Improving Nursing Home Care Through Feedback On PerfoRMance Data
INFORM
2 other identifiers
interventional
119
0 countries
N/A
Brief Summary
This project will evaluate three different strategies to get research findings back to managers of care units in nursing homes. Feedback will be provided in a timely and effective way so that it results in improvements in organizational context (modifiable features of the care unit work environment, such as Formal Interactions, Informal Interactions, Social Capital or Slack Time), quality of care providers' work life (e.g., burnout, job satisfaction, general health) and quality of care. Three feedback packages will be tested to determine the strategy that is most effective at fostering improvements and is also cost-effective. The project will be carried out in nursing homes in Alberta and British Columbia. The information developed will contribute to better care for Canadian seniors who spend their final years in a nursing home.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Mar 2016
Longer than P75 for not_applicable
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
January 22, 2016
CompletedFirst Posted
Study publicly available on registry
March 1, 2016
CompletedStudy Start
First participant enrolled
March 1, 2016
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 31, 2017
CompletedStudy Completion
Last participant's last visit for all outcomes
December 31, 2019
CompletedMarch 24, 2020
March 1, 2020
1.8 years
January 22, 2016
March 23, 2020
Conditions
Keywords
Outcome Measures
Primary Outcomes (2)
Formal Interactions (FI)
FI is one of ten concepts included in the Alberta Context Tool (ACT). It is defined as "formal exchanges that occur between individuals working within an organization (unit) through scheduled activities that can promote the transfer of knowledge." FI includes four items asking care aides how often, in the last typical month, they participated in (a) team meetings about residents, (b) family conferences, (c) change-of-shift report, and (d) continuing education (conferences, courses) outside the nursing home (rated from 1=never to 5=almost always). To score FI, scores of each item are recoded (1 and 2 =\> 0; 3 =\> .5; 4 and 5 =\> 1) and summed up. FI therefore is scored with values ranging from 0 to 4, and averaged.
Post-intervention assessment, up to 6 months (July-December 2017)
Formal Interactions (FI)
FI is one of ten concepts included in the Alberta Context Tool (ACT). It is defined as "formal exchanges that occur between individuals working within an organization (unit) through scheduled activities that can promote the transfer of knowledge." FI includes four items asking care aides how often, in the last typical month, they participated in (a) team meetings about residents, (b) family conferences, (c) change-of-shift report, and (d) continuing education (conferences, courses) outside the nursing home (rated from 1=never to 5=almost always). To score FI, scores of each item are recoded (1 and 2 =\> 0; 3 =\> .5; 4 and 5 =\> 1) and summed up. FI therefore is scored with values ranging from 0 to 4, and averaged.
Long-term follow up, up to 6 months (January-June 2019)
Secondary Outcomes (18)
Evaluation (Unit Feedback)
Post-intervention assessment, up to 6 months (July-December 2017)
Evaluation (Unit Feedback)
Long-term follow up, up to 6 months (January-June 2019)
Social Capital
Post-intervention assessment, up to 6 months (July-December 2017)
Social Capital
Long-term follow up, up to 6 months (January-June 2019)
Organizational Slack (OS) Time
Post-intervention assessment, up to 6 months (July-December 2017)
- +13 more secondary outcomes
Study Arms (3)
Standard feedback
ACTIVE COMPARATORFacilities in this arm will receive an initial face-to-face dissemination workshop that includes feedback of research data on modifiable aspects of their microsystem context but no goal setting.
Basic assisted feedback
EXPERIMENTALIn addition to the face-to-face dissemination workshop, facilities in this arm will receive a face-to-face goal setting workshop focused on modifiable areas of their microsystem context and two virtual support workshops at six month intervals.
Enhanced assisted feedback
EXPERIMENTALIn addition to the face-to-face dissemination workshop, facilities in this arm will receive an additional face-to-face goal setting workshop focused on modifiable areas of their microsystem context, two additional face-to-face support workshops at six month intervals plus on-demand email and telephone support.
Interventions
Managers and directors of care will receive a printed report (tailored to their facility) on their facility's performance and performance of each unit (microsystem) within that facility. The workshop will include a presentation of the feedback reports with a particular focus on the core set of actionable context targets (Formal Interactions, Evaluation, Social Capital, Organizational Slack (OS) - Time) in the face-to-face workshops. Following the presentation, participants will discuss their reports in facilitated, round-table group discussions to a) help with interpretation of the results overall, b) draw attention to elements of context that are modifiable, c) encourage microsystem teams to work on improving the more modifiable areas
Sessions will build on the dissemination workshops and will be held three months after. Feedback reports on Formal Interactions, Evaluation, Social Capital, and Organizational Slack (OS) - Time will be discussed. Small group activities will take place including: a) reflecting on context data, b) performance goal setting using the 'tell and sell' method, which capitalizes on the workshop leaders' perceived expertise about what goals are achievable, c) establishing a series of proximal learning goals that will provide teams with explicit strategies for attaining performance goals set in (b). An action plan and instructions for reporting back at the Virtual Support Workshop will be provided.
On virtual support workshop will be held six months after the feedback and goal setting workshop, and a second one another six months later. Groups will a) report on their progress in the proximal learning goals and strategies used toward their performance goals, b) discuss challenges they may be encountering, and c) receive support from the research team in addressing these challenges.
On face-to-face support workshop will be held six months after the feedback and goal setting workshop, and a second one another six months later. Groups will a) report on their progress in the proximal learning goals and strategies used toward their performance goals, b) discuss challenges they may be encountering, and c) receive support from the research team in addressing these challenges. Workshops will be attended by all participating teams from a region, to maximize opportunities for teams to learn from one another and trouble-shoot together with the support of workshop leaders.
Participants can contact the research team if needed with requests for support in defining or implementing improvement strategies or dealing with barriers towards improvement.
Eligibility Criteria
You may qualify if:
- Participates in the Translating Research in Elder Care program
- Located in on of the following health regions in Alberta and British Columbia: Alberta North, Alberta South, Fraser Health, Interior Health
- At least one care unit in the facility with 10 or more care aide responses to our TREC survey
- Care aide responses can be assigned to a care unit in the facility as defined by TREC (TREC microsystem)
You may not qualify if:
- Does not participate in TREC
- Not located in the above named health regions
- No care unit in the facility with 10 or more care aide responses to our TREC survey
- Care aide responses cannot be assigned to a TREC defined microsystem
- Care Units:
- or more care aide responses to our TREC survey
- Clearly identifiable unit leader (can also lead other units)
- Stable leadership over the last year
- Less than 10 care aide responses to our TREC survey
- No clearly identifiable unit leader
- No stable leadership over the last year
- Care Professionals:
- Leader of one or more included care units (care managers, directors of care)
- Assistant leader of one or more included care units
- Quality improvement specialist or clinical educator/instructor of one or more included care units
- +5 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Related Publications (3)
Ginsburg LR, Hoben M, Easterbrook A, Anderson RA, Estabrooks CA, Norton PG. Fidelity is not easy! Challenges and guidelines for assessing fidelity in complex interventions. Trials. 2021 May 29;22(1):372. doi: 10.1186/s13063-021-05322-5.
PMID: 34051830DERIVEDHoben M, Ginsburg LR, Easterbrook A, Norton PG, Anderson RA, Andersen EA, Bostrom AM, Cranley LA, Lanham HJ, Weeks LE, Cummings GG, Holroyd-Leduc JM, Squires JE, Wagg AS, Estabrooks CA. Comparing effects of two higher intensity feedback interventions with simple feedback on improving staff communication in nursing homes-the INFORM cluster-randomized controlled trial. Implement Sci. 2020 Sep 10;15(1):75. doi: 10.1186/s13012-020-01038-3.
PMID: 32912323DERIVEDHoben M, Norton PG, Ginsburg LR, Anderson RA, Cummings GG, Lanham HJ, Squires JE, Taylor D, Wagg AS, Estabrooks CA. Improving Nursing Home Care through Feedback On PerfoRMance Data (INFORM): Protocol for a cluster-randomized trial. Trials. 2017 Jan 10;18(1):9. doi: 10.1186/s13063-016-1748-8.
PMID: 28069045DERIVED
Related Links
Study Officials
- PRINCIPAL INVESTIGATOR
Carole A Estabrooks, PhD
University of Alberta
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- PARTICIPANT, OUTCOMES ASSESSOR
- Masking Details
- Participants and outcome assessors are blinded to study arm assignment
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor & Canada Research Chair in Knowledge Translation
Study Record Dates
First Submitted
January 22, 2016
First Posted
March 1, 2016
Study Start
March 1, 2016
Primary Completion
December 31, 2017
Study Completion
December 31, 2019
Last Updated
March 24, 2020
Record last verified: 2020-03