scholarly journals Audit Feedback Interventions to Address High-Risk Prescriptions in Long-Term Care Homes: A Costing Study and Return on Investment Analysis

2020 ◽  
Author(s):  
Kednapa Thavorn ◽  
Srishti Kumar ◽  
Catherine Reis ◽  
Jonathan Lam ◽  
Gail Dobell ◽  
...  
Keyword(s):  
Return On Investment ◽  
Long Term Care ◽  
Cost Savings ◽  
Audit And Feedback ◽  
Health Staff ◽  
Term Care ◽  
Total Cost ◽  
Intervention Cost ◽  
Costing Study

Abstract Background: Audit and feedback is a common implementation strategy, but little literature describes its costs. ‘MyPractice’ is an audit and feedback initiative produced by Ontario Health, the provincial agency tasked with supporting quality of care. This study sought to estimate the costs of ‘MyPractice’ and assess whether the financial benefit of ‘MyPractice’ offsets those costs. Methods: We conducted a costing study from the perspective of the government of Ontario, which funds both Ontario Health and necessary healthcare costs for people living in long-term care (LTC) homes in the province. Total cost of ‘MyPractice’ was calculated as the sum of the costs of producing and disseminating the reports (covering three report releases) which were obtained from Ontario Health staff interviews and document reviews. Return on investment (ROI) was calculated as the ratio of net cost-savings and the intervention cost. Net cost-savings were estimated as the reduction in the costs of antipsychotics incurred by LTC home residents attributable to ‘MyPractice’ reports. Results: Total intervention costs were C$223,691 (C$838 per physician and C$74,564 per release). Costs incurred during the development phase accounted for 74% of the total cost (C$166,117), while implementation costs for three report releases were responsible for 26% of the total costs (C$57,575). The ROI for every C$1 spent on the ‘MyPractice’ intervention was 1.22 (95% CI: 0.82, 1.61) for three report releases. Conclusion: ‘My Practice’ report offers a good return on investment and the value for money increases if physicians sign up and view the reports.

scholarly journals Audit feedback interventions to address high-risk prescriptions in long-term care homes: a costing study and return on investment analysis

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Kednapa Thavorn ◽  
Srishti Kumar ◽  
Catherine Reis ◽  
Jonathan Lam ◽  
Gail Dobell ◽  
...  
Keyword(s):  
Return On Investment ◽  
Cost Savings ◽  
Audit And Feedback ◽  
Health Staff ◽  
Financial Benefit ◽  
Term Care ◽  
Total Cost ◽  
Intervention Cost ◽  
Costing Study ◽  
Implementation Costs

Abstract Background Audit and feedback is a common implementation strategy, but few studies describe its costs. ‘MyPractice’ is a province-wide audit and feedback initiative to improve prescribing in nursing homes. This study sought to estimate the costs of ‘MyPractice’ and assess whether the financial benefit of ‘MyPractice’ offsets those costs. Methods We conducted a costing study from the perspective of the Ontario government. Total cost of ‘MyPractice’ was calculated as the sum of the costs of producing and disseminating the reports (covering three report releases) which were obtained from Ontario Health staff interviews and document reviews. Return on investment (ROI) was calculated as the ratio of net cost-savings and the intervention cost. Cost savings were based on the effectiveness of ‘MyPractice’ derived from a published cohort study. Cost-savings attributable to ‘MyPractice’ were estimated from the changes in the rates of antipsychotics over time between physicians who signed up and viewed the reports and those who did not sign up to the reports. Results Total intervention costs were C$223,691 (C$838 per physician and C$74,564 per release). Costs incurred during the development phase accounted for 74% of the total cost (C$166,117), while implementation costs for three report releases were responsible for 26% of the total costs (C$57,575). The ROI for every C$1 spent on the ‘MyPractice’ intervention was 1.02 (95% CI 0.51, 1.93) for three report releases. Conclusion ‘MyPractice’ report offers a good return on investment and the value for money could improve with greater number of report releases.

scholarly journals Calculating the True Costs of Food Service in Long-Term Care: Development of a Costing Methodology

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 88-88
Author(s):  
Mikaela Wheeler ◽  
Karen Abbey ◽  
Sandra Capra
Keyword(s):  
Long Term Care ◽  
Systems Approach ◽  
Food Service ◽  
Term Care ◽  
Oral Nutrition ◽  
Total Cost ◽  
Real Cost ◽  
Future System ◽  
Care Development

Abstract As population’s age and the need for long term care (LTC) increases, so too does the focus on the costs to provide that care. Providing food, oral nutrition supplements and meals, can be a considerable expense to a home. The objective of this research was to develop a valid foodservice costing tool (FCT), to calculate the real cost of providing foods and meals in LTC. Current costing methodologies are not specific to LTC and do not account for all costs of a foodservice, including staff, procurement and nutrition supplements. An initial tool was developed using the systems approach in conjunction with literature and professional knowledge. This was piloted in real world contexts, using volunteer LTC homes. Four iterations of the tool were completed to assess its feasibility in calculating costs and useability. Managers were interviewed after completing the tool to gather an understanding of how the tool was interpreted and to refine completion. Following feedback, the resulting tool consists of nine sections, measuring both costs incurred in meal production and service as well as analysis of staff workloads. Preliminary results show consistency between homes within Australia, indicating that the true cost is much higher than that reported in the literature to date. The development of a comprehensive, usable tool which captures the total cost of foodservice allows homes to accurately report and understand costs from a systems level. This information can be used to demonstrate cost effectiveness of a foodservice and the potential to justify and plan future system changes.

Enhancing Quality Care in Ontario Long-Term Care Homes Through Audit and Feedback for Physicians

2020 ◽  
Vol 21 (3) ◽  
pp. 420-425
Author(s):  
Cara L. Mulhall ◽  
Jonathan M.C. Lam ◽  
Patrick S. Rich ◽  
L. Gail Dobell ◽  
Anna Greenberg
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
Audit And Feedback ◽  
Care Homes ◽  
Term Care

scholarly journals 1236. Infection Control Risk Mitigation and Implementation of Best Practice Recommendations in Long-Term Care Facilities

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S375-S376
Author(s):  
Teresa Fitzgerald ◽  
Regina Nailon ◽  
Kate Tyner ◽  
Sue Beach ◽  
Margaret Drake ◽  
...  
Keyword(s):  
Infection Control ◽  
Best Practice ◽  
Long Term Care ◽  
Audit And Feedback ◽  
Risk Assessments ◽  
Term Care ◽  
Practice Recommendations ◽  
Care Facilities

Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a quality improvement initiative supported by the NE Department of Health and Human Services. This initiative utilizes subject matter experts (SMEs) including infectious diseases physicians and certified infection preventionists (IP) to assess and improve infection prevention and control programs (IPCP) in various healthcare settings. NE ICAP conducted on-site surveys and observations of IPCP in many volunteer facilities to include long-term care facilities (LTCF) between November 2015 and July 2017. SMEs provided on-site coaching and made best practice recommendations (BPR) for priority implementation. Impact of this intervention on LTCF IPCP was examined. Methods Using a standardized questionnaire, follow-up phone calls were made with LTCF to evaluate implementation of the BPR one-year post-assessment. Descriptive analyses were performed to examine BPR implementation in LTCF that had follow-up between 4/4/17 to 4/17/18 and to identify factors that promoted or impeded BPR implementation. Results Overall, 45 LTCF were assessed. The top 5 IC categories requiring improvement were audit and feedback practices (28 of 45, 62%), PPE supplies at point of use (62%), IC risk assessments (58%), TB risk assessments (56%), and supply and linen storage practices (56%). Follow-up assessments were completed for 270 recommendations in 25 LTCF. Recommendations reviewed ranged from three to 26 per LTCF (median = 15). The majority of the 270 recommendations (n = 162, 60%) had been either completely (35%) or partially (25%) implemented by the time of the follow-up calls. The ICAP visit itself was reported as the most helpful resource for BPR implementation (77 of 162). Lack of staffing was the most commonly mentioned barrier to implementation when LTCF implemented BPR partially or implementation was not planned (37 of 85). BPR Implementation most frequently involved additional staff training (64 of 162), review of policies and procedures (38 of 162), and implementing audit (34 of 162) and/or feedback (23 of 162) programs. Conclusion Numerous IC gaps exist in LTCF. Peer-to-peer feedback and coaching by SMEs facilitated implementation of many BPR directed toward mitigating identified IC gaps. Disclosures All authors: No reported disclosures.

scholarly journals Recommendations from long-term care reports, commissions, and inquiries in Canada

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 87
Author(s):  
Eric K. C. Wong ◽  
Trina Thorne ◽  
Carole Estabrooks ◽  
Sharon E. Straus
Keyword(s):  
Long Term Care ◽  
National Level ◽  
Indirect Costs ◽  
Median Number ◽  
Primary Objective ◽  
Direct Care ◽  
Term Care ◽  
Total Cost ◽  
Governmental Agencies

Background: Multiple long-term care (LTC) reports have issued similar recommendations for improvement across Canadian LTC homes. Our primary objective was to identify the most common recommendations made over the past 10 years. Our secondary objective was to estimate the total cost of studying LTC issues repeatedly from 1998 to 2020. Methods: The qualitative and cost analyses were conducted in Canada from July to October 2020. Using a list of reports, inquiries and commissions from The Royal Society of Canada Working Group on Long-Term Care, we coded recurrent recommendations in LTC reports. We contacted the sponsoring organizations for a cost estimate, including direct and indirect costs. All costs were adjusted to 2020 Canadian dollar values. Results: Of the 80 Canadian LTC reports spanning the years of 1998 to 2020, 24 (30%) were based on a national level and 56 (70%) were focused on provinces or municipalities. Report length ranged from 4 to 1491 pages and the median number of contributors was 14 (interquartile range, IQR, 5–26) per report. The most common recommendation was to increase funding to LTC to improve staffing, direct care and capacity (67% of reports). A median of 8 (IQR 3.25–18) recommendations were made per report. The total cost for all 80 reports was estimated to be $23,626,442.78. Conclusions: Problems in Canadian LTC homes and their solutions have been known for decades. Despite this, governments and non-governmental agencies continue to produce more reports at a monetary and societal cost to Canadians.

scholarly journals COST SAVINGS FOR CAPABLE PROGRAM DRIVEN BY DECREASES IN HOSPITAL AND LONG-TERM CARE FOR PARTICIPANTS

2017 ◽  
Vol 1 (suppl_1) ◽  
pp. 1392-1392
Author(s):  
S.L. Szanton ◽  
N.H. Alfonso ◽  
L. Roberts ◽  
D.H. Bishai
Keyword(s):  
Long Term Care ◽  
Cost Savings ◽  
Term Care

Investing in a “Rehabilitation Model” to Improve the Decision-Making Process in Long-Term Care

2013 ◽  
pp. 37-47
Author(s):  
Connie D’Astolfo
Keyword(s):  
Decision Making ◽  
Health System ◽  
Chronic Diseases ◽  
Long Term Care ◽  
Hospital Costs ◽  
Cost Savings ◽  
System Transformation ◽  
Term Care ◽  
Rehabilitation Model

An aging population is a primary factor associated with escalating healthcare costs due to increased drug spending, chronic diseases and co-morbidities, physician visits, and hospital costs (TD Report, 2010). There has already been a marked increase in the number of Long-Term Care (LTC) residents with co-morbidities, and chronic diseases will be more prevalent in future years (Conference Board of Canada, 2011). The chapter explores the use of a rehabilitation model to improve the current decision-making processes that impact the health outcomes of seniors across the Ontario LTC continuum. Improved clinical management of this population through rehabilitation could result in not only enhanced quality of care but also significant cost savings for both the Long-Term Care (LTC) industry and the health system at large. The chapter highlights the need for the LTC sector to identify strategies for harnessing innovation to improve its own activities and outcomes and become a leader in health system transformation.

scholarly journals Effect of a multimethod quality improvement intervention on antipsychotic medication use among residents of long-term care

2021 ◽  
Vol 10 (2) ◽  
pp. e001211
Author(s):  
Heather M Hanson ◽  
Tova Léveillé ◽  
Mollie Cole ◽  
Lesley JJ Soril ◽  
Fiona Clement ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Antipsychotic Medication ◽  
Long Term Care ◽  
Medication Use ◽  
Implementation Fidelity ◽  
Audit And Feedback ◽  
Quality Improvement Initiative ◽  
Term Care ◽  
Antipsychotic Medications

BackgroundAntipsychotic medications are used to address neuropsychiatric symptoms associated with dementia. Evidence suggests that among older adults with dementia, their harms outweigh their benefits. A quality improvement initiative was conducted to address inappropriate antipsychotic medication use in long-term care (LTC) in the province of Alberta.MethodsWe conducted a multimethod evaluation of the provincial implementation of the project in 170 LTC sites over a 3-year project period incorporating a quasi-experimental before–after design. Using a three-component intervention of education and audit and feedback delivered in a learning workshop innovation collaborative format, local LTC teams were supported to reduce the number of residents receiving antipsychotic medications in the absence of a documented indication. Project resources were preferentially allocated to supporting sites with the highest baseline antipsychotic medication use. Changes in antipsychotic medication use, associated clinical and economic outcomes, and the effects of the project on LTC staff, physicians, leaders and administrators, and family members of LTC residents were assessed at the conclusion of the implementation phase.ResultsThe province-wide initiative was delivered with a 75% implementation fidelity. Inappropriate antipsychotic medication use declined from 26.8% to 21.1%. The decrease was achieved without unintended consequences in other outcomes including physical restraint use or aggressive behaviours. The project was more expensive but resulted in less inappropriate use of antipsychotics than the pre-project period (incremental cost per inappropriate antipsychotic avoided of $5 678.71). Accounts from family, organisational leaders, and LTC staff were supportive of the project activities and outcomes.ConclusionThis quality improvement initiative was successfully delivered across an entire delivery arm of the continuing care sector. Quality of care in LTC was improved.

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