semester, students meet with the older adult to understand, gather, construct and then develop a designed artifact that reflects the stories and the memories of the participating residents. The designed artifacts (e.g., memory maps, videos, small books) are presented and given to the participating residents and their families. This project results in rich stories for both the residents and students. Students also gain interviewing and empathy skills necessary for designing compelling artifacts and potentially age-friendly long term care environments where 2 million older adults live.

Dementia, ageing, and the city: learning from the streets of Melbourne

2018 ◽  
Vol 22 (2) ◽  
pp. 104-114
Author(s):  
Rebecca McLaughlan ◽  
Michael Annear ◽  
Alan Pert
Keyword(s):  
Social Inclusion ◽  
Design Thinking ◽  
Ageing Population ◽  
Care Providers ◽  
Term Care ◽  
Ageing In Place ◽  
The University ◽  
The City ◽  
Speculative Design

One of the most difficult challenges associated with an ageing population will be a significant increase in the number of people living with dementia. In Australia, this number is estimated to triple by 2050; a situation that is reflected globally. This will place increased demands on health and long-term care providers but it should also force an examination of the ability of contemporary cities to facilitate or constrain inclusion. Globally, designers and students of this discipline are contributing their skills to the challenge of dementia but solutions are typically proposed at a product, institutional or suburban scale. This paper will present two propositional projects, created using a speculative design methodology within a design studio at The University of Melbourne, that provoke architects to more seriously interrogate what it means for a city to support social inclusion, independence and choice for those who are ageing in place. These projects illuminate new avenues for critical and necessary research. This paper will begin with a reflection on the limitations of the Hogeweyk Dementia Village (Amsterdam), considered the current gold standard in dementia design, to highlight the value of thinking speculatively within the context of dementia; to disrupt the limitations of contemporary design thinking and ask what role the architect can play in improving the lives of those living with dementia?

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