Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention
Abstract Background Comprehensive adoption of culture change via person-centered care (PCC) practices in nursing homes has been slow. Change such as this, requires transformation of organizational culture, frequently generating resistance and slow moving change. This study examined how nursing homes...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12877-019-1121-3 |
| _version_ | 1818216149091876864 |
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| author | Laci J. Cornelison Linda Hermer Maggie L. Syme Gayle Doll |
| author_facet | Laci J. Cornelison Linda Hermer Maggie L. Syme Gayle Doll |
| author_sort | Laci J. Cornelison |
| collection | DOAJ |
| description | Abstract Background Comprehensive adoption of culture change via person-centered care (PCC) practices in nursing homes has been slow. Change such as this, requires transformation of organizational culture, frequently generating resistance and slow moving change. This study examined how nursing homes perceive their adoption of PCC practices across seven domains and how these perceptions change in response to an educational intervention embedded in a statewide program, Promoting Excellent Alternatives in Kansas nursing homes (PEAK 2.0). Given perception is an important feature of the change process, it was hypothesized that pre-adopters engaging in PEAK 2.0’s initial Foundation year (level 0) would have lower perceived PCC adoption following a year of education and exposure to PCC, whereas adopters (PEAK 2.0 level 1–5 homes) would have higher perceived PCC adoption following a year of participation in their respective level in the program. Methods A multi-arm, pre/post intervention study was conducted during the 2014 and 2015 years of the PEAK 2.0 program comparing pre-PCC adopters to adopters. Outcomes were self-ratings of perceived PCC implementation across seven domains of PCC at the beginning and end of the 2014–15 program year, after pre-adopters had received PCC education and adopters had implemented a year of PCC. Paired t-tests and mixed repeated-measures linear models, controlling for potential confounders, were employed to test the study hypotheses. Results Across all seven domains of PCC, pre-adopters rated their PCC implementation as significantly higher on pre-test (2014) than on post-test (2015). In contrast, adopters rated their PCC achievement as higher on post-test (2015) than on pre-test (2014). Conclusions Pre-adopters’ lower score following a year of education and exposure to PCC may reflect a shift in perceptions of PCC as a concept or a deeper conceptualization of PCC. Since perceptions or assumptions can serve as a source of resistance to change, redefinition or “unlearning” to make way for more accurate definitions of PCC could aid in reducing organizational resistance to implementation of PCC and thus improve the rate of adoption. |
| first_indexed | 2024-12-12T06:47:23Z |
| format | Article |
| id | doaj.art-0a212b9cc5084d4e95d12959dcb9f990 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T06:47:23Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-0a212b9cc5084d4e95d12959dcb9f9902022-12-22T00:34:08ZengBMCBMC Geriatrics1471-23182019-04-0119111110.1186/s12877-019-1121-3Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post interventionLaci J. Cornelison0Linda Hermer1Maggie L. Syme2Gayle Doll3Center on Aging, Kansas State UniversityLeadingAge Center for Applied ResearchCenter on Aging, Kansas State UniversityCenter on Aging, Kansas State UniversityAbstract Background Comprehensive adoption of culture change via person-centered care (PCC) practices in nursing homes has been slow. Change such as this, requires transformation of organizational culture, frequently generating resistance and slow moving change. This study examined how nursing homes perceive their adoption of PCC practices across seven domains and how these perceptions change in response to an educational intervention embedded in a statewide program, Promoting Excellent Alternatives in Kansas nursing homes (PEAK 2.0). Given perception is an important feature of the change process, it was hypothesized that pre-adopters engaging in PEAK 2.0’s initial Foundation year (level 0) would have lower perceived PCC adoption following a year of education and exposure to PCC, whereas adopters (PEAK 2.0 level 1–5 homes) would have higher perceived PCC adoption following a year of participation in their respective level in the program. Methods A multi-arm, pre/post intervention study was conducted during the 2014 and 2015 years of the PEAK 2.0 program comparing pre-PCC adopters to adopters. Outcomes were self-ratings of perceived PCC implementation across seven domains of PCC at the beginning and end of the 2014–15 program year, after pre-adopters had received PCC education and adopters had implemented a year of PCC. Paired t-tests and mixed repeated-measures linear models, controlling for potential confounders, were employed to test the study hypotheses. Results Across all seven domains of PCC, pre-adopters rated their PCC implementation as significantly higher on pre-test (2014) than on post-test (2015). In contrast, adopters rated their PCC achievement as higher on post-test (2015) than on pre-test (2014). Conclusions Pre-adopters’ lower score following a year of education and exposure to PCC may reflect a shift in perceptions of PCC as a concept or a deeper conceptualization of PCC. Since perceptions or assumptions can serve as a source of resistance to change, redefinition or “unlearning” to make way for more accurate definitions of PCC could aid in reducing organizational resistance to implementation of PCC and thus improve the rate of adoption.http://link.springer.com/article/10.1186/s12877-019-1121-3Long-term careSkilled nursing facilitiesCulture changeResident-centered careOrganizational changeIncentives |
| spellingShingle | Laci J. Cornelison Linda Hermer Maggie L. Syme Gayle Doll Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention BMC Geriatrics Long-term care Skilled nursing facilities Culture change Resident-centered care Organizational change Incentives |
| title | Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention |
| title_full | Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention |
| title_fullStr | Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention |
| title_full_unstemmed | Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention |
| title_short | Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention |
| title_sort | initiating aha moments when implementing person centered care in nursing homes a multi arm pre post intervention |
| topic | Long-term care Skilled nursing facilities Culture change Resident-centered care Organizational change Incentives |
| url | http://link.springer.com/article/10.1186/s12877-019-1121-3 |
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