Importance of Team Functioning as a Target of Quality Improvement Initiatives in Nursing Homes: A Qualitative Process Evaluation

The Journal of Continuing Education in the Health Professions
Laura DesveauxNoah M Ivers

Abstract

Quality improvement interventions demonstrate variable degrees of effectiveness. The aim of this work was to (1) qualitatively explore whether, how, and why an academic detailing intervention could improve evidence uptake and (2) identify perceived changes that occurred to inform outcomes appropriate for quantitative evaluation. A qualitative process evaluation was conducted involving semistructured interviews with nursing home staff. Interviews were analyzed inductively using the framework method. A total of 29 interviews were conducted across 13 nursing homes. Standard processes to reduce falls are well-known but not fully implemented due to a range of mostly postintentional factors that influence staff behavior. Conflicting expectations around professional roles impeded evidence uptake; physicians report a disconnection between the information they would like to receive and the information communicated; and a high proportion of casual and part-time staff creates challenges for those looking to effect change. These factors are amenable to change in the context of an active, tailored intervention such as academic detailing. This seems especially true when the entire care team is actively engaged and when the intervention can b...Continue Reading

References

Jan 26, 1990·JAMA : the Journal of the American Medical Association·S B Soumerai, J Avorn
Mar 11, 2004·JAMA : the Journal of the American Medical Association·Kevin Grumbach, Thomas Bodenheimer
Dec 14, 2004·Medical Care·Stephen M ShortellMayde Rosen
Mar 11, 2005·Archives of Physical Medicine and Rehabilitation·Dale C StrasserJay Uomoto
Jul 5, 2005·The Journal of Primary Prevention·James H DerzonPaul Brounstein
Jun 9, 2006·Journal of Professional Nursing : Official Journal of the American Association of Colleges of Nursing·Julie ApkerNancee Hofmeister
Sep 12, 2006·The Medical Clinics of North America·Laurence Z Rubenstein, Karen R Josephson
Apr 28, 2007·Social Science & Medicine·Karen SolheimMi Ja Kim
Oct 19, 2007·The Cochrane Database of Systematic Reviews·M A O'BrienE L Harvey
Jan 1, 2008·Archives of Physical Medicine and Rehabilitation·Dale C StrasserAndrea B Burridge
Feb 6, 2008·Journal of Rehabilitation Research and Development·Alan B StevensJudith A Falconer
Feb 7, 2008·The Cochrane Database of Systematic Reviews·S ReevesI Koppel
Dec 6, 2008·The Journal of Continuing Education in the Health Professions·Joan SargeantGerard Murphy
Jan 15, 2009·Journal of Interprofessional Care·Esther SuterSiegrid Deutschlander
Jun 30, 2009·Journal of the American Medical Directors Association·Frederick N RowlandPaul R Katz
Feb 16, 2011·Nurse Researcher·Joanna Smith, Jill Firth
Feb 18, 2011·The Cochrane Database of Systematic Reviews·Ralph MöhlerGabriele Meyer
Apr 1, 2011·Journal of the American Medical Directors Association·Anne E SalesSharon Warren
Apr 23, 2011·Research in Social & Administrative Pharmacy : RSAP·Pankdeep T ChhabraIlene H Zuckerman
Dec 21, 2012·Journal of Health Organization and Management·Jenna M Evans, G Ross Baker
Sep 21, 2013·BMC Medical Research Methodology·Nicola K GaleSabi Redwood
Jan 1, 2014·Health Care Management Review·Nicholas G CastleJennifer Johs-Artisensi
Mar 22, 2014·Journal of Applied Gerontology : the Official Journal of the Southern Gerontological Society·Francis EtheridgeCara Tannenbaum
Aug 12, 2015·Canadian Journal on Aging = La Revue Canadienne Du Vieillissement·Laura M WagnerDavid K Conn
Apr 19, 2017·JAMA Internal Medicine·Jennifer TjiaSusan Wehry

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.