Clinical trial NCT00572221: Improving the Quality of Care in Nursing Homes
Official title: Improving the Quality of Care in Nursing Homes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Underperforming Nursing Homes
Keywords: CQI
QA
Best Practice
Quality Improvement
Nursing Facilities
Nursing Homes
Care
Lead sponsor: Hebrew SeniorLife
Sponsor class: OTHER
Collaborators: name: National Institute of Nursing Research (NINR)
First posted: 2007-12-12
Enrollment: 4316
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: The overall goal of this project is to increase the number of high quality nursing homes in Massachusetts. The study will evaluate an intervention involving two active treatment arms: one implementing a CQI program and a second implementing the CQI program and specific protocol programming. The intervention will be implemented in 24 nursing homes identified as performing, over multiple quality indicator domains, at a poor or average level across multiple outcome domains.

Detailed description: Nursing facilities as well as CMS and state governments are under pressure to find cost-effective methods to improve quality, particularly in poor and average facilities. In our prior work, we found that better performing facilities make more extensive use of CQI mechanisms, have more protocol driven problem advanced resolution mechanisms and systematically address multiple areas Both arms of the study apply the same standardized approach to CQI, while one arm will include specific best-practice care strategies targeted at identified problems. The study will evaluate whether the CQI program improves quality indicator scores in multiple domains, relative to control facilities, and whether improvement is greater in facilities that also utilize the study's best-practice protocols.

The study consent form describes the MDS assessment (used to evaluate the reliability of the facility's assessment), including items to be reviewed and how information will be obtained. The subject is informed that there is no known risk for participating in research, the purpose of which is to determine if the intervention improves nursing home care in Massachusetts

The outcomes will be reviewed by means of a change in twelve quality indicator scores: ADL decline, ADL decline following improvement, Mobility change, walking improvement, cognitive change, communication change, bowel continence change, bladder continence change, depressed mood change, new insertion of an indwelling urinary catheter, infection prevalence, worsening pain.

Eligibility criteria: Inclusion Criteria:

* Men and Women
* Residents of long-term care facilities in Massachusetts who have had
* a Minimum Data Set assessment completed by the facility in the last 90 days.

Exclusion Criteria:

* None

Primary outcomes:
measure: Change in twelve quality indicator scores
timeFrame: 15 Months
Secondary outcomes:
Other outcomes:
Locations:
city: Roslindale
country: United States
facility: Institute for Aging Research, Hebrew Senior Life
state: Massachusetts
Study officials:
affiliation: Institute of Aging Research, Hebrew Rehabilitation Center for the Aged
name: John N Morris, PhD
role: PRINCIPAL_INVESTIGATOR
References: