Care coordinator assistants: Job satisfaction and the importance of teamwork in delivering person-centered dementia care

As the prevalence of persons with dementia increases, a larger, trained, and skilled healthcare workforce is needed. Attention has been given to models of person-centered care as a standard for dementia care. One promising role to deliver person-centered care is the care coordinator assistant. An inquiry about care coordinator assistant’s job satisfaction is reasonable to consider for retention and quality improvement purposes. We evaluated care coordinator assistants' job satisfaction quantitatively and qualitatively. This study was part of a Centers for Medicare & Medicaid Services Health Care Innovation Award to the Indiana University School of Medicine. Sixteen care coordinator assistants, predominately female, African American or Caucasian, college graduates with a mean age of 43.1 years participated. Care coordinator assistants wrote quarterly case reports to share stories, lessons learned, and/or the impact of their job and completed the revised Job Satisfaction Inventory and Job in General scales during the second year of the Centers for Medicare & Medicaid Services award. For the Job Descriptive Index subscales promotion, supervision, and coworkers and Job in General, care coordinator assistants scored similar to normative means. Care coordinator assistants reported significantly higher satisfaction on the work subscale and significantly lower satisfaction on the pay subscale compared to normative data. Care coordinator assistants completed 119 quarterly case reports. Job satisfaction and teamwork were recurring themes in case reports, referenced in 47.1% and 60.5% of case reports, respectively. To address the demands of increasing dementia diagnoses, care coordinator assistants can constitute a compassionate, competent, and satisfied workforce. Training care coordinator assistants to work together in a team to address the needs of persons with dementia and caregivers provides a viable model of workforce development necessary to meet the growing demands of this population.

Download Full-text

Working Conditions Supporting Person-Centered Care of Persons Living with Dementia in Long-Term Care Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.3516 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 962-962

Author(s):

Marie Savundranayagam ◽

Susan Docherty-Skippen ◽

Shalane Basque

Keyword(s):

Working Conditions ◽

Long Term Care ◽

Dementia Care ◽

Term Care ◽

Support Person ◽

Personal Support ◽

Person Centered Care ◽

Centered Care ◽

The Impact

Abstract The COVID-19 pandemic has underscored the importance of person-centered dementia care and working conditions that support such care in long-term care (LTC) home settings. Personal support workers (PSWs), known also as certified nursing assistants, provide the most direct formal care for persons living with dementia. However, little is known about the working conditions that enable person-centered care. Accordingly, the purpose of this study was to examine the working conditions and the impact of those conditions on PSWs in LTC homes. PSWs (N=39) employed at one of five LTC homes in southwestern Ontario, Canada participated in a series of one-hour focus groups before, during, and after Be-EPIC, a person-centred communication training program for formal caregivers of persons living with dementia. Using an interpretive description investigative framework, textual data from focus group conversation transcripts were open-coded into categories. Overarching themes were interpreted inductively. Study credibility was enhanced through investigator triangulation. Three themes emerged related to working conditions of PSWs: dementia care is complex, lack of trained staff to provide person-centered dementia care, and residents’ families are not situated in the residents’ care circle. Four themes emerged related to the impact of current working conditions of PSWs: occupational burnout, poor resident care, frustrated and disengaged families, and PSWs leave their role. The findings offer opportunities for employers to ameliorate working conditions to support person-centered care. We conclude with specific workplace recommendations that respond to the complexity of dementia care and the associated occupational stresses PSWs experience in the current LTC environment.

Download Full-text

COVID-19 and Person-Centered Care: Lessons Learned Through a Statewide Program for Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igab046.1041 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 270-271

Author(s):

Migette Kaup ◽

Laci Cornelison

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Infection Control ◽

Pay For Performance ◽

Control Strategies ◽

Lessons Learned ◽

Frail Elders ◽

Person Centered Care ◽

Centered Care ◽

The Impact

Abstract Frail elders in nursing homes are the highest risk group for developing complications of COVID-19. This lead to a response from CMS and state regulators that was heavily focused on protection and safety through segregation and infection control. The purpose of this study was to gather the narrative of this pandemic response and understand the impact on person-centered care and be able to address provider needs in real-time. This qualitative method focused on nursing home providers who are a part of PEAK 2.0, a Medicaid pay-for-performance program in Kansas. Interviews with nursing home staff (n=168) revealed two critical themes of need; mandated responses disregarded elders’ autonomy and self-determination in decision making, and infection control strategies required new approaches to facets of resident care that still maintained dignity. This data, along with COVID-19 guidance were then used to inform feasible resource development and education to maintain PCC practices during the pandemic.

Download Full-text

Parents’ Perceptions of the Impact of Information at a Voiding Cystourethrogram of Their Child: An Example of Person-Centered Care in Radiography

Journal of Radiology Nursing ◽

10.1016/j.jradnu.2020.12.004 ◽

2021 ◽

Author(s):

Anetta Bolejko ◽

Jenny Gårdling

Keyword(s):

Voiding Cystourethrogram ◽

Person Centered Care ◽

Centered Care ◽

The Impact

Download Full-text

Person-Centered Care in Persons Living with Dementia: A Systematic Review and Meta-Analysis

The Gerontologist ◽

10.1093/geront/gnaa207 ◽

2020 ◽

Author(s):

Kyung Hee Lee ◽

Ji Yeon Lee ◽

Bora Kim

Keyword(s):

Systematic Review ◽

Cognitive Function ◽

Effect Size ◽

Psychological Symptoms ◽

Meta Analysis ◽

Healthcare Providers ◽

Clinical Excellence ◽

Dementia Care ◽

Person Centered Care ◽

Centered Care

Abstract Background and Objectives The concept of person-centered care has been utilized/adapted to various interventions to enhance health-related outcomes and ensure the quality of care delivered to persons living with dementia. A few systematic reviews have been conducted on the use of person-centered interventions in the context of dementia care, but to date, none have analyzed intervention effect by intervention type and target outcome. This study aimed to review person-centered interventions used in the context of dementia care and examine their effectiveness. Research Design and Methods A systematic review and meta-analysis were conducted. We searched through five databases for randomized controlled trials that utilized person-centered interventions in persons living with dementia from 1998 to 2019. Study quality was assessed using the National Institute for Health and Clinical Excellence. The outcomes of interest for the meta-analysis were behavioral and psychological symptoms in dementia (BPSD) and cognitive function assessed immediately after the baseline measurement. Results In total, 36 studies were systematically reviewed. Intervention types were: reminiscence, music, and cognitive therapies, and multisensory stimulation. Thirty studies were included in the meta-analysis. Results showed a moderate effect size for overall intervention, a small one for music therapy, and a moderate one for reminiscence therapy on BPSD and cognitive function. Discussion and Implications Generally speaking, person-centered interventions showed immediate intervention effects on reducing BPSD and improving cognitive function, although the effect size and significance of each outcome differed by intervention type. Thus, healthcare providers should consider person-centered interventions as a vital element in dementia care.

Download Full-text

From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

Innovation in Aging ◽

10.1093/geroni/igaa057.3062 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 836-836

Author(s):

Katherine Abbott ◽

Kristine Williams

Keyword(s):

Nursing Home ◽

Assisted Living ◽

Fixed Effects ◽

Nursing Home Residents ◽

Direct Care ◽

Multiple Perspectives ◽

Person Centered Care ◽

Fixed Effects Panel Regression ◽

Centered Care ◽

The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

Download Full-text

The impact of person-centered care on residents' perceptions of care quality in nursing homes: an intervention study

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v7i2.628 ◽

2018 ◽

Vol 7 (2) ◽

pp. 118-124

Author(s):

Vigdis Abrahamsen Grøndahl ◽

Liv Berit Fagerli ◽

Heidi Karlsen ◽

Ellen Rosseland Hansen ◽

Helena Johansson ◽

...

Keyword(s):

Nursing Home ◽

Intervention Study ◽

Care Quality ◽

Legal Rights ◽

Nursing Home Administrators ◽

Person Centered Care ◽

Before And After ◽

Centered Care ◽

The Impact ◽

Perceptions Of Care

Background: The quality of care offered to older people is still poor. Nursing home administrators often claim that they provide person-centered care, but research indicates that institutional goals take precedence. Aim: The aim was to explore the impact of person-centered care on residents’ perceptions of care quality. Methods: An intervention study was conducted in one nursing home (41 residents). Person-centered care was operationalized into the interventions: greeting the resident on each shift, one-to-one contact (resident – carer) for 30 minutes twice a week, informing the residents continuously about changes in medication, and informing the residents about their legal rights at admission and three months after admission. The interventions were systematically conducted for 12 months. Face-to-face interviews using the Quality from Patient’s Perspective (QPP) questionnaire were conducted both prior to interventions and immediately after the 12-month period. Descriptive and comparative statistics were used to test for differences between care quality perceptions before and after intervention (p ≤ .05). Results: The residents rated all four quality dimensions (caregivers’ medical-technical competence and identity-oriented approach, care organization’s socio-cultural atmosphere, and physical-technical conditions) more highly after the 12-month period, and the socio-cultural atmosphere was rated significantly more highly. At item level, 44 items received higher scores, and, among them, significantly higher scores were given to 6 items. One item received a significantly lower score. Conclusions: Residents’ perceptions of care quality increase when person-centered care is operationalized and takes precedence over the ward’s routines or is part of the ward’s routines. The results indicate that it is possible to design a care system where the residents are at the centre of the health care offered.

Download Full-text

Improving the patient experience through a comprehensive performance framework to evaluate excellence in person-centred care

BMJ Open Quality ◽

10.1136/bmjoq-2019-000737 ◽

2019 ◽

Vol 8 (4) ◽

pp. e000737 ◽

Cited By ~ 2

Author(s):

Sara Guastello ◽

Karin Jay

Keyword(s):

Patient Experience ◽

Scientific Evidence ◽

Evaluation Approach ◽

Experience Of Care ◽

Person Centered Care ◽

Patient Loyalty ◽

Centered Care ◽

Certification Programme ◽

The Impact ◽

Staff Engagement

BackgroundPerson-centred care (PCC) is now recognised as an important component of healthcare quality. However, a lack of consensus of its most critical elements and absence of a global measure of person-centredness has limited the ability to evaluate the impact of implementation.AimIntroduce a measurable construct for PCC that yields improvement in quality, patient loyalty and staff engagement.MethodsInformed by scientific evidence and the voices of patients, families and healthcare professionals, the Person-Centered Care Certification Programme was developed as a comprehensive measure of PCC (Person-Centered Care Certification is a registered trademark of Planetree Registered in the US Patent and Trademark Office). Ten years after its development, the programme was redesigned to offer a more complete evaluative framework to focus organisations’ PCC efforts and better understand their impact. Drawing on the National Academy of Medicine’s Guiding Framework for Patient and Family Engaged Care, five drivers for excellence were identified that delineate the critical inputs required to create and maintain a culture of PCC. Aligned within the drivers are 26 interventions that connect staff to purpose, promote partnership with patients and families, engage individuals in care and promote continuous learning. A multimethod evaluation approach assesses how effectively these PCC strategies have been executed within the organisation and to understand their impact on the human experience of care.ResultsThe Person-Centered Care Certification Programme is associated with improvements in patient experience, patient loyalty and staff engagement.ConclusionThe structured Certification framework can help organisations identify PCC improvement opportunities, guide their implementation efforts, and better understand the impact on patient and staff outcomes. Tested in cultures around the world and across the care continuum, the framework has proven effective in converting PCC into a definable, measurable and attainable goal. This paper outlines how the programme was designed, the measurable benefits derived by organisations and lessons learnt through the process.

Download Full-text

THE IMPACT OF PREFERENCE-BASED PERSON-CENTERED CARE ON QUALITY AND SATISFACTION OUTCOMES

Innovation in Aging ◽

10.1093/geroni/igy023.755 ◽

2018 ◽

Vol 2 (suppl_1) ◽

pp. 206-206

Author(s):

K M Abbott ◽

B K Anjali ◽

A Raymore ◽

J Straker ◽

K Van Haitsma

Keyword(s):

Person Centered Care ◽

Centered Care ◽

The Impact

Download Full-text

Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

Journal of Wound Care ◽

10.12968/jowc.2020.29.sup9b.s1 ◽

2020 ◽

Vol 29 (Sup9b) ◽

pp. S1-S22 ◽

Cited By ~ 1

Author(s):

Georgina Gethin ◽

Sebastian Probst ◽

Jan Stryja ◽

Natalia Christiansen ◽

Patricia Price

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Chronic Wounds ◽

Chronic Wound ◽

Wound Care ◽

Patient Knowledge ◽

Person Centered Care ◽

Centered Care ◽

Recommendations For Practice ◽

The Impact

Background Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided. Aim We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research. Method Using a systematic review methodology, we searched six databases for full-text papers from 2009–2019 published in peer-reviewed journals with no limits on language. Results Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care. Conclusions The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

Download Full-text