scholarly journals Understanding Contextual Differences in Residential LTC Provision for Cross-National Research: Identifying Internationally Relevant CDEs

2019 ◽  
Vol 5 ◽  
pp. 233372141984059 ◽  
Author(s):  
Elena O. Siegel ◽  
Annica Backman ◽  
Yi Cai ◽  
Claire Goodman ◽  
Oscar Noel Ocho ◽  
...  
Keyword(s):  
The United States ◽  
Term Care ◽  
Common Data Elements ◽  
Working Definition ◽  
Centered Care ◽  
Definition Of ◽  
Data Elements ◽  
Measurement Infrastructure ◽  
Contextual Differences

Long-term care (LTC) reflects a growing emphasis on person-centered care (PCC), with services oriented around individuals’ needs and preferences. Addressing contextual and cultural differences across countries offers important insight into factors that facilitate or hinder application of PCC practices within and across countries. This article takes an international lens to consider country-specific contexts of LTC, describing preliminary steps to develop common data elements that capture contextual differences across LTC settings globally. Through an iterative series of online, telephone, and in-person sessions, we engaged in in-depth discussions with 11 colleague experts in residential LTC and coauthors from six countries (China and Hong Kong, England, Sweden, Thailand, Trinidad and Tobago, and the United States). Our discussions yielded rich narrative describing a vast range in types of LTC settings, leading to our development of a working definition of residential LTC. Scope of services, funding, ownership, and regulations varied greatly across countries and across different residential LTC settings within countries. Moving forward, we recommend expanding our activities to countries that reflect different stages of residential LTC development. Our goal is to contribute to a larger initiative underway by the WE-THRIVE consortium to establish a global research measurement infrastructure that advances PCC internationally.

scholarly journals Measuring What Matters in Long-Term Care: Common Data Elements in Brazil, China, and the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Michael Lepore ◽  
Kirsten Corazzini ◽  
Sheryl Zimmerman
Keyword(s):  
Healthy Aging ◽  
Long Term Care ◽  
The United States ◽  
Term Care ◽  
Common Data Elements ◽  
Low Resource ◽  
Person Centered Care ◽  
Centered Care ◽  
Data Elements

Abstract Internationally sharable common data elements on residential long-term care (LTC) settings, such as nursing homes and assisted living facilities, can facilitate comparisons across diverse LTC settings for valuable insights on LTC regulation and oversight, practice and operations, infrastructure development, human resources issues, and quality and safety. However, such insights are predicated on the premise that data elements capture information that matters to the full LTC community, including residents, relatives and staff, and are able to be collected across diverse care settings, including low-resource contexts. A critique of much current LTC measurement is its focus on deficits and loss, rather than thriving, person-centered care, and healthy aging, which have been established as important to LTC communities internationally. Further, measurement burden, cultural differences in perceptions of data sharing, and data infrastructure differences are key issues for international data. An international collaborative of LTC researchers—Worldwide Elements to Harmonize Research in Long-Term Care Living Environments (WE-THRIVE)—has developed a set of common data elements that are recommended for parsimoniously assessing key outcomes, workforce and staffing, person-centered care, and the contexts within which LTC settings operate. The studies in this symposium provide insights into the validation and implementation of WE-THRIVE recommended measures in diverse, low-resource LTC contexts, including LTC settings in Brazil, China, and rural Midwest US. Study findings validate WE-THRIVE measures, and provide new knowledge to inform capacity-building for the measurement of person-centered care and healthy aging outcomes in diverse, low-resource, LTC settings.

scholarly journals Measuring What Matters Across International Long-Term Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Kirsten Corazzini ◽  
Michael Lepore
Keyword(s):  
Long Term Care ◽  
Assessment Tool ◽  
Term Care ◽  
Common Data Elements ◽  
Person Centered Care ◽  
Care Assessment ◽  
Centered Care ◽  
Data Elements ◽  
What Matters

Abstract Measuring what matters most to residents, relatives and staff in residential long-term care settings is critical, yet underdeveloped in our predominantly frailty and deficits-focused measurement frameworks. The Worldwide Elements to Harmonize Research in Long-Term Care Living Environments (WE-THRIVE) consortium has previously prioritized measurement concepts in the areas of care outcomes, workforce and staffing, person-centered care, and care context. These concepts include knowing the resident and what matters most to the resident, and outcomes such as quality of life, and personhood. We present findings of our currently recommended measures, including both general population and dementia-specific measures, such as the Person-Centered Care Assessment Tool (PCAT), the Personhood in Dementia Questionnaire (PDQ), and the ICEpop CAPability Measure for Older People (ICECAP-O). We also describe remaining gaps in existing measures that will need to be addressed to fully specify common data elements focused on measuring what matters most to residents, relatives and staff.

scholarly journals Laying Down the Groundwork for an International Measurement Infrastructure

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 145-145
Author(s):  
Katherine McGilton ◽  
Franziska Zuniga ◽  
Michael Lepore ◽  
Kirsten Corazzini ◽  
Charlene Chu
Keyword(s):  
Staff Training ◽  
Staff Retention ◽  
Policy And Practice ◽  
Term Care ◽  
Common Data Elements ◽  
Supervisor Effectiveness ◽  
Data Elements ◽  
Measurement Infrastructure ◽  
International Measurement

Abstract The COVID-19 epidemic has brought to light the significant problems in the long-term care (LTC) sector, specifically the lack of an infrastructure to collect and aggregate data between LTC sectors in different countries. This talk will briefly describe goals of the WE-THRIVE initiative, and focus on exploring the development of “workforce and staffing” common data elements for LTC. We will describe how the subgroup is “laying down the groundwork” within this domain with various methodologies to develop CDEs related to workforce and staffing. The CDEs aim to measure staff retention and turnover, evaluating nursing supervisor effectiveness, and staff training in LTC. Anticipated challenges of this international work will also be highlighted. International research on LTC can valuably inform LTC policy and practice, and the proposed CDEs can facilitate data sharing and aggregation internationally, including low-, middle-, and high-income countries.

scholarly journals Toward Common Data Elements for International Research in Long-term Care Homes: Advancing Person-Centered Care

2019 ◽  
Vol 20 (5) ◽  
pp. 598-603 ◽  
Author(s):  
Kirsten N. Corazzini ◽  
Ruth A. Anderson ◽  
Barbara J. Bowers ◽  
Charlene H. Chu ◽  
David Edvardsson ◽  
...  
Keyword(s):  
International Research ◽  
Long Term Care ◽  
Care Homes ◽  
Term Care ◽  
Common Data Elements ◽  
Person Centered Care ◽  
Centered Care ◽  
Data Elements

scholarly journals Common Data Elements for Workforce and Staffing Measurements in Long-Term Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 144-145
Author(s):  
Charlene Chu ◽  
Franziska Zúñiga ◽  
Kirsten Corazzini
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
Policy And Practice ◽  
High Quality ◽  
Term Care ◽  
Common Data Elements ◽  
Centered Care ◽  
Care Outcomes ◽  
Data Elements

Abstract The workforce in residential long-term care (LTC) is key in providing high-quality, person-centered care for residents. However, low staffing and adverse staffing outcomes such as turnover or job dissatisfaction hinder the provision of high-quality care. International research can add valuable insights for policy and practice by learning from different settings and cultures. The initiative “To Harmonize Research In long-term care liVing Environments (WE-THRIVE)”, is led by an international group of LTC researchers to identify common data elements (CDE) for cross-comparative research that support older adults thriving in LTC. In this symposium, we will present an overview of the WE-THRIVE initiative with a specific focus on CDEs and measurement. The first talk will provide the context for the WE-THRIVE initiative, and discuss the collaborative and iterative processes required to develop the initial CDEs in the area of workforce and staffing. In the second talk, we will discuss which staff should be “in the house” to meet the needs of residents during and after a pandemic, and what type of workforce data system should be available to ensure the best quality outcomes for residents and carers. Next, current issues in the measurement of staffing in LTC based on a review of reviews of staffing’s relationship to quality of care will be discussed. Finally, we extend the debate to consider theoretical and empirical explanations for the relationship between staffing and quality in LTC and the promotion of person-centred care outcomes.

scholarly journals Advancing International Research on Long-Term Care: Using Adaptive Leadership to Build Consensus on International Measurement Priorities and Common Data Elements

2019 ◽  
Vol 5 ◽  
pp. 233372141986472
Author(s):  
Michael Lepore ◽  
Kirsten Corazzini
Keyword(s):  
International Research ◽  
Long Term Care ◽  
Geriatric Medicine ◽  
Term Care ◽  
Common Data Elements ◽  
Person Centered Care ◽  
Special Collection ◽  
Centered Care ◽  
Data Elements

International research on long-term care (LTC) can valuably inform LTC policy and practice, but limited transnational collection of data on key LTC issues restricts the contributions of international LTC research. This special collection of Gerontology and Geriatric Medicine helps close the gap between the status quo and the potential for international LTC research by cultivating a transnational common ground of internationally prioritized measurement concepts and sowing the seeds of international LTC common data elements. The articles in this special collection address both adaptive and technical challenges to international LTC measurement, build on and complement existing LTC measurement systems, and provide diverse international perspectives on the measurement of LTC across four overarching domains: LTC contexts, workforce and staffing, person-centered care, and care outcomes. From large transnational teams of scholars specifying the meanings of central LTC concepts, to smaller subnational research teams testing new measures of person-centered care across diverse local LTC settings, contributors spark new insights and point in new directions for a LTC measurement infrastructure supportive of person-centered care and lifelong thriving.

Cycling Without Age Program: The Impact for Residents in Long-Term Care

2019 ◽  
Vol 42 (9) ◽  
pp. 728-735 ◽  
Author(s):  
Paula McNiel ◽  
Judith Westphal
Keyword(s):  
Lived Experience ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Structured Interviews ◽  
Term Care ◽  
Long Term Care Facility ◽  
Centered Care ◽  
The Impact

Long-term care facilities seek ways to enhance the quality of life for residents. Cycling Without Age (CWA), a new international cycling program, is gaining momentum for older adults. This study explored resident riders’ and trishaw pilots’ lived experience of their participation in the CWA program using a qualitative approach at a long-term care facility in the United States. Researchers conducted 27 face-to-face, semi-structured interviews with riders and pilots. For resident riders, the three themes identified included (a) breath of fresh air; (b) wave, chat, and remember; and (c) sit back and relax. Two themes were identified for the pilots: (a) change in frame of mind, and (b) mental and physical rewards. CWA can be as a new strategy for person-centered care. The CWA program provides nursing an opportunity to advocate, recommend, and obtain an order for residents to participate in the program.

scholarly journals How Long-Term Care Quality Assurance Measures Address Dementia in Australia, England, Japan, and the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 503-503
Author(s):  
Michael Lepore ◽  
David Edvardsson ◽  
Ayumi Igarashi ◽  
Julienne Meyer
Keyword(s):  
United States ◽  
Quality Assurance ◽  
Risk Adjustment ◽  
Long Term Care ◽  
The United States ◽  
Term Care ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract The prevalence of people with dementia living in long-term care (LTC) is high and rising internationally, and the need to improve LTC for people with dementia is widely recognized. In some countries, LTC quality assurance programs use quantitative measures of LTC quality, and international bodies emphasize the importance of person-centered care and healthy ageing outcomes. To better understand how LTC quality assurance programs address dementia, programs were reviewed in four countries—Australia, England, Japan, and the United States. Quality measures from each program were identified (n = 38) and examined to determine how they address dementia. Most measures did not address dementia, but four risk-adjusted for dementia (antipsychotic use, fractures, falls, mobility), one was dementia-specific (dementia/delirium hospitalizations), and one excluded people with dementia (losing bowel/bladder control). The other 32 measures were calculated equally regardless of the prevalence of dementia among LTC residents. Overall, LTC quality measurement differs internationally, but few measures address dementia. When dementia is addressed in quality measure calculations, it is most often as a risk-adjustor. Risk adjustment can help with attributing performance on these measures to the LTC setting rather than to the types of residents that the setting serves, but risk adjustment factors also are highly amenable to fraud, and thus require ongoing monitoring. Although LTC quality assessment programs and measures can help ensure people with dementia have access to quality LTC, adoption of measures that are meaningful to people with dementia—including measures of person-centered care and healthy ageing outcomes—remains needed.

scholarly journals Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life

2019 ◽  
Vol 5 ◽  
pp. 233372141984267 ◽  
Author(s):  
David Edvardsson ◽  
Rebecca Baxter ◽  
Laura Corneliusson ◽  
Ruth A. Anderson ◽  
Anna Beeber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Organizational Context ◽  
Long Term Care ◽  
Well Being ◽  
Term Care ◽  
Common Data Elements ◽  
Care Outcomes ◽  
Data Elements

To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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