Applying Agile Methodology to Reengineer the Delivery of Person-Centered Care in a Nursing Home: A Case Study.

Autor:	Abbott KM; Scripps Gerontology Center, Department of Sociology and Gerontology, Miami University, Oxford, OH, USA. Electronic address: abbottkm@miamioh.edu., Hulshult A; Computer and Information Technology, Miami University Hamilton, Hamilton, OH, USA., Eshraghi K; Abramson Senior Care, University Park, PA, USA; College of Nursing, The Pennsylvania State University, University Park, PA, USA., Heppner A; Scripps Gerontology Center, Miami University, Oxford, OH, USA., Crumbie V; Independent consultant, Ambler, PA, USA., Heid AR; Independent research consultant, Ardmore, PA, USA., Madrigal C; Center of Innovation in Long-term Services and Supports, US Department of Veterans Affairs, Providence, RI, USA., Spector A; Independent consultant, Bala Cynwyd, PA, USA., Van Haitsma K; Ross and Carol Nese College of Nursing, The Pennsylvania State University, University Park, PA, USA; The Polisher Research Institute at Abramson Senior Care, University Park, PA, USA.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2022 Sep; Vol. 23 (9), pp. 1442-1447. Date of Electronic Publication: 2022 Jun 15.
DOI:	10.1016/j.jamda.2022.05.012
Abstrakt:	Nursing home (NH) providers would benefit from adopting evidence-based measures for gathering and utilizing resident preference information in their daily care activities. However, providers face barriers when implementing assessment tools used to promote person-centered care (PCC). Although Agile methodology is not commonly used in NH settings, this case study shows how it can be used to achieve the goal of delivering preference-based, PCC, within a large NH. We present a road map for breaking down care processes, prioritizing, and implementing iterative plan, do, study, act cycles using Agile methodology to enhance group collaboration on quality improvement cycles, to achieve our goal of providing preference-based PCC. We first determined if care plans reflected each resident's important preferences, developed a method for tracking whether residents attended activities that matched their preferences, and determined if residents were satisfied that their preferences were being met. These efforts had positive effects throughout the NH particularly when COVID-19 limited visitors and significantly modified staff workflow. Specifically, Agile processes helped staff to know how to honor preferences during quarantines which necessitated a shift to individualized (and not group) approaches for meeting preferences for social contact, comfort, and belonging. The ready availability of preference-based reporting was critical to quickly informing new staff on how to meet residents' most important preferences. Based on lessons learned, we describe a developmental approach that other providers can consider for adoption. Implications of this work are discussed in terms of the need for provider training in Agile methodologies to support iterative improvements, the need for policies that reimburse providers for their efforts, and additional research around workflow processes. (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.)
Databáze:	MEDLINE
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