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Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention

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 perceiv...

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Detalles Bibliográficos
Autores principales: Cornelison, Laci J., Hermer, Linda, Syme, Maggie L., Doll, Gayle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480647/
https://www.ncbi.nlm.nih.gov/pubmed/31014260
http://dx.doi.org/10.1186/s12877-019-1121-3
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author Cornelison, Laci J.
Hermer, Linda
Syme, Maggie L.
Doll, Gayle
author_facet Cornelison, Laci J.
Hermer, Linda
Syme, Maggie L.
Doll, Gayle
author_sort Cornelison, Laci J.
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1121-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-64806472019-05-01 Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention Cornelison, Laci J. Hermer, Linda Syme, Maggie L. Doll, Gayle BMC Geriatr Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-019-1121-3) contains supplementary material, which is available to authorized users. BioMed Central 2019-04-23 /pmc/articles/PMC6480647/ /pubmed/31014260 http://dx.doi.org/10.1186/s12877-019-1121-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Cornelison, Laci J.
Hermer, Linda
Syme, Maggie L.
Doll, Gayle
Initiating Aha moments when implementing person-centered care in nursing homes: a multi-arm, pre-post intervention
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 Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480647/
https://www.ncbi.nlm.nih.gov/pubmed/31014260
http://dx.doi.org/10.1186/s12877-019-1121-3
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