Risk Management in Nursing Homes

Study Overview
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Brief Summary
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The Réseau QualiSanté (risk management network) hardly works on risk management in nursing homes. A model to help nursing homes managers to structure and analyze adverse events has been constructed by a working group of health professionals in the Réseau QualiSanté. Several questions appeared: is the model able to increase patient safety culture of professionals working in nursing homes? How to characterize adverse events in nursing homes? How frequent are they? The main objective of this research project EHPAGE is to measure the impact of the model to structure and analyze adverse events in nursing homes on the patient safety culture of professionals. The project combines quantitative data (questionnaire) and qualitative data (interviews).

Detailed Description
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The main objective of this research project EHPAGE is to measure the impact of the model to structure and analyze adverse events in nursing homes on the patient safety culture of professionals. The coaching model is composed of a 20 hours methodological help for each nursing home and of an implementation kit. To answer to the main objective, quantitative and qualitative data will be collected twice during the project: before the implementation of the coaching model and 12 months after. Secondary objectives are: To encourage the place of patient safety culture in strategic issues of nursing homes To develop patient safety culture of professionals working in nursing homes To develop a way to structure and make the reporting of adverse events in nursing homes more sustainable To describe epidemiologic characteristic of adverse events in nursing homes To propose a French validated questionnaire to evaluate patient safety culture reported by professionals in nursing homes An ancillary study is perform to describe epidemiologic characteristic of adverse events in nursing homes

Official Title
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Measuring Impact on Safety Culture in Nursing Homes, a Multifaceted Device for the Analysis of Care Associated Adverse Events

Conditions
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Adverse Events Management in Nursing Homes

Intervention / Treatment
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* Other: Implementation of the coaching model


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Nursing homes members of the Réseau QualiSanté (risk management network) Public or private legal status Agreeing to participate in the project Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 105 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Case group<br>Nursing homes benefiting first the implementation of the coaching model (methodological help for professionals on the patient safety culture): just after the first measure (overview of the situation) | Other: Implementation of the coaching model<br>* 20 hours methodological help for each nursing home and an implementation kit<br>|
| Control group<br>Nursing homes benefiting the implementation of the coaching model (methodological help for professionals on the patient safety culture): after the second measure (impact of the device on case group) | Other: Implementation of the coaching model<br>* 20 hours methodological help for each nursing home and an implementation kit<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| impact of the coaching of the réseau QualiSanté: score expressed by the average percentages of positive responses to the Overall perception of the safety of residents dimension (= sum of 2 terms of positive response from the Likert scale) | Initial analysis: estimate baseline characteristics of nursing homes (2 groups) Analysis of the primary endpoint primarily for professionals and secondly for nursing homes (consideration of cluster randomization) Professionals Analysis: Score of each professional Overall perception of the safety of residents - OPOTSOR dimension of NHSOPS questionnaire calculated for both measures in each arm Linear mixed model implemented to reflect the hierarchical data structure: score of the dimension OPOTSOR at assessment2 explained by the fixed effect group and the random effect of nursing homes. Adjustment with other variables if necessary Facility effect estimated with Intraclass correlation coefficient Nursing homes analysis: Global perception of the safety of residents dimension score of each nursing home calculated at assessment1 and 2 in each group Comparison of the average test scores at assessment2 for each nursing home | 14 months after initial diagnosis. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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risk management, nursing home, elderly, care