Testing the Implementation of a Toolbox to Optimize Data Collection and Data Quality of the National Medical Quality Indicators in Long-term Care Facilities: A Pilot Study. (NIP-Q-UPGRADE Subaim 1.8)

NCT06848725 | Completed

• 1 other identifier: NIP-Q-UPGRADE WP 1.8
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 3

Brief Summary

Since 2019, long-term care facilities in Switzerland are obliged by the Federal Insurance Law (KVG, Art. 59a) to report data for the calculation and public reporting of medical quality indicators (MQI). By 2024, this is done in four clinical domains: polypharmacy, pain, malnutrition and the use of physical restraints. This data is used for both monitoring quality of care on a national level and for internal quality of care development. To be valid and reliable, MQI data needs to be collected according to specified measurement instructions. An ethnographic study conducted within the NIP-Q-UPGRADE identified numerous challenges, which can lead to poor data quality. The overall aim of this pilot study is to test the implementation of a data quality development toolkit concerning the MQI. The toolkit uses a train-the-trainer strategy. The research team will prepare external training providers to train delegated staff from the long-term care facilities (further called champions), who will then train and support their co-workers to collect reliable MQI data. The research team developed training and support materials and organized an e-mail contact centre for MQI related questions for the participating facilities. Implementation outcomes will be assessed at two levels: long-term care facilities and the external training providers. Objectives at the external training provider level:

1. 1.To determine the acceptability and feasibility of the training and support materials.
2. 2.To determine the fidelity to the training and adaptations made when implementing it.
3. 3.To identify the barriers and facilitators for the implementation of the training.
4. 4.To measure the costs associated with delivering the training.
5. 5.To determine the acceptability and the feasibility of the data quality development toolkit components.
6. 6.To determine the fidelity to toolkit components and adaptations made when implementing it.
7. 7.To identify the barriers and facilitators for the implementation of the toolkit.
8. 8.To measure the costs associated with implementing the toolkit.

Conditions

Toolbox to Optimize Data Quality of the National MQIs

Keywords

NIP-Q-UPGRADE; quality indicators; long-term care; data quality improvement

Outcome Measures

Primary Outcomes (6)

• Acceptability of the toolbox

  Acceptability of toolbox components will be assessed in a survey with Acceptability of Intervention Measure (AIM), a 4-item instrument measuring the acceptability of an intervention. Further exploration of acceptability in qualitative interviews and focus groups

  After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.

• Feasibility of the toolbox

  Feasibility of toolbox components will be assessed in a survey with Feasibility of Intervention Measure (FIM), a 4-item instrument measuring the feasibility of an intervention. Further exploration of feasibility in qualitative interviews and focus groups.

  After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.

• Implementation fidelity

  Degree of fidelity to each component (yes, partial, no) will be measured using a questionnaire survey. Further exploration of implementation fidelity in qualitative interviews and focus groups.

  After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: survey and focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.

• Barriers to the implementation of the toolbox

  Barriers to the implementation will be explored in qualitative interviews and focus groups, and categorized according to the Consolidated Framework of Implementation Research (CFIR)

  After each champion's training unit (baseline, 3 weeks and 9 weeks): interview with trainer. At 3 months: focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.

• Facilitators to the implementation of the toolbox

  Facilitators to the implementation will be explored in qualitative interviews and focus groups, and categorized according to the Consolidated Framework of Implementation Research (CFIR)

  At 3 months: focus groups with champions, leadership, nursing and care staff. At 6 months: focus group with champions.

• Sum of costs associated with implementation of the toolkit in Swiss francs

  Costs will be calculated based on time spent on implementation activities per staff group with corresponding hourly salary estimate, recorded in an activity logbook

  Continuously from baseline training to 3 months after

Study Arms (1)

Long-term care facilities

EXPERIMENTAL

All participating facilities will be offered the same toolbox

Behavioral: Data quality development toolkit concerning the medical quality indicators (MQI)

Interventions

Data quality development toolkit concerning the medical quality indicators (MQI) BEHAVIORAL

The toolkit uses a train-the-trainer strategy. The research team will: * develop training and support materials for external training providers and delegated staff (champions) from the long-term care facilities * prepare external training providers within a one 3h session to train champions from the long-term care facilities * organize an e-mail contact centre for MQI related questions for the participating facilities. The external training providers will: \- train the champions in one full day (8h) in-person training session and in 2 online sessions a 4h and 2h to support their co-workers to collect reliable MQI data. Based on the received training, the champions will: * provide internal trainings to the care and nursing team, * perform data quality monitoring, * provide feedback on data quality and act as a contact person for questions on MQI in their facility.

Long-term care facilities

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• External training providers:
• willing to implement trainings as designed by the research team and to all interested long-term care facilities
• have capacity to provide the trainers and infrastructure for the trainings - agree to non-commercial use of training materials
• Trainer:
• with competence in training staff of long-term care facilities
• with knowledge on data collection of the current MQIs
• Long-term care facilities:
• with a cantonal recognition as a residential long-term care facility
• willing to implement the toolkit
• which can nominate at least one champion
• Champions:
• Long-term care facility employees motivated to take up the role
• having sufficient knowledge of the residents, infrastructure and processes in the facility (e.g., resident care, needs assessment instrument, electronic health records)
• Ideally with experience in leadership, staff training, MQI data collection and quality monitoring, e.g., nurse, nurse expert, quality manager, needs assessment instrument manager
• Management and staff responsible for quality:

You may not qualify if:

• \. long-term care facilities that are participants of the study "Data Quality and National Quality Indicators in Long-term Care Facilities: a Validation Study and Evaluation Study"

Sponsors & Collaborators

• University of Basel: lead
• University of Applied Sciences and Arts of Southern Switzerland: collaborator
• Institut et Haute Ecole de la Santé la Source: collaborator

Study Sites (3)

Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), Manno, Switzerland.

Manno, Canton Ticino, 6928, Switzerland

Location

Institut für Pflegewissenschaft - Nursing Science (INS), University of Basel

Basel, 4056, Switzerland

Location

La Source School of Nursing, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland

Lausanne, Switzerland

Location

Study Officials

• Franziska Zúñiga, Prof. Dr.

  University of Basel

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof. Dr. Franziska Zúñiga

Model Details: The study addresses long-term care facilities

Study Record Dates

• First Submitted: January 3, 2025
• First Posted: February 27, 2025
• Study Start: December 5, 2024
• Primary Completion: April 30, 2025
• Study Completion: June 30, 2025
• Last Updated: February 25, 2026

Record last verified: 2025-02

Data Sharing

• IPD Sharing: Will not share

Locations

CH (3)